Pharynx: referred otalgia after tonsillectomy: practice question

A Anatomy question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anatomy · Pharynx: referred otalgia after tonsillectomy

Sample item

A 25-year-old woman has severe right ear pain on the second day after tonsillectomy, although the ear examines normally. Which nerve pathway explains the referred pain?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Glossopharyngeal nerve and its tympanic branch, supplying both the tonsil bed and the middle ear

The tonsillar bed is supplied mainly by the glossopharyngeal nerve, whose tympanic branch (Jacobson) supplies the mucosa of the middle ear. The pain of tonsillectomy is thus referred to the ear along the shared nerve. This is why earache with a normal ear should prompt examination of the throat.

Option by option

  • A. Glossopharyngeal nerve and its tympanic branch, supplying both the tonsil bed and the middle ear (correct)

    Correct. The glossopharyngeal nerve supplies both sites, so pain is referred to the ear.

  • B. Hypoglossal nerve through its meningeal branch

    The hypoglossal nerve is motor to the tongue and does not carry pain from the tonsil.

  • C. Lesser palatine nerves, supplying both the tonsil and the external ear

    The lesser palatine nerves supply the soft palate and part of the tonsil and do not supply the ear.

  • D. Auriculotemporal nerve, supplying both the tonsil and the ear canal

    The auriculotemporal nerve supplies the external ear and not the tonsillar bed.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is A, Glossopharyngeal nerve and its tympanic branch, supplying both the tonsil bed and the middle ear. The tonsillar bed is supplied mainly by the glossopharyngeal nerve, whose tympanic branch (Jacobson) supplies the mucosa of the middle ear.

Why is "Hypoglossal nerve through its meningeal branch" not the answer?

The hypoglossal nerve is motor to the tongue and does not carry pain from the tonsil.

Why is "Lesser palatine nerves, supplying both the tonsil and the external ear" not the answer?

The lesser palatine nerves supply the soft palate and part of the tonsil and do not supply the ear.

Why is "Auriculotemporal nerve, supplying both the tonsil and the ear canal" not the answer?

The auriculotemporal nerve supplies the external ear and not the tonsillar bed.

What concept does this question test?

It tests Pharynx: referred otalgia after tonsillectomy in Anatomy. The pain of tonsillectomy is thus referred to the ear along the shared nerve. This is why earache with a normal ear should prompt examination of the throat.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Pharynx: referred otalgia after tonsillectomy?

Learn every nerve by its route, its muscles and what a lesion looks like at the bedside. That one habit answers a large share of questions. Then use the flashcards and the other Anatomy questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.