The Ear

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The Ear

• The ear contains the vestibulocochlear organ and consists of three main parts: external, middle, and internal.
• It has two functions, balance and hearing.

• The tympanic membrane (eardrum) separates the external ear from the middle ear.
• The auditory tube joins the middle ear or tympanic cavity to the nasopharynx.

The External Ear

• The auricle (L. auris, ear) is the visible, shell-like part of the external ear.
• It consists of a single elastic cartilage that is covered on both surfaces with thin, hairy skin.
• The external ear contains hairs, sweat glands, and sebaceous glands.
• The cartilage is irregularly ridged and hollowed, which gives the auricle its shell-like form.
• It also shapes the orifice of the external acoustic meatus.

The Ear Lobule (p. 763)

• The ear lobule (earlobe) consists of fibrous tissue, fat and blood vessels that are covered with skin.
• The arteries are derived mainly from the posterior auricular artery and the superficial temporal artery.
• The skin of the auricle is supplied by the great auricular and auriculotemporal nerves.

• The great auricular nerve supplies the superior surface and the lateral surface inferior to the external acoustic meatus with nerve fibres from C2.
• The auriculotemporal nerve supplies the skin of the auricle superior to the external acoustic meatus.

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The External Acoustic Meatus (pp. 763, 765)

• This passage extends from the concha (L. shell) of the auricle to the tympanic membrane (L. tympanum, tambourine). It is about 2.5 cm long in adults.
• The lateral 1/3 of the S-shaped canal is cartilaginous, whereas its medial 2/3 is bony.

• The lateral third of the meatus is lined with the skin of the auricle and contains hair follicles, sebaceous glands, and ceruminous glands.
• The latter glands produce cerumen (L. cera, wax).

• The medial two-thirds of the meatus is lined with very thin skin that is continuous with the external layer of the tympanic membrane.

• The lateral end of the meatus is the widest part. It has the diameter about that of a pencil.
• The meatus becomes narrow at its medial end, about 4 mm from the tympanic membrane.
• The constricted bony part is called the isthmus.

• Innervation of the external acoustic meatus is derived from three cranial nerves:

1. The auricular branch of the auriculotemporal nerve (derived from the mandibular, CN V³).
2. The facial nerve (CN VII) by the branches from the tympanic plexus.
3. The auricular branch of the vagus nerve (CN X).

The Tympanic Membrane (p. 765)

• This is a thin, semi-transparent, oval membrane at the medial end of the external acoustic meatus.
• It forms a partition between the external and middle ears.
• The tympanic membrane is a thin fibrous membrane, that is covered with very thin skin externally and mucous membrane internally.

• The tympanic membrane shows a concavity toward the meatus with a central depression, the umbo, which is formed by the end of the handle of the malleus.
• From the umbo, a bright area referred to as the cone of light, radiates anteroinferiorly.

• The external surface of the tympanic membrane is supplied by the auriculotemporal nerve.
• Some innervation is supplied by a small auricular branch of the vagus nerve (CN X); this nerve may also contain some glossopharyngeal and facial nerve fibres.

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The Middle Ear

Click here for a schematic of the tympanic cavity or middle ear.

• This part of the ear is in a narrow cavity in the petrous part of the temporal bone.
• It contains air, three auditory ossicles, a nerve and two small muscles.
• The middle ear is separated from the external acoustic meatus by the tympanic membrane.

• This cavity includes the tympanic cavity proper, the space directly internal to the tympanic membrane, and the epitympanic recess, the space superior to it.

• The middle ear is connected anteriorly with the nasopharynx by the auditory tube.
• Posterosuperiorly, the tympanic cavity connects with the mastoid cells through the aditus ad antrum (mastoid antrum).
• The tympanic cavity is lined with mucous membrane that is continuous with the mucous membrane of the auditory tube, mastoid cells, and aditus ad antrum.

Contents of the Tympanic Cavity or Middle Ear (p. 769)

• This cavity contains the auditory ossicles (malleus, incus and stapes); the stapedius and tensor tympani muscles; the chorda tympani nerve (a branch of the facial nerve, CN VII); and the tympanic plexus of nerves.

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Walls of the Tympanic Cavity or Middle Ear (pp. 769, 771-2)

• This cavity is shaped like a narrow six-sided box that has convex medial and lateral walls.
• It has the shape of the biconcave lens in cross-section (like a red blood cell).

The Roof or Tegmental Wall (p. 769)

• This is formed by a thin plate of bone, called the tegmen tympani (L. tegmen, roof).
• It separates the tympanic cavity from the dura on the floor of middle cranial fossa.
• The tegmen tympani also covers the aditus ad antrum.

The Floor or Jugular Wall (p. 769)

• This wall is thicker than the roof.
• It separates the tympanic cavity from the superior bulb of the internal jugular vein. The internal jugular vein and the internal carotid artery diverge at the floor of the tympanic cavity.

• The tympanic nerve, a branch of the glossopharyngeal nerve (CN IX), passes through an aperture in the floor of the tympanic cavity and its branches form the tympanic plexus.

The Lateral or Membranous Wall (p. 769)

• This is formed almost entirely by the tympanic membrane.
• Superiorly it is formed by the lateral bony wall of the epitympanic recess.
• The handle of the malleus is incorporated in the tympanic membrane, and its head extends into the epitympanic recess.

The Medial or Labyrinthine Wall (pp. 769, 771)

• This separates the middle ear from the membranous labyrinth (semicircular ducts and cochlear duct) encased in the bony labyrinth.
• The medial wall of the tympanic cavity exhibits several important features.

• Centrally, opposite the tympanic membrane, there is a rounded promontory (L. eminence) formed by the first turn of the cochlea.
• The tympanic plexus of nerves, lying on the promontory, is formed by fibres of the facial and glossopharyngeal nerves.

• The medial wall of the tympanic cavity also has two small apertures or windows.

• The fenestra vestibuli (oval window) is closed by the base of the stapes, which is bound to its margins by an annular ligament.
• Through this window, vibrations of the stapes are transmitted to the perilymph window within the bony labyrinth of the inner ear.

• The fenestra cochleae (round window) is inferior to the fenestra vestibuli.
• This is closed by a second tympanic membrane.

The Posterior or Mastoid Wall (p. 771)

• This wall has several openings in it.
• In its superior part is the aditus ad antrum (mastoid antrum), which leads posteriorly from the epitympanic recess to the mastoid cells.

• Inferiorly is a pinpoint aperture on the apex of a tiny, hollow projection of bone, called the pyramidal eminence (pyramid).
• This eminence contains the stapedius muscle.
• Its aperture transmits the tendon of the stapedius, which enters the tympanic cavity and inserts into the stapes.

• Lateral to the pyramid, there is an aperture through which the chorda tympani nerve, a branch of the facial nerve (CN VII), enters the tympanic cavity.

The Anterior Wall or Carotid Wall (pp. 771-2)

• This wall is a narrow as the medial and lateral walls converge anteriorly.
• There are two openings in the anterior wall.

• The superior opening communicates with a canal occupied by the tensor tympani muscle.
• Its tendon inserts into the handle of the malleus and keeps the tympanic membrane tense.

• Inferiorly, the tympanic cavity communicates with the nasopharynx through the auditory tube.

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The Auditory Tube (p. 772)

• This is a funnel-shaped tube connecting the nasopharynx to the tympanic cavity.

• Its wide end is towards the nasopharynx, where it opens posterior to the inferior meatus of the nasal cavity.
• The auditory tube is 3.5 to 4 cm long; its posterior 1/3 is bony and the other 2/3 is cartilaginous.
• It bony part lies in a groove on the inferior aspect of the base of the skull, between the petrous part of the temporal bone and the greater wing of the sphenoid bone.

• The function of the auditory tube is to equalise pressure of the middle ear with atmospheric pressure.

The Auditory Ossicles (p. 772)

The Malleus (p. 772)

• Its superior part, the head, lies in the epitympanic recess.
• The head articulates with the incus.

• The neck, lies against the flaccid part of the tympanic membrane.
• The chorda tympani nerve crosses the medial surface of the neck of the malleus.

• The handle of the malleus (L. hammer) is embedded in the tympanic membrane and moves with it.
• The tendon of the tensor tympani muscle inserts into the handle.

The Incus (p. 772)

• Its large body lies in the epitympanic recess where it articulates with the head of the malleus.
• The long process of the incus (L. an anvil) articulates with the stapes.
• The short process is connected by a ligament to the posterior wall of the tympanic cavity.

The Stapes (p. 772)

• The base (footplate) of the stapes (L. a stirrup), the smallest ossicle, fits into the fenestra vestibuli or oval window on the medial wall of the tympanic cavity.

Functions of the Auditory Ossicles (p. 772)

• The auditory ossicles increase the force but decrease the amplitude of the vibrations transmitted from the tympanic membrane.

Muscles Moving the Auditory Ossicles

The Tensor Tympani Muscle (p. 773)

• This muscle is about 2 cm long.

• Origin: superior surface of the cartilaginous part of the auditory tube, the greater wing of the sphenoid bone, and the petrous part of the temporal bone.
• Insertion: handle of the malleus.
• Innervation: mandibular nerve (CN V³) through the nerve to medial pterygoid.

• The tensor tympani muscle pulls the handle of the malleus medially, tensing the tympanic membrane, and reducing the amplitude of its oscillations.
• This tends to prevent damage to the internal ear when one is exposed to load sounds.

The Stapedius Muscle (p. 773)

• This tiny muscle is in the pyramidal eminence or the pyramid.

• Origin: pyramidal eminence on the posterior wall of the tympanic cavity. Its tendon enters the tympanic cavity by traversing a pinpoint foramen in the apex of the pyramid.
• Insertion: neck of the stapes.
• Innervation: nerve to the stapedius muscle, which arises from the facial nerve (CN VII).

• The stapedius muscle pulls the stapes posteriorly and tilts its base in the fenestra vestibuli or oval window, thereby tightening the anular ligament and reducing the oscillatory range.
• It also prevents excessive movement of the stapes.

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Internal Ear

• Osseous labyrinth: a complex system of cavities in the substance of the petrous bone.
• Membranous labyrinth: filled with endolymph, bathed in perilymph.

• Note (quotation from Anatomy Class Notes): "The students are not required to know in detail about the inner ear, apart from the fact that it is made up of the vestibule (utricle, saccule, and 3 semicircular canals for perception of position and movement of the head, vestibular portion of CN VIII) and the cochlea for hearing (cochlear portion CN VIII). Only a basic understanding of the structure of the cochlea and its role in hearing is required (Refer to Moore p. 775)."

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