Ear, nose and throat quiz

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October 4, 2015

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Question 1
Correct

The tongue is partially innervated by the facial nerve

A True

B False

Question 1 Explanation:
Although this statement is true, the body is never that straightforward, particularly the
tongue! The tongue itself is split into motor and sensory functions. The majority of motor
function is innervated by the hypoglossal nerve (Cranial Nerve 12, XII) however the
palatoglossus (a small muscles involved in initiating swallowing and elevating the posterior
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tongue, extremely specific) is Vagus. Now the sensory part is split into taste and sensation
(as in pain). The posterior third of the tongue is innervated by the glossopharyngeal nerve
(Cranial Nerve 9, IX). Whereas the anterior 2/3rds are innervated by the chorda tympani
branch of the facial nerve (taste, Cranial nerve 7, VII) and sensation is the lingual branch of
the trigeminal nerve (Cranial Nerve 5, V).

Question 2
Wrong

The bridge of the nose is made out of cartilage.

A True

B False

Question 2 Explanation:
The nasal bridge is the area of the nose that overlies the nasal bones and is the most
superior part of the nose. Below this point the nose is made of cartilage; septal cartilage,
lateral cartilage and the alar cartilage that makes up the tip of the nose. It is important to
know where the nasal bridge is as during a nosebleed you should squeeze just below this
point.

Question 3
Wrong

The bones of the ear from the outside to inside are: Incus, Stapes and Malleus?

A True

B False

Question 3 Explanation:
This statement is not true. Think of someone saying “I MISsed that”. MIS: Malleus, Incus
and Stapes. This is the order of the ossicles (bones of the ear) from the outside to in.
These bones and are all inside the middle part of the ear. The malleus transmits sound
vibration from the tympanic membrane to the incus. The stapes transmits sound to the oval
window, which is the first part of the inner ear and leads to the vestibule. Malleus translates
to Hammer. Incus translates to Anvil. Stapes translates to Stirrup. These names are of
Latin origin and all refer to their appearance.

Question 4
Correct

The ‘cone of light’ is a reflection of light on the tympanic membrane that points superiorly.

A True

B False

Question 4 Explanation:
The cone of light / light reflex can be viewed using an otoscope to look into an ear. It points
anterior-inferior in a normal ear. This is handy to know as you can use it to orientate
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yourself as to which tympanic membrane you are looking at. It points to 7 o’clock in the left
ear and 5 o’clock in the right ear. The peak of the cone originates from the ‘umbo’ which is
the middle point and most depressed part of the tympanic membrane. The umbo is the tip
of the handle of the malleus. The absence of the light reflex can be normal or due to an
increased inner ear pressure (e.g. otitis media).

Question 5
Wrong

The vocal cords are attached anteriorly by the arytenoid cartilage.

A True

B False

Question 5 Explanation:
In fact the arytenoid cartilage attaches the vocal cords posteriorly, it is attached anteriorly
by the thyroid cartilage. The vocal cords are two infoldings of mucous membrane that allow
vibrations to be transmitted as sounds. The vagus nerve innervates the cords. They are
located at the top of the trachea within the larynx and are covered by the epiglottis when
swallowing to prevent anything from entering the trachea.

Question 6
Correct

The Eustachian tube connects the eye to the nose.

A True

B False

Question 6 Explanation:
The Eustachian tube can also be called the auditory tube or pharyngotympanic tube. It is a
connection between the middle ear and the nasopharynx. It has several functions; it
equalises pressure between the middle ear and the atmosphere by letting a small amount
of air through (this is the sensation of ears ‘popping’). It also drains mucus from the middle
ear. In children the tube is more horizontal and shorter than in an adult and as a result
bacteria are able to enter the middle ear more easily, meaning ear infections are more
common in younger individuals.

Question 7
Correct

Waldeyer’s ring is the ring that surrounds the tympanic membrane.

A True

B False

Question 7 Explanation:
Nope! This statement is absolute rubbish. Waldeyer’s ‘tonsillar’ ring is actually a ring of
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lymphoid tissue located at the pharynx. It is made up of the following tonsils: • 2 Palatine
tonsils – these are what most people refer to as ‘the tonsils’ and are located at the
oropharynx. • 1 or 2 pharyngeal tonsils – known as the adenoids, these are located at the
top of the nasopharynx below the sphenoid. • 2 tubal tonsils – located where the
Eustachian tubes open in the nasopharynx. • 1 or more – lingual tonsils located on the
posterior tongue.

Question 8
Wrong

The superior part of the tympanic membrane is known as the pars flaccida.

A True

B False

Question 8 Explanation:
Tympanic membrane anatomy is important to know for a number of reasons. The pars
flaccida is comparatively fragile to the pars tensa (which is the inferior and larger part of the
tympanic membrane, made up of three layers: skin, fibrous tissue and mucosa) and is
made up of two layers. A cholesteatoma (an accumulation of keratinising squamous
epithelial cells) can form if the pars flaccida prolapses into the middle ear. This can cause
significant problems within the ear, damaging ossicles and can even spread through the
base of the skull. Clinically the anatomy behind the tympanic membrane must be known.
Including information about which bones, nerves and muscles that run behind the ear. If a
grommet is needed to ventilate the ear, such as in otitis media, it must be inserted into the
posterior inferior part of the tympanic membrane to avoid any structures of the middle ear.

Question 9
Wrong

The tensor tympani is the only muscle present in the inner ear.

A True

B False

Question 9 Explanation:
There are two muscles that are present in the inner ear, they are: the tensor tympani and
the stapedius. The tensor tympani is innervated by the trigeminal nerve (more accurately
the medial pterygoid nerve, a branch of the mandibular nerve of the trigeminal nerve, but
that is very specific). An easy way to remember this is TTT – tensor tympani trigeminal.
This muscle is attached to the malleus and dampens the sounds of mastication (chewing,
as this is also innervated by the trigeminal nerve, isn’t the body amazing!?).

Question 10
Wrong

The cochlea is responsible for balance.

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 A True

B False

Question 10 Explanation:
The cochlea is responsible for hearing and the vestibule for balance. The cochlea is a
spiralled hollow canal within the skull. Mechanical signals that travel through the tympanic
membrane, ossicles and the oval window are turned into nerve impulses using the ‘organ
of Corti’. The nerve impulses are then interpreted as sound. The vestibule is made up of
three semicircular canals. Hair cells in the canals detect the sensations of balance and
motion.
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