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THE EAR

Kevin Kelliher
READING: Moore and Dalley. Clinically Oriented Anatomy. (5th ed.) pp. 1022-1037. Netter Plates 92-98

A. Development of the ear B. External ear* 1. auricle (pinna) 2. external acoustic meatus (canal) 3. tympanic membrane C. Middle ear* 1. walls and positional relationships 2. contents within the tympanic cavity D. Inner ear* 1. bony and membranous labyrinths 2. auditory and vestibular systems (and cranial nerve VIII) 3. Internal acoustic meatus (canal)

The anatomy of the ear can be separated in to three regions External ear – Auricle (pinna) and external acoustic meatus Middle ear – tympanic membrane, ossicles and everything in the tympanic cavity Inner ear – cochlea and vestibular apparatus

Function

The function of the ear is to transform sound waves into electrical signals and this transformation occurs at four different places. Sound waves travel through the external ear and produce vibrations of the tympanic membrane. The membrane transmitted to the ossicles. The ossicles transmit this energy in the form of pressure waves in the fluid of the cochlea. Finally fluid movement in the cochlea results in activation of receptor cells in the cochlea resulting in neurotransmitter release. Since hearing requires a long chain of energy conduction before neuronal stimulation hearing loss can be a result of either defects or disturbances in conduction (conduction deafness) of energy or defects or disturbances in the sensory organ or neuronal pathways (sensorineural deafness).

antihelix. Major cartilages of the auricle are the helix. . and antitragus.CONDUCTIVE DEAFNESS I can’t hear you I have a banana in my ear SENSORNEURONAL DEAFNESS Acoustic Neuroma and damaged hair cells External ear Auricle is elastic cartilage covered with skin (exception is there is no cartilage in the lobe). The depression in the center is the concha and the lobule the lobe. tragus.

Lateral 1/3 (external) is skin-lined cartilage with many sebaceous glands and ceruminous (wax producing) glands and hairs.Auricular tubercule The auricle is nexus of many nerves including C2 and C3 from the cervical plexus and cranial nerves CNV3. . The manubrium (handle) of the mallus can be observed when looking at the outer surface. The membrane is concave because of the attachment of the mallus to the medial surface. External auditory meatus. Blood supply to the auricle is from the superficial temporal and posterior auricular arteries (braches of the external carotid). Radial fibers can be observed because of connective tissue between the two membrane layers. The Umbo is the center of the depression. CN IX. Medial (inner) 2/3 is a more sensitive skin lining a bony canal (tympanic part of the temporal bone). The pars tensa is below the handle of the mallus and the largest part of the membrane. It is semitransparent and covered with a thin skin (squamous epithelium) externally and a mucus membrane (columnar epithelium) internally. this is often seen in wrestlers. . X and VIII. The auriculotemporal nerve (from CN V3) and auricular branch of vagus (CN X) provide sensory innervation to the inner external auditory meatus.Cauliflower ear is caused by blood under the perichondrium of the cartilage after ear is traumatized. Blood supply to the external meatus is via the deep auricular artery (branch of the maxillary) Tympanic Membrane The Tympanic membrane serves as the medial wall of the external ear and lateral wall of the middle ear.

The pars flaccida is the membrane above the handle of the mallus and appears smooth because it has only the two membrane layers. Two muscles attach to the ossicular chain to help dampen vibrations i. The tensor tympani attaches to the mallus (innervated by V3) ii. The ossicular chain vibrations increase the force of tympanic membrane vibrations f. Three small bones that transmit vibrations from the tympanic membrane on the lateral wall to the oval window on the medial wall. The incus articulates with the head of the mallus and the head of the stapes d. Ossicles a. Blood supply to the tympanic membrane is via the deep auricular artery for the lateral surface and the anterior tympanic artery on the internal surface (both maxillary branches) Middle ear 1. The bones are interconnected by synovial joints h. Otosclerosis is a defect that appears in middle to late age where the stapes becomes affixed to the oval window causing conduction deafness . b. The footplate of the stapes is joined to the oval window of the cochlea e. The manubrium (handle) of the mallus is joined to the tympanic membrane. c. The stapedius attaches to the stapes (innervated by tympanic branch of VII) g.

ii. The promontory is a bulge formed by the first turn of the cochlea. The footplate of the stapes rests on the window. The pyramidal eminence is the attachment point of the stapedious muscle. The tympanic cavity is an oblique slit like cavity whose long axis runs parallel to the tympanic membrane. The floor of the cavity is a thin layer of bone that lies directly over the jugular foramen b. As it bends back to enter the facial canal there is a ganglion (geniculate ganglion) that gives off the greater petrosal nerve which heads to the peytrogopalatine ganglion. Another prominence above and behind the promontory is the caused by the facial canal. Also on the medial wall are two openings in the bone covered with a membrane the oval (vestibular) window and the round (cochlear) window. The chordia tympani enters the infratemporal fossa and joins the lingual branch of V3. A third bulge is a prominence formed by the lateral semicircular canal just anterior to the entrance of the mastoid air cells. glossopharyngeal). On the promontory is a plexus of pain and sympathetic nerve fibers (the tympanic plexus) from the tympanic nerve a branch of CN IX. The anterior wall has two openings one for the auditory tube the other for the tensor tympani. e. vestibulocochler) but continues along to the lateral wall of the inner ear (medial wall of the tympanic cavity). . d. Near the tympanic membrane there is a recess in the roof called the epitympanic recess allowing room for the head of the mallus c. a. which is continuous with the scala vestibuli of the cochlea. This auditory tube allows the free flow of air to equalize pressure in the middle ear. The lateral wall is the tympanic membrane. It is located in the petrous part of the temporal bone. iv. Mucus and pathogens may also pass into the middle ear through this tube. The medial wall a number of bulges from underling inner ear structures i. f. The middle ear cavity has been equated to a box with each side having distinct structures or openings equated to it. The posterior wall has openings to the mastoid air cells.2. Passing anteriorly of the plexus preganglionic parasympathetic fibers help form the lesser petrosal nerve and head to the otic ganglion. The roof is called the tegman tympani. The auditory (Eustachian) tube opens at the anterior end and communicates with the nasopharrynx. The round window is posterior to the promontory and is continuous with the scala tympani of the cochlea. facial) passes over the handle of the mallus. The chordia tympani (a branch of CN VII. The rest of the CNII continues through the facial canal and exits through the stylomastoid foramen. The oval (vestibular) window is high up on the wall between the promontory and the facial canal prominence. The CNVII. iii. facial enters into the inner ear along with VIII.

Within these bony structures are membranous ducts and sacs (membranous labyrinths). It houses the sensory organs for hearing (cochlea) and balance (vestibular apparatus).Inner ear The inner ear sits inside the petrous part of the temporal bone. CNVIII enters the inner ear as the vestibulocochlear nerve then separates into the vestibular and cochlear nerves to innervate the cochlea and vestibular apparatus separately . Two labyrinths contain two types of fluid the bony canals contain perilymph and the membranous ducts endolymph. These interconnected structures consist of a series of bony canals and sacs (bony labyrinths).

the organ of Corti. Within the canals are membranous ducts filled with endolymph. Two bony (with internal membranous sacs) vestibules attached to the semicircular canals transduce movement in relation to gravity. posterior and horizontal) each with an enlargement called an ampulla. The membranous duct within the bony duct separates the structure in to three spaces.The cochlea is the spiral labyrinth that is two and a half turns. These two compartments are continuous with each other at the apex of the spiral. The membranous duct between the two is the scalia media and contains endolymph. called the modiolus. On the organ of Corti are receptors that transduce vibrations of the membranous duct caused by pressure waves traveling though the perilymph in the bony canals. Receptors here transduce fluid movement (rotational movement) and release neurotransmitter on to bipolar neurons whose cell bodies are in the vestibular (Scarpa’s) ganglia. Within the scalia media is the auditory receptor organs. Cell bodies of the bipolar neurons lie in spiral (cochlear) ganglia in the centerpiece of the cochlea. The receptor organs for the vestibular apparatus are in the ampulla. The scalia tympani is continuous with the round window at the base. . The vestibular apparatus consists of three bony semicircular canals (anterior. The scalia vestibuli (perilymph filled) is continuous with the oval window at the base of the cochlea. Blood supply of the inner ear comes from the internal auditory artery originating primarily from the anterior inferior cerebellar artery (ACIA) with contributions from the superior cerebellar and basilar arteries. Receptors release neurotransmitter on to bipolar neurons of the cochlear nerve.

. Tympanic membrane may often appear red or bulge outward. Meniere’s disease is an over production of endolymph. Antibiotics and other drugs in high doses and are know to damage the receptors on the organ of corti. Symptoms may come on slowly and start with vertigo. Mastoditis is an infection in the mastoid air cells that may be secondary to a middle ear infection.Clinical Correlations Otis media is an infection of the middle ear can cause pus or fluid buildup in the tympanic cavity. tinnitus (ringing in the ears) and other hearing deficits and may progress to deafness.