EAR

Introduction
 For descriptive
purpose the ear
anatomy is
 divided into
External, middle
and inner ears.
Ear Introduction.
• Primarily concerned with balance &
hearing.
• The tympanic membrane separates the
first two parts.
• The Labyrinthine wall separates the last
two parts.
EAR INTRO.
 outer and middle are
concerned with the
transmission of sound
to the inner ear
 Inner ear converts
sound to fluid motion
and then to electrical
impulses (action
potentials)
EXTERNAL EAR
 Composed of Auricle
and External Acoustic
meatus.
 The Auricle collects
and directs sound into
the external acoustic
meatus.
 The External Acoustic
Meatus conducts
sound to the tympanic
membrane.
The External Auditory Canal
 Its an S-shaped canal
that extends from the
Concha to the
Tympanic Membrane.
 It measures about
2.5cm long in adults
 Consist of a wider
Lateral Cartilaginous
and a narrow medial
Osseous parts.
The External Auditory Canal
 Lateral Third: is
Cartilaginous and
contains: Hair
follicles, Ceruminous
glands and
Sebaceous glands
 Medial Two Thirds:
 Is Bony and Develops
after birth
The External Auditory Canal
 The lateral 1/3 is lined with skin that
continues with the auricular skin while the
medial 2/3 is lined by skin that continues
with that lining the lateral surface of the
Tympanic membrane
 It relates to the condyloid process of
Mandible anteriorly, mastoid air cells
posteriorly and middle cranial fossa
superiorly
THE EAR
 AURICLE OR PINNA
 Composed
i. Irregularly shaped elastic
cart. Covered by skin
ii. Medial and lateral surfaces
iii. Helix, the Superiorly
elevated margin
iv. Concha, the deepest
depression
v. Lobule, the non-
cartilaginous part
vi. Tragus, the projection
overlapping the opening of
the EAM.
Eustachian tube
 It connects the middle ear to the back of
the nose;
 it equalizes the pressure between the
middle ear and the air outside. When you
"pop" your ears as you change altitude
(going up a mountain or in an airplane),
you are equalizing the air pressure in your
middle ear.
The Eustachian  The Eustachian tube extends
from the anterior wall of the
tube
middle ear to the lateral wall
of the nasopharynx,
approximately at the level of
the inferior nasal concha.
 A portion of the tube (~1/3)
proximal to the middle ear is
made of bone; the rest is
composed of cartilage and
raises a tubal elevation,
the torus tubarius, in the
nasopharynx where it opens.
Eustachian tube is about 36mm long.
• its Lateral1/3rd is bony and Medial 2/3rd is cartilaginous
both portions meeting at an angle –isthmus.
 Embryologic development
And Muscles
 The tube is derived from the first pharyngeal pouch,
which during embryogenesis forms the tubotympanic
recess. The distal part of the tubotympanic sulcus gives
rise to the tympanic cavity, while the proximal tubular
structure becomes the Eustachian tube.
 Four muscles associated with its function
 Levator veli palatini (innervated by the vagus nerve)
 Salpingopharyngeus (innervated by the vagus nerve)
 Tensor tympani (innervated by the mandibular nerve)
 Tensor veli palatini (innervated by the mandibular nerve)
Auricular (VAN)
 Posterior and Anterior Auricular and Occipital Arteries

 Great auricular Nerve supplies the skin on the medial

surface and post. part of the lateral surface.

 Auriculotemporal nerve supplies the anterior part of the

lateral surface. Vagus and Facial Nerves also
contributes

 Lymph from superior half drains to superficial parotid,

mastiod, and deep cervical lymph nodes.
 Others drain into superficial cervical lymph nodes.
TYMPANIC MEMBRANE
 Tympanic membrane: (eardrum)
semitransparent, thin fibroelastic
connective tissue membrane, covered by
epidermis on the external side and a
simple low cuboidal mucous epithielium on
the inner side
TYMPANIC MEMBRANE
 It’s a thin, oval semitransparent membrane that
separates the external acoustic meatus from the
tympanic cavity.
 It’s about 1cm in diameter, with a concave lateral
surface and convex medial surface.
 The lateral surface faces laterally, slightly
interiorly and downwards.
 The lateral surface is covered by a thin skin
while the medial surface is covered by a mucous
membrane.
 TYMPANIC MEMBRANE
 An: annulus fibrosus
 Lpi: long process of incus
sometimes
 Um: umbo the end of the malleus
handle and the centre of the drum
 Lr: light reflex anteroinferioirly
 Lp: Lateral process of the malleus
 At: Attic also known as pars
flaccida
 Hm: handle of the malleus
Middle ear.
 The middle ear, an air-filled cavity behind
the ear drum
 Includes the three ear bones or ossicles:
the malleus (or hammer), incus (or anvil),
and stapes (or stirrup). (MIS)
 The opening of the Eustachian tube is also
within the middle ear.
TYMPANIC CAVITY
 It’s an irregular, laterally compressed air-filled
chamber in the petrous part of temporal bone.
 Functions.
i. its involved in the efficient transfer of energy from
the relatively weak vibration in the elastic,
compressible air in the Ext Acoustic Meatus to
overcome the inertia of the incompressible fluid
in the cochlear.
ii. It also equalizes pressure on both sides of the
tympanic membrane.
CONTENT OF TYMPANIC CAVITY
 i. Auditory ossicles – Malleus, incus,
stapes
 ii. Muscles – Tensor tympani, stapedius
 iii. Nerve – Chorda tympani nerve
which is a branch of facial nerve.
 iv. Tympanic plexus of nerves from
tympanic nerves, a branch of
glossopharyngeal nerve
 DIVISION
I. Tympanic cavity
proper - the larger
area opposite the
tympanic
membrane.
II. Epitympanic
recess - the
smaller area above
the tympanic
membrane
 I. Middle Ear Bones
 The ossicles (the
smallest bones in the
body) amplify the sound
20 X due to leverage
 advantage: sensitivity to
soft sounds
 Disadvantage; possible
damage to sensory cells
from loud sounds
 The ossicles
 Malleus: Attached to
tympanic membrane.
 Vibrations of membrane
are transmitted to the
stapes.
 Incus:(Anvil).
 Stapes: Attached to oval
window. It Vibrates in
response to vibrations in
tympanic membrane.
  The smallest skeletal muscle in
Muscles of the Middle the human body.
Ear (Stapedius)  Connects to the stapes (the
stirrup)
 When it contracts, it reduces the
action of the stapes (i.e., it
reduces amplification)
 It contracts just before speaking
and chewing because our own
speaking and chewing actually
could be loud enough to damage
the sensitive mechanisms of the
inner ear if the sounds were
further amplified.
 Nerve supply: branch of the
Facial Nerve (CN VII).
Tensor
 Inserts on the malleus
tympani and acts to tense the
tympanic membrane
reducing the
effectiveness of sound
transmission, protecting
the inner ear during loud
sounds.
 Innervation from a
branch of the
mandibular nerve (V3 of
CN V).
COMMUNICATION
 Posterosuperioly with mastoid antrum and through this
with mastoid air cells.
 Anteromedially with nasopharynx through the
pharyngotympanic tube.
BOUNDARIES
 Roof (tegmental
wall) formed by
tegmen tympani
and related to dura
on the floor of the
middle cranial
fossa.
BOUNDARIES
 Floor (jugular
Wall) formed by
a layer of bone
that separates
the cavity from
the bulb of the
internal jugular
vein.
Lateral wall (membranous wall) formed by the
tympanic membrane and lateral wall of
epitympympanic recess
Medial wall (labyrinthine wall) formed by the promontory of
the labyrinthine wall presents the (round window), closed
by the secondary tympanic membrane; the (oval
window), occupied by the base of the stapes; the
promontory, formed by the first turn of the cochlea; and
the prominence caused by the underlying canal for the
facial nerve
Anterior wall (carotid wall) separates the
tympanic cavity from the carotid canal. The
opening of the pharyngotympanic tube and the
canal for tensor tympani lies superiorly.
Posterior wall (mastiod wall) features the Aditus
to the mastoid antrum in its superior part.
A diagram representing the middle
ear as an opened-out box
INTERNAL EAR
 Its made up of a series of fluid-filled
cavities, sacs and ducts which contains
the Vestibulocochlear organ concerned
with reception of sound and maintenance
of balance.
 Its composed of Bony labyrinth (cavities),
Membranous Labyrinth (sacs & ducts) and
the surrounding Otic capsule ( bone).
 Perilymph and endolymph fill the bony and
membranous labyrinths respectively
BONY
LABYRINTH
The osseous labyrinth:
comprises the
vestibule, the
semicircular canals
and the cochlea.
The labyrinth itself
consists of spaces in
the petrous temporal
bone and it contains
the membranous
labyrinth
This bony labyrinth contains a fluid known
as perilymph and encloses the membranous
labyrinth
 The membranous labyrinth
 Comprises the utricle
and saccule (in the
vestibule), the
semicircular ducts (in
the semicircular
canals) and the duct
of the cochlea (in the
cochlea).
The membranous labyrinth
 The utricle and saccule are concerned
with the sense of position and
 the semicircular ducts are concerned with
the sensation of motion.
 The cochlear duct is the organ of hearing.
 All are supplied by the vestibulocochlear
nerve.
 In each component of the membranous
labyrinth there are specialized sensory
receptor areas known as the maculae of
the utricle and saccule, the ampullary
crests of the semicircular canals and the
spiral organ of Corti in the cochlea.
 The disposition of the semicircular canals
in three planes at right angles to each
other makes it well suited to signal
changes in position of the head.
 The organ of Corti is adapted to record the
sound vibrations transmitted by the stapes
at the oval window.
THE VESTIBULO-COCHLEAR
NERVE
The Valsalva Maneuver
 The Valsalva maneuver is performed by
attempting to forcibly exhale while keeping
the mouth and nose closed.
 This allows your ears to gently pop when
you are experiencing pressure changes
outside of your head such as when you
are flying (low pressure) or scuba diving
(higher pressure).
The Valsalva Maneuver
 Equalizing the pressure inside of your ears
is important when diving.
 When you do the VS maneuver, you are
allowing air from your sinus cavity into
your inner ear via your Eustachian tubes.
Failure to equalize causes pain and injury
to the eardrum.
Otitis media
 Otitis media is an infection or inflammation
of the middle ear.
 This inflammation often begins when
infections that cause sore throats, colds,
or other respiratory or breathing problems
spread to the middle ear.
Otitis media
 Almost half of these children will have
three or more ear infections during their
first 3 years.
 It can also affect adults. Air travelers and
divers suffer from it as well.