Anatomy and Physiology of Hearing Anatomy External Ear • Pinna (auricle) • External auditory canal • Tympanic Membrane External Ear • • • • • • Auricle funnel-shaped elastic cartilage Except lobule Anterior : Zygomatic process Superior : bony external meatus Posterior : mastoid process http://users.bergen.org/dondew/bio/AnP/AnP1/AnP1Tri2/FIGS/EARS/03hearing.html External Ear • ectodermal and mesodermal of 1st and 2nd branchial arches • 1st branchial arch : tragus and most of the helix • 2nd branchial arch : antihelix, antitragus, lobule, and inferior helix External Ear • • • • External auditory canal : Posterosuperior wall 2.5 cm long Anteroinferior wall 3.1 cm long lateral 1/3 : cartilage ,cerumenproducing glands and hair follicles • medial 2/3 : bone External Ear • Fissures of Santorini • Inconstant fissure filled with connective tissue occur in cartilaginous part of EAC • meatus to the superficial mastoid , parotid gland http://www.sciencedirect.com/science/article/pii/S0009926006000444 External Ear • Foramen of Huschke • Bony part of EAC is deficient anteroinferior • produces an opening into the infratemporal region • meatus to the deep lobe of the parotid gland http://www.scielo.br/scielo.php?pid=S0100-39842006000400009&script=sci_arttext&tlng=en External Ear • dorsal portion of 1st branchial cleft, which extends toward and eventually makes contact with endoderm of the expanding tubotympanic recess. External Ear • Blood supply • Auricle : posterior auricular and small auricular rami of superficial temporal vessels. (external carotid artery) External Ear • Blood supply • EAC : posterior auricular , auricular rami of superficial temporal vessels , deep auricular artery (1st part of maxillary artery) External Ear • • • • Lymphatic drainage Parotid node Superficial cervical node Retroauricular node External Ear • Innervation • Auriculotemporal branch of the trigeminal nerve • Cutaneous branch of cervical plexus - great auricular nerve (C2,C3) - lesser occipital nerve (C2,C3 ) • Auricular branch of vagus nerve (nerve of Arnold) • CN 7,9 Tympanic Membrane • medial wall of the EAC • lateral wall of the middle ear • Protects middle ear space from foreign material • Maintains air cushion that prevents insufflation of foreign material from the nasopharynx. 8-9 mm. 9-10mm. Tympanic Membrane • 4 layer, concave-shaped 1. Squamous epithelium 2. Radiating fibrous layer 3. Circular fibrous layer 4. Mucosa layer • Pars flaccida or Shrapnell's membrane • Pars tensa Tympanic Membrane • Blood supply • Small peripheral vascular ring formed by deep auricular branch of maxillary artery • Anterior tympanic branch of maxillary artery • Stylomastoid branch of posterior auricular artery http://otoscopy.hawkelibrary.com/album06/Anat_10_D Tympanic Membrane • Sensory innervation • Outer surface - Auriculotemporal branch of trigeminal nerve - Auricular branch of vagus nerve • Inner surface : Tympanic plexus Middle Ear • transmits acoustic energy from the air-filled EAC to the fluid-filled cochlea • Tympanic cavity Middle Ear • Tympanic cavity • Cavum tympani, Tympanum proper, middle ear cavity • Temporal bone • Bones of Middle ear • Eustachian tube Middle Ear • • • • Bones of Middle ear Malleus Incus Stapes Middle Ear • 2 striated muscles : smallest , high innervation ratio - tensor tympani :attaches to malleus , trigeminal nerve - stapedius : attaches to stapes , stapedial branch of facial nerve. Middle Ear • 1st Arch (Mandibular Arch) - Malleus head and neck - Incus body and short process - Tensor tympani • 2nd Arch (Hyoid Arch) - Stapes - Malleus manubrium - Incus long process - Facial expression - stapedius Middle Ear • Artery • Anterior tympanic artery (the maxillary artery) • Inferior tympanic artery (derived from ascending pharyngeal artery) • Stylomastoid artery (posterior auricular artery) • Posterior tympanic artery • Middle meningeal artery (Maxillary artery) • Caroticotympanic artery (Internal carotid artery) Middle Ear • Vein • Ptergoid plexus • Superior petrosal sinus • Lymphatic • Retropharyngeal , Parotid lymph node Middle Ear • Innervation • Tympanic plexus Middle Ear • Eustachian tube is the conduit through which air is exchanged between middle ear space and upper aerodigestive tract. • 45 degrees , 17-18mm. at birth grows to 35mm. in adult • proximal 1/3 (11mm.) • distal 2/3 (24mm.) Middle Ear • • • • • • Blood supply Maxillary artery Ascending pharyngeal artery Ascending palatine branch of facial artery Superior tympanic branch of middle meningeal artery Artery of pterygoid canal Middle Ear • • • • Innervation Tympanic plexus Chorda tympani Mandibular nerve Inner Ear • Osseous labyrinth • Membranous labyrinth Inner Ear • • • • • Osseous labyrinth Bony Vestibule Semicircular canal Cochlea Inner Ear • Cochlea : 35 mm long • Snail-shaped cavity within mastoid bone • 2 ½ turns, 3 fluid-filled chambers Inner Ear • • • • • • • Membranous labyrinth Semicircular ducts Utricle Saccule Utriculosaccular duct Endolymphatic duct , sac Cochlear duct Inner Ear • Cochlear duct Inner Ear • Cochlear duct • Organ of Corti Inner Ear • Outer hair cell • Inner hair cell • Outer and inner hair cells : mechanical (acoustic) energy -> electrical (neural) energy Inner Ear • Artery • Internal auditory artery (anterior inferior cerebellar artery 83% , basillar artery 17%) Inner Ear • Vein • Vestibular vein • Spiral vein • Lymphatic • Not usually described Inner Ear • • • • Innervation Vestibulocochlear nerve (CN 8) Vestibular nerve Cochlear nerve Physiology Physiology External Ear • External ear : 15 dB gain (3kHz), 10 dB gain (2-5kHz) • Concha : resonant frequency 5 kHz • EAC : resonant frequency 3.5 kHz External Ear • NIHL occur first and most prominently at the 4kHz (boilermaker notch). External Ear • >2 kHz : head shadow effect , interaural intensity differences of 5-15 dB • <2 kHz : Interaural time differences ~0.6 ms Middle Ear • low impedance of air ->high impedance of the fluid-filled cochlea • Impedance match : 25-30 dB 1. area ratio = 17-20 times , 26 dB 2. lever ratio = 1:1.3 times , 2.3 dB 3. shape of TM Middle Ear • One function of the middle ear muscles is to protect the cochlea from loud sounds (>80 dB SPL ,low-frequency (<2 kHz)) :CN V and VII Inner Ear • Oval window -> cochlea -> scala vestibuli -> Helicotrema -> scala tympani -> round window Inner Ear • Organ of Corti • cochlear amplifier : outer hair cells , stereocilia ,tectorial membrane Inner Ear • Organ of Corti • Na-K-ATPase pumps Inner Ear • Organ of Corti Inner Ear • Cochlea • Transduction: displacement of the basilar membrane in response to displacement of the stapes due to acoustic energy • basilar membrane (base ,apex) Auditory cortex • Primary auditory cortex : area A1 , Brodmann’s area 41 • Associated auditory cortex : area A2 , Broadmann’s area 22,42