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Anatomy of the Ear: Hearing and Balance •

Contains Mechanoreceptor

3 Major Areas of Ear 1. Outer or External Ear

2. 3.

Middle Ear or Tympanic Cavity Inner or Internal Ear

Outer or External Ear (Involved in Hearing or Sound Transmission only) 1. Pinna or Auricle (“The Ear”)


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Shell shaped; surrounds auditory canal opening.

External Auditory Canal • Short narrow chamber carved into Temporal Bone

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Surrounded with small hairs and Ceruminous Glands, which secretes waxy yellow substance called Cerumen or Earwax. Sounds that enter here set the eardrum into vibration.

Tympanic Membrane or Eardrum

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Separates outer from middle ear.

Middle Ear or Tympanic Cavity (Involved in Hearing or Sound Transmission only) Small, air filled cavity within the Temporal Bone. With 2 Openings: Oval Window and Round Window Consist of Ossicles - 3 smallest bones in the body that transmits vibrations of eardrum to inner ear. a. Hammer or Malleus b. Anvil or Incus c. Stirrup or Stapes

Eustachian Tube or Auditory Tube

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Links middle ear with the throat (pharynx) Allows pressure to be equalized on both sides of the eardrum. When pressures are unequal, the eardrum bulges causing difficulty in hearing (ex. Airplane)

Homeostatic Imbalance: Otitis Media

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Inflammation of the Middle Ear; common result of sore throat esp in children whose auditory tube runs horizontally. Eardrum bulges and becomes inflamed Myringotomy – lancing of eardrum to relieve pressure.

Inner or Internal Ear (Involved in Hearing and Balance) Maze of bony chambers called Osseus or Bony Labyrinth located at Temporal Bone. Filled with plasma like fluid called Perilymph. Within perilymph, there’s a system of membraneous sacs called Membraneous Labyrinth which contains thicker fluid called Endolymph.

3 Subdivisions of Bony Labyrinth 1. Cochlea

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Vestibule Semi – Circular Canal

1st Stimuli 2nd Receptor 3rd Nerve

4th Motor Output Mechanism of Hearing: Cochlea

Contains Organ of Corti (receptor) which is stimulated when their hairs cells are bent or tweaked by the movement of Tectorial Membrane (wave of fluids). Once stimulated, hair cells transmit impulses along Cochlear Nerve (division of CN 8 – Vestibulocochlear) to Auditory Cortex in Temporal Bone where hearing occurs.

Organ of Corti (receptor) Tectorial Membrane  Cochlear Nerve  Auditory Cortex in Temporal Lobe
Vestibular Apparatus / Equilibrium Receptors of Inner Ear 1. Static Equilibirum – at rest or steady

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Dynamic Euilibrium – movement

Mechanism of Static Equilibrium: Vestibule Contains Maculae (receptor) which report for the head position due to pull of gravity when body is not moving. Their hair cells are embedded in Otolithic Membrane that contains Otoliths, tiny stones made of calcium salts. As the head moves, Otoliths response to the changes in the pull of gravity and activates hair cells which sends impulses along Vestibular Nerve (division of CN 8) to Cerebellum for head position.

Maculae (receptor)  Otoliths  Vestibular Nerve  Cerebellum

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They keep HEAD ERECT.

Mechanism of Dynamic Equilibrium: Semicircular Canal Responds to Angular or Rotational Body Movements. (Head Rotation) Contains Crista Ampullaris (receptor) which consist of hair cells covered with gelatinous cap called Cupula When Head Moves, Endolymph moves in opposite direction pushing the cupula and stimulates hair cells and sends impulses to Vestibular Nerve to the Cerebellum.

Crista Ampullaris  Cupula (for opposite direction of head) Vestibular Nerve  Cerebellum
Homeostatic Imbalance: Deafness • Hearing loss of any degree

diagnosed with Tuning Fork or Audiometry Testing 1. Conduction Deafness


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Blocking of sound waves conducted thru outer and middle ear to the sensory areas of inner ear. Interference with the conduction of sound vibration to inner ear fluids. Bone conduction is better than air conduction (normal condition route) Temporary or Permanent Treatment: Hearing Aids Causes a. Earwax builds up b. Otoscelrosis (fusion of ossicles that interferes sound conduction to inner ear; d/t excessive loud sounds) c. Perforated or Ruptured Membrane d. Otitis Media

2. Sensorineural Deafness


Degeneration or damage to the receptor in Organ of Corti, Cochlear Nerve, or Auditory Cortex (Damage to the Nervous System structures involved in hearing) More difficult to correct and hearing aids aren’t usually helpful

Cant hear by either conduction route Cause: Prolonged listening to excessive loud sounds.

Presbycusis • A type of sensorineural deafness


Gradual deterioration and atrophy of Organ of Cortin causes inability to hear loud tones and speech sounds A normal consequence of aging.

Hearing Tests: 1. Weber Test – conduction problem is indicated on the side louder than the other (lateralization)

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Rinne’s Test – Air conduction is longer than bone conduction. Romberg’s Test – to demonstrate the ability to use information sensed by utricle and saccule (labyrinth)

Meniere’s disease • Serious pathology of inner ear which can lead to progressive deafness

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S/S: Nausea and Vertigo (sensation of spinning) Causes: Arteriosclerosis, Degeneration of CN8, Increase pressure of inner ear fluids Treatment: Anti – motion drugs to decrease discomfort