How to Draw a Normal Tympanic Membrane

🖍 How to Draw a Normal Tympanic Membrane in Under 30 Seconds

In this post, you'll learn how to identify, draw, and label the normal tympanic membrane (TM) — an essential skill for ENT clinical exams, case presentations, and viva questions.

👁 What Structures Are Visible in a Normal Tympanic Membrane?

During otoscopic examination, the following structures can be visualized:

• Handle of Malleus: Long vertical shadow from upper to center
• Umbo: Tip of the handle; causes a central retraction
• Cone of Light: Seen in the anteroinferior quadrant
• Lateral Process of Malleus: Seen near the top of the handle
• Anterior & Posterior Malleal Folds: Extend from lateral process
• Pars Flaccida: Region above malleal folds
• Pars Tensa: Remaining taut portion of the membrane
• Annulus Tympanicus: Fibrocartilaginous ring surrounding the TM

🔍 Occasionally visible middle ear shadows:

• Eustachian tube shadow (anterosuperior)
• Round window (posterior superior)
• Incudostapedial joint (posterior superior)

✏️ Step-by-Step Guide to Drawing a Tympanic Membrane

Check out the YouTube video to see how to draw a normal tympanic membrane.

✅ Basic Outline:

• Draw a tilted oval to represent the TM.

• For the right ear, tilt right; for the left ear, tilt left.

• Remember, the TM is angled at 45–55° to the horizontal.

✅ Add Key Landmarks:

1. Annulus Tympanicus: Outline the rim of the membrane.

2. Handle of Malleus: Long line from top center to umbo.

3. Lateral Process of Malleus: Small dot or bulge near the top.

4. Malleal Folds: Extend from lateral process to annulus (anterior & posterior).

5. Cone of Light: Wedge shape from umbo downwards.

🧠 Mnemonic for Cone of Light:

• Right ear = 5 o'clock position
• Left ear = 7 o'clock position

🔲 Quadrants of Tympanic Membrane

Divide the TM into 4 quadrants for clinical documentation:

✂️ How to Divide It:

1. Draw a line along the handle of malleus (long axis).

2. Draw a perpendicular line at the umbo.

This creates 4 clear quadrants for locating perforations or pathology.

📸 Real Image Correlation

In endoscopic views, compare your drawing to real TM appearances:

• Right TM: Tilted right, cone of light at 5 o'clock.

• Left TM: Tilted left, cone of light at 7 o'clock.

• Landmarks such as umbo, malleus, malleal folds, and pars tensa/flaccida remain the same.

🧾 Summary Table

🎓 Final Tips

• Practice drawing both right and left tympanic membranes.
• Always label major structures in your schematic.
• Use this skill to draw perforations accurately during long case exams.