THE EAR The ear consists of three parts and has two functions; balance and hearing. 1.

External/outer ear 2. Middle ear 3. Inner ear The External ear This consists of 2 parts; a) Auricle (pinna) b) External acoustic meatus (external auditory canal) The Auricle This is the outer part that captures sound waves. It consists of elastic cartilage covered with thin hairy skin. The skin has various elevations and depressions. The helix: this is the large outside rim of the auricle. It extends inferiorly to the lobe. Antihelix: this is the curved rim anterior to the helix The lobule/earlobe: this is the fleshy part not supported by cartilage. It consists of fibrous tissue, fat and blood vessels. The concha: the concha of the auricle is its hollow centre. The external acoustic meatus leaves from the depths of this area. The tragus: this is an elevation in front of the concha. It is just anterior to the opening of the external acoustic meatus. Antitragus: this is the elevation above the lobule. Muscles: numerous intrinsic and extrinsic muscles are associated with the auricle. Intrinsic muscles pass between the cartilaginous parts of the auricle and may change its shape. Extrinsic muscles pass from the scalp/skull to the auricle and may also play a role in positioning the auricle.
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Innervation Superficial surfaces 1. Great auricular nerve 2. Lesser occipital nerve 3. Auricular temporal nerve Deeper parts 1. Branches of facial nerve 2. Branches of vagal nerve Blood vessels 1. Posterior auricular artery a branch of external carotid artery 2. Anterior auricular artery a branch of superficial temporal artery Also branches of occipital artery Lymphatics 1. Parotid L/N 2. Retroauricular/mastoid L/N Also to superficial cervical nodes External acoustic/auditory meatus This extends from the deepest part of the concha to the tympanic membrane/ear drum, about 2.5 cm long. Its wall consists of cartilage and bone. The first 1/3rd is cartilage while the medial 2/3rds is a bony tunnel in the temporal bone. The diameter varies being wider laterally and narrow medially. The entire length of the meatus is covered with skin, hairs, sebaceous and ceruminous glands. The latter are modified sweat glands that secrete cerumen/ear wax. The external acoustic meatus does not follow a straight course. From the external opening, it passes upward in an anterior direction, then turns slightly posteriorly still passing in an upward direction, and finally turns again in an anterior direction with a slight descent. Thus, for examination purposes, observation can be improved by pulling the ear superiorly, posteriorly, and slightly laterally.
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Innervation 1. Auriculotemporal nerve 2. Auricular branch of vagus nerve Also branches of facial nerve Tympanic membrane/eardrum This membrane separates the outer ear from the middle ear. . It is very sensitive to pain. It is a thin, semi-transparent, oval membrane at the medial end of the external acoustic meatus. It slopes obliquely at an angle posteriorly to anteriorly. Its outer surface is lined with skin while the inner surface is a mucous membrane. Around its periphery, a fibrocartilaginous ring attaches it to the temporal bone. At its center on the internal surface is a concavity produced by the attachment of the handle of the hamate of the malleus bone. This point of attachment is called the UMBO of the tympanic membrane. When viewed with an otoscope, a cone of light radiates anteroinferiorly from the umbo. Superior to the lateral process of the malleus or in between the malleolar folds, the membrane is thin and slack, pars flaccida. The rest of the membrane is thick and taut, pars tensa. Innervation Skin: Auriculotemporal nerve Auricular branch of the vagus Mucous membrane: tympanic plexus

The middle ear/tympanic cavity This is a narrow space or cavity in the petrous part of the temporal bone. This space is air filled and lined by mucous membrane. The middle ear lies between the tympanic membrane and the lateral wall of the internal ear. It consists of 2 parts; 1. Tympanic cavity proper-immediate to tympanic membrane 2. Epitympanic recess superior or above the tympanic membrane The middle ear communicates anteriorly with the nasopharynx, and posterosuperiorly with the mastoid antrum. Its basic function is to transmit vibrations of the tympanic membrane across its cavity to the internal ear. This is accomplished through the 3 interconnected but movable bones called ear ossicles. These bones are; malleus, incus and stapes (in the order MIS). Contents of the middle ear 1. Auditory ossicles 2. Muscles; Stapedius and tensor tympani muscles 3. Nerves; Chorda tympani nerve and Tympanic plexus of nerves Walls of the middle ear The middle ear has a roof, floor, anterior, posterior, medial and lateral walls. Roof (tegmental wall) This consists of a thin layer of bone which separates the middle ear from the middle cranial fossa. The layer of bone is the tegmen tympani on the petrous part of the temporal bone.
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The tegmen tympani also surrounds the aditus to the mastoid antrum. Floor (jugular wall) The floor consists of a thin layer of bone that separates it from the internal jugular vein. -The floor is associated with a small aperture through which the tympanic branch of the glossopharyngeal nerve enters the middle ear. Lateral wall (membranous wall) This consists almost entirely of the tympanic membrane; superiorly it is formed by the bony wall of the epitympanic recess. The handle of malleus is embedded in the tympanic membrane, and its head extends into the epitympanic recess. Posterior wall (mastoid wall) This wall is incomplete; -The lower part consists of a bony partition btn the tympanic cavity and mastoid air cells. -Superiorly, the epitympanic recess is continuous with the aditus to the mastoid antrum. Associated with this wall are: 1. Pyramidal eminence thru which the tendon of stapedius muscle enters middle ear. 2. Opening of chorda tympani (facial nerve branch) into middle ear.

Anterior wall (carotid wall) This wall is also incomplete. -The lower part consists of a bony partition between the tympanic cavity and the internal carotid artery. - superiorly, the wall is deficient due to presence of;
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1. 2. 3.

a large opening for the pharyngotympanic tube canal containing tensor tympani muscle the foramen for the exit of the chorda tympani

Medial wall (Labyrinthine wall) It separates the middle from internal ear. This is also the lateral wall of the internal ear. A prominent structure on this wall is a promontory/bulge produced by the first turn of the cochlea. Associated with the mucous membrane covering this promontory is the tympanic plexus (branches from internal carotid plexus + tympanic branch of glossopharyngeal). The tympanic plexus supplies mucous membrane of middle ear, mastoid area and pharyngotympanic tube Other structures associated with the medial wall are; 2 openings and 2 prominences. 1. Oval window: point of attachment for the base of stapes and leads into inner ear. 2. Round window 3. Prominence of facial canal with facial nerve 4. Prominence of lateral semicircular canal Mastoid antrum Posterior to the epitympanic recess of the middle ear is the aditus to the mastoid antrum. The mastoid antrum is a cavity in the mastoid part of the temporal bone. The mastoid antrum contains air-filled spaces called mastoid cells. The antrum is separated from the middle cranial fossa above by the tegmen tympani. The mucous membrane lining the mastoid air cells is continuous with that of the middle ear. Thus, infections of the middle ear can easily spread into the mastoid area. Pharyngotympanic tube/Eustachian tube/auditory tube
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This is a funnel-shaped tube about 4cm long that connects the middle ear to the nasopharynx. It equalizes pressure between the middle ear and pharynx. From the anterior wall of the middle ear, it extends forwards, medially and downward to enter the nasopharynx. Its mucous membrane is continuous with that of the tympanic cavity and nasopharynx. The tube consists of; rd 1. a bony part - first 1/3 2. cartilaginous part-last 2/3rds Blood vessels ascending pharyngeal artery (branch of external carotid) middle meningeal&artery of the pterygoid canal(maxillary arterybranches) Veins go to the pterygoid plexus and Nerves are from the tympanic plexus Auditory ossicles/ear ossicles The bones of the middle ear consist of the malleus, incus and stapes. They form an osseus chain across the middle ear from the tympanic membrane to the oval window of the internal ear. The ossicles transmit the vibrations of the tympanic membrane to the perilymph of the internal ear. Muscles associated with these ossicles modulate movement during the transmission of vibrations. Malleus This is the largest and attached to the tympanic membrane. Its parts include; head, neck, processes (anterior &lateral), and the handle. The head is the rounded upper part in the epitympanic recess. Its posterior surface articulates with the incus. Inferior to the head is the constricted neck, and below this are the anterior and lateral processes. The neck lies against pars flaccida.

The anterior process is attached to the anterior wall of the middle ear by a ligament. The lateral process is attached to the anterior and posterior malleolar folds of the tympanic membrane. The downward extension of the malleus below the process is the handle, attached to the tympanic membrane. The tendon of tensor tympani inserts into the handle. Incus It is the 2nd in the series of the ear ossicles. It consists of the body, long and short limbs/processes. The enlarged body articulates with the head of malleus and is in the epitympanic recess. The long limb articulates with the stapes. The short limb is attached to the posterior wall of the middle ear by a ligament. Stapes This is the most medial and attached to the oval window. It consists of the head, anterior and posterior limbs, and the base (foot plate). The head articulates with the long limb of incus. The two limbs separate from each other and attach to the base. The base of stapes fits into the oval window on the labyrinthine wall of the middle ear. The base is smaller than the tympanic membranevibration; ossicles increase force but decrease amplitude in a noisy situation. Muscles associated with ear ossicles 1. Stapedius: contraction, usually in response to loud noise pulls the stapes posteriorly and prevents its excessive oscillation. 2. Tensor tympani: tenses the tympanic membrane on contraction. Vessels of the middle ear. These are mainly; branches of the maxillary artery
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Branches of posterior auricular artery Innervation is by the tympanic plexus. Internal ear (labyrinth) This consists of 2 cavities; 1. A bony labyrinth 2. A membranous labyrinth Bony/osseous labyrinth The cavities contain perilymph, and these include; Vestibule Semicircular canals Cochlea Vestibule This is the central part of the bony labyrinth. Laterally, the vestibule is separated from the middle ear by a thin bony plate with 2 pores; the oval window (fenestra vestibule) and round window (fenestra cochlea). The oval window is closed by the base of stapes and its surrounding annular ligament. The round window is covered by a secondary tympanic membrane. The vestibule lies between the cochlea and semicircular canals with which it communicates. Lodged within the vestibule are the saccule and utricle of the membranous labyrinth. A narrow canal called the vestibular aqueduct leaves the vestibule and passes through the temporal bone to open on the posterior surface of the petrous part of the temporal bone. Semicircular canals These are 3 in number; anterior/superior, posterior and lateral semicircular canals.

Each of these canals forms 2/3rds of a circle with one end dilated to form the ampulla. These canals open into the posterior part of the vestibule by 5 orifices, one of which is common to two of the canals. The canals are oriented in such away that each canal is at right angles to the other two (anterior&posterior are vertical, lateral is horizontal). Lodged within the canals are the semicircular ducts. Cochlea This resembles a snail shell and opens into the vestibule. It consists of a central column of bone known as the modiolus, around which a hollow bony tube twists on itself 2.5 times. Each successive turn is of decreasing diameter so that the whole structure is cone-shaped. The wide base of the modiolus faces the internal acoustic meatus, where it is perforated by branches of the cochlea part of the vestibulocochlear nerve. The first basal turn of the cochlea is responsible for the promontory of the medial wall of the middle ear. Lodged within the cochlea is the cochlea duct.

Membranous labyrinth This is a continuous system of ducts and sacs within the bony labyrinth. It is filled with endolymph and surrounded by perilymph. Contents include; Semicircular ducts Cochlea ducts utricle
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 saccule) Vestibular labyrinth (Organs of balance) The utricle is the larger of the 2 sacs. It is in the posterosuperior part of the vestibule. The 3 semicircular ducts empty into the utricle. The saccule is a smaller, rounded sac lying in the anteroinferior part of the vestibule. The cochlea duct empties into the saccule. The utricosaccular duct establishes continuity between all components of the membranous labyrinth. It connects the utricle and saccule. Branching from this small duct is the endolymphatic duct, which enter the vestibular aqueduct. Here the endolymphatic duct expands into the endolymphatic sac, a blind subdural pouch that stores and absorbs excess endolymph. Sensory receptors In the utricle the sense organ is called macula of utricle, while for the saccule is macula of saccule. In the ampulla of each of the 3 semicircular ducts the sense organ is the crista. The crista and maculae receptors form sensory afferents for maintenance of balance and equilibrium. Chochlear labyrinth (Organ of hearing) Cochlea duct This is a spiral, blind tube triangular in cross section and firmly suspended within the cochlea canal. One corner of the triangle is attached to the edge of the osseous spiral lamina. The other two corners are attached to the outer wall of the bony cochlea.

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This makes the cochlea duct and osseous spiral lamina act as a partition separating the cochlea canal into two; 1. Scala vestibule above, separated from middle ear by oval window 2. Scala tympani below, separated from middle ear by round window. The two canals communicate at the apex of the cochlea through a narrow slit called the helicotrema. NB. Near the round window is a small channel called the chochlea canaliculus, which passes through the temporal bone to open into the posterior cranial fossa. This provides a connection between the perilymph containing cochlea and the CSF containing subarachoid space.

The cochlea duct is triangular-shaped and has; 1. An outer wall; spiral ligament 2. A roof/vestibular membrane. It separates the endolymph in the cochlea duct from the perilymph in the scala vestibule. 3. A floor. It separates the endolymph in the cochlea duct from the perilymph in the scala tympani. It consists of the osseous spiral lamina of the modiolus and basilar membrane. The spiral organ of Corti is the organ of hearing, rests on the basilar membrane, and projects into the enclosed endolymph filled cochlea duct. Internal acoustic meatus This is a narrow canal about 1cm long that runs laterally within the petrous temporal bone. The opening of this canal is in line with the external acoustic meatus.

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It is closed by a thin perforated plate of bone that separates it from the internal ear. Through this plate pass the facial nerve, vestibulocochear nerve and blood vessels. Blood vessels of the internal ear Bony labyrinth is supplied by the same arteries that supply the surrounding temporal bone. These are branches of; 1. Maxillary artery 2. Posterior auricular artery 3. Middle meningeal artery Membranous labyrinth is supplied by the labyrinthine arteries (branches of either inferior cerebellar or direct branches of basilar artery) The labyrinthine artery divides into; 1. A cochlear branch 2. A vestibular branch The labyrinthine vein drains into the petrosal or sigmoid sinus. Innervation The vestibulocochlear/auditory nerve, at the distal end of the internal acoustic meatus divides into; 1. A cochlear nerve that innervates the organ of Corti. 2. A vestibular nerve that innervates the maculae. Read about the mechanism of HEARING

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