PENDENGARAN &

PENCIUMAN

Nurfitri Bustamam, SSi, MKes, MPdKed.

Learning Objectives

 Describe the components & functions of the

external, middle & inner ear
 Describe the way that movements of
molecules in the air are converted into
impulses generated in hair cells in the cohlea
 Explain the roles of the tympanic membrane,
the auditory ossicles & scala vestibule in
sound transmission
 Explain how auditory impulses travel from
the cochlear hair cells to auditory cortex
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Learning Objectives

 Explain how pitch, loudness & timbre are coded in

the auditory pathways
 Describe the various forms of deafness & the test
used to distinguish between them
 Describe the basic features of the neural elements in
the olfactory epithelium & olfactory bulb
 Describe signal transduction in odorant receptors
 Outline the pathway by which impulses generated in
the olfactory epithelium reach the olfactory cortex

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Anatomy of Ear

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Telinga Luar
a. Pinna (ear lobe)
- collect & channel sound wave into external auditory meatus (pd bbrp
species dpt digerakan, misal pd anjing)
- membantu membedakan arah datangnya suara
b. External auditory meatus (ear canal)
- 2,5 – 3 cm, berbentuk huruf S
- tdpt rambut & serumen utk proteksi m tympani
c. Membran tympani (ear drum)
- a periodik (dpt bergetar sembarang frekuensi)
- bergetar bebas jika tekanan di kedua sisi membran sama
- diredam dg baik

Telinga Tengah
- ossicles: maleus-incus-stapes
- dindingnya dilapisi mucosa yg mudah menyerap udara

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- Tuba eustachii:
menghubungkan t. tengah dg nasofaring, berfungsi utk
menyamakan tekanan pd ke-2 sisi m. tympani; terbuka
saat menelan, mengunyah, dan menguap.

Acute Otitis Media

- infeksi telinga tengah, umumnya oleh bakteri
- Sering tjd pd bayi & anak, jarang pd dewasa (note:
seiring dg pertumbuhan, tuba eustachii melebar shg
drainage lbh baik selama ada infeksi sal napas atas)
- Infeksi sal napas atas t eustachii telinga tengah
multiplikasi patogen leukosit akumulasi pus
ruptur m tympani ( di US jarang terjadi)
- Otitis media perforata (miringotomi): sengaja melubangi
m tympani utk mengeluarkan pus
- Th/ antibiotik bakteri, analgesik nyeri,
decongestan stagnan mucus & swelling

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- di negara berkembang, pengobatan blm baik otitis
media kronis
- Perforasi/scaring m. tympani some degree of hearing
loss
- Pathogen dr telinga tengah menginvasi mastoideus
mastoiditis (nyeri telinga, demam, pembengkakan di
blkg telinga) infeksi ke otak mll N. VII.
- Th/ antibiotik & mastoidectomy (opening & drainage of
mastoid sinuses)
T. dalam berisi cairan yg inertianya > udara perlu tekanan
yg tinggi utk menggerakannya via:
1. pemusatan energi (m. tympani 22X lbh luas drpd oval
window)
2. Ossicles hukum tuas shg tek meningkat 1,3X. Oleh
karena melawan inertia, hanya 60% energi suara dari m
tympani yg sampai ke cochlea.

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Tensor Tympani & Stapedius

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Tensor tympani & stapedius
- kontraksi t tympani m tympani kaku
- Kontraksi stapedius kurangi gerak stapes pd oval
window
- Fungsi:
1. Memperkeras suara lemah jika ke-2 otot tsb
berkontraksi bergantian
2. Jika kedua otot tsb berkontraksi bersamaan
kekakuan telinga tengah shg mengurangi transfer
energi ke telinga dalam
Tympanic reflex/ Attenuation reflex
terjadi jika ada rangsang suara >70 dB, tetapi waktu
reaksinya 40 – 160 mdt shg hy melindungi telinga dari
suara keras yg lama (prolonged) tetapi tidak terhadap
suara letusan mendadak.

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Telinga Dalam
- inner hair cells: primary sensory cells that generate action
potentials, they stimulate by fluid movement
- Outer hair cells jika memanjang, pengaruh getaran m basilar
thd inner hair cells berkurang
- Reseptor pendengaran sangat sensitive shg dpt mendengar bunyi
organ-organ internal. Namun, karena adaptasi perifer & sentral,
suara tsb tidak terdengar. Pd saat istirahat di tempat sunyi dpt
terdengar bunyi jtg.

Masking
Adanya suara lain mengurangi kemampuan utk mendengar suatu suara
sebab reseptor dlm masa refrakter
Sound localization
ditentukan oleh perbedaan waktu tibanya suara ke telinga, telinga yg
lebih dekat ke sumber suara mendengar lbh keras.

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Fig. 52-8. Stimulation of the hair cells by the to-and-fro
movement of the hairs projecting into the gel coating of the
tectorial membrane.

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Properties of sound waves

 Pitch (tone) depend on

frequency
 Intensity (loudness) depend on
amplitude
 Timbre (quality) depend on
overtones

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 Frekuensi
- telinga manusia dpt mendeteksi 20 – 18.000 Hz
- Paling sensitive pd 1000 – 4000 Hz
 Amplitudo
Standard: Acustical Society of American (ASA) & International
Standard Organization (ISO)
0 dB (ASA) = auditory threshold for average human = 0,000204
dyne/cm2
Note:
10 dB (10 x lbh keras dr 0 dB), 20 dB (100 x lbh keras dr 0 dB)
0 dB ISO = 10 dB ASA
 Timbre
pure: garputala
most sounds: mixture of overtones

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 Pitch discrimination depends
on the basilar membrane that
vibrate
 Loudness depends on the
amplitudo of the vibration

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 Overtones: many points
along basilar membrane
vibrate but less intense
than fundamental tones

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Tonotopycally: auditory cortex mapping

Nada yg berbeda akan

merangsang tempat yg berbeda di
kortex:
Low tones anterolateral
High tones posteromedial

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 Tuli hantar (conductive hearing loss)
- block normal transfer of vibration from m tympani to
oval window, misal impacted cerumen or foreign bodies
in ear canal, scarring/perforation m tympani, otitis
media, otosclerosis
- Gejala: tdk dpt mendengar & berbicara dg suara pelan
sebab mendengar sendiri suaranya yg keras
- Th/ implantasi artifisial ossicles, hearing aid
- Hearing aid: by pass a defective conduction system by
amplifying & transmitting soundwaves through the bone
to inner ear

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 Tuli saraf (sensory hearing loss)
- noise exposure
- ototoxicity: gentamycin, neomycin
- tumor vestibulo-cochlea
- systemic disease: DM, syphilis
- Terapi:
cochlear implant (a small, battery-powered
devise is inserted beneath the skin behind the
mastoid process);
regeneration of hair cells of the organ of Corti

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Penelitian: mencit dipapar musik
rock 2000 Hz, 120 dB, selama 24
jam inner & outer hair cells
rusak

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 Presbycusis
- gradual hearing loss associated with aging
- affects > 1/3 dari org berusia > 75 tahun
- gradual cumulative loss of hair cells & neurons
- tdk dpt mendeteksi suara konsonan berfrekuensi
tinggi: s, sh, f
Pemeriksaan ketajaman pendengaran
1. Suara berbisik
2. Garputala (512 Hz): Rinne, Weber, Schwabach
Air conduction (aerotympanal), bone conduction
3. Audiometri

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Hasil pemeriksaan:
1. Weber: lateralisasi ke kiri
2. Rinne: kanan positif, kiri negatif
3. Schwabach: kanan normal, kiri memanjang
Kesimpulan?

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Audiometric Testing

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 Audiogram

a. nerve deafness b. middle ear sclerosis

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Artificial Cochlea

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Introduction

Smell (olfaction) & taste (gustation)

 Visceral senses (close association with
gastrointestinal function)
 They are related to each other
 Chemoreceptors
 Exteroceptors
 Able to distinguish 30 million compounds

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 SMELL
 Flavor (cita rasa)
 Trigger the memory
 Aroma theraphy
 Conditional Reflex
(Refleks bersyarat)

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 Macrosmatic animals: dog
Microsmatic animals: human (area 10 cm2 )
 Olfactory mucous membran mengandung
supporting cells, progenitor, 10-20 juta reseptor,
mucus (dihslkan oleh Bowman’s gland)
 Fisiologi penciuman: reseptor hy berespons dg
zat yg bersentuhan dg olfactory epitelium &
larut dlm mucus

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Signal Transduction

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Pathway

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 Ambang reseptor thd suatu zat berbeda-beda, manusia
dpt membedakan 2000-4000 jenis bau
 Kemampuan manusia membedakan intensitas bau
kurang (berbeda 30% baru disadari)
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 Arah bau ditentukan oleh waktu molekul odoriferus ke nostril
 Strong odors adalah zat yg relatif tinggi kelarutannya pd air &
lemak
 Odorant binding protein: concentrate & transfer molekul
odoriferous
 - N I: bau enak salivasi, bau tidak enak nausea
- stimulasi ujung saraf bebas  N V: inisiasi bersin,
lakrimasi, dan menahan napas
 Sniffing (meningkatkan aliran udara ke reseptor)
 Adaptasi cepat

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Abnormalities in Odor Detection

 Anosmia: inability to smell

 Hyposmia/hypesthesia: diminished olfactory
sensitivity
 simple nasal congestion/nasal polyps,
 damage olfactory nerve due to fractures of the
cribiform plate/head trauma,
 tumors (neuroblastoma/meningiomas)
 respiratory tract infections

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Abnormalities in Odor Detection

 Hyperosmia: oversensitive to smell

pregnant women
 Dysosmia: distorted sense of smell  sinus
infections, partial damage olfactory nerve,
poor dental hygiene
 THERAPHY
 Antibiotic
 Surgery
 Corticosteroid

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The Smell Survey by A.N. Gilbert & C.J. Wysocki.
National Geographic 1987; 172(4): 514-525

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Tujuan: mdptkan informasi fisiologi & perilaku manusia
6 sampel: - adrostenone (sweat)
- isoamyl acetate (banana)
- galaxolide (musk)
- eugenol (cloves)
- mercaptans (gas)
- rose (floral)
Could you smell it?
Did you correctly identify odor?

Ada 1,5 juta data yg masuk dirandom 26.200 (US) &

100.000 (di luar US)

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 di US 35% subjek anosmia thd androstenone, 29%
anosmia thd galaxolide
 Kemampuan menghidu pd wanita lbh baik dari pria
 Lingkungan (geografis & tempat bekerja) mempengaruhi
kemampuan menghidu

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- merokok mempengaruhi kemampuan menghidu
- kemampuan menghidu bau tdk enak dari
mercaptant (gas odor) dipengaruhi usia

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