EAR

The ear is the organ of hearing and balance. It has three parts; the first part is the external ear
consisting of the part attached to the lateral aspect of the head and the canal leading inward.

Structures of the Outer Ear

1. Auricle / Pinna
The visible portion that is commonly referred to as
"the ear”. It helps localize sound sources and Directs
sound into the ear

2. External Auditory Meatus

External auditory meatus extends from the pinna to the
tympanic membrane about 26 millimeters (mm) in length and 7 mm in
diameter in adult ear. Size and shape vary among individuals. It
protects the eardrum; it is “S” shaped and Lined with cerumen and
sebaceous glands.
Resonator
 Provides about 10 decibels (dB) of gain to the eardrum at around
3,300 Hertz (Hz).
 The net effect of the head, pinna, and ear canal is that sounds in the
2,000 to 4,000 Hz region are amplified by 10 to 15 dB.
 Sensitivity to sounds greatest in this frequency region
 Noises in this range are the most hazardous to hearing

External auditory meatus has two parts

1. Outer 1/3 surrounded by cartilage
2. Inner 2/3’s surrounded by mastoid bone
1. Cartilaginous part is Outer one third; this Skin is thick having ceruminous and sebaceous
glands. Heir s only confined to outer canal
2. b) Bonny Part is Inner two third; Skin lining is thin and continues over tympanic membrane.
Isthumus

Function of Outer Ear

1. Collects sound
2. Localization
3. Resonator
4. Protection
5. Sensitive (earlobe)
 Cerulean
The purpose of wax:
 Repel water
 Trap dust, sand particles, micro-organisms, and other debris
 Moisturize epithelium in ear canal
 Odor discourages insects
 Antibiotic, antiviral, antifungal properties
 Cleanse ear canal

Blood supply
 Posterior auricular arteries
 Superfacial temporal arteries
 Deep auricular branch of maxillary artery

Lymphatic drainage
 Preauricular,
 Postauricular, &
 Superfacial cervcal lymph nodes

Nervee supply
 Auriculo temporal nerve
 Great auricular nerve
 Auricular branch of vagus nerve
 Auricular branches of facial nerve

Tympanic Membrane
 The eardrum separates the outer ear from the middle ear
 Creates a barrier that protects the middle and inner areas from foreign objects
 9-10mm tall, 8-9 mm wide, and 0.1mm thick
 Cone-shaped in appearance about 17.5 mm in
diameter
 It is at an angle, sloping medially from top to bottom
and posteriorly to anteriorly.
 Its lateral surface therefore faces inferiorly and
anteriorly.
 The eardrum vibrates in response to sound pressure
waves.
 Transmit sounds to middle ear.
 Around the periphery of the tympanic membrane a
fibrocartilaginous ring attaches it to the tympanic
part of the temporal bone.

Tympanic membrane has two parts

A) Pars Tensa: lower, tense
B) Pars Flaccida: upper, thin, loose
a) Pars Tensa
It forms most of tympanic membrane. The central part of pars tensa is tented inwards at the level of
the tip of malleus and is called the umbo. A bright cone of light can be seen radiating from the tip
of malleus to the periphery in the antero inferior quadrant

b) Pars Flaccida
It is the small, triangular, flaccid portion of the tympanic membrane.

Layers of Tympanic Membrane: Tympanic membrane consists of three layers:

i Outer epithelial layer: which is continuous with the skin lining the meatus.
ii Inner mucosal layer, which is continuous with the mucosa of the middle ear.
iii Middle fibrous layer, which encloses the handle of malleus

Blood supply
 Deep auricular branch of maxillary
artery
 Tympanic branch of maxillary artery
 Posterior auricular artery

Nerve Supply
 Auriculotemporal nerve
 Auricular branch of vagus nerve
 Tympanic branch of glossopharyngeal nerve
 Middle Ear

Also called middle ear cavity, tympanic cavity, middle ear cleft, tympanum. The middle ear is an
air-filled, mucous membrane-lined space in the temporal bone between the tympanic membrane
and internal ear. The middle ear communicates posteriorly with the mastoid area through the aditus
to the mastoid antrum, and the nasopharynx anteriorly via the pharyngotympanic tube. Middle ear
divided into
(i) mesotympanum (lying opposite the pars tensa) ,
(ii) epitympanum or (lying above the pars tensa),
(iii) hypotympanum (lying below the level of pars tensa)

Boundaries of middle ear: Middle ear can

be likened to a six-sided box with a
1. A roof,
2. A floor,
3. Medial wall, Lateral wall
4. Anterior and
5. Posterior wall

The roof
The roof is formed by a thin plate of bone
called tegmen tympani. Also extends
posteriorly to form the Roof of the aditus and
antrum. It separates tympanic cavity from
the middle cranial fossa.

The Floor
The floor is also a thin plate of bone which
separates tympanic cavity from the jugular
bulb..

Part of temporal bone

1. Anterior wall the anterior wall has a thin
plate of bone which separates the cavity
from internal carotid artery. It also has
two openings;
1. for the eustachian tube and
2. for the canal of tensor tympani
muscle
2. Posterior wall the posterior wall lies
close to the mastoid air cells. It presents a bony projection called the pyramid, through
which appears the tendon of the stapedius muscle to get attachment to the neck of stapes.
Aditus, an opening through which attic communicates with the antrum, lies above the
pyramid.
 3. Lateral wall the lateral wall is formed largely by the tympanic membrane and to a lesser
extent by the bony part. The tympanic membrane is semitransparent and forms a 'window'
into the middle ear.
4. Medial wall is formed by the laby rinth. It presents a
bulge called promontory which is due to the basal coil
of cochlea; oval window into which is fixed the
footplate of stapes; round window which is covered by
the secondary tympanic membrane. canal for facial
nerve

Mastoid Process
It is the Bony ridge behind the auricle. The mastoid consists
of bone cortex with a "honeycomb“of air cells underneath. It
Provides support to the external ear and posterior wall of the middle ear cavity

Matoid antrum
It is a large, air-containing space in the upper part of mastoid and communicates with the attic
through the aditus. Aditus is an opening through which the attic communicates with the antrum.

Eustachian Tube also called Pharyngotympanic tube, Lined with mucous membrane Connects
middle ear to nasopharynx. Equalizes” air pressure.
It consists of:
1. a bony part (the one-third nearest the middle ear);
2. a cartilaginous part (the remaining two-thirds).

Ossicles
The bones of the middle ear consist of the
1. malleus,
2. incus, and
3. Stapes.
They form an osseous chain across the middle ear from the tympanic membrane to the oval
window of the internal ear. The ossicles conduct sound energy from the tympanic membrane to the
oval window and then to the inner ear fluid.

1. Malleus
The malleus is the largest of the auditory ossicles and is attached to the tympanic membrane. It has
a head, neck, handle (manubrium), a lateral and an anterior process. the handle of malleus, is
attached to the tympanic membrane

2. Incus
The incus has a body, a short process, and a long process which hangs vertically and attaches to the
head of stapes

3. Stapes
The stapes is the most medial bone in the osseous chain and is attached to the oval window. It
consists of the head of stapes, anterior and posterior limbs, and the base of stapes. The shortest
bone in human
Middle Ear Muscles
Tensor tympani: Attached to malleus, Innervated by V, trigeminal nerve
Stapedius: Attached to stapes,
Innervated by VII, facial nerve

Middle Ear Muscle Function:

They help maintain ossicles in proper
position and protect inner ear from
excessive sound levels. When ear
exposed to sound levels above 70 dB, the
muscles contract, decreasing amount of
energy transferred to inner ear. This
protective reflex termed "acoustic reflex"

Function of Middle Ear

1. Conduction: Conduct sound from
the outer ear to the inner ear
2. Protection: Creates a barrier that
protects the middle and inner areas from foreign objects., iddle ear muscles may provide
protection from loud sounds
3. Transducer: Converts acoustic energy to mechanical energy and Converts mechanical energy
to hydraulic energy
4. Amplifier: Transformer action of the middle ear. only about 1/1000 of the
acoustic energy in air would be transmitted to the
inner-ear fluids
Blood Supply of Middle Ear

A) Major arteries
1. Anterior tympanic branch of maXillary artery
2. Stylomastoid branch of posterior auricular artery

B) Minor vesseles
1. Petrosal branch of middle meningeal artery.
2. Superior tympanic branch of middle meningeal artery
3. Branch of artery of pterygoid canal.
4. Tympanic branch of internal carotid

Venous Drainage of ME
Veins drain into pterygoid venous plexus and Superior
petrosal sinus.

Lymphatic Drainage
Lymphatics from the middle ear drain into Retropharyngeal &
Parotid nodes
Inner Ear
Inner Ear: The internal ear or the labyrinth is an important
organ of hearing and balance. It consists of:
1. Bony labyrinth
2. Membranous labyrinth.

The membranous labyrinth is filled with a clear fluid called endolymph. The space between
membranous and bony labyrinths is filled with perilymph

1) Bony Labyrinth: These bony cavities are lined with periosteum and contain a clear fluid (the
perilymph). The bony labyrinth consists of the

1. Vestibule 2. Three semicircular canals 3. Cochlea

1. Vestibule is the central chamber of the labyrinth. Lies medial to the middle ear cavity. Its
lateral wall contains oval window. It assists in maintaining body balance.
2. Semicircular Canal They are three in numbers. Each canal has an ampullated end which
independently opens in to vestibule and non ampullated ends.
1. The lateral
2. The posterior
3. The superior
4. Cochlea: The cochlea is a spiraled, hollow, conical chamber of bone. The bony cochlea is a
coiled tube making 2.5 to 2.75 turns round a central pyramid of bone called the modiolus.In
which waves propagate from the base (near the middle ear and the oval window) to the apex
(the top or center of the spiral). The bony cochlea contains three compartments:
(a) scala vestibuli,
(b) scala tympani,
(c) scala media or the membranous cochlea
2) The membranous labyrinth: These membranous spaces are filled with endolymph the
membranous labyrinth consists of
1. Semicircular ducts
2. Cochlear duct, and
3. Two sacs (the utricle and the saccule).
1. Cochlear duct
Also called membranous cochlea or the scala media. It is a blind coiled tube. It appears triangular
on cross-section and its three walls are formed by:

1. The basilar membrane, which supports the organ

of corti
2. The Reissner's membrane which separates it from
the scala vestibuli,
3. The stria vascularis, which contains vascular epithelium and is concerned with secretion of
endolymph.

2. Semicircular ducts
They are three in number and correspond exactly to the three bony canals. They open in the utricle.

3. Utricle and saccule. The utricle lies in the posterior part of bony vestibule. It receives the five
openings of the three semicircular ducts. It is also connected to the saccule through utriculosaccular
duct. The saccule also lies in the bony vestibule, anterior to the utricle and opposite the stapes
footplate. Its exact function is not known.

4. Endolymphatic duct and sac. Endolymphatic duct is formed by the union of two ducts, one
each fromthe saccule and the utricle.

Organ of Corti: it is the sensitive element in the inner ear and can be thought of as the body's
microphone. It is situated on the basilar membrane in one of the three compartments of the
Cochlea. It contains four rows of hair cells which protrude from its surface.

Hair Cells: Frequency specific

High pitches= base of cochlea

Low pitches= apex of cochlea
Function of Inner Ear: it converts mechanical sound waves to neural impulses that can be
recognized by the brain for:
 Hearing
 Balance

VIII Cranial Nerve

Attached inner ear to brain, Pass electrical impulses from cochlea to brain.