Anatomy and Physigology Of The Ear

ARTONO
Dept. of Otolaryngology Dr. Soetomo Hospital/
Faculty of Medicine Airlangga University
Surabaya
ANATOMY OF THE EAR

 TEMPORAL BONE
 EXTERNAL EAR
 MIDDLE EAR
 INNER EAR
 TEMPORAL BONE
 Tympanic bone
 Squamous portion
 Mastoid portion
 Petrosa
 ANATOMY OF THE EAR

 EXTERNAL :
Pinna (auricle)
Exernal Auditori cannal

 MIDDLE EAR

 INNER EAR
 EXTERNAL EAR
PINNA (AURICLE)
elastic cartilage frame
no useful muscles
lateral surface is
dominated by concavities
hair, sebaceous and
sudoriferous glands
the attachment of the skin
 tightly to the
perichondrium on the
lat
 loosely on the medial
 EXTERNAL EAR
EXTERNAL AUDITORY CANAL
2.5 cm long
lateral third : cartilagenous portion
continuation of pinna
contains : cerumen glands
sebaceous glands
hair follicles
medial two thirds :
bony portion
epithelial lining over tympanic membrane
the isthmus : lies just medial to the junction of the bony and
cartilage canal
 EXTERNAL EAR

INNERVATION
 sensory
N V, auriculotemporal branch
Greater auricular nerve (C3
branch)
Lesser occipital nerve (C2 and C3
derivation)
N X, auricular branch (Arnold’s n)
N VII, twigs
 local anesthesia
EXTERNAL EAR
Vascular Supply
External carotid artery :
 post auricular a
 superficial temporal a
Internal jugular vein
 TYMPANIC MEMBRANE

Elliptically shape
(irregular cone)
9 – 10 mm in diameter
Firmly attached to the
malleus
 TYMPANIC MEMBRANE
Structures of pars tensa (0.1 mm thick)
1. Cutaneous layer, squamous epithelium
2. Middle layer (pars propria) consist of :
 radiate fibrous layer
 circular fibrous layer
3. Inner layer, mucous membrane of midlle ear cavity

Structures of pars flaccida

1. Cutaneous layer
2. Inner layer
 TYMPANIC MEMBRANE
Major features from lateral aspect :
1. Umbo
2. Malleal stria
3. Mallear prominence
4. Pars tensa
5. Pars flaccida
(Shrapnell’s membrane)
 Tympanic cavity
CAVITY :
• Lateral : tympanic
membrane
• Medial : promontorium
• Superior : tympanic tegmen
• Inferior : jugular bulb
• Anterior : Carotid artery,
tensor tympanic canal
• Posterior : aditus ad
antrum
 Tympanic cavity
Tympanic cavity :
 Continuity with Eustachian
tube and mastoid air cells via
aditus ad antrum
 Lined with a mucosal
epithelium
 Subdivide :
Epitympanum
Mesotympanum
Hypotympanum
Protympanum
Posterior tympanic
cavity
 MIDDLE EAR
Vascular Supply :
 Anterior tympanic a (maxillary a)
 Posterior tympanic a
(stylomastoid a)
 Inferior tympanic a (external
carotid a)
 Superficial petrosal a , superior
tympanic a ( middle meningeal a)
 Caroticotympanic a (internal
carotid a)
Veins :
 superior petrosal dural sinus
 Pterigoidal plexus
Innervations :
• Tympanic branch of
glossopharyngeal nerve
(Jacobson’s nerve)
• Modalities :
– greatest portion: sensory of
mucosa of me, air cells
andauditory tube
– Parasympathetic : no function in
me
• Sympathetic fibers : internal
carotid plexus
 MIDDLE EAR - OSSICLES

• Ossicular chain
– Malleus
– Incus
– Stapes
 MIDDLE EAR - MUSCLES
1. Tensor tympanic
1. N.V
2. originate : cartilage of ET
3. tendon : sweeps around
cochleariform proc,
across the tympanic cavity-
medial aspect of neck ,
manubrium of malleus
2. Stapedius
1. Runs vertically in the
posterior wall adjacent to
N.VII
2. Tendon : traverses pyramidal
eminence attach to
posterior crus
 MIDDLE EAR - EUSTACHIAN TUBE
 Approximately 35 mm
 Mucosa : abundance of
mucociliary cells clearance
function
 2/3 anteromedial -
fibrocartilaginous
 1/3 posterolateral – bony
 Normal resting position : close
 Opening : tensor veli palatini m
(N.V)
 Fat pad of Ostmann – maintaining
resting closure
 FACIAL NERVE (CN.VII)
5 segments :
1. Intracranial : pons IAC porus ;
24 mm
2. Intracanalicular : IAC joined by
N.itermedius
3. Labyrinthine : fallopian canal 
geniculate gangl ; 4 mm
4. Tympanic : geniculate gang
pyramidal em (2nd genu) ;13
mm
5. Mastoid: second genu
stylomastoid foramen; 20 mm
 INNER EAR
• COCHLEA
Bony tube 35mm long
Spiral 2 ½ turns , 5 mm height
Base abuts the fundus of IAC, cribrose  N VIII
Divided into :
scala vestibuli,
scala tympani,
scala media
 INNER EAR
• COCHLEA • Scala vestibuli
Bony tube 35mm long • Scala tympani
Spiral 2 ½ turns , 5 mm perilymph; extracellular
height fluid
Base abuts the fundus of
communicates at
IAC, cribrose  N VIII
helicotrema
Divided into :
scala vestibuli,
scala tympani,
scala media
 COCHLEA (2)
 Scala media bounded by :
Reissner membrane
Basilar membrane : organ of Corti
Osseous spiral lamina
Contain endolymph
 Organ of Corti contain :
Outer and Inner hair cells
Supporting cells (Deiters, Hansen, Claudius) structural
Tectorial membrane metabolic
Reticular lamina-cuticular plate complex support
 INNER EAR
Semicircular canals :
Lateral (horizontal)
Superior (anterior vertical) vestibular organ
Posterior (posterior vertical)
How Sound Travels Through The Ear

Acoustic energy, in the form of sound waves, is

channeled into the ear canal by the pinna. Sound waves
hit the tympanic membrane and cause it to vibrate, like
a drum, changing it into mechanical energy. The
malleus, which is attached to the tympanic membrane,
starts the ossicles into motion. The stapes moves in and
out of the oval window of the cochlea creating a fluid
motion, or hydraulic energy. The fluid movement causes
membranes in the Organ of Corti to shear against the
hair cells. This creates an electrical signal which is sent
up the Auditory Nerve to the brain. The brain
interprets it as sound!
 Upper Airway
Nose
Oral Cavity
Pharyng : Throat
 Anatomy of the Nose
Bone and Cartilage
Partition in the nose is called the nasal septum
Air enters through the nostrils or nares
Two nasal passages are called choanae
Vibrissae filter the incoming gas
First 1/3 is stratified squamous epithelium (PROTECTION)
Posterior 2/3 is pseudostratified ciliated columnar
epithelium (MUCUS SECRETION)
Nasus eksternus

• dorsum nasi,
• apeks nasi,
• radiks nasi,
• ala nasi.
 • Nasal Bone
• Nasal Cartilage:
– Lateral
– Alaris mayor : medial
y (x) & lateral(y)
– Alaris minor
x
NASAL SEPTUM
Kartilago
kuadrangularis
(anterior) (KK)
LP
Lamina
KK V Perpendikularis
Os. etmoidalis
x (LP)
KP
KM
Krista maksila &
palatina(KM,KP)
Medial Alaris mayor(x)
vomer (V)
 Nasus Internus

• Nasal Turbinates
KS
• Superior
• Medius KM

• Inferior SPT

• Nasal Septum KI
 SF
RSE KS MS
KM MM

SS
KI

OT MI
SINUS SFENOID(SS), SINUS FRONTAL(SF),KONKA
INFERIOR(KI), KONKA MEDIUS(KM), KONKA
SUPERIOR(KS), MEAT SUPERIOR(MS), MEAT
MEDIUS(MM), MEATUS INFERIOR(MI), OSTIUM
TUBA EUST.(OT), RESESUS SFENO-ETMOID(RSE)
Nose and Nasal Cavities
 EA EP

SfP

PM

Ethmoidalis anterior(EA) & ethmoidalis posterior(EP),

Sfenopalatina(SfP), palatina mayor(PM).
Pleksus Kiesselbach
 Paranasal Sinuses
• Empty air spaces found in the bones of the
skull; Paired
– Frontal
– Maxillary ANTERIOR
– Ethmoid anterior
– Ethmoid posterior POSTERIOR
– Sphenoid
• They contain mucous secreting goblet cells
which drain into the nasal cavity
 OSTEOMEATAL
COMPLEX

• Ostium sinus maksila

• Ostium sinus frontal
• Prosesus unsinatus
• Bula etmoid
• Konka medius
 Nose divided coronally in to two chambers it
acts as a functional unit
• SMELL :
– The nose contains the organs of smell
• RESPIRATION :
– The nose warms, cleans and humidifies the inspired air
and prepares it for pulmonary
– It is a self-cleaning structure surfaces
• VENTILATION & DRAINAGE
• RESONATION :
– It also adds quality to speech production
Anatomy of the Oral Cavity
• Roof of the mouth is formed by the hard and
soft palate
– Hard – Bony portion
– Soft – Fleshy portion
• Uvula is the soft fleshy structure
• Epithelium is stratified squamous epithelium
which is non-ciliated.
• Palatine (faucial) tonsils are located on each
side of the oral cavity.
TONSILS
 Ring Waldeyer :
ADENOID
(tonsila faringealis)

jar. limfoid sekitar tuba E jar. Limfoid sekitar tuba E

Lateral band Lateral band

(ddg lateral faring) (ddg lateral faring)

tonsila palatina tonsila palatina

tonsila lingualis
 SWALLOWING
 Deglutition is the act of swallowing, through
which a food or liquid bolus is transported from
the mouth through the pharynx and esophagus
into the stomach.
 Normal deglutition is a smooth coordinated
process that involves a complex series of
voluntary and involuntary neuromuscular
contractions and typically is divided into three
distinct phases:
Oral,
Pharyngeal
Esophageal
 Pharynx - Throat
• Nasopharynx
• Oropharynx
• Laryngopharynx
 Nasopharynx
• Located posterior to nasal cavity
• Pseudostratified ciliated columnar
epithelium
• Includes pharyngeal tonsils or
adenoids
• Eustachian Tubes (auditory tubes)
– Connects the middle ear and
nasopharynx
– Middle ear infection is called otitis
media
• Complication of ET tubes
 Oropharynx

• Lies behind the oral

cavity
• Lingual tonsils lie at
the root of the
tongue
• Statified squamous
epithelium
 Laryngopharynx

• Lies between the base of the

tongue and the entrance to
the esophagus
• Lies posterior to the
epiglottis
• Stratified squamous
epithelium
• aka Hypopharynx
 LARYNX
STRUCTURES
• Os hioid
• Tiroid Cartilage
• Crikoid Cartilage
• Epiglotic Cartilage
• Aritenoid Cartilage

Ligament & Membrane

• Tirohioid Membrane
• Hioepiglotic Ligament
• Krikotiroid Membrane
 LARYNX ANATOMY
Parts of :
• korda vokalis
• plika ventrikularis
• epiglotis
• komisura anterior
• komisura posterior
• plika ariepiglotika
• fosa piriformis
• kartilago aritenoid
• Post. Wall faring
• radiks linguae
• sinus Morgagni
• konus elastikus
 LARYNX ANATOMY
CARTILAGE :
• tiroid cartilage
• Krikoid c
• Epiglotis c
• Aritenoid c
 LARYNX ANATOMY
Muscle :
• Ekstrinsic muscle
• Intrinsic muscle

Intrinsik
• adduktor (5 )  move KV to medial
1. mm. krikoaritenoid lateral (d/s)
2. mm. tireoaritenoid (d/s) = m. vokalis
3. mm. krikotiroid
4. mm. interaritenoid obligus
5. mm. interaritenoid transversus
• abduktor  move KV to lateral
MUSCLE
Muscle
Vascular and nerve
 Three important functions
• The larynx serves three important functions in
humans. In order of functional priority, they are
protective, respiratory, and phonatory.
• In humans the protective and respiratory functions
are compromised in favor of its phonatory function.
• The protective function is entirely reflexive and
involuntary, whereas the respiratory and phonatory
functions are initiated voluntarily but regulated
involuntarily.
 Cough Reflex
• Cough ejects mucus and foreign matter from the
lungs and helps maintain patency of the pulmonary
alveoli. May be voluntary, but more often in
response to stimulation of receptors in the larynx or
lower respiratory tract.
• Three phases:
– inspiratory- larynx opens wide to permit rapid and
deep inspiration;
– compressive- tight closure of the glottis and
strong activation of expiratory muscles;
– expulsive- larynx opens widely and a sudden
outflow of air in the range of 6-10 liters/sec.
 Phonation
• The requirements of normal phonation are as
follows:
– Active respiratory support
– Adequate glottic closure
– Normal mucosal covering of the vocal cord
– Adequate control of vocal fold length and
tension.
THANK’S