The history •

EAR
clearly. The outer portion of the canal has hair, and glands
Anatomy and physiology that produce ear wax, which forms a protective barrier.

The ear is the specialised sensory organ of hearing and

balance. It is divided anatomically into the external, middle and
inner ear.
External ear
The external ear consists of the cartilaginous pinna, the external
auditory canal (cartilage in the lateral one-third, bone in the
medial two-thirds) and the lateral surface of the tympanic
membrane (Fig. 9.1). Sound is collected and channelled by
the pinna and transmitted via the external auditory canal to
the tympanic membrane. The external auditory canal has an
elongated S-shaped curve; hence it is important to retract
the pinna when examining the ear to see the tympanic
membrane
Middle ear
The middle ear is an air-filled space that contains the three
bony, articulated ossicles: the malleus, incus and stapes.
The Eustachian tube opens into the middle ear inferiorly and
allows equalisation of pressure and ventilation. Vibrations of the
tympanic membrane are transmitted and amplified through
the ossicular chain and focused on to the smaller oval
window on which the stapes sits (Fig. 9.1B). The malleus is
attached to the tympanic membrane and can be seen clearly
on otoscopy (Fig. 9.2). The long process of the incus can also
be visible occasionally. The tympanic membrane has a flaccid
upper part (pars flaccida) and it is important to look carefully
in this area, as this is where a

Auditory ossicles
Helix Malleus Incus Stapes
(on oval
Triangular fossa window)
Pinna Semicircular canal
Vestibular nerve
Antihelix Cochlear nerve
External Cochlea
auditory meatus
Tympanic cavity
Tympanic membrane
Tragus

Eustachian tube
Concha

Earlobe Earlobe External auditory

meatus
A B
Fig. 9.1 The ear. A B
The pinna. Cross-section of the outer, middle and inner ear.

A B
Fig. 9.2 Structures seen on otoscopic examination of the right ear. A Main structures. B Normal tympanic membrane.