ENT examination

Question 1

Otoscopy/auroscopy

a) Pinna movement
b) Grip
c) Tympanic membrane - anatomy
d) Left vs. right ear

Answer 1

a) Upwards and backwards (adults):
- pain on movement = ?otitis externa
- downward/outward appearance = ?mastoiditis

b) Pencil
c) Pars tensa (inner), pars flaccida (outer), handle of malleus

d) Left - light reflex on left
Right - light reflex on right

Question 2

Tuning fork tests.

a) Frequency fork used
b) Rinne’s positive in both ears (AC > BC), Weber’s lateralises to left
c) Rinne’s positive in both ears (AC > BC), Weber’s lateralises to right
d) Rinne’s negative in left ear (BC > AC), Weber’s lateralises to left
e) Rinne’s negative in left ear (BC > AC), Weber’s lateralises to right
f) Rinne’s negative in right ear (BC > AC), Weber’s lateralises to left
g) Rinne’s negative in right ear (BC > AC), Weber’s lateralises to right

Answer 2

a) 512 Hz
b) Sensorineural loss in R ear
c) Sensorineural loss in L ear
d) Conductive loss in R ear
e) Severe SNHL in L ear
f) Severe SNHL in R ear
g) Conductive loss in L ear

Question 3

Investigations for hearing loss

a) Primary care
b) Secondary care

Answer 3

a) Ear examination, Otoscopy, Tuning forks

b) - Pure tone audiometry (PTA)
- Tympanometry