Eustachian Tube

Eustachian Tube

Q. 1

Which of the following is formed of elastic cartilage?

 A

Auditory tube

 B

Nasal septum

 C

Articular cartilage

 D

Costal cartilage

Q. 1

Which of the following is formed of elastic cartilage?

 A

Auditory tube

 B

Nasal septum

 C

Articular cartilage

 D

Costal cartilage

Ans. A

Explanation:

Auditory tube


Q. 2

All of the following are TRUE about the middle ear, EXCEPT:

 A

The joints between ossicles are synovial

 B

The chorda tympani nerve is related to the lateral wall

 C

The facial nerve passes in a canal situated in the medial and anterior walls

 D

The auditory tube connects the nasopharynx with the anterior wall

Q. 2

All of the following are TRUE about the middle ear, EXCEPT:

 A

The joints between ossicles are synovial

 B

The chorda tympani nerve is related to the lateral wall

 C

The facial nerve passes in a canal situated in the medial and anterior walls

 D

The auditory tube connects the nasopharynx with the anterior wall

Ans. C

Explanation:

The facial nerve passes in a canal situated in the posterior and medial walls of the middle ear. It is not associated with the anterior wall. 

 


Q. 3

What is the indication for radical mastoidectomy in an middle aged female?

 A

ASOM

 B

CSOM

 C

Cholesteatoma invading eustachian tube

 D

Acute mastoiditis

Q. 3

What is the indication for radical mastoidectomy in an middle aged female?

 A

ASOM

 B

CSOM

 C

Cholesteatoma invading eustachian tube

 D

Acute mastoiditis

Ans. C

Explanation:

Indications for radical mastoidectomy:
  • When all cholesteatoma cannot be safely removed, e.g., that invading eustachian tube, round window niche, perilabyrinthine or hypotympanic cells.
  • If previous attempts to eradicate chronic inflammatory disease or cholesteatoma have failed.
  • As an approach to petrous apex
  • Removal of glomus tumor
  • Carcinoma middle ear

Q. 4

Which of the following structure is made up of elastic cartilage?

 A

Auditory tube

 B

Nasal septum

 C

Costal cartilage

 D

Articular cartilage

Q. 4

Which of the following structure is made up of elastic cartilage?

 A

Auditory tube

 B

Nasal septum

 C

Costal cartilage

 D

Articular cartilage

Ans. A

Explanation:

Cartilage is a form of connective tissue in which cells and fibers are embedded in a gel like matrix. Elastic cartilage has large number of elastic fibers embedded in the matrix. It is very flexible and is found in the auditory tube, auricle of ear, external auditory meatus, epiglottis and the cuneiform cartilage in the larynx.


Q. 5

The site where elastic cartilage is found is which of the following?

 A

Auditory tube

 B

Nasal septum

 C

Articular cartilage

 D

Pubic symphysis

Q. 5

The site where elastic cartilage is found is which of the following?

 A

Auditory tube

 B

Nasal septum

 C

Articular cartilage

 D

Pubic symphysis

Ans. A

Explanation:

In elastic cartilage the matrix contains numerous elastic fibres which form a network. The surface of elastic cartilage is covered by perichondrium. It is found in lateral part of external acoustic meatus, epiglottis, medial part of the auditory tube, corniculate and cuneiform cartilage.


Q. 6

True regarding the development of ear:

 A

Eustachian tube opens at the level of interior turbinate

 B

Pinna develops from the cleft of Ist arch

 C

Growth of the inner- ear completed by 4th month

 D

All

Q. 6

True regarding the development of ear:

 A

Eustachian tube opens at the level of interior turbinate

 B

Pinna develops from the cleft of Ist arch

 C

Growth of the inner- ear completed by 4th month

 D

All

Ans. D

Explanation:

A i.e. Eustachian tube opens at the level of inferior turbinate; B i.e. Pinna develops from the cleft of arch; C i.e. Growth of inner ear completed by 4th month

Eustachian tube connects tympanic cavity with nasopharynx. It is about 36cm long in adults and runs downwards, forwards & medially at an angle of 45° with horizontal from bony tympanic end to slit like pharyngeal end. Tympanic end is in the anterior wall of middle ear, just above the level of floor. While nasopharyngeal end is situated in the lateral wall about 1 -1.25 cm behind the posterior end of inferiro turbinateQ


Q. 7

Elastic cartilage is found in :

 A

Auditory tube

 B

Nasal septum

 C

Articular cartilage

 D

Costal cartilage

Q. 7

Elastic cartilage is found in :

 A

Auditory tube

 B

Nasal septum

 C

Articular cartilage

 D

Costal cartilage

Ans. A

Explanation:

A i.e. Auditory tube 


Q. 8

Which of the following structuers is inferior to spheno petrosal Synchondrosis-

 A

Abducens nerve

 B

Osseous part of auditory tube

 C

Cartilaginus part of auditory tube

 D

Petro squamous sinus

Q. 8

Which of the following structuers is inferior to spheno petrosal Synchondrosis-

 A

Abducens nerve

 B

Osseous part of auditory tube

 C

Cartilaginus part of auditory tube

 D

Petro squamous sinus

Ans. C

Explanation:

Sphenopetrosal synchondrosis is cartilagenous union b/w lateral half margin of great wing of sphenoid & petrous bone. On the under surface of sphenopetrosal synchondrosis, is a furrow, the sulcus of auditory tube for lodgement of cartilagenous part of auditory tubeQ


Q. 9

Eustachian tube opens into middle ear cavity at:

 A

Anterior wall

 B

Medial wall

 C

Lateral wall

 D

Posterior wall

Q. 9

Eustachian tube opens into middle ear cavity at:

 A

Anterior wall

 B

Medial wall

 C

Lateral wall

 D

Posterior wall

Ans. A

Explanation:

 

The tympanic end of the eustachian tube is bony and is situated in the anterior wall of middle ear.

The pharyngeal end of the tube is slit like and is situated in the lateral wall of the nasopharynx, 1-1.25 cm behind the posterior end of inferior tubinate.



Q. 10

The length of Eustachian tube is:

 A

16 mm

 B

24mm

 C

36 mm

 D

40 mm

Q. 10

The length of Eustachian tube is:

 A

16 mm

 B

24mm

 C

36 mm

 D

40 mm

Ans. C

Explanation:

Q. 11

True about Eustachian tube are:

 A

24mm in length

 B

Outer 1/3rds is cartilaginous

 C

Inner 2/3rds is bony

 D

Inner 2/3rds is cartilaginous

Q. 11

True about Eustachian tube are:

 A

24mm in length

 B

Outer 1/3rds is cartilaginous

 C

Inner 2/3rds is bony

 D

Inner 2/3rds is cartilaginous

Ans. D

Explanation:

Q. 12

True about Eustachian tube is/are:

 A

Size is 3.75 cm

 B

Cartilagenous 1/3 and 2/3rd bony

 C

Opens during swallowing

 D

a and c

Q. 12

True about Eustachian tube is/are:

 A

Size is 3.75 cm

 B

Cartilagenous 1/3 and 2/3rd bony

 C

Opens during swallowing

 D

a and c

Ans. D

Explanation:

 

  • The Eustachian tube/auditory tube in the adult is 36 mm in length. (Range 32-38 mm) From its tympanic end, it runs downward forward and medially joining an angle of 45° with horizontal.
  • In infants, the tube is shorter, wider and is more horizontal.
  • It has two parts -a pharyngeal cartilaginous part which forms 2/3rd (24 mm) of its length (i.e. inner or medial part) and a tympanic bony part which forms remaining 1/3rd (outer or lateral part -12 mm). This is just reverse of external auditory canal



Q. 13

Which of the following causes opening of Eustachian tube?

 A

Salpingophayngeus

 B

Levator veli palatine

 C

Tensor veli palatini

 D

None of the abvoe

Q. 13

Which of the following causes opening of Eustachian tube?

 A

Salpingophayngeus

 B

Levator veli palatine

 C

Tensor veli palatini

 D

None of the abvoe

Ans. B

Explanation:

 

Eustachian tube serves to ventilate the middle ear and exchange nasopharyngeal air in the middle ear.

In children, ET is rela­tively narrow. It is prone to obstruction when mucosa swell in response to infection or allergic challenge and it results in middle ear effusion


Q. 14

True about Eustachian tube:

 A

Length is 36mm in adults and 1.6 to 3 mm in children

 B

Higher elastin content in adults

 C

Ventilatory function of ear better developed in infants

 D

More horizontal in adults

Q. 14

True about Eustachian tube:

 A

Length is 36mm in adults and 1.6 to 3 mm in children

 B

Higher elastin content in adults

 C

Ventilatory function of ear better developed in infants

 D

More horizontal in adults

Ans. B

Explanation:

Q. 15

Eustachian tube develops from:

 A

2nd and 3rd pharyngeal pouch

 B

1st pharyngeal pouch

 C

2nd pharyngeal pouch

 D

b and c

Q. 15

Eustachian tube develops from:

 A

2nd and 3rd pharyngeal pouch

 B

1st pharyngeal pouch

 C

2nd pharyngeal pouch

 D

b and c

Ans. D

Explanation:

 

  • The Eustachian tube, tympanic cavity, attic, antrum and mastoid develops from endoderm of tubotympanic recess which arises from the first and partly from the second pharyngeal pouch. 
  • From 2″d pharyngeal pouch –> develops tonsil
  • From 3rd pharyngeal pouch –> develops thymus and inferior parathyoid
  • From 4th pharyngeal pouth –> Part of thyroid and superior parathyroid gland

Q. 16

True regarding development of the ear:

 A

Eustachian tube develops from 1st cleft

 B

Eustachian tube opens behind the level of inferior turbinate

 C

Pinna develops from 1st pouch

 D

All

Q. 16

True regarding development of the ear:

 A

Eustachian tube develops from 1st cleft

 B

Eustachian tube opens behind the level of inferior turbinate

 C

Pinna develops from 1st pouch

 D

All

Ans. B

Explanation:

Q. 17

Which of the following statement regarding Eustachian tube dysfunction is wrong?

 A

Undistorted light image on the anterior quadrant of tympanic membrane

 B

No movement of the tympanic membrane on siegel’s method

 C

Malleus is easily visible

 D

Lusterless tympanic membrane

Q. 17

Which of the following statement regarding Eustachian tube dysfunction is wrong?

 A

Undistorted light image on the anterior quadrant of tympanic membrane

 B

No movement of the tympanic membrane on siegel’s method

 C

Malleus is easily visible

 D

Lusterless tympanic membrane

Ans. A

Explanation:

 

 

  • Normally Eustachian tube (ET) is closed and opens intermittently during yawning, swallowing and sneezing through active contraction of Tensor vili palatini muscle.

Q. 18

Common cause of eustachian diseases is due:

 A

Adenoids

 B

Siegle’s

 C

Otitis media

 D

Pharyngitis

Q. 18

Common cause of eustachian diseases is due:

 A

Adenoids

 B

Siegle’s

 C

Otitis media

 D

Pharyngitis

Ans. A

Explanation:

Q. 19

All are tests to check eustachian tube patency except: 

 A

Valsalva manuvere

 B

Fistula’s test

 C

Frenzel’s manuvere

 D

Tonybee’s manuvere

Q. 19

All are tests to check eustachian tube patency except: 

 A

Valsalva manuvere

 B

Fistula’s test

 C

Frenzel’s manuvere

 D

Tonybee’s manuvere

Ans. B

Explanation:

Q. 20

Throat infection causes Ear infection through: 

 A

Blood spread

 B

Eustachian tube

 C

Nasocranial spread

 D

Simultaneous infection

Q. 20

Throat infection causes Ear infection through: 

 A

Blood spread

 B

Eustachian tube

 C

Nasocranial spread

 D

Simultaneous infection

Ans. B

Explanation:

 

 M/C route of infection in middle ear is Eustachian tube. Infection travels via the lumen of the tube or along subepithelial peritubal lymphatics.

Eustachian tube is infants and young children is shorter, wider and more horizontal and thus accounts for higher incidence of infections in this age group.



Q. 21

All of of the following steps are done in radical mastoidectomy except:

 A

Lowering of facial ridge

 B

Removal of middle ear mucosa and muscles

 C

Removal of all ossicles of eustachiean tube plate

 D

Maintainance of patency of eustachian tube

Q. 21

All of of the following steps are done in radical mastoidectomy except:

 A

Lowering of facial ridge

 B

Removal of middle ear mucosa and muscles

 C

Removal of all ossicles of eustachiean tube plate

 D

Maintainance of patency of eustachian tube

Ans. D

Explanation:

Q. 22

Radical mastoidectomy includes all except: 

 A

Closure of the auditory tube

 B

Ossicles removed

 C

Cochlea removed

 D

Exteriorisation of mastoid

Q. 22

Radical mastoidectomy includes all except: 

 A

Closure of the auditory tube

 B

Ossicles removed

 C

Cochlea removed

 D

Exteriorisation of mastoid

Ans. C

Explanation:

Q. 23

Communication between middle ear and Eustachian tube is obliterated in which surgery?

 A

Tympanoplasty

 B

Schwartz operation

 C

Modified radical mastoidectomy

 D

Radical mastoidectomy

Q. 23

Communication between middle ear and Eustachian tube is obliterated in which surgery?

 A

Tympanoplasty

 B

Schwartz operation

 C

Modified radical mastoidectomy

 D

Radical mastoidectomy

Ans. D

Explanation:

 

In radical mastoidectomy, the opening of Eustachian tube is closed by curetting its mucosa and plugging the opening with tensor tympani muscle or cartilage.


Q. 24

Eustachian tube gets blocked if pressure difference is more than:

 A

15 mm Hg

 B

30 mm Hg

 C

50 mm Hg

 D

90 mm Hg

Q. 24

Eustachian tube gets blocked if pressure difference is more than:

 A

15 mm Hg

 B

30 mm Hg

 C

50 mm Hg

 D

90 mm Hg

Ans. D

Explanation:

Q. 25

Which is not visualized on posterior rhinoscopy: 

 A

Eustachian tube

 B

Inferior meatus

 C

Middle meatus

 D

Superior concha

Q. 25

Which is not visualized on posterior rhinoscopy: 

 A

Eustachian tube

 B

Inferior meatus

 C

Middle meatus

 D

Superior concha

Ans. B

Explanation:

 

Posterior rhinoscopy:

  • It is method of examination of the posterior aspect of nose and pharynx.
  • Structures seen on posterior rhinoscopy:

–  Both choanae    

–  Posterior end of nasal septum

–  Opening of Eustachian

–  Posterior end of superior/tube  middle and inferior turbinates

–  Fossa of Rosenmuller         

–  Torus Tubarius

–  Adenoids              

–  Roof and posterior wall and nasopharynx.


Q. 26

True regarding nasopharynx are all except:

 A

Fossa of rosenmuller corresponds to the internal carotid artery

 B

Lateral wall has pharyngeal opening of Eustachian

 C

Passavant’s muscle is formed by Stylopharyngeus

 D

Also called as epipharynx

Q. 26

True regarding nasopharynx are all except:

 A

Fossa of rosenmuller corresponds to the internal carotid artery

 B

Lateral wall has pharyngeal opening of Eustachian

 C

Passavant’s muscle is formed by Stylopharyngeus

 D

Also called as epipharynx

Ans. C

Explanation:

Q. 27

True regarding opening of auditory tube in nasopharynx is:     

 A

Posterior to inferior nasal concha

 B

Posterior to middle nasal concha

 C

Superior to inferior nasal concha

 D

Inferior to inferior nasal concha

Q. 27

True regarding opening of auditory tube in nasopharynx is:     

 A

Posterior to inferior nasal concha

 B

Posterior to middle nasal concha

 C

Superior to inferior nasal concha

 D

Inferior to inferior nasal concha

Ans. A

Explanation:

The lateral wall of nasopharynx has pharyngeal opening of the auditory tube, at the level of the inferior nasal concha and 1.2 cm behind it


Q. 28

Muscle which helps to open Eustachian tube while sneezing:

March 2005, September 2010

 A

Tensor veli palatini

 B

Levator veli palatini

 C

None of the.above

 D

Both A and B

Q. 28

Muscle which helps to open Eustachian tube while sneezing:

March 2005, September 2010

 A

Tensor veli palatini

 B

Levator veli palatini

 C

None of the.above

 D

Both A and B

Ans. D

Explanation:

Ans. D: Both A and B

Pharyngotympanic (Auditory) tube is 4 cm long, consists of two parts:

  • Bony part forms posterior and lateral one third of the tube (12 cm long)
  • Cartilaginous part forms the anterior and medial two third (25 cm long)
  • Connects the middle ear with the nasopharynx
  • Equalizes pressure on both sides of the tympanic membrane
  • Usually closed to prevent entrance of particles from the nose
  • Muscles that open auditory tube while swallowing, yawning and sneezing are levator veli palatini and tensor veli palatini

Q. 29

Length of the cartilaginous part of “Eustachian tube”

 A

15 mm

 B

20 mm

 C

25 mm

 D

30 mm

Q. 29

Length of the cartilaginous part of “Eustachian tube”

 A

15 mm

 B

20 mm

 C

25 mm

 D

30 mm

Ans. C

Explanation:

  • The external auditory meatus is 4 cm long and conducts sound waves from the auricle to the tympanic membrane. The framework of the anterior and medial two-thirds of the meatus is elastic cartilage (measures 25 mm in length), and the posterior and lateral one third is bony, formed by the tympanic plate (measures 12 mm in length). The sensory nerve supply of the lining skin is derived from the auriculotemporal nerve and the auricular branch of the vagus nerve.
  • The lymph drainage is to the superficial parotid, mastoid, and superficial cervical lymph nodes.

Q. 30

Length of Eustachian tube‑

 A

12 mm

 B

24mm

 C

36mm

 D

48mm

Q. 30

Length of Eustachian tube‑

 A

12 mm

 B

24mm

 C

36mm

 D

48mm

Ans. C

Explanation:

 

  • Length of Eustachian tube is 36 mm. (reached by the age of 7 years)
  • Lateral third (i.e. 12 mm) is bony.
  • Medial 2/3 (i.e. 24 mm) is fibrocartilaginous.

Q. 31

Not a test for Eustachian tube patency ‑

 A

Tympanometry

 B

Toynbee

 C

Valsalva

 D

Frenzel maneuver

Q. 31

Not a test for Eustachian tube patency ‑

 A

Tympanometry

 B

Toynbee

 C

Valsalva

 D

Frenzel maneuver

Ans. A

Explanation:

Ans. is ‘a’ i.e., Tympanometry

Tests for Eustachian tubepatency

  • Valsalva test
  • Methylene blue test
  • Sonotubometry
  • Politzer test 
  • Toynbee test
  • Frenzel maneuver
  • Catheterization
  • Inflation – Deflation test

Q. 32

Ostmann fat pad is related to ‑

 A

Ear lobule

 B

Buccal mucosa

 C

Eustachian tube

 D

Tip of nose

Q. 32

Ostmann fat pad is related to ‑

 A

Ear lobule

 B

Buccal mucosa

 C

Eustachian tube

 D

Tip of nose

Ans. C

Explanation:

Ans. is ‘c’ i.e., Eustachian tube

There are small fat bodies located infermedial to Eustachian tube. These are called Ostmann fat pads.

They are important in normal closure of eustachian tube and preventing transmission of nasopharyngeal pressure to middle ear.

These fat pads are absent in Patulous tube syndrome.


Q. 33

Which of the following is not a derivative of the middle ear cleft ‑

 A

Semicircular canal

 B

Mastoid air cell

 C

Tympanic cavity

 D

Eustachian tube

Q. 33

Which of the following is not a derivative of the middle ear cleft ‑

 A

Semicircular canal

 B

Mastoid air cell

 C

Tympanic cavity

 D

Eustachian tube

Ans. A

Explanation:

Ans. is ‘a’ i.e., Semicircular canal

The middle – ear cleft in the temporal bone includes :‑

  1. Eustachian tube
  2. The middle ear (tympanic cavity)
  3. Aditus which leads posteriorly to the mastoid antrum and air cells.

Q. 34

Eustachian tube patency seen by ‑

 A

Valsalva

 B

Methylene blue test

 C

Tonybee test

 D

All the above

Q. 34

Eustachian tube patency seen by ‑

 A

Valsalva

 B

Methylene blue test

 C

Tonybee test

 D

All the above

Ans. D

Explanation:

Ans. is d i.e., All the above

Tests for Eustachian tube patency

  • Valsalva test
  • Methylene blue test 
  • Sonotubometry
  • Politzer test
  • Toynbee test 
  • Frenzel maneuver
  • Catheterization
  • Inflation – Deflation test


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