Anatomy
3 questionsSite of glomus jugulare tumor?
Which nerve does NOT carry referred ear pain?
Which of the following does not contribute to the formation of the nasal septum?
NEET-PG 2013 - Anatomy NEET-PG Practice Questions and MCQs
Question 961: Site of glomus jugulare tumor?
- A. Hypotympanum (Correct Answer)
- B. Epitympanum
- C. Mesotympanum
- D. Internal ear
Explanation: ***Hypotympanum*** - **Glomus jugulare tumor** is a paraganglioma arising from the **paraganglia** (chemoreceptor cells) located in the **adventitia of the jugular bulb** in the **jugular foramen**. - This anatomical location places the tumor in the **hypotympanum** (inferior compartment of the middle ear cavity), which lies directly above the jugular bulb [1]. - These tumors typically present with **pulsatile tinnitus**, **hearing loss**, and a **reddish-blue mass** behind the tympanic membrane (rising sun sign). - The hypotympanum extends from the floor of the middle ear to the level of the inferior margin of the tympanic membrane [1]. *Epitympanum* - The **epitympanum** (attic) is the **superior compartment** of the middle ear, located above the tympanic membrane [1]. - It contains the head of the **malleus** and body of the **incus** [1]. - **Glomus tympanicum tumors** (arising from paraganglia along the tympanic plexus on the promontory) may present here, but glomus jugulare tumors originate inferiorly in the hypotympanum. *Mesotympanum* - The **mesotympanum** is the **middle compartment** of the middle ear, at the level of the tympanic membrane. - It contains the **manubrium of malleus** and **long process of incus**. - While glomus jugulare tumors may extend into this region as they grow, their primary site of origin is the hypotympanum. *Internal ear* - The **internal ear** (inner ear) is located medial to the middle ear and contains the **cochlea**, **vestibule**, and **semicircular canals** [1]. - Advanced glomus jugulare tumors may erode into the inner ear causing **sensorineural hearing loss** and **vertigo**, but this is not their site of origin.
Question 962: Which nerve does NOT carry referred ear pain?
- A. Glossopharyngeal nerve
- B. Vagus nerve
- C. Trigeminal nerve
- D. Abducens nerve (Correct Answer)
Explanation: ***Abducens nerve*** - The **abducens nerve (CN VI)** primarily controls the **lateral rectus muscle** of the eye, responsible for **abduction of the eyeball**. - It has **no sensory function** and, therefore, cannot carry referred pain from any region, including the ear. *Trigeminal nerve* - The **trigeminal nerve (CN V)**, particularly its **auriculotemporal branch**, provides sensory innervation to part of the external ear and temporomandibular joint, making it a common pathway for **referred otalgia** from dental or TMJ issues. - Pain from conditions like **trigeminal neuralgia**, **TMJ disorders**, or **dental caries** can be referred to the ear via this nerve. *Glossopharyngeal nerve* - The **glossopharyngeal nerve (CN IX)** supplies sensory innervation to the **middle ear**, pharynx, and posterior tongue. - Conditions affecting these areas, such as **glossopharyngeal neuralgia**, **tonsillitis**, or **pharyngitis**, can cause **referred ear pain**. *Vagus nerve* - The **vagus nerve (CN X)**, specifically the **auricular branch (Arnold's nerve)**, provides sensory innervation to a portion of the external auditory canal and concha. - Irritation of this nerve from conditions in the **larynx**, **pharynx**, **esophagus**, or **heart** can lead to referred ear pain.
Question 963: Which of the following does not contribute to the formation of the nasal septum?
- A. Nasal bone (Correct Answer)
- B. Vomer
- C. Ethmoid
- D. Septal cartilage
Explanation: ***Nasal bone*** - The **nasal bones** form the bridge of the nose and are part of the external nasal skeleton, not the internal nasal septum. - They articulate with the frontal bone superiorly and the maxilla laterally, forming the **roof of the nasal cavity** anteriorly. *Septal cartilage* - The **septal cartilage**, or quadrangular cartilage, forms the anterior and inferior parts of the cartilaginous nasal septum. - It provides flexibility and support to the anterior nasal cavity. *Vomer* - The **vomer** is a thin, plowshare-shaped bone that forms the posteroinferior part of the bony nasal septum. - It articulates with the sphenoid, ethmoid, palatine, and maxillary bones. *Ethmoid* - The **perpendicular plate of the ethmoid bone** forms the superior part of the bony nasal septum. - It extends downward from the cribriform plate to meet the vomer and septal cartilage.
ENT
6 questionsIn otosclerosis, the tympanogram is:
Endolymphatic sac decompression is done in?
Which of the following conditions is associated with objective tinnitus?
Electrode of cochlear implant is placed in:
What is a specific indication for the use of a Bone-Anchored Hearing Aid (BAHA)?
Hyponasal voice is seen in all except?
NEET-PG 2013 - ENT NEET-PG Practice Questions and MCQs
Question 961: In otosclerosis, the tympanogram is:
- A. Low compliance (Correct Answer)
- B. High compliance
- C. Normal compliance
- D. None of the options
Explanation: ***Low compliance*** - In **otosclerosis**, the **stapes footplate** becomes fixed in the **oval window**, hindering sound transmission. - This fixation leads to reduced movement of the **tympanic membrane** and ossicular chain, resulting in a **low-compliance tympanogram** (Type As). *High compliance* - **High compliance** (Type Ad tympanogram) indicates a very mobile or **flaccid tympanic membrane**, often seen in conditions like **ossicular discontinuity**. - This is opposite to the stiffening effect seen in otosclerosis. *Normal compliance* - A **normal tympanogram** (Type A) signifies healthy middle ear function with appropriate pressure and mobility. - This would not be observed in otosclerosis, where there is a clear pathology affecting the **ossicular chain** and sound conduction. *None of the options* - This is incorrect because **otosclerosis** presents with a characteristic **low-compliance tympanogram**. - The disease specifically impairs the **mobility of the middle ear system**, which directly impacts tympanometric findings.
Question 962: Endolymphatic sac decompression is done in?
- A. Management of endolymphatic hydrops in early-stage Meniere's disease
- B. Prophylactic treatment in recurrent vertigo syndromes
- C. Definitive treatment for intractable vertigo in Meniere's disease (Correct Answer)
- D. Primary surgical approach for cochlear disorders
Explanation: ***Definitive treatment for intractable vertigo in Meniere's disease*** - **Endolymphatic sac decompression** is a surgical procedure aimed at relieving pressure in the inner ear for patients with **Meniere's disease** who experience **intractable vertigo** despite medical management. - It works by improving fluid drainage from the **endolymphatic sac**, thereby reducing episodes of vertigo without significantly affecting hearing. *Management of endolymphatic hydrops in early-stage Meniere's disease* - This procedure is typically reserved for **later stages** of Meniere's disease when medical treatments have failed, not early-stage management. - Early-stage management usually involves **dietary modifications**, **diuretics**, and other medical therapies. *Prophylactic treatment in recurrent vertigo syndromes* - Endolymphatic sac decompression is a **therapeutic intervention** for diagnosed Meniere's disease, not a prophylactic treatment for general recurrent vertigo syndromes. - Its use is specific to the underlying **endolymphatic hydrops** of Meniere's disease. *Primary surgical approach for cochlear disorders* - This procedure addresses issues related to the **vestibular system** and fluid balance in Meniere's disease, not primary cochlear disorders like hearing loss unrelated to hydrops. - **Cochlear disorders** primarily affecting hearing might involve different surgical approaches, such as **cochlear implantation**.
Question 963: Which of the following conditions is associated with objective tinnitus?
- A. Acoustic neuroma
- B. Ear wax
- C. Glomus tumor (Correct Answer)
- D. Ménière's disease
Explanation: ***Glomus tumor*** - A glomus tumor is a **vascular tumor** that can cause turbulent blood flow, leading to a pulsatile, objective tinnitus that can be heard by an examiner. - The sound is often described as a **thumping or whooshing** sound synchronous with the patient's heartbeat. *Ménière's disease* - **Ménière's disease** is associated with subjective tinnitus, a ringing or roaring sensation perceptible only to the patient. - It is characterized by the triad of **vertigo, fluctuating hearing loss, and tinnitus**. *Acoustic neuroma* - An acoustic neuroma (vestibular schwannoma) typically causes **unilateral, subjective tinnitus**, often described as a high-pitched ringing. - It is a benign tumor on the **vestibulocochlear nerve** and is also associated with sensorineural hearing loss and balance issues. *Ear wax* - **Impacted ear wax** can cause subjective tinnitus due to its interference with sound conduction and resonance within the ear canal. - The tinnitus is not typically audible to an examiner, making it a **subjective finding**.
Question 964: Electrode of cochlear implant is placed in:
- A. Horizontal semicircular canal
- B. Scala media
- C. Scala tympani (Correct Answer)
- D. Scala vestibuli
Explanation: ***Scala tympani*** - The electrode array of a **cochlear implant** is carefully inserted into the **scala tympani** of the cochlea. - This placement allows the electrodes to directly stimulate the **spiral ganglion neurons**, bypassing damaged hair cells and transmitting electrical signals to the auditory nerve. *Horizontal semicircular canal* - The **horizontal semicircular canal** is part of the **vestibular system**, responsible for sensing angular head movements, not hearing. - Placing an electrode here would cause **vestibular dysfunction** and would not restore hearing. *Scala media* - The **scala media** (cochlear duct) contains the **organ of Corti** and **endolymph**, which has a high potassium concentration. - Inserting an electrode here would damage the delicate structures essential for natural sound transduction and could lead to electric potential imbalances. *Scala vestibuli* - The **scala vestibuli** is filled with **perilymph** and receives sound vibrations from the stapes. - While it's adjacent to the scala tympani, the **scala tympani** offers a safer and more direct path for optimal electrode insertion with less trauma to the sensory structures.
Question 965: What is a specific indication for the use of a Bone-Anchored Hearing Aid (BAHA)?
- A. Bilateral conductive hearing loss
- B. Unilateral sensorineural hearing loss
- C. Congenital canal atresia (Correct Answer)
- D. Conductive hearing loss due to other causes
Explanation: ***Congenital canal atresia*** - **Congenital canal atresia** represents a classic, specific indication for BAHA because the ear canal is congenitally absent or severely stenosed, making conventional hearing aids impossible to fit or ineffective. - BAHA bypasses the absent ear canal entirely by transmitting sound vibrations directly to the **cochlea through bone conduction**, providing an ideal solution for this anatomical abnormality. *Bilateral conductive hearing loss* - While BAHA can be used for conductive hearing loss, **conventional hearing aids** are typically the first-line treatment when ear canals are intact and functional. - Bilateral cases often benefit from traditional amplification devices or **surgical correction** of the underlying conductive pathology before considering BAHA. *Unilateral sensorineural hearing loss* - BAHA is commonly used for **single-sided deafness (SSD)** to route sound from the deaf ear to the hearing ear via bone conduction using the **CROS principle**. - However, this indication is less specific than congenital canal atresia, as other treatment options like **conventional CROS hearing aids** may also be considered. *Conductive hearing loss due to other causes* - This option is too **broad and non-specific** as it encompasses many different etiologies of conductive hearing loss. - Many other causes of conductive hearing loss have **alternative treatments** such as surgical repair, conventional hearing aids, or medical management, making BAHA a secondary consideration.
Question 966: Hyponasal voice is seen in all except?
- A. Adenoids
- B. Nasal polyp
- C. Deviated nasal septum
- D. Cleft lip (Correct Answer)
Explanation: ***Cleft lip*** - A **cleft lip** primarily affects the appearance of the lip and a portion of the nose but doesn't typically obstruct the nasal passages to cause a hyponasal voice. - The voice quality in individuals with a cleft lip, without an associated cleft palate, is usually normal. *Adenoids* - **Enlarged adenoids** can obstruct the nasopharyngeal airway, leading to reduced nasal resonance and a **hyponasal (rhinolalia clausa)** voice. - This obstruction prevents air from exiting through the nose during speech, making sounds like 'm' and 'n' sound like 'b' and 'd'. *Nasal polyp* - **Nasal polyps** can physically block the nasal passages, impairing airflow through the nose during speech. - This blockage leads to a reduction in nasal resonance, resulting in a **hyponasal voice**. *Deviated nasal septum* - A **deviated nasal septum** can significantly narrow one or both nasal passages, restricting airflow. - This structural obstruction can cause a **hyponasal voice** due to reduced nasal resonance.
Radiology
1 questionsWhich condition is characterized by a specific radiological appearance resembling a sunburst pattern?
NEET-PG 2013 - Radiology NEET-PG Practice Questions and MCQs
Question 961: Which condition is characterized by a specific radiological appearance resembling a sunburst pattern?
- A. Chondrosarcoma
- B. Fibrosarcoma
- C. Osteosarcoma (Correct Answer)
- D. Ewing's sarcoma
Explanation: ***Osteosarcoma*** - **Osteosarcoma** is known for its classic radiological findings, including the **sunburst (rising sun)** or **spiculated periosteal reaction**, where new bone forms perpendicular to the cortex. - Another characteristic finding is **Codman's triangle**, which is a triangular elevation of the periosteum visible on X-ray. *Chondrosarcoma* - **Chondrosarcomas** are typically characterized by a **"rings and arcs"** pattern of calcification within the cartilaginous matrix on imaging studies. - They tend to appear as lobular masses with endosteal scalloping and soft tissue components rather than the sunburst pattern. *Ewing's sarcoma* - **Ewing's sarcoma** classically presents with an **"onion skin" (lamellated)** periosteal reaction due to layers of parallel new bone formation. - It often appears as an ill-defined lytic lesion with cortical destruction, differing from the sunburst appearance. *Fibrosarcoma* - **Fibrosarcomas** are typically **lytic lesions** with aggressive cortical destruction and soft tissue involvement. - They generally do not produce characteristic periosteal reactions like the sunburst or onion skin appearance, often presenting as non-specific destructive lesions.