Physiology of Ear

Ear consists of three parts:

• External ear
• Middle ear
• Inner ear
THE EXTERNAL EAR
• External ear consists of two parts- the pinna and the auditory
canal.
• This canal is about 2.5 cm in length in an adult and ends in the
tympanic membrane or eardrum.
• The canal has sebaceous glands which secrete cerumen or earwax
• Excessive and hard earwax can interfere with hearing since it
interferes with the conduction of sound to the middle ear; when
severe, this can result in conduction deafness.
The external ear has the following functions:
1. The pinna helps to funnel sound into the auditory
canal.
2. The auditory canal helps to transmit sounds from the
outside to the tympanic membrane.
3. The cerumen prevents dust particles and foreign bodies
from entering the ear.
4. The direction from where the sound waves enter the
external ear helps us determine the direction of the
sound.
 THE MIDDLE EAR

This part of the ear lies between the outer ear and the inner ear. It
consists of the following structures:
1. The tympanic membrane: This is made up of collagen and
elastic fibres. It is shaped like a shallow conical hat and appears
translucent
2. Three ossicles: These are the smallest bones in the body and
(malleus, incus and stapes)
3. Two muscles: These include tensor tympani which is attached to
the malleus and the stapedius muscle which is attached to the
stapes.
4. Eustachian tube: It connects the middle ear to the pharynx.
The functions of the middle ear include the following:
1. The major function of the middle ear is to transmit
sound waves from the external ear to the internal ear.
The tympanic membrane vibrates when sound waves
reach it through the auditory canal. These vibrations
are then transferred to the ossicles. The malleus rests
on the tympanic membrane and the footplate of the
stapes rests on the oval window of the inner ear. Thus,
vibrations are transferred to the inner ear.
2. The ossicles are so arranged that they act like a lever
and amplify the sound waves that reach the inner ear.
This process by which the normal damping (reduction)
of sound waves that would occur over a distance is
overcome by the lever action of the ossicles is called
impedance matching.
3. The muscles of the middle ear help to control the
movement of the ossicles. Thus, when we are exposed
to a loud sound, tensor tympani contracts - this pulls
the malleus inwards, the tympanic membrane and thus
reduces its movement.
The stapedius muscle contracts and pulls the stapes
away from the oval window, and this reduces the
transmission of sound to the inner ear. The net result is to
reduce the sound and decrease the damage to the ear due
to loud sounds. This reflex in response to a loud sound,
which attempts to reduce transmission and damage to the
inner ear, is called the attenuation reflex or acoustic reflex.
4. The Eustachian tube helps to equalize the pressure in
the middle ear to that of the atmospheric pressure.
However, the connection of the middle ear to the
pharynx via the Eustachian tube means that
infections of the nose and throat may result in the
swelling of the lining of the Eustachian tube - in these
circumstances, individuals sometimes experience
reduced hearing. Swallowing or yawning may open
this constricted Eustachian tube with a 'pop’.
 THE INNER EAR
• The inner ear consists of two parts - the cochlea and the vestibular
apparatus. As part of sound transmission in inner ear the stapes vibrates
and pushes onto the oval window of the cochlea.
• The cochlea is so called because it resembles
a snail's shell derived from the Latin word
(with 3/4 turns of the shell). If you look at the
cross-section of the tube that is twisted 3/4
times, you will find that it is actually made up
of three compartments.
• The three compartments from top to bottom
are the scala vestibuli, the scala media and
the scala tympani.
• The scala vestibuli and the scala tympani are
filled with a fluid called perilymph, while the
scala media, also sometimes called the
cochlear duct, is filled with endolymph. A
membrane called the basilar membrane
separates the scala media from the scala
tympani.
• Organ of Corti which is the actual sense organ of hearing is located on the
basilar membrane. If you straighten out the cochlea you will observe that
when the sound waves are transmitted into the middle ear, it sets up a
vibrations of the oval window which are transmitted into the cochlea and
these vibrations are then damped out at the round window.
• If you look at the organ of Corti more closely you will observe that it
consists of special cells which have hair-like projections on the top - these
are the hair cells. When the basilar membrane vibrates with the sound
waves, these hair cells are pushed against a membrane on the top of the
organ of Corti called the tectorial membrane.
• The distortion of these hair-like projections signals the reception of sound
which is then conveyed to the brain by the cochlear branch of the VIII
cranial nerve.
• A question that naturally follows is the following: how does the ear
distinguish between sounds of different frequencies and why is it that the
human ear can hear frequencies only between 20 and 20,000 Hz.
Although the cochlea becomes narrower at the apex, the basilar
membrane thickness is opposite, i.e. the basilar membrane is thinner at
the base and thicker at the apex. If you have plucked the strings of a
guitar or a violin or any other stringed instrument, you will have observed
that the thicker strings of the instrument give a lower (more base) sound,
while the thinner strings give a higher sound. Lower sounds are
associated with lower frequencies of sound waves and higher sounds
have a higher frequency of sound waves.
• When we listen to a sound, the sound is transmitted to the cochlea - if it is
a more base sound, it will cause the thicker part of the basilar membrane
to vibrate, while if it is a higher sound, a thinner part of the
• basilar membrane will vibrate. Fig. 84.6 indicates that individual parts
of the basilar membrane, based on their thickness, can vibrate only
between 20 and 20,000 Hz. Twenty hertz is regis- tered at the apex of
the cochlea where the basilar membrane is thickest, while 20,000 Hz is
registered at the base of the cochlea where the basilar membrane is
thinnest. This is why the human ear can appreciate sound only
between 20 and 20,000 Hz. Many animals such as dogs and cats can
appreciate sounds at much higher frequencies than humans.
THE AUDITORY PATHWAY
• The auditory pathway which carries the signals from the organ of Corti in the
cochlea to the brain involves several neurons and hence multiple synapses.
• The first nerve fibres are those of the cochlea branch of the VIII cranial nerve which
synapse in the cochlear nuclei in the brainstem. From here, nerve fibres cross to the
other side of the brain and relay first at the superior olive and then at the inferior
calculus.
It is at these two areas that information is processed to allow us to localize sound (i.e.
tell us where the sound is coming from).
There is another relay in a part of the thalamus (the sensory relay station of the brain)
called the medial geniculate body.
It is here that a response to the sound that we have heard begins to take place - this:
response may be in the form of a vocal response, i.e. a reply to something that we
have just heard. Information from the thalamus is finally sent to the auditory cortex
which is located in the temporal lobe.
 THE EFFECTS OF AGEING ON HEARING

Factors causing Hearing loss with ageing

• Prior ear infections
• Injury
• Chronic exposure to loud sounds and
• Chronic medical conditions such as diabetes and high blood
pressure, as well as certain medications, can all affect hearing.
The hearing loss with ageing typically starts with a decrease in
hearing at higher frequencies and then progresses to lower
frequencies along with a deterioration of the hearing threshold.
Bilateral and symmetrical hearing loss.
The reasons for decreased hearing with ageing (presbycusis) are
multifactorial and include the following:
• Degeneration of the hair cells which help to convert the sound
waves into electrical signals for transmission in the auditory
nerve (peripheral presbycusis) (this is responsive to the use of
hearing aids)
• Degeneration of the cochlear nerves that receive signals from
the hair cells or degeneration of the nerves involved in the
auditory pathway and in auditory processing (central
presbycusis)
 TESTS OF HEARING
• Hearing can be tested using simple tuning fork tests. However,
these tests are less sensitive than audiometry’.
Tuning Fork Tests
Tuning fork tests of hearing are typically carried out using a tuning
fork of 512 Hz. Among other reasons, this frequency is used
because it is in the mid-speech frequency range and it allows for
the best determination of air-bone conduction gap.
1. Rinne Test
2. Weber test
Audiometry
• Conducted in a soundproof room.
• Each ear is tested separately and subjected to sounds of a specific tone and
intensity through specially designed ear phones.
• A tone is typically measured in hertz - sounds of lower frequency are heard
as base and sounds of higher frequency appear shriller.
• Intensity of sound is measured in decibels. (Whispering is about 30 dB,
while a food mixer is about 85 dB).
• The minimum intensity at which a particular frequency is heard is marked
on a special chart and the completed test constitutes an audiogram.
• Audiometry can also be tested by applying the frequency through the
auditory canal (air conduction) or through the mastoid bone (bone
conduction).