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1. External ear
a. Pinna/auricle
Irregular plate of ELASTIC CARTILLAGE with various depressions and elevations
Deepest compression: concha of pinna
Elevated margin: helix
Fat, fibrous tissue, blood vessels; lobule: gapunya cartillage
Arterial supply; superior auricle and auricotemporal arteries
Innervation; great auricular (medial/back and lateral ear/front) and auricotemporal nerve (branch
V3, skin of auricle anterior to external acoustic meatus
Lymphatic drainage; laterosuperior half of auricle to superficial parotid lymph node; cranial superior
half of auricle to mastoid and deep cervical lymph nodes, the rest is to superficial cervical lymph
node.
c. Tympanic Membrane
Diameter +- 1 cm; an oval semitransparent membrane at medal end of external acoustic meatus
Ext layer : skin, int layer: mucous membrane
Concave + ada cone-like central depression yang ujungnya bernama umbo (bentuknya kyk
parabola)
Pars flaccida: thin membrane, superior to lateral process of malleus
Pars tensa: radial and circular fibers di sisa bagian membrane
Tympanic membrane moves in response to air vibration; dideteks CN X di bbrp tempat, CN IX di
internal surface
2. Middle ear
a. Tympanic cavity
Air-filled chamber in petrous part of the temporal bone; part of cranial floor
Connected anteromedially by pharyngotympanic tube to nasopharnyx
Connected posterosuperiorly to mastoid cells through mastoid antrum
2 part: tympanic cavity proper (directly setelah tympanic membrane) dan epitympanic process
(superior to membrane)
Lined with mucous membrane
Contents: auditory ossicles, stapedius and tensor tympani muscles, chorda tympani (branch of CN
VII), and tympanic plexus of nerve
Walls of tympanic cavity:
1. Tegmental (roof) dari tegmen tympani, separates cavity from duramater
2. Jugular (floor) dari bone, separates tympanic cavity dari bulb of internal jugular vein
3. Membranous wall (lateral) dari peaked convexity of tympanic membrane, superior dar lateral
bony wall of eptympanic recess
4. Labyrinthe (medial wall) separates tympanic cavity from internal ear
- Promontory of labyrinth wall dari basal turn of cochlea
- Oval and round windows; communicates w internal ear adjacent to cranium
5. Mastoid wall (posterior) ada aditus (opening to mastoid antrum) to connect mastoid cells dan
tympanic cavity
6. Anterior carotid wall: separates cavity dgn carotid canal. Superior: punya opening dari
pharyngotympanic tube dan canal buat tensor tympani
b. Pharyngotympanic Tube
Opens posterolaterally to inferior nasal meatus
Dilapisi oleh mucous membrane
1/3 posterolateral bony, sisanya cartilaginous
Function: menyeimbangkan pressure di middle ear dengan pressure atmosfer; kalo seimbang,
tympanic membrane bisa bergerak dgn leluasa jadi bisa denger
Tube harus selalu terbuka; dibantu oleh levator veli palatini dan tensor veli palatini
Vascularization: internal carotid artery -> ascending pharyngeal artery dan maxillary artery-> middle
meningeal artery dan artery of pterygoid canal
Nerve: tympanic plexus dari CN IX
Venous drainage: to pterygoid venous plexus
c. Auditory Ossicles
mobile small bones crossng to the oval window (fenestrae vestibularis) dari tympanic membrane
tulang2 yang pertama kali matur saat lahir dan paling cepet untuk ossifikasi
tipe tulang keras, gapunya osteogenic periosteum
I. malleus/hammer
- nempel ke tympanic membrane
- bagian head ada di tympanic recess; neck nempel ke pars flaccida; handle tertanam di
tympanic membrane
- malleus bergerak bersamaan dgn tympanic membrane
II. incus/anvil
- antara maleus dan stapes; one body and two limbs
- long limb; paralel sama handle of malleus
- short limb; nempel ke bagian posterior dr tympanic cavity
III. stapes/stirrup
- paling kecil
- head articulates dgn incus
- base; seukuran dgn oval window, vibratory forcenya 10x lbh besar dari tympanic
membrane, tapi nurunin amplitudo
d. Muscles
to dampen movement dan vibration
by tensor tympani dari superior cartilaginous part of pharyngotympanic membrane; narik handle
maleus scr medial, tympanic membrane jadi tense/lebih mengeras; untuk mengurangi amplitudo jd
melindungi telinga dari loud sounds. Supplied by CN V3
stapedius di dalam pyramidal eminence (ada gambarnya di wall tympanic cavity) mencegah
excessive movements dari stapes; inervasi CN VII
3. Internal Ear
Vestibulocochlear organ: untuk hearing dan balance
Terdapat membranous labyrinth berisi endolymph
Ditahan oleh bony labyrinth yang berisi perilymph
Gak ngambang, krn fluidnya buat stimulasi hearing dan balance
a. Bony labyrinth
Ruang2 di dalam otic capsule; tulangnya lebih keras drpd jaringan sekitar
Berisi fluid
b. Cochlea
Berisi cochlear duct
Spiral canal berputar 2,5 rotasi sekitar bony cone yg bernama modiolus (spongy bone, cone
shaped, contains blood vessels and nerve)
Di bagian basal turn, bony labyrinth communicates dengan subarachnod space melalui cochlear
aqueduct
Ada round window; berhubungan dgn secondary tympanic membrane
d. Membranous Labyrinth
Filled with endolymph (intracell fluid)
Consists of vestibular labyrinth, 3 semicicular ducts, cochlear albyrinth
+ spiral ligament: penebalan dari periosteal lining di cochlear canal, nempelin cochlear duct ke
spiral canal of cochlea
Sisanya di suspend oleh transverse filaments dari perilymph
Semicircular ducts open to utricle dari 5 openings
Utricle -> utriculosaccular duct -> saccule -> ductus reuniens -> cochlear duct
Utricle dan saccule punya sensory epthelium yang bernama maculae; di base utricle dan medial
wall of saccule
Maculae innervated by vestbulocochlear ganglia dari internal acoustic meatus
Endolymphatic duct transverses vesitubular aqueduct and expands to blind pouch called
endolymphatic sac buat naro excess endolymph
e. Semicircular ducts
Punya ampulla di setiap ujung sbg sensory area (ampullary crest)
Crest untuk record movements dari endolymph -> hasil rotasi dari head @ plane of the dduct
Hair cells of crest: stimulates primary sensor neurons, badan sel di vestibular ganglia
f. Cochlear duct
Memisahkan perilymph into two channels di helicotrema
Vibration ascends to cochlea dari scala vestibuli -> helicotrema -> balik ke basal turn of
cochlea lewat scala tympani -> vibrations akhirnya ke tympanic cavity lg lewat round
window
Roof: vestibular membrane, floor: basillar membrane, receptor: spiral organ/organ of Corti,
overlaid by tectorial membrane