Ear, Temporal Bone, and Facial Nerve April 13, 2010 1.

Identify the bony features of the temporal bone related to the external, middle, and inner ear and describe the importance of each feature a. Mastoid process: attachment of SCM muscle; filled with MASTOID AIR CELLS b. Petrous part of the temporal bone: ridge between middle and posterior cranial fossas i. Contains middle and inner ear c. External auditory meatus: ends medially at the tympanic membrane d. Internal auditory meatus: exit for CN VII and VIII from the cranial cavity e. Stylomastoid foramen: end of facial canal through the temporal bone w/ CN VII 2. Describe the main parts, functions, and relationships of the external, middle, and internal ear Site of communication Posterior to VII going
of middle ear to posterior mastoid airs cells (network of epithelial-lined spaces in the mastoid process) through internal auditory

Skin covered cartilage that is moveable by facial expression mm.

Eardrum: slightly oval, transparent, attached to manubrium of malleus Canal is cartilage and bone

Filled by the footplate of the stapes w/ air on the lateral side and perilymph on the internal ear side

Shell-like spiral turns; contains VIII

Closed by the secondary tympanic membrane which moves in synchrony w/ Site of communication the stapes going of middle ear to in/out of the oval anterior nasopharynx window (i.e. it bulges outward)

3. List in order the anatomical elements that are encountered in sound transmission starting with sound waves approaching the auricle of the external ear and ending with the transmission of afferent nerve impulses carried by the cochlear nerve a. Sound waves enter the ear through the external auditory meatus b. The sound waves hit the tympanic membrane eardrum vibrates c. The vibrations cause the ossicles to move

d. This movement causes the footplate of the stapes to push in and out of the oval window e. Perilymph is displaced (pressure waves) through the scala vestibuli and the scala tympani f. As the perilymph is circulating, the endolymph is vibrated in the cochlear duct (scala media) moves hair cells generation of nerve impulse from the hair cells CN VIII g. The round window receives fluid waves and bulges out to provide fluid pressure relief 4. Name the nerves that supply the skin of the external ear and the mucous membrane of the middle ear, auditory canal, and mastoid antrum and air cells. a. Auriculotemporal nerve (V3)

Cutaneous nerves of the cervical plexus (C1-4 ventral rami)

External auditory meatus: V3, VII, IX, and X

5. List the structures that lie within the tympanic cavity that might be affected by an untreated infection that festers within the middle ear. Name the structures that course within the walls of the middle ear cavity that might be affected if the infection were to invade bone a. Tympanic membrane i. Manubrium (handle) of malleus attaches to its inner surface ii. Chorda tympani runs along its superior part of its inner surface iii. Skin and mucosa: lines Eustachian tube, tympanic cavity, inside of eardrum, and mastoid air cells 1. Innervated by CN IX b. Ear ossicles i. Malleus 1. Head: articulates w/ incus ii. Incus 1. Long process: articulates with stapes iii. Stapes

1. Footplate enters the oval window c. Eustachian tube i. Leads to nasopharynx; usually closed ii. Pops @ high altitudes when air accumulates in the middle ear and the tube suddenly opens iii. First structure to become inflamed w/ cold infection fluid builds up fluid gets infected with surrounding bacteria d. Walls of the middle ear i. Lateral wall = tympanic 1. Tympanic membrane, surrounding bone, external auditory meatus ii. Superior wall = roof 1. Middle cranial fossa iii. Medial wall = inner ear 1. Promontory (bulge of bone covering cochlea), oval/round windows iv. Inferior wall = jugular 1. Beginning of the internal jugular vein v. Anterior wall = carotid 1. Internal carotid artery (90 degree turn); opening to Eustachian tube vi. Posterior wall = mastoid 1. Mastoid air cells 6. Name the skeletal muscles that attach to the middle ear ossicles and discuss their function Muscle
Tensor tympani

Attachments
* medial wall of tympanic cavity goes medial to lateral posteriorly to attach to the manubrium of the malleus *Arises from posterior wall of tympanic cavity attaches to neck of the stapes

Innervat ion
V3

Function
Contracts w/ stapedius muscle to protect ear against high intensity sounds dampens vibrations of the eardrum Contracts w/ tensor tympani to protect ear dampens movements of the stapes in the oval window

Stapedius

VII

7. Describe the course of the facial nerve, name the components of each branch of the facial nerve, and discuss the specific structures innervated by each component

a. Course i. Internal auditory meatus geniculate ganglion walls of the middle ear cavity stylomastoid foramen b. Branches i. Chorda tympani 1. Arises from VII near stylomastoid foramen enters middle ear cavity crosses inside of eardrum exits middle ear cavity into infratemporal fossa thorugh bony fissure on medial side of mandibular fossa 2. Carries parasymp to submandibular/sublingual glands and taste to tongue ii. Greater petrosal nerve 1. Arises from geniculate ganglion goes forward through fissure to enter middle cranial fossa continues to pterygoid canal and pterygopalantine ganglion 2. Carries parasymp to lacrimal glands and nasal mucosa c. Nerve components i. Somatosensory: brainstem facial nerve facial canal through stylomastoid foramen innervates external auditory meatus ii. Somatomotor: motor nucleus of VII in brainstem facial nerve 1. Stapedius 2. Facial expression muscles 3. Posterior belly of digastrics; stylohyoid iii. Taste: brainstem facial nerve chorda tympani joins with lingual nerve (V3) synapses on anterior 2/3 of tongue iv. Parasympathetic: superior salivatory nucleus in brainstem DIVIDES into: 1. Greater petrosal nerve nerve of pterygopalatine ganglion lacrimal gland and nasal mucosa 2. Chorda tympani lingual nerve a. Sublingual gland b. Submandibular ganglion submandibular gland