MBBS ENT Syllabus

ENT syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for ENT in MBBS, not a summary of it.

1. 1

   Anatomy and Physiology

   2 topics

   • Anatomy of the ear, nose, throat, and related structures
     • External ear
     • Middle ear
     • Inner ear
     • Nasal cavity
     • Paranasal sinuses
     • Pharynx
     • Larynx
     • Trachea
   • Physiology of hearing, balance, smell, taste, and speech production
2. 2

   Otology

   5 topics

   • Ear examination
     • Otoscopy
     • Tuning fork tests (Weber and Rinne tests)
     • Audiometry
   • Outer ear disorders
     • Otitis externa
     • Foreign body in the ear
     • Trauma to the external ear
   • Middle ear disorders
     • Acute otitis media
     • Chronic otitis media
     • Otosclerosis
     • Tympanic membrane perforation
   • Inner ear disorders
     • Meniere's disease
     • Vestibular neuritis
     • Labyrinthitis
   • Hearing loss
     • Conductive hearing loss
     • Sensorineural hearing loss
     • Mixed hearing loss
     • Evaluation and management
3. 3

   Rhinology

   4 topics

   • Nasal examination
     • Anterior rhinoscopy
     • Endoscopy
     • Imaging (CT scan, MRI)
   • Nasal obstruction
     • Deviated nasal septum
     • Nasal polyps
     • Allergic rhinitis
     • Nasal tumors
   • Sinusitis
     • Acute sinusitis
     • Chronic sinusitis
     • Fungal sinusitis
     • Complications of sinusitis
   • Epistaxis
     • Causes
     • Evaluation
     • Management of anterior and posterior epistaxis
4. 4

   Laryngology

   4 topics

   • Laryngeal examination
     • Indirect laryngoscopy
     • Direct laryngoscopy
     • Flexible laryngoscopy
   • Voice disorders
     • Hoarseness
     • Dysphonia
     • Vocal cord nodules
     • Vocal cord paralysis
     • Laryngeal tumors
   • Laryngopharyngeal reflux
     • Clinical features
     • Diagnosis
     • Management
   • Stridor
     • Causes of inspiratory and expiratory stridor
     • Evaluation
     • Management
5. 5

   Head and Neck Surgery

   4 topics

   • Neck masses
     • Evaluation and management of cervical lymphadenopathy
     • Evaluation and management of thyroid nodules
     • Evaluation and management of salivary gland tumors
   • Thyroid surgery
     • Thyroidectomy for benign and malignant thyroid disorders
     • Lobectomy for benign and malignant thyroid disorders
     • Isthmectomy for benign and malignant thyroid disorders
   • Parathyroid surgery
     • Parathyroidectomy for hyperparathyroidism
   • Head and neck cancer
     • Squamous cell carcinoma of the head and neck
     • Management principles
     • Surgical approaches
6. 6

   Pediatric Otorhinolaryngology

   3 topics

   • Pediatric ear disorders
     • Otitis media with effusion
     • Acute otitis media
     • Congenital hearing loss
   • Pediatric nasal and sinus disorders
     • Choanal atresia
     • Adenoid hypertrophy
     • Nasal foreign bodies
   • Pediatric airway disorders
     • Laryngomalacia
     • Tracheomalacia
     • Congenital laryngeal anomalies
7. 7

   Audiology and Vestibular Disorders

   3 topics

   • Audiological evaluation
     • Pure tone audiometry
     • Speech audiometry
     • Tympanometry
     • Auditory brainstem response (ABR)
   • Vertigo and dizziness
     • Benign paroxysmal positional vertigo (BPPV)
     • Vestibular neuritis
     • Meniere's disease
     • Vestibular migraine
   • Vestibular testing
     • Caloric testing
     • Vestibular evoked myogenic potentials (VEMP)
     • Rotary chair testing
8. 8

   Obstructive sleep apnea (OSA)

   3 topics

   • Clinical features
   • Diagnosis
     • Polysomnography
   • Management
     • Continuous positive airway pressure
     • Surgical options
9. 9

   Allergy and Immunology

   2 topics

   • Allergic rhinitis
     • Clinical features
     • Allergen testing
     • Management
   • Immunodeficiency disorders
     • Evaluation and management of primary and secondary immunodeficiencies affecting the upper respiratory tract
10. 10

    Emergency Otorhinolaryngology

    2 topics

    • Airway management
      • Assessment and management of upper airway obstruction
      • Foreign body aspiration
      • Epiglottitis
    • Facial trauma
      • Evaluation and management of facial fractures
      • Nasal fractures
      • Laryngeal trauma

ENT flashcards for MBBS

20 of 50 cards from the ENT deck — real questions with worked answers.

1. Name the three anatomical parts of the ear and state the boundary between the outer and middle ear.

   External (outer) ear, middle ear, and inner ear. The tympanic membrane (eardrum) separates the external ear from the middle ear.

2. What are the three auditory ossicles of the middle ear, in order from the tympanic membrane to the oval window?

   Malleus (hammer) attached to the tympanic membrane, incus (anvil), and stapes (stirrup) whose footplate sits in the oval window.

3. What are the two muscles of the middle ear and their nerve supply?

   Tensor tympani (supplied by the mandibular branch of CN V, trigeminal) which tenses the eardrum, and stapedius (supplied by CN VII, facial) which dampens stapes movement to protect against loud sounds (acoustic reflex).

4. What is the function of the Eustachian (pharyngotympanic) tube?

   It connects the middle ear to the nasopharynx and equalises middle-ear pressure with atmospheric pressure, allowing the tympanic membrane to vibrate freely. It also drains middle-ear secretions.

5. Name the two parts of the bony labyrinth concerned with hearing and balance.

   The cochlea (hearing) and the vestibular apparatus comprising the three semicircular canals plus the utricle and saccule (balance).

6. Which structure within the cochlea is the sensory organ of hearing, and what cells does it contain?

   The organ of Corti, sitting on the basilar membrane within the scala media. It contains inner and outer hair cells whose stereocilia contact the tectorial membrane.

7. Trace the pathway of a sound wave from the pinna to the generation of a nerve impulse.

   Pinna -> external auditory canal -> tympanic membrane vibrates -> ossicles (malleus, incus, stapes) -> oval window -> perilymph waves in scala vestibuli/tympani -> basilar membrane movement -> hair cell stereocilia deflect -> mechanoelectrical transduction -> action potentials in cochlear nerve (CN VIII).

8. Explain the principle of tonotopic (place) coding of frequency in the cochlea.

   The basilar membrane is narrow and stiff at the base (responds to high frequencies) and wide and floppy at the apex (responds to low frequencies). Sound of a given frequency maximally vibrates a specific place, so pitch is coded by the location of peak stimulation.

9. What is the impedance-matching function of the middle ear and what is its approximate amplification?

   The middle ear matches low-impedance air to high-impedance cochlear fluid. The ratio of tympanic membrane area to stapes footplate area (about 17:1) plus ossicular lever action gives roughly a 22-fold pressure gain, about $25$-$30\,\text{dB}$, preventing loss of sound energy at the air-fluid interface.

10. Which structures detect angular (rotational) acceleration versus linear acceleration and gravity?

    The semicircular canals (with the crista ampullaris/cupula) detect angular/rotational acceleration; the otolith organs - utricle and saccule (with maculae and otoconia) - detect linear acceleration and head position relative to gravity.

11. Describe the olfactory transduction pathway for the sense of smell.

    Odorants dissolve in nasal mucus and bind G-protein-coupled receptors on cilia of olfactory receptor neurons in the olfactory epithelium (roof of nasal cavity). These bipolar neurons send axons through the cribriform plate to synapse in the olfactory bulb, then via the olfactory tract to the primary olfactory cortex.

12. List the five basic taste modalities and the cranial nerves carrying taste from the tongue.

    Sweet, salty, sour, bitter, and umami. Anterior two-thirds of tongue: chorda tympani of CN VII (facial); posterior one-third: CN IX (glossopharyngeal); epiglottis/pharynx: CN X (vagus).

13. What are the three subsystems involved in speech production?

    Respiration (lungs/diaphragm provide airflow as the power source), phonation (vocal cords/larynx generate sound), and articulation/resonation (pharynx, oral and nasal cavities, tongue, lips, palate shape the sound into speech).

14. What instrument is used for ear examination and what is the correct technique to straighten the canal in an adult?

    An otoscope (auriscope). In adults pull the pinna upward, outward and backward to straighten the external auditory canal; in young children pull it downward and backward.

15. Describe a normal tympanic membrane on otoscopy.

    Pearly-grey, translucent and intact, with a visible cone of light (light reflex) in the antero-inferior quadrant, the handle of the malleus running superiorly, and the pars tensa and pars flaccida identifiable.

16. Compare the Rinne test results in normal hearing, conductive hearing loss, and sensorineural hearing loss.

    Normal: air conduction > bone conduction (Rinne positive). Sensorineural loss: AC > BC (Rinne positive) but both reduced. Conductive loss: BC > AC (Rinne negative) on the affected side.

17. How does the Weber test localise in conductive versus sensorineural hearing loss?

    A tuning fork on the forehead/vertex. In conductive loss the sound lateralises TO the affected (worse) ear. In sensorineural loss the sound lateralises to the better (normal) ear, away from the affected ear.

18. What is otitis externa and which organisms most commonly cause it?

    Diffuse inflammation/infection of the external auditory canal skin ('swimmer's ear'), presenting with pain, itch, discharge and tragal tenderness. Common causes: Pseudomonas aeruginosa and Staphylococcus aureus; fungal otomycosis often Aspergillus or Candida.

19. What is malignant (necrotising) otitis externa and who is at risk?

    An aggressive, potentially life-threatening osteomyelitis of the temporal bone and skull base spreading from the external canal, usually caused by Pseudomonas aeruginosa. It occurs chiefly in elderly diabetics and immunocompromised patients and can cause cranial nerve palsies (especially CN VII).

20. What is exostosis of the external auditory canal and its typical cause?

    Benign bony overgrowths in the ear canal ('surfer's ear'), often multiple and bilateral, caused by repeated exposure to cold water/wind. They can trap debris and cause conductive hearing loss if they obstruct the canal.

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