EAR

Organ of hearing & balance

Ear
3 parts
• External ear
– Auricle
– External acoustic meatus
• Middle ear/ tympanic cavity /
tympanum
– Air filled cavity within petrous part
of temporal bone
• Connected to nasopharynx by
Eustacian tube/auditory tube
– Contain
• auditory ossicles (malleus, incus &
stapes)
• 2 middle ear muscles – stapedius &
tensor tympani
• Internal ear
– Between middle ear & internal
acoustic meatus
– Osseous labyrinth
– Membranous labyrinth
• Contain auditory & vestibular nerve
receptors
 Auricle / Pinna
• Capture sound
• Elastic Cartilage – thrown
into folds covered with hairy
skin
• Lobule
– Fibrofatty tissue
• Cartilage extend inward in
tubular fashion –
cartilagenous part of external
acoustic meatus
• Auricular muscles
– Attach pinna to scalp & skull
– Supplied by facial nerve
 External acoustic meatus
• Sinuous tube
• 3 cm
• Straighten for otoscope
introduction – pull auricle
up & back
• Obliquity of tympanic
membrane
– Anteroinferior wall –
longest
– Posterosuperior wall –
shortest
• Outer 1/3 – cartilage
• Inner 2/3 - bone
• Bony part
– Tympanic part of temporal
bone ‘C’ shaped
– Gap – squamous & petrous
parts
• Whole canal lined by skin
• Hair & sebaceous glands
abundant in skin of
cartilagenous portion
• Ceruminous glands
– Modified sweat gland
– Secrete yellowish brown wax
• Meatus narrowest at
isthmus
 Tympanic membrane
• Circular, Fibrous structure, I cm diameter
• Separate middle ear from external ear
• Made up of
– Outer cutaneous layer-continues with skin
– Middle - fibrous layer
– Inner – mucous layer
• Continuous with mucoperiostium of middle
ear cavity
• translucent
• lies obliquely
– Face downwards, forwards & laterally
• Concave towards meatus
• Handle(manubrium) of malleus firmly
attached to inner surface
• At depth of concavity
– Umbo
• When drum illuminated for inspection
– Cone of light radiate from umbo over
anteroinferior quadrant
• Lateral process of malleus
– 2 Fibrous folds diverge to margin of
tympanic membrane
• Tympanic membrane
– Pars flaccida /sharpnell’s membrane -
lax
• Crossed by chorda tympani
– Pars tensa
• Kept tensed by tensor tympani
 Middle ear
Tympanic cavity
• Cavity of middle ear
• Biconcave lens
• 6 walls
• Lateral wall
– Tympanic membrane- bulges inwards
– Epitympanic recess – above tympanic membrane
• Contents:
– Head of the malleus
– Body of the incus
– Associated ligaments and
mucosal folds
 Middle ear
• Medial wall- structures
seen
– Promontory – 1st turn of
cochlea
• Tympanic plexus
– Canal for facial nerve
– Lateral semicircular canal
– Oval window- closed in life
by foot piece of stapes
– Round window – closed in
life by secondary tympanic
membrane
Tympanic plexus and lesser petrosal nerve
 Middle ear
• Roof
– Tegmen tympani
– Temporal lobe – above
• Floor
– Thin bone above jugular
fossa
• Tympanic branch of
glossapharyngeal nerve enter
via tympanic canaliculi
Anterior wall
• Shortened by
approximation of roof &
floor
• Perforated by opening of
2canals
– Upper – canal for tensor
tympani muscle
– Lower – bony part of
auditory tube
• Lower wall – posterior
wall of carotid canal
– Perforated by tympanic
branch of internal carotid
artery
– Sympathetic fibers from
internal carotid plexus
 Auditory tube / pharyngotympanic
tube/ Eustachian tube
• Connect nasopharynx
with anterior wall of
middle ear cavity
• 3 cm long
• Slope medially &
downwards
• Bony (1 cm) &
cartilagenous parts (2 cm)
• Lined by ciliated epithelium
• Numerous mucous glands in
cartilagenous portion
• Near pharyngeal orifice – tubal
tonsils
• Posterior wall
– Aditus – leads to mastoid
andrum & air cells
– Ridge for the canal of facial
nerve
– Pyramid
• Apex perforated by stapedius
– Posterior canaliculus for
chorda tympani nerve
 Mastoid antrum/ tympanic antrum
• Lies behind epitympanic
recess in petrous part of
temporal bone
• Connected to recess by
aditus
• Size vary
• Lateral wall –
– 15 mm deep to suprameatal
triangle
• Mastoid air cells invade
• Infection from middle ear spread
to mastoid andrum
• Middle ear infection –may lead
to sigmoid sinus thrombosis &
cerebellar abscess
 Interconnected Auditory Ossicles
1 - malleus handle
2 - head and neck of malleus
3- Malleus-incudal joint
4- body of incus
5 - short limb of incus
6 - long limb of incus
7 - head of stapes
8 – base of stapes
9 - limbs of stapes
 Muscles of middle ear
• Tensor tympani
– Origin
• Bony canal
• Insertion- handle of malleus
• Contraction – make the drum
more tense
• Stapedius
– Hollow pyramid
- Back of neck of stapes
- Tilt foot piece of stapes in
oval window
Facial nerve & ear
 Inner ear
• Within petrous part of
temporal bone
• osseous labyrinth
• Perilymph
• Membranous labryinth
• endolymph
Temporal bone & Inner Ear (Labyrinth)
Bony Part: SemiCircular Canals, Vestibule, Cochlea

SC ducts, Utricle, Saccule

Membranous
Part

Choclear membranes
Cochlear duct and cochlea
Cochlea-with organ of Corti
Organ of Corti – high magnification
 Auditory pathway
• Conduct impulse
concerned with sound
from organ of Corti
• 1st order neuron – spiral
ganglion of cochlea
– Peripheral process-end in
hair cells
– Central process-fibers of
cochlear nerve
• 2nd order neuron –
cochlear nucleus
– Situated in relation to
inferior cerebellar peduncle
– At the level of pons &
medulla
– Dorsal & ventral nucleus
• Axons from 2nd order
neuron
– Most cross to opposite site
– trapezoid body
– Form lateral lemniscus
• Relay in
• superior olivary
nucleus
– nucelus of trapezoid body
– lateral lemniscus nucleus
• On same side or opposite
side
• lateral lemniscus
– End in inferior colliculus

Fibers – inferior brachium

Medial geniculate body

Auditory radiation –sublentiform

part of internal capsule

Auditory area of cerebral cortex-

temporal lobe –upper surface of
superior temporal gyrus
Each lobe receive fibers from
both cochlea
lesion of temporal lobe –not
complete deafness
 Vestibular nerve
Conduct impulse from
• utricle & saccule- information
regarding the position of
head/static balance
• Semicircular canal information
regarding movement of
head/kinetic balance
• 1st order neuron
– Vestibular ganglion (in internal
acoustic meatus)
• Peripheral process end in hair cells
• Central process –vestibular nerve
fibers
• Enter brain stem between pons &
medulla
• 2nd order neuron- vestibular
nuclear complex
– Located beneath floor of 4th
ventricle
– 4 nuclei
• Lateral, medial, superior &
inferior
– Efferents
• Reach cerebellum
• Descend uncrossed to spinal
cord
– Vestibulospinal tract
• Pass to 3rd, 4th & 6th cranial
nerve nuclei
– Medial longitudinal fasciculus
• Pass to cerebral cortex
– Vestibular area in post central
gyrus – above lateral fissure
• Disturbance of Cochlear nerve function
– Deafness
– Tinnitus
• Disturbance of vestibular function
– Vertigo
– Nystagmus
– Vomiting
– nausia