Anatomy of the Ear

Perry C. Hanavan, Au.D. Audiologist

Major Divisions of the Ear

Peripheral Mechanism Central Mechanism

VIII Outer Middle Inner Cranial Ear Ear Ear Nerve

Brain

Question
What is the purpose of the pinna? A. Cosmetics B. Sound collector C. Same side localization D. A and B E. A, B and C

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Outer Ear
Virtual Tour of the Ear

Pinna

Pinna

Preauricular Tags Preauricular Pits

EAM

External Auditory Meatus

Cerumen

Q-tips
Microtia Anotia

Function
EAM resonance

Atresia

Pinna

Question
Another name for pinna? A. External auditory meatus B. External auditory canal C. Ear lobe D. Auricle E. None of the above

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Function of Outer Ear

Collect sound Localization Resonator Protection Sensitive (earlobe) Other?

Pinna
The visible portion that is commonly referred to as "the ear" Helps localize sound sources Directs sound into the ear Each individual's pinna creates a distinctive imprint on the acoustic wave traveling into the auditory canal

External Auditory Meatus

Extends from the pinna to the tympanic membrane
About 26 millimeters (mm) in length and 7 mm in diameter in adult ear. Size and shape vary among individuals.

Protects the eardrum Resonator

Provides about 10 decibels (dB) of gain to the eardrum at around 3,300 Hertz (Hz).

The net effect of the head, pinna, and ear canal is that sounds in the 2,000 to 4,000 Hz region are amplified by 10 to 15 dB.
Sensitivity to sounds greatest in this frequency region Noises in this range are the most hazardous to hearing

Outer Ear Resonance

Influence of pinna (p) Influence of ear canal (m) Combine influence (t) At 3000 Hz, the final amplification (t) is 20 dB

Question
Cerumen should be routinely removed from the ear canal? A. True B. False
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Cerumen
The purpose of wax:
Repel water Trap dust, sand particles, microorganisms, and other debris Moisturize epithelium in ear canal Odor discourages insects Antibiotic, antiviral, antifungal properties Cleanse ear canal

Embryological Development
External Ear Development

Disorders of the Outer Ear

Accessory auricle Additional pinna or auricular tissue

Anotia
Cleft pinna Coloboma lobuli Macrotia Microtia Melotia Low-set-ears Polyotia Preauricular tags Scroll ear

Congenital absence of pinna

Congenital fissure of the pinna Congenital fissure of the earlobe Congenital excessive enlargement of the auricle Congenital small pinna Congenital displacement of the pinna Congenitally displaced pinna Additional pinna on one or both sides Small appendage anterior to pinna Rim (helix) of pinna is rolled forward and inward

Outer Ear Hearing Disorders

Outer ear CHARGE Down Syndrome
Ears small and low set

Fetal Alcohol Syndrome

Deformed ears

DiGeorge syndrome
Low set ears

External Ear Care

Hazardous to health: Ear candling Swabs Foreign objects

Time of Onset
Congenital Present at birth

Acquired
Adventitious Acute Chronic Sudden Gradual Temporary Permanent Progressive Fluctuating

Occurring after birth

Occurring after birth Sudden onset or short duration Long duration Rapid onset Occurring slowly Limited duration Irreversible Increasing in degree over time Increasing and decreasing in degree of loss

Middle Ear
The function of the middle ear is to? A. Cause middle ear infections in young children B. Amplify sounds C. Interpret sounds D. Analyze sounds Senteo Question E. None of the above

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Middle Ear
The Eustachian tube is a part of the middle ear? A. No, it is a part of the inner ear B. No, it isnt part of the hearing mechanism C. Yes D. I dont know Senteo Question
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Middle Ear

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Which is not true? A. There are two middle ear muscles B. There are three ossicles C. There are three layers of tympanic membrane tissue D. The acoustic reflex occurs from soft sounds E. The stapes is the smallest bone in the human body

Middle Ear
Virtual Tour of the Ear

Middle Ear Cavity

Tympanic Cavity Tympanic Membrane Ossicles Middle Ear Muscles Eustachian Tube Mastoid

Ossicles Middle Ear Muscles

Mastoid
Eustachian Tube Function Amplifier

Cholesteatoma
Temporal bone fractures Otitis Media PE tubes Otosclerosis

Function of Middle Ear

Conduction
Conduct sound from the outer ear to the inner ear

Protection
Creates a barrier that protects the middle and inner areas from foreign objects Middle ear muscles may provide protection from loud sounds

Transducer
Converts acoustic energy to mechanical energy Converts mechanical energy to hydraulic energy

Amplifier
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)

The middle ear:

A. Converts acoustic energy to hydraulic B. Converts hydraulic energy to mechanical C. Converts acoustic energy to mechanical D. Converts acoustic energy to electrical E. Converts mechanical to electrical
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Middle Ear
Tympanum: Timpani, or kettledrums, are musical instruments in the percussion family. A type of drum, they consist of a skin called a head stretched over a large bowl commonly made of copper. They are played by striking the head with a special drum stick called a timpani stick. Timpani evolved from military drums to become a staple of the classical orchestra in the 17th century. Today, they are used in many types of musical ensembles including classical orchestra

Tympanic Membrane
The eardrum separates the outer ear from the middle ear Creates a barrier that protects the middle and inner areas from foreign objects Cone-shaped in appearance
about 17.5 mm in diameter

The eardrum vibrates in response to sound pressure waves. The membrane movement is incredibly small
as little as one-billionth of a centimeter

The pars tensa portion of the TM:

A. Consists of 2 layers of tissue B. Consists of 4 layers of tissue C. Consists of 1 layer of tissue D. Consists of 3 layers of tissue E. Consists of 5 layers of tissue
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Eustachian Tube
The eustachian tube connects the front wall of the middle ear with the nasopharynx The eustachian tube also operates like a valve, which opens during swallowing and yawning
This equalizes the pressure on either side of the eardrum, which is necessary for optimal hearing. Without this function, a difference between the static pressure in the middle ear and the outside pressure may develop, causing the eardrum to displace inward or outward
This reduces the efficiency of the middle ear and less acoustic energy will be transmitted to the inner ear.

The Eustachian tube:

A. Opens when one yawns B. Opens when one smiles C. Opens when one blinks D. It is always open E. Never opens
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Ossicles
Malleus (hammer) Incus (anvil) Stapes (stirrup) smallest bone of the body

The middle ear amplifies sound:

A. About 15 dB B. About 25 dB C. About 35 dB D. About 20 dB E. About 30 dB
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Transformer/Amplifier
Transform the vibrating motion of the eardrum into motion of the stapes. The middle ear enhances the transfer of acoustical energy in two ways:
The area of the eardrum is about 17 times larger than the oval window
The effective pressure (force per unit area) is increased by this amount.

The ossicles produce a lever action that further amplifies the pressure

Without the transformer action of middle ear, about 1/1000 of acoustic energy in air transmitted to inner-ear fluids (about 30 dB loss). Malleus and incus vibrate together, transmitting the sound waves from the eardrum to the footplate of the stapes (this pushes the oval window in and out)(mechanical energy)

Transformer/Amplifier
Area ratio
Thumbtack

Lever
crowbar

Which provides the most amplification in the middle ear?

A. The lever hypothesis B. The area/ratio hypothesis C. The Hanavan principle D. I dont know E. None of the above
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Middle Ear Muscles

Tensor tympani
Attached to malleus Innervated by V, trigeminal nerve

Stapedius
Attached to stapes Innervated by VII, facial nerve

Middle Ear Muscle Function:

Help maintain ossicles in proper position Protect inner ear from excessive sound levels
When ear exposed to sound levels above 70 dB, the muscles contract, decreasing amount of energy transferred to inner ear

This protective reflex termed "acoustic reflex"

The VII cranial nerve innervates:

A. Tensor tympani muscle B. Incus C. Stapedial muscle D. Malleus E. Stapes
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The tensor tympani:

A. Innervated by the facial nerve B. Innervated by the trigeminal nerve C. Innervated by the VII cranial nerve D. Innervated by the VIII cranial nerve E. Innervated by the VI cranial nerve
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Ligaments of Middle Ear

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

Mastoid

Mastitis
A. Inflammation of the mastoid B. Inflammation of the breast C. Cancer of the mast cells D. A and B E. B and C
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Question
The correct order of the ossicles from the TM to inner ear is? A. Anvil, hammer, stapes B. Hammer, incus, anvil C. Hammer, anvil, stapes D. Stapes, anvil, hammer Senteo Question E. Malleus, stapes, incus

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Development of Middle Ear

Middle Ear Development

Middle Ear Disorders

Middle Ear disorders
Acute otitis media Otosclerosis Disarticulation Mastoiditis Tympanosclerosis OME TM Perforation TM Retraction Cholesteatoma

Down Syndrome Treacher Collins Syndrome BOR Syndrome

OM/OME

Cholesteatoma

Otosclerosis
Develops most frequently between ages of 10 and 30. About 1015% of patients have unilateral loss. Affects women more frequently than men by a ratio of 2:1. Pregnancy once thought to be a risk factor for the development and / or worsening of otosclerosisrecent studies have disputed this. May progress to nerve deafness called cochlear otosclerosis.

Question
The Amy Tan syndrome is: A. Down syndrome B. BOR syndrome C. Treacher Collins syndrome D. Measles syndrome E. Waardenburg syndrome

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Question
The function of the inner ear: A. Balance B. Hearing C. Touch D. All the above E. A and B

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Inner Ear
Virtual Tour of the Ear
Vestibular
semicircular canals

Auditory

utricle and saccule

Cochlear
traveling wave

Vestibular

traveling wave traveling wave pathologies

Function of Inner Ear

Convert mechanical sound waves to neural impulses that can be recognized by the brain for:
Hearing Balance

Balance
Linear motion Rotary motion

Question
Which is true about the inner ear and balance?
A. The semicircular canals detect linear motion B. The utricle and saccule detect linear motion C. The cochlea detects linear motion Senteo Question D. The utricle and saccule detect rotary motion

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Cochlea
The cochlea resembles a snail shell and spirals for about 2 3/4 turns around a bony column Within the cochlea are three canals:
Scala Vestibuli Scala Tympani Scala Media

The channel that houses the organ of Corti: A. Scala tympani B. Scala media C. Scala vestibuli D. Semicircular canals Senteo Question E. B and D

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Anatomy of the adult mammalian cochlea

Barald, K. F. et al. Development 2004;131:4119-4130

Organ of Corti

Organ of Corti

Organ of Corti

OHC vs. IHC Function

OHC Motility Models

Afferent Neural Innervations

Hair Cells
Outer Hair Cells Inner Hair Cells

OHC movie

OCH Cilia Theory: Tip-links

<<<IHC OHC >>>

OHC Cilia: Tip-links

Tip Link Protiens

Flexoelectric Effect
Quiet sounds are magnified by bundles of tiny, hair-like tubes atop "hair cells" in the ear (stereocilia: when the tubes dance back and forth, they act as "flexoelectric motors" that amplify sound mechanically. "It's like a car's power steering system. "
" You turn the wheel and mechanical power is added. Here, the incoming sound is like your hand turning the wheel, but to drive, you need to add power to it. These hair bundles add power to the sound. If you did not have this mechanism, you would need a powerful hearing aid.
http://www.medicalnewstoday.com/articles/147081.php

OHC Somatic Motility

Which cells are motile? A. Brain cells B. Inner hair cells C. Outer hair cells D. B and C E. None of the above

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OHCWith and Without Prestin

No other cells except OHC Prestin is the motor protein of mammalian OHCs. It is highly expressed in OHC, and is not expressed in nonmotile IHC.

OHCWith and Without Prestin

About 55 dB difference OHC in Prestin Knockout Mouse

Traveling Waves

Traveling wave Basilar membrane Traveling Wave info Cochlear Traveling Wave

High frequencies stimulate this part of inner ear: A. Apical portion of inner ear B. Basilar portion of inner ear C. Utricle D. Saccule Senteo Question E. Semicircular canals

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Inner Ear Etiologies

Genetic
Connexin 26

Excessive Noise Head Trauma Metabolic

Diabetes, kidney disfunction, thyroid dysfunction

Ototoxic
Gentamiacin, cisplatin, etc.

Disease

Connexin 26

Noise Trauma

Persons with diabetes are at greater risk for hearing lossthis would be? A. Metabolic B. Noise related C. Ototoxic D. Genetic Senteo Question E. Acoustic trauma related

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Persons with Connexin 26 are at greater risk for hearing lossthis would be: A. Metabolic B. Noise related C. Ototoxic D. Genetic Senteo Question E. Acoustic trauma related

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Developmental
Inner Ear Embryological Development

The hearing nerve is located in: A. Eustachian tube B. External auditory meatus C. Internal auditory meatus D. Organ of Corti E. Tympani

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The auditory nerve is which cranial nerve: A. VI B. VII C. VIII D. V Senteo Question E. X

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VIII Cranial Nerve

Virtual Tour of the Ear Auditory Branch

Auditory Branch Vestibular Branch

Vestibular Branch
Spiral ganglion Acoustic Tumors

Standard ABR
Cross-section of Internal Auditory Canal Sup. Vest Nerve Facial Nerve

HIGHFREQUENCY FIBERS

The wave V latency used in the standard ABR IT5 and I-V delay measures is dominated by neural activity from the high-frequency regions of the cochlea. Thus, unless the tumor affects these high-frequency fibers sufficiently, standard ABR latencies will be normal.

Acoustic Nerve
Large Tumor Abnormal Standard ABR

Inf. Vest Nerve Small Tumor Abnormal Standard ABR Small Tumor Normal Standard ABR

TUMOR

Acoustic Neuroma
Tumor

Spiral Ganglion

Question
The Auditory Nerve is: A. V Cranial Nerve B. VI Cranial Nerve C. VII Cranial Nerve D. VIII Cranial Nerve E. IX Cranial Nerve

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Acoustic Neuroma

Another term for acoustic tumor: A. VII cranial nerve tumor B. Vestibular schwannoma C. Facial nerve tumor D. Ear schwannoma
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Central Auditory Mechanism

Virtual Tour of the Ear
Auditory Path

Auditory Path

Central Auditory Path

Etiologies
Central auditory processing disorders
Brainstem Cerebrum Corpus callosum

Learning disorders Vascular

Stoke

Head trauma Tumors

Nonorganic Hearing Loss

Sometimes referred to as functional, feigning, etc. No physical evidence of hearing loss Conscious and unconscious Adults: medical/legal reasons Children: attention, psychological, reward, etc.

Development of the otocyst

Barald, K. F. et al. Development 2004;131:4119-4130

Inductive interactions that regulate otocyst induction and ventral patterning

Barald, K. F. et al. Development 2004;131:4119-4130

Development of the cochlear duct and organ of Corti

Barald, K. F. et al. Development 2004;131:4119-4130

Effects of modulating gene expression on development of the organ of Corti (OC)

Barald, K. F. et al. Development 2004;131:4119-4130

Generation of stereociliary bundle orientation

Barald, K. F. et al. Development 2004;131:4119-4130

Six1 expression during inner ear development

Zheng, W. et al. Development 2003;130:3989-4000