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AUD 6305-001 FALL 2004

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SYLLABUS AUD 6305-001 ANATOMY AND PHYSIOLOGY OF AUDITION, FALL 2005 Instructor: Aage R. Møller Ph.D. E-mail: AMOLLER@UTDALLAS.EDU This course is integrated and taught together with AUD-6303 HEARING SCIENCE Location: Room A229, Callier Center for Communication Disorders Time: Tuesday and Thursday 9:00-11:45 Begin: August 18, 2004 The course provides basic knowledge about the normal function of the ear and the auditory nervous system and their pathophysiology. It is important that those who work with hearing impaired people are knowledgeable about the function of not only the normal auditory system but also of the diseased auditory system. This course will therefore also provide knowledge about the function of the pathologic auditory system and it will discuss diagnosis of disorders of the auditory system. The use of electrophysiological methods in the operating room for reducing the risk of hearing loss (intraoperative neurophysiological monitoring) will be discussed. Course layout The course begins with the anatomy and physiology of the ear. Sound conduction to the cochlea and the role of the middle ear in increasing the sensitivity of the ear will be discussed. The frequency analysis in the cochlea and the transduction of sound into a neural code is described. The role of the outer hair cells in increasing the sensitivity of the ear and sharpening cochlear frequency selectivity is discussed. The course covers the anatomical organization of the ascending and the descending auditory pathways and implications of its complexity are discussed. Coding of sound in the

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individual nerve fibers of the auditory nerve and the transformation that occurs in the nuclei of the ascending auditory pathway are covered. The importance of this transformation for interpretation of complex sounds such as speech sounds is emphasized. The anatomy and the function of the descending auditory nervous system and of the non-classical (extralemniscal) ascending auditory nervous system is also included. Evoked potentials that originate in the ear and the auditory nervous system have played important roles in studies of the function of the auditory system in animals and now play an important role in diagnosis of disorders of the auditory system. The generation of auditory evoked potentials in general is discussed and the different kinds of electrical potentials that can be recorded from the ear and the auditory nervous system in responses to sounds are described. The difference between near field and far field evoked potentials are discussed and the neural generators of the brainstem auditory evoked potentials are described. The pathophysiology of some common disorders of the auditory nervous system will be discussed.

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OUTLINE A. ANATOMY OF THE EAR Outer ear and ear canal Middle ear Tympanic membrane Ossicles Middle ear muscles Cochlea Organ of Corti Inner and outer hair cells Supporting cells Nerve supply Blood supply to the cochlea Fluid systems of the cochlea Importance of maintaining normal pressure in the inner ear B. SOUND CONDUCTION TO THE COCHLEA The acoustic properties of the head Physical basis for directional hearing in the horizontal plane Intra-aural time difference Intensity difference Directional hearing in the vertical plane The middle ear The middle ear as an impedance transformer Frequency dependence of sound transmission through the middle ear The function of the tympanic membrane The middle ear muscles

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C. PATHOLOGIES OF THE SOUND CONDUCTING APPARATUS Outer ear and ear canal Ear canal collapse Ear canal atresia Middle ear Perforation of the tympanic membrane. Fixation of the ossicular chain Interruption of the ossicular chain Cholesteatoma etc. Air pressure in the middle ear Fluid in the middle ear (middle ear effusion). Hearing without the middle ear Middle ear prostheses D. FUNCTION OF THE COCHLEA Basilar membrane Frequency selectivity of the basilar membrane Role of the traveling wave motion Active and non-linear cochlea Outer hair cells as "motors" (positive feedback) Cochlea as a generator of sound (otoacoustic emission) Role of the olivocochlear efferent system. Sensory transduction in the cochlea Inner hair cells as mechano-transducers Are the hair cells sensitive to velocity or displacement of the basilar membrane? Generation of electrical potentials in the cochlea. Cochlear microphonics (CM) Summating potentials (SP) Action potential (AP) Electrocochleographic (ECoG) potentials

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E. DISORDERS OF THE COCHLEA Audiometric signatures of cochlear injury Relationship between hearing loss and speech discrimination. Injuries to the cochlea from external causes Noise induced hearing loss Prevention of hearing loss from noise exposure Hearing loss from pharmacological agents Hearing loss from disease processes Ménière’s disease Meningitis and other infectious diseases Fistula of the cochlear windows Hereditary hearing loss Sudden hearing loss Age related hearing loss (Presbycusis) F. ANATOMY OF THE AUDITORY NERVOUS SYSTEM Classical ascending auditory nervous system Auditory nerve Cochlear nucleus Superior olivary complex and nuclei of the lateral lemniscus Inferior colliculus Medial geniculate body Auditory cortex Non-classical ascending auditory systems Acoustic middle ear reflex

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G. PHYSIOLOGY OF THE AUDITORY NERVOUS SYSTEM Ascending (classical) auditory nervous system Frequency selectivity Coding of temporal pattern Transformation of complex sounds in the auditory nuclei "Hearing with two ears" Importance of parallel processing in the auditory system Efferent (descending) system Ascending (non-classical) auditory systems The acoustic middle ear reflex Functional importance of the acoustic middle ear reflex Other acoustic reflexes Generation of sound evoked potentials Farfield auditory evoked potentials Brainstem auditory evoked potentials (BAEP) Neural generators of the (BAEP), human studies Recording of auditory evoked potentials in the operating room Near field evoked responses from the auditory nervous system Recordings from the intracranial portion of the auditory nerve. Recordings from other parts of the ascending auditory pathway Middle latency evoked potentials (MLR) The 40 Hz response Magnetoencephalography

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H. DISORDERS OF THE AUDITORY NERVOUS SYSTEM Injury to the auditory nerve Audiometric changes related to auditory nerve injury Importance of neural coherency Relationship between hearing loss and speech discrimination. Injury to the central auditory pathway The effect of bilirubinemia Injury of auditory cortical areas Relationship between hearing loss and speech discrimination Low redundancy speech tests Role of neural plasticity in disorders of the auditory nervous system Effect of deprivation of input and overstimulation. Tinnitus Hyperacusis and phonphobia Similarity between tinnitus and chronic pain Similarities with phantom sensations (pain) Involvement of the non-classical ascending auditory system Required book: Møller, A.R. Hearing: Its Physiology and Pathophysiology. Academic Press, San Diego, 2000 ISBN 0-12-504255-8 (Instructor will provide this book at a discounted price). Supplementary readings: Zigmond MJ, Bloom FE, Landis SC, Roberts JL, Squire LR: Fundamental Neuroscience, San Diego, Academic Press, 1999 ISBN 0-12-780870-1 7/6/05