1. ANATOMY AND PHYSIOLOGY OF THE EAR Yard.Doc.Dr.Müzeyyen Doğan

2. Learning goal and objectives of the lesson Learning goal of the lesson: The learner should know the basic anatomic structures and physiology of external, middle and inner ear Learning objectives of the lesson the learner will be able to: identify the anatomic structures of the external, middle and inner ear identify the anatomic structures of the external, middle and inner ear identify the physiology of the external, middle and inner ear identify the physiology of the external, middle and inner ear identify the physiology of the hearing identify the physiology of the hearing identify the physiology of the balance identify the physiology of the balance Skill objectives the learner will be able to ear examination

5. OUTER EAR Consists of the auricle and EAM Consists of the auricle and EAM Skin-lined apparatus Skin-lined apparatus Approximately 2.5 cm in length Approximately 2.5 cm in length Ends at tympanic membrane Ends at tympanic membrane

6. OUTER EAR Auricle is mostly skin- lined cartilage Auricle is mostly skin- lined cartilage External auditory meatus External auditory meatus Cartilage: ~40% Cartilage: ~40% Bony: ~60% Bony: ~60% S-shaped S-shaped Narrowest portion at bony-cartilage junction Narrowest portion at bony-cartilage junction

7. Anatomy and Physiology EAC is related to various contiguous structures EAC is related to various contiguous structures Tympanic membrane Tympanic membrane Mastoid Mastoid Glenoid fossa Glenoid fossa Cranial fossa Cranial fossa Infratemporal fossa Infratemporal fossa

8. Anatomy and Physiology Squamous epithelium Squamous epithelium Bony skin – 0.2mm Bony skin – 0.2mm Cartilage skin Cartilage skin 0.5 to 1.0 mm 0.5 to 1.0 mm Apopilosebaceous unit Apopilosebaceous unit

9. The Middle Ear: A cleft within the temporal bone A cleft within the temporal bone Lining is mucous membrane Lining is mucous membrane Tympanic Membrane separates it from EAC Tympanic Membrane separates it from EAC Eustachian tube connects it to nasopharynx Eustachian tube connects it to nasopharynx Also Connected to Mastoid Air Cells Also Connected to Mastoid Air Cells

10. Middle Ear Structures 1- Malleus 2- Incus --Ossicles 3- Stapes 4- Tympanic Membrane (Eardrum) 5- Round Window 6- Eustachian Tube

11. Middle Ear Muscles 1. The Stapedius Attaches to Stapes,Contracts in Response to Loud sounds, chewing, speaking; Facial (VIIth cranial) nerve 2. The Tensor Tympani Helps open Eustachian tube

14. Ligaments of Middle Ear Function Function restrict and confine the effect of ossicles to act as a lever restrict and confine the effect of ossicles to act as a lever restrict movements to reduce the chance of damage to the inner ear restrict movements to reduce the chance of damage to the inner ear prevents distortion to sound prevents distortion to sound

15. Middle Ear Functions Impedance Matching Impedance Matching Filtering Filtering Acoustic Reflex Acoustic Reflex

16. Impedance Matching The middle ear allows the impedance matching of sound traveling in air to acoustic waves traveling in a system of fluids and membranes in the inner ear The middle ear allows the impedance matching of sound traveling in air to acoustic waves traveling in a system of fluids and membranes in the inner earimpedance matchingimpedance matching

17. Acoustic Reflex The movement of the ossicles may be stiffened by two muscles, the stapedius and tensor tympani, which are under the control of the facial nerve and trigeminal nerve, respectively. These muscles contract in response to loud sounds, thereby reducing the transmission of sound to the inner ear. This is called the acoustic reflex The movement of the ossicles may be stiffened by two muscles, the stapedius and tensor tympani, which are under the control of the facial nerve and trigeminal nerve, respectively. These muscles contract in response to loud sounds, thereby reducing the transmission of sound to the inner ear. This is called the acoustic reflexstapedius tensor tympanifacial nervetrigeminal nerve acoustic reflexstapedius tensor tympanifacial nervetrigeminal nerve acoustic reflex

18. Middle Ear Transmits Energy by Two Pathways:

19. MECHANISMS OF MIDDLE-EAR GAIN Acoustic Coupling Ossicular Coupling Area Difference (TM to footplate) Area Difference (TM to footplate) Lever Action (Malleus to Incus) Lever Action (Malleus to Incus)

20. Acoustic Coupling The collected pressure of sound vibration that strikes the tympanic membrane is therefore concentrated down to this much smaller area of the footplate, increasing the force but reducing the velocity and displacement, and thereby coupling the acoustic energy. The collected pressure of sound vibration that strikes the tympanic membrane is therefore concentrated down to this much smaller area of the footplate, increasing the force but reducing the velocity and displacement, and thereby coupling the acoustic energy.

21. Anatomy and Physiology Ossicular Amplifier System

22. MIDDLE-EAR GAIN The ossicles are classically supposed to mechanically convert the vibrations of the eardrum, into amplified pressure waves in the fluid of the cochlea (or inner ear) with a lever arm factor of 1.3. Since the area of the eardrum is about 17 fold larger than that of the oval window, the sound pressure is concentrated, leading to a pressure gain of at least 22. The ossicles are classically supposed to mechanically convert the vibrations of the eardrum, into amplified pressure waves in the fluid of the cochlea (or inner ear) with a lever arm factor of 1.3. Since the area of the eardrum is about 17 fold larger than that of the oval window, the sound pressure is concentrated, leading to a pressure gain of at least 22. eardrumcochleainner earoval window eardrumcochleainner earoval window

23. Function of Middle Ear Conduction Conduction Conduct sound from the outer ear to the inner ear Conduct sound from the outer ear to the inner ear Protection Protection Creates a barrier that protects the middle and inner areas from foreign objects Creates a barrier that protects the middle and inner areas from foreign objects Middle ear muscles may provide protection from loud sounds Middle ear muscles may provide protection from loud sounds Transducer Transducer Converts acoustic energy to mechanical energy Converts acoustic energy to mechanical energy Converts mechanical energy to hydraulic energy Converts mechanical energy to hydraulic energy Amplifier Amplifier Transformer action of the middle ear Transformer action of the middle ear only about 1/1000 of the acoustic energy in air would be transmitted to the inner-ear fluids (about 30 dB hearing loss) only about 1/1000 of the acoustic energy in air would be transmitted to the inner-ear fluids (about 30 dB hearing loss)

24. Ear

25. INNER EAR INNER EAR : Cochlea – hearing Cochlea – hearing Vestibule – static equilibrium Vestibule – static equilibrium Semicircular canals – dynamic equilibrium Semicircular canals – dynamic equilibrium

35. OHC vs. IHC Function Vestibulocochlear nerve – cranial nerve VIII Vestibulocochlear nerve – cranial nerve VIII Audible range: 20 -- 20,000 hertz Audible range: 20 -- 20,000 hertz Ossicles amplify sound 22 X Ossicles amplify sound 22 X Some nerve fibers cross over to opposite side of brain Some nerve fibers cross over to opposite side of brain

36. Hair Cells Outer Hair Cells Outer Hair Cells Inner Hair Cells Inner Hair Cells OHC movie OHC movie OHC movie OHC movie

37. OCH Cilia Theory: Tip-links <<<IHC OHC >>>

38. Equilibrium – Balance Static equilibrium – maintenance of body posture relative to gravity while the body is still. Dynamic equilibrium – maintenance of the body posture (mainly the head) in response to sudden movements. Tracking a moving object.

39. Static Equilibrium Inside the vestibule are two chambers : utricle and saccule. Regions of hair cells and supporting cells called maculae. Otoliths – “ear rocks”

43. Dynamic Equilibrium Semicircular canals In ampulla is the crista ampullaris – contains hair cells and supporting cells covered by a gelatinous mass called the cupula. Neurological connections between eyes and semicircular canals – for tracking Nystagmus