Auditory System

With Dr. Craig Canby

Nicole Yatawara, nicoleyatawara@gmail.com

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 Ear
Components

• Outer ear

• Middle ear

• Inner ear

Paulsen and Waschke: Atlas of nicoleyatawara@gmail.com

Nicole Yatawara, Human Anatomy, 15th edition, Elsevier GmbH 2011
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 Ear
Components

• Outer ear

• Middle ear

• Inner ear

Paulsen and Waschke: Atlas of nicoleyatawara@gmail.com

Nicole Yatawara, Human Anatomy, 15th edition, Elsevier GmbH 2011
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 Ear
Components

• Outer ear

• Middle ear

• Inner ear

Paulsen and Waschke: Atlas of nicoleyatawara@gmail.com

Nicole Yatawara, Human Anatomy, 15th edition, Elsevier GmbH 2011
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 Tympanic Membrane
Tympanostomy (ear tube)

• Recurrent ear infections

• Reduce pressure in middle ear

• Drain fluid and pus

• Antibiotic drops

Grommet

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 Ear Ossicles
Mis

Malleus

Nicole Yatawara, nicoleyatawara@gmail.com

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 Ear Ossicles
Mis

Incus

Nicole Yatawara, nicoleyatawara@gmail.com

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 Ear Ossicles
Mis

Stapes

Nicole Yatawara, nicoleyatawara@gmail.com

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 Ear Ossicles
Function

Osseous conduction of
sound waves

Paulsen and Waschke: Atlas of nicoleyatawara@gmail.com

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 Ear Ossicles
Muscles

M. tensor tympani

M. tensor tympani
• Innervation: N. musculi tensoris
tympani (branch of N. mandibularis
- V3 of N. trigeminus)

M. stapedius (not shown)

• Innervation: N. stapedius
(branch of N. facialis)

Paulsen and Waschke: Atlas of nicoleyatawara@gmail.com

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 Ear Ossicles
Muscles

M. tensor tympani

Function
• Attenuate sound conduction

Pathology
• Paralysis >> hyperacusis

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 Cochlea
Harbors the Cellular Machinery of the Auditory Apparatus

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 Cochlea
Labyrinths

• Osseous labyrinth

• Membranous labyrinth

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 Cochlea
Scala

• Scala vestibuli perilymph Scala vestibuli

• Scala tympani perilymph

• Scala media (cochlear duct)

endolymph

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 Cochlea
Scala

• Scala vestibuli perilymph Scala vestibuli

• Scala tympani perilymph

• Scala media (cochlear duct)

endolymph

Scala tympani
Paulsen and Waschke: Atlas of nicoleyatawara@gmail.com
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 Cochlea
Scala

• Scala vestibuli perilymph Scala vestibuli

• Scala tympani perilymph Scala media

• Scala media (cochlear duct)

endolymph

Scala tympani
Paulsen and Waschke: Atlas of nicoleyatawara@gmail.com
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 Cochlea
Membranes

Vestibular
membrane

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 Cochlea
Membranes

Vestibular
membrane

Basilar
membrane

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 Organ of Corti
Masterpiece of Cellular Microarchitecture

• Rows of hair cells

(receptors)

• Basilar membrane

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 Organ of Corti
Masterpiece of Cellular Microarchitecture

• Rows of hair cells

(receptors)

• Basilar membrane

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 Cochlea
Frequency Tuning of Basilar Membrane

• High frequency base

• Low frequency apex

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 Cochlea
Frequency Tuning of Basilar Membrane

• High frequency base

• Low frequency apex

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 Cochlea
Innervation

Cochlear component of VN VIII

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 Cochlea
Innervation

Spiral ganglion

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 Cochlea
Innervation

Internal acoustic meatus

Cochlear nerve

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 Cochlea
Innervation

Internal acoustic meatus

Cochlear nerve

Paulsen and Waschke: Atlas of nicoleyatawara@gmail.com

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 Cochlea
Innervation

Internal acoustic meatus

Cochlear nerve

Paulsen and Waschke: Atlas of nicoleyatawara@gmail.com

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 Auditory Nuclei
Conductors of Beautiful Music

Medial geniculate body

Inferior colliculus

Lateral lemniscal nuclei

Cochlear nuclear

Cochlear nuclei
Olivary nuclei

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 Auditory Pathway
Circuitry

• Cochlear hair cells

• Cochlear nerve fibers to ipsilateral Nucleus olivaris superior

anterior cochlear nucleus

• Fibers from anterior cochlear nucleus

travel to superior olivary on same and
opposite sides Cochlea
Nucleus cochlearis
anterior

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 Auditory Pathway
Circuitry

• Lateral lemniscus conveys auditory input

from cochlear and superior olivary nuclei Colliculus inferior
to inferior colliculus

• Inferior colliculus to medial geniculate Lemniscus

body (thalamus) lateralis

• Primary auditory cortex (transverse

temporal gyrus)

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 Auditory Pathway
Lesions

• Lesion at green line unilateral

sensorineural hearing loss

• Lesions at black line and elsewhere

centrally bilateral sensorineural
diminishment of hearing and poor ability
to localize source of sound

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 Otosclerosis
Clinical Considerations

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 Conductive Hearing Loss
Clinical Considerations

Poor transmission from external to

middle ear

Causes
• Otosclerosis

• Impacted wax

• Tympanic membrane perforation

• Middle ear fluid

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 Auditory Tests
Clinical Considerations

1. Rinne test

2. Weber test

1. 2.
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 Rinne Test
Auditory Tests

• Tuning fork at mastoid process (bone

conduction)

• Tuning fork near ear canal (air conduction)

• Normal: air conduction time is longer than

the bone conduction time

• Conduction hearing loss bone

conduction

• Sensorineural loss air conduction

> bone conduction but less than twice as
long

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 Weber Test
Auditory Tests

• Tuning fork on middle of skull.

• Where is the sound coming from?

• Normal hearing in both ears

• Unilateral conduction hearing loss

vibration is louder in affected ear.

• Unilateral sensorineural loss

vibration is louder in normal ear.

Nicole Yatawara, nicoleyatawara@gmail.com

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 Auditory Tests
Interpretation of Weber and Rinne Test

Rinne result Weber result

Air conducted > bone

Normal Midline
conducted bilaterally

Conductive BC > AC in affected ear

Lateralizes to affected ear
hearing loss AC > BC in unaffected ear
Sensorineural Lateralizes to unaffected ear, away
AC > BC in both ears
hearing loss from affected ear
BC > AC in affected ear Lateralizes to unaffected ear, away
Mixed hearing loss
AC > BC in unaffected ear from affected ear

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 Summary
Auditory System
• Vibration of hair cells in the Organ of Corti activates
auditory conduction to the cochlear nuclei.
• A series of axons from the cochlear nuclei relay
through a series of additional nuclei and project
bilaterally to the primary auditory cortex with
contralateral input dominating.
• Lesions at the cochlear nuclei or peripherally result
in complete deafness.
• More centrally located lesions result in difficulty
locating sound.
• The Rinne and Weber tests are useful in
differentiating conduction hearing loss versus
sensorineural loss.
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 Attribution

Unless noted otherwise on the slide, images

used in this presentation were sourced from:

Paulsen and Waschke:

Atlas of Human Anatomy, 15th edition,
Elsevier GmbH 2011

Nicole Yatawara, nicoleyatawara@gmail.com

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 This document is a property of: Nicole Yatawara

Note: This document is copyright protected. It may not be copied, reproduced, used, or
distributed in any way without the written authorization of Lecturio GmbH.

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