1、Clinical anatomy & physiology of the earAnatomy of earLocated On both sides of cranial bone. Close with parietal bone, sphenoid bone and occipital boneComposition: squamaous, tympanic, mastoid and petrous parts + styloid processTemporal boneTemporal bone and its abutment1.Occipitomastoid suture 2.Sq
2、uamosomastoid suture3.Occipital bone4.Parietomastoid suture5.Squamous suture6.Parietal bone 7.Temporal bone8. Sphenosquamosal suture9. Frontal bone10.Spheoid bone11.Zygomatic bone12.Mandible 13.External acoustic meatusExternal surface of left tymporal bone in adult1.External acoustic meatus 2.Supram
3、eatal trinangle3.Squamous part 4.Mastoidale5.Tympanomastoid fissure6.Zygomatic process 7.Mandibular fossa8.Tymporal line 9.Tympanosquamous fissure 10. Styloid processInternal surface of left tymporal bone in adult11.Sulcus for middle meningeal artery12.Petrous bone 13. Inner acoustic meatus 14.Sigmo
4、id sulcus15.Sulcus for superior petrosal sinus16.Sulcus for inferior petrosal sinus17. Petrous apex 18 = Arcuate eminence19 = Inner orifice of internal carotid canal9.Notch of rivinus 10. Suprameatal spine11.Suprameatal triangle12.Temporal linef 13.Parietal notch 14.External acoustic foramen15.Masto
5、id part16.Occipital margin17.Sutura mastoideosquamalis18.Mastoid foramen19.Tympanomastoid fissure External surface of tymporal bone1.Margo parietalis2.Squamous part3.Temoral surface 4.Margo sphenoidalis 5.Processus retroarticularis6.Zygomatic process7.Articular tubercle8.Mandibular fossa20.Mastoid n
6、otch 21.Mastoid22.Petrotympanic fissure 23.Tympanic part24.Styloid processInternal surface of tymporal bone5.Posterior branch sulcus of middle meningeal artery6.Arcuate eminence 7.Groove for superior perosal sinus8.Internal auditory foramen 9.Styloid process1.Sutura petrosquamosa 2.Sigmoid sulcus 3.
7、Mastoid foramen 4.Orifice of vestibular aqueduct Inferior surface of tymporal bone1.Caroticotympanic canals2.Carotid canal 3.Tympanic canaliculus for jacobson nerve4.Sulcus of mastoid canaliculus 5.External aperture of aqueduct of cochlea6.Mastoid canaliculus for arnold nerve 7.Jugular fossa8.Zygoma
8、tic process9.Articular tubercle 10.Articular fossa of mandible 11.Tympanosquamous fissure12.Tympanic part 13.Styloid process 14.External acoustic foramen15.Styloimastoid foramen 16.Mastoid 17.Mastoid notch18.Sulcus for occipital artery 19.Mastoid partAnatomic relationship of fundus of internal acous
9、tic meatus3.Area of facial nerve4.Superior vestibular area5.Vertical crest6.Inferior vestibular area7.Haplopore8.Central canal of cochlea1.Transverse crest2.Cochlear area（Tractus spiralis foraminosus）External earAnatomy of external ear Pinna of ear anterior notch of ear External acoustic meatus 2.5-
10、3.5cm Lateral 1/3 : cartilage; medial 2/3: bone 2 stenosis：Juncture between bone and cartilage Isthmus of external acoustic meatus Anatomy of external ear1.Triangular fossa2.Cymba of auricular concha 3.Cavity of auricular concha4.Auricular concha5.Anterior incisure of ear 6.Tragus7.Intertragic notch
11、8.Ear lobe 9.Helix10.Superior crura of antihelix 11.Inferior crura of antihelix12.Auricular tubercle 13.Scaphoid fossa 14.Antihelix 15.Crus of helix 16.External acoustic meatus19.Antitragus Middle earAnatomy of middle ear Tympanic cavity Eustachian tube Tympanic sinus MastoidAnatomy of middle ear De
12、limitation according to membrane tensaAtticMesotympanumHypotympanumInternal surface of tympanic lateral wall1.Incudomallear articulation2.Superior ligament of malleus 3.Head of malleus 4.Tympanic attic5.Processus anterior mallei 6.Anterior fold of tympanic membrane 7.Anterior fossa of tympanic membr
13、ane 8.Cord of tympanum9.Eustachian tube 12.Body of incus13.Short crus of incus14.Tympanic antrum 15.Posterior ligament of incus in incudal fossa16. Posterior fold of tympanic membrane 17.Long crus of incus 18. Posterior fossa of tympanic membrane 19.Lenticular process of incus 20.Tympanichordal path
14、way 10.Limbus membranae tympani 11.Pars tensa21.Tensor tympani muscle 22.Handle of malleusTympanic membraneTympanic membrane(TM) semi-transparent film, 9*8*0.1mm3 flaccid part，tensa part 3 layered structure: Epithelial lamina Fibrous lamina Mucous laminaTM1.Flaccid part 2.Short process of malleus3.H
15、andle of malleus4.Tensa part 5.Light coneInternal wall of tympanum Internal wall of middle ear =lateral wall of inner ear Center - Promontorium tympani Posterosuperior vestibular window(oval window)-vestibule Posteroinferior cochlear window(round window)-Scala tympani Superior of vestibular window h
16、orizontal part of fallopian aqueduct Posterosuperior of fallopian aqueduct prominence of lateral semicircular canal Anterior of vestibular window cochleariform processInternal wall of tympanumGlomus jugulareCarotid arteryFossula of round windowTympanic membraneChorda tympani nerveIncusMalleusTensor
17、tympani muscleOstium tympanicum tubae auditivaeCanal for tensor tympani musclePromontorium tympaniTymporal lobeCochleariform processOrifice of chorda tympani nerveFicial nervePyramidal eminenceProminence of lateral semicircular canalProminence of facial canalStapedial footplateAditus ad antrumAnteri
18、or wall of tympanum Anterior wall of middle ear = carotid wall separated inferiorly by carotid 2 orifices in superior part: orifice of canalis tensor tympani (superior) orifice of semicanalis eustachii (inferior)Anterior wall of tympanum1.Tympanic attic 2.Stapes 3.Tegmen tympani 4.Tendon of tensor t
19、ympani muscle5.Cochleariform process6. Greater superficial petrosal nerve7.Lesser petrosal nerve 8.Bony septum of eustachian canal 9.Tensor tympani muscle10.Eustachian tube11.Carotid wall of tympanum12.Labyrinthine wall of tympanum13.Head of malleus 14.Superior ligament of malleus 15.Neck of malleus
20、 16.Anterior process and ligament of malleus 17. Lateral process of malleus(short process of malleus) 18.Handle of malleus19.Umbo of tympanic membrane20.Limbus membrane tympani 21.Fibrocartilaginous ring 22.Tympanic sulcusPosterior wall of tympanum Posterior wall - mastoid wall Superior orifice adit
21、us ad antrum Incudal fossa posterior junction of horizontal and vertical segment of fallopian aqueduct Height of vestibular window pyramidal eminence facial recess posterior tympanic approachPosterior wall of tympanum1.Stapes 2.Incus 3.Chorda tympani nerve 4.Facial recess 5.Chorda tympanic crest 6.
22、Chorda tympanic eminence 7.Pyramidal eminence 8.Lateral sinus tympani9.Styloid process eminence10.Malleus 11.Sinus tympani 12.Fossula of cochlear windowSuperior and inferior wall of tympanum Superior wall - tegmen tympani separated with temporal lobe in middle cranial fossa Petrosquamous suture in i
23、nfant is not close yet -infection of middle ear invade into cranium Posterior wall - Jugular wall separated with glomus jugulare if deletion of posterior wall blue drumContent of tympanumAuricular bone (the smallest bone): Malleus, incus, stapes ossicular chainLigament of auricular boneTympanic musc
24、le: tensor tympani muscle, stapedius muscleChorda tympani nerve1.Superior ligament of malleus 2.Anterior ligament of malleus3.Tensor tympani muscle4.Superior ligament of incus5.Posterior ligament of incus6.Stapedius muscleEustachian tubePassway between tympanum and nasopharynx.Lateral 1/3: bony part
25、, medial 2/3：cartilaginous parJunction between bony and cartilaginous: isthmusRegulate tympanic pressure1.Incus2.Tympanic membrane 3.Mandibular fossa4.Styloid process5.Carotid artery6.Tensor tympani muscle7.Pharyngeal opening of auditory tubeTympanic antrum1.Tympanic antrum2.Tygmen tympani 3.Lateral
26、 semicircular duct4.Fallpian aqueduct5.Vestibular window6.Canal for tensor tympani muscle7.Bony septum of eustachian canal8.Hiatus canalis facialis9.Carotid canal10.Bony part of auditory tube11.Promontorium tympani12.Pyramidal eminence13.Cochlear window14.Tympanic sulcus15.Stylomastoid foramen16.Mas
27、toid air cellMastoid Mastoid: intratemporal cells Typing: pneumatic type, dipoetic type, sclerotic type, mixed type Distribution: mastoidale group, perisigmoid group, antrodural group, perilabyrinthine group, epidural group, zygomatic group, perifacial group.Anatomy of inner ear labyrinth，including
28、receptor of auditory and equilibratory sensation Contain：bony and membrane labyrinth Perilymph：between bony and membrane labyrinth, KNa Endolymph: in endolymphatic labyrinth, KNaAnterolateral view of bony labyrinth Bony labyrinth: vestibule, semicircular canals,cochlea1.Anterior semicircular canal 2
29、.Common crus 3.Lateral bony ampulla 4.Crura ampullaria 5.Crus simplex 6.Lateral semicircular duct 7.Vestibular window 8.Posterior semicircular canal 9.Posterior bony ampulla10.Anterior bony ampulla11.Utricle 12.Sacculus13.Vestibule 14.Cupula of cochlea15.Cochlear middle cycle16.Cochlear top cycle 17
30、.Cochlear basic cycle18.Vestibular crest19.Cochlear windowInternal view of bony labyrinth1.Anterior semicircular canal2.Common crus 3.Lateral semicircular canal4.Posterior semicircular canal5.Pars ampullaris6.Orifice of vestibular aqueduct 7.Cochlear recess8.Orifice of common crus9.Utricular recess
31、10.Vestibular crest 11.Spherical recess 12.Cochlea 13.Scala tympani 14.Bony spiral lamina 15.Scala vestibuli 16.Orifice of cochlear aqueduct17. Cochlear windowVestibule Located between cochlea and semicircular canals Spherical recess, utricular recess Lateral wall: vestibular window, stapedial footp
32、lateBony semicircular canals 3 curved bony canals, perpendicularly, lateral,superior, posterior semicircular canals. Common crus: superior and posterior canals Position of semicircular canalsMembranous labyrinth Composition: Utricle, sacculus, membranous semicircular canals and membranous cochlear c
33、anal1.Anterior semicircular canal2.Common crus 3.Semicircular canal isthmus 4.Posterior semicircular canal5.Lateral semicircular canal6.Endolymphatic sac7.Pars ampullaris8.Utricle 9.Utricle duct10.Saccule 11.Saccule duct12.Union duct13.Vestibular cecum14.Semicircular canal sinus15.Pars ampullarisMem
34、branous labyrinth Utricle Sacculus Membranous semicircular canals Membranous cochlear canal: between bony spiral lamina and lateral wall of bony cochlear duct18.Basilar membrane 19.Cortis tunnel 20.inner and outer pillar cell 21. Scala tympani 22.tympanic pic 23.inner spiral sulcus1.Spiral limbus 2.
35、Vestibular lip 3.Internal beam of spiral ganglion4.Spiral ganglion 5.Scala vestibuli 6.Vestibular membrane 7.Inner hair cells 8.Outer hair cell 9.Tectorial membrane 10.Hensen cell11.Claudius cell12.Vestibular membrane crest 13.Stria vascularis 14.Spiral prominence 15.External spiral sulcus 16.Basila
36、r membrane 17. Spiral ligament of cochleaMembranous labyrinthBasilar membrane11.Claudius cell 12. Deiters cell 13.outer pillar cell 14.Cortis tunnel15.Basilar membrane 16.spiral vessel 17.inner pillar cell 18.tympanic lip 19.nerve fibers 20.arcuate zone 21.Pectinate zone1.Spiral limbus 2.Vestibular
37、lip 3.Tectorial membrane4. Outer hair cell 5.Outer tunnel 6.Henson cell7.Inner spiral sulcus 8.Marginal cell 9.Inner hair cell10.NueI interspace Membranous labyrinthModel of acoustic transduction1.Medial longitudinal bundle 2.Superior nucleus 3.Lateral nucleus 4.Medial nucleus5.Inferior nucleus 6.Ve
38、stibulospinal tract 7.Vestibular ganglionModel of acoustic transduction1.Auditory cortex 2.Dorsal acoustic striae3.Middle acoustic striae 4.Gastral acoustic striae5.Reticular formation 6.Medial geniculate body7.Inferior colliculus 8.Nucleus dorsalis9.Lateral lemniscus 10.Ventralis anterior11.Superio
39、r olivary nuclear complex 12.Cochlear dorsal nucleus13.Cochlear gastral nucleusCentral passway of vestibular nerve1.Auditory cortex 2.Brachium quadrigeminum inferius 3.Cochlea 4.Medial geniculate nucleus 5.Nucleus of inferior colliculus6.Nucleus of lateral lemniscus 7.Superior olivary nuclear comple
40、x8.Cochlear nucleusPhysiology of ear Auditory perception Equilibratory sensationSound afferent passway Air conduction： sound wave pinna of ear external acoustic meatus auditory ossicles vestibular window perilymph, endolymph Spiral organ of Corti acoustic nerve different levels of nucleus acoustic c
41、enterSound afferent passway Bone conduction translatory mode of bone conduction compressonal mode of bone conductionPhysiology of external ear Sound collection Distinguish direction Sympathetic vibration Protection Sound pressure amplificationPhysiology of middle ear Sound transformation and gain of
42、 middle ear Sound transmission and transformation structure: tympanic membrane and ossicular chainPhysiology of middle ear Effective vibrative aera: 55 mm2 , 2/3 of anatomic area. Stapedial footplate area: 3.2 mm2 , 1/17 of effective vibrative areaPressure = Force/areaArea of tympanic membrane 17 ar
43、ea stapesGain of area ratio 24 dBFunction Middle ear: amplification from area ratioEnergy loss at air-fluid interface-99.9% loss (-30 dB)Malleus longer than incus-amplify pressure 1.7X (+2 dB)Function of Middle earpressure amplification-ossicles Physiology of tympanic muscle Stapedius muscle Tensor
44、tympani musclePhysiology of eustachian tube Maintains pressure balance between middle ear and outside Drainage Prevent retrograde infection Prevent strong soundAuditory physiology Sound transduction Sound perceptionBasilar membrane displacement for a 1 kHz toneBasilar membrane displacement for a 250
45、 Hz toneBasilar membrane displacement for a 4 kHz tone Mass-increases from base (stapes) to apexStiffness-increases from apex to base1234Envelope of traveling waveCharacteristic frequencyCochlear mechanical response due mass and stiffness gradientStereocilia on OHCs attached to tectorial membraneSte
46、reocilia on IHCs free standingMotion of basilar membrane towards scala vestibuli deflects stereocilia in excitatory directionTectorial membrane deflects OHC stereociliaViscous fluid drag of fluid deflects IHC stereociliaModel: OHC contraction cause organ of Corti to distort as shown here Cell motili
47、ty feeds back enhancing basilar membrane motion thereby increasing traveling wave amplitude and making the “cochlea active”Cortis organ responds OHCs electromotionOHCPhysiology of quilibriumEquilibrium is the state of balance of the body. An erect standing human has a highly unstable equilibrium. Th
48、rough a variety of sensory inputs (vestibule,visual and so forth) and postural reflexes (proprioception), the body is maintained in its erect posture.Vestibule: Recognize linear acceleration by otolithic macula (utricle + saccule)Semicircular canal: receptor of positive and negateive angular accelerationThanks for your attention
