Nose and paranasal sinuses: internal nasal valve: practice question

A ENT 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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ENT · Nose and paranasal sinuses: internal nasal valve

Sample item

A patient has nasal obstruction on inspiration with narrowing of the nasal sidewalls on deep breath. Gentle lateral traction of the cheek improves breathing. Which structure is responsible?

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

The answer and the reasoning

B. The internal nasal valve between the upper lateral cartilage and the septum

The internal nasal valve, between the caudal edge of the upper lateral cartilage and the septum is the narrowest part of the nasal airway. In the Cottle manoeuvre, lateral traction on the cheek opens it, and improved airflow indicates valve collapse as the cause.

Option by option

  • A. The choanal mucosa

    Choanal obstruction does not change with cheek traction.

  • B. The internal nasal valve between the upper lateral cartilage and the septum (correct)

    Correct. Improvement on the Cottle manoeuvre localises the problem to the internal valve.

  • C. The ostiomeatal complex

    The ostiomeatal complex drains sinuses and is not the airway valve.

  • D. The posterior end of the inferior turbinate

    A turbinate problem is fixed and does not alter with cheek traction.

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 ENT question

What is the answer to this ENT question?

The best answer is B, The internal nasal valve between the upper lateral cartilage and the septum. The internal nasal valve, between the caudal edge of the upper lateral cartilage and the septum is the narrowest part of the nasal airway.

Why is "The choanal mucosa" not the answer?

Choanal obstruction does not change with cheek traction.

Why is "The ostiomeatal complex" not the answer?

The ostiomeatal complex drains sinuses and is not the airway valve.

Why is "The posterior end of the inferior turbinate" not the answer?

A turbinate problem is fixed and does not alter with cheek traction.

What concept does this question test?

It tests Nose and paranasal sinuses: internal nasal valve in ENT. In the Cottle manoeuvre, lateral traction on the cheek opens it, and improved airflow indicates valve collapse as the cause.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Nose and paranasal sinuses: internal nasal valve?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT 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.