ANATOMY OF THE EAR

ANATOMY & HISTOLOGY DEPT.

BRAWIJAYA MEDICAL FACULTY
EXPECTED OUTCOMES :

TO BE ABLE TO IDENTIFY THE

STRUCTURES OF THE EAR

TO UNDERSTAND THE HEARING

MECHANISM
 EXTERNAL EAR
PINNA OR AURICLE
EXTERNAL AUDITORY CANAL
TYMPANIC MEMBRANE

MIDDLE EAR
MALLEUS, INCUS AND STAPES
EUSTATION TUBE

INNER EAR
VESTIBULE
SEMI-CIRCULAR CANALS
COCHLEA
VESTIBULAR NERVE
AUDITORY NERVE
 THE EXTERNAL EAR

1. AURICLE
(PINNA)
Collects sound
Helps in sound localization
Amplifies sound approx. 5-6
dB
External and Internal muscles
 EXTERNAL MUSCLES

M. AURICULARIS
SUPERIOR

M. AURICULARIS M. AURICULARIS
POSTERIOR ANTERIOR
 EXTERNAL
MUSCLES

M. HELICES MAJOR

M. HELICES MINOR

M. TRAGICES
M. ANTITRAGICES
2. EXTERNAL AUDITORY
MEATUS: Approx. 1 inch long

S shaped
Outer 1/3 of canal is cartilage,
inner 2/3 consists of bone
covered with skin
Allows air to warm before
reaching TM
Protects the TM from physical
ISTHMUS damage
Cerumen glands moisten
/soften skin cerumen
obturans (keras/menyumbat))
Kelaianan ditelinga luar dan
tengah
- Otitis erxterna ; infeksi pd kulit telinga

luar, biasanya karena elergi dr hiasan

telinga
- Otitis media = radang dari telinga tengah
ditandai dengan keluarnya cairan dr
telinga tengah
- Ini bisa : - otitis media acut
- - otitis media kronis
- - otitis media perforata / purulenta :
membrana tympani pecah keluar nanah
 3. TYMPANIC
MEMBRANE
Diameter 1cm
Separates external and
middle ear.
Translucent membrane
Pars Flaccida Pearly, gray color
Cone of light reflection
Os. malleus when using otoscope
Oval and slightly
Pars tensa concave shape, pulled
Umbo
in at center by malleus
Changes acoustical
Cone of light energy into mechanical
energy
VASCULARISATION :
Branches of A. carotis externa :
A. auricularis posterior

A. temporalis superficialis

INNERVATION :
Sensoris :
N.Maxillaris (N.V.1) : N. auriculotemporalis
Plexus cervicalis : N. auricularis magnus
 THE MIDDLE EAR
(TYMPANIC CAVITY)
Tiny airfilled cavity in the temporal bone
contains:

Auditory ossicles (bones)

Malleus
Incus
Stapes

Openings to
Outer ear covered by tympanic membrane
Inner ear = oval and round windows
Eustachian tube connects middle ear to the
nasopharnyx for air passage (normally closed,
opens with swallowing/yawning)
 ISI CAVUM TYMPANI:
- Udara
- Ossiculae auditoria : MALLEUS INCUS STAPES :
Sistem pengungkit bersudut untuk
mengkonduksikan getaran suara
- Otot : M. tensor tympani :(N.V.3)
Pars cartilagines tuba auditiva malleus
M. stapedius ( N. VII)
Eminentia pyramidalis - stapes
Fungsi : Meredam vibrasi pada suara keras
TYMPANIC REFLEX
- Chorda tympani
- Plexus tympanicus
Middle ear has 3 functions
1. Conducts sound vibration from outer ear to
inner ear
2. Protects the inner ear by reducing the
amplitude of loud sounds
3. Eustachian tube allows equalization of air
pressure on each side of the ear drum to avoid
rupture ( high altitudes)
Bl tekanan tdk sama oclusio tuba membrana
tympani tidak datar = rasa tdk enak ; mis kita
masuk kedaerah tinggi ; naik pesawat diberi
permen supaya orang menelan, lewat tuba
Eustachius tekanan jadi sama
 CONTAINS OF MIDLLE
EAR
STABILIZING
LIGAMENT

INCUS
MALLEUS

CHORDA
TYMPANI M.TENSOR
TYMPANI
M.STAPEDIUS
STAPES
 THE WALLS OF
TYMPANIC CAVITY
 LATERAL WALL OF TYMPANIC
CAVITY :

ADITUS ANTHRUM
MASTOIDEA
MBR. TYMPANI
CELLULAE
MASTOIDEA
TUBA
AUDITIVA
CANALIS
FACIALIS
A. CAROTIS
INTERNA
V.JUGULARIS
INTERNA
MEDIAL WALL OF TYMPANIC CAVITY :
ADITUS ANTHRUM MASTOIDEA

PROMONTORIUM

CANALIS M.TENSOR TYMPANI

TUBA AUDITIVA
 THE OSSICLES
Ossicular chain = malleus, incus &
stapes
Malleus
TM attaches at Umbo
Incus
Connector function
Stapes
Smallest bone in the body
Footplate inserts in oval window on
medial wall
Focus/amplify vibration of TM to smaller
area, enables vibration of cochlear
fluids
Pd orang tua, tulang2 ini bisa kaku
sclerosis / otosclerosisi
 Stapedius Muscle

Attaches to stapes
Contracts in response to loud sounds the Acoustic Reflex
Changes stapes mode of vibration; makes it less efficient and reduce
loudness perceived
Absent acoustic reflex could signal conductive loss or
marked sensorineural loss
 EUSTACHIAN TUBE

Mucous-lined, connects middle

ear cavity to nasopharynx
Equalizes air pressure in
middle ear
Normally closed, opens under
certain conditions (chewing,
swallowing)
May allow a pathway for
infection
Children grow out of most
middle ear problems as this
tube lengthens and becomes
more vertical
Eustachian tube
 ANTHRUM MASTOIDEA

Ruangan pd Procc.
Mastoidea os Temporal, di
dorsal dari cavum tympani,
berisi cellulae mastoidea dan
udara,
Mukosa yang melapisi sama
dengan cavum tympani
memudahkan penyebaran
infeksi Mastoiditis
Mastoidectomi
 THE INNER EAR
Contains the Bony Labyrinth which
holds the sensory organs for hearing
and equilibrium
1. Vestibule
2. Semicircular canals
3. Cochlea (contains the central hearing
apparatus)
 AURIS INTERNA

SUPERIOR

UTRICULUS

LATERAL

VESTIBULUM
POSTERIOR

SACCULUS
AMPULLAE

COCHLEA
 STRUCTURES OF THE INNER
EAR
Labyrinthus Osseus Labyrinthus Membranaceu

Canalis
semicircularis Duct. semicircularis
Utriculus
Vestibulum
Sacculus

Ductus
Cochlea cochlearis
 ORGAN VESTIBULARIS
CANALIS SEMICIRCULARIS
Terdiri dari 3 saluran, yg saling tegak lurus :
(anterior/superior,posterior,lateral)
Di dalamnya terdapat ductus semicircularis yang ujungnya
melebar disebut AMPULLA, berisi epithelium sensorium (Crista
Ampullaris)
VESTIBULUM
Berhubungan dengan auris media melalui fenestra vestibuli
Terdiri dari :
UTRICULUS

SACCULUS

Keduanya mengandung epithel sensorium, yaitu macula

sacculi dan macula utriculi
ORGAN COCHLEARIS

COCHLEA
1. Canalis cochlearis : Saluran yang mengitari sumbu tulang
(modiolus) perilymph
a. Scala vestibuli di atas ductus cochlearis dari fenestra
vestibuli, bertemu scala tympani di helicotrema. Dinding
bawahnya dibtk oleh Lamina vestibuli
b. Scala tympani, di bawah Ductus Cochlearis berakhir
di fenestra cochlea yg tertutup mbr. tympanica secundaria
2. Ductus cochlearis (scala media) endolymph
Dimulai dari saluran buntu : caecum vestibulare berakhir di
cupula sebagai caecum cupulare. Dinding bawahnya dibentuk
oleh Lamina basilaris Organon Corti
 COCHLEA

SCALA VESTIBULI

MBR. VESTIBULI

SCALA MEDIA

MBR. BASILARIS

SCALA TYMPANI

ORGANON CORTI
 Structures of the Inner
Ear:
The Cochlea
Snail shaped cavity within mastoid bone
2 turns, 3 fluid-filled chambers
Scala Media contains Organ of Corti
Converts mechanical energy to electrical
energy
 Organ Of Corti
The end organ of hearing
Contains stereocilia & receptor hair cells

3 rows OHC, 1 row IHC

Tectorial and Basilar Membranes

UTRICULUS
Cochlear fluids

(From Augustana College, Virtual Tour of the Ear)

 Hair Cells
Frequency specific
High pitches= base of cochlea

Low pitches= apex of cochlea

Fluid movement causes

deflection of nerve endings
Nerve impulses (electrical
energy) are generated and sent
to the brain
Vestibular System
Consists of three semi-circular
canals
Monitors the position of the
head in space
Controls balance
Shares fluid with the cochlea
Cochlea & Vestibular system
comprise the inner ear
 Function of hearing
3 levels
1. Peripheral ear transmits sound and
converts its vibrations into electrical
impulses that can be analyzed by the brain.
The electrical impulses are conducted by
the auditory process of cranial nerve VIII
(Acoustic) to the brain stem
1. Amplitude=loudness
2. Frequency=pitch
 Sound waves cause the eardrum to vibrate
Vibrations travel via the ossicles thru the
oval window, the cochlea and are scattered
against the round window
The basilar membrane of the cochlea contain
the organ of Corti receptor hair cells that
translate the vibrations to electric impulses
The impulses go to the brainstem via
Acoustic nerve (VIII)
2. Brain stem function is binaural
interaction permits identification of
sound and locating the direction of a
sound in space. The acoustic nerve
(Cranial nerve VIII) sends signals from
each ear to both sides of the brain stem.
Brainstem is sensitive to intensity &
timing from the ears depending on head
position
3. Cerebral cortex interprets the meaning
of the sound and begins the appropriate
response
Pathways of hearing
1. Air conduction (AC) normal pathway of
hearing, the most efficient
2. Bone conduction (BC) bones of the
skull vibrate and transmit vibrations to
the inner ear and acoustic nerve
 Hearing loss
1. Conductive mechanical dysfunction of
the external or middle ear resulting in
partial hearing loss (if amplitude to
reach nerve elements in inner ear,
person can hear)
1. Causes= impacted cerumen, FB,
perforated eardrum, pus/bld in the middle
ear, otosclerosis
Hearing loss
2. Sensorineural ( perceptive) pathology
of the inner ear, acoustic nerve or
auditory areas of the cerebral cortex.
amplitude may not help
1. Causes= Presbycusis, a nerve degeneration
due to aging (50yrs) or ototoxic drugs
3. Equilibrium labyrinth feeds info to the
brain about the bodys position in space,
inflammation causes vertigo / tinitus
 Central Auditory System
VIIIth Cranial Nerve or Auditory Nerve
Bundle of nerve fibers (25-30K)

Travels from cochlea through internal auditory

meatus to skull cavity and brain stem
Carry signals from cochlea to primary auditory
cortex, with continuous processing along the way
Auditory Cortex
Wernickes Area within Temporal Lobe of the brain

Sounds interpreted based on

experience/association
Main Components of the
Hearing Mechanism:
Peripheral Mechanism Central Mechanism

VIII
Outer Middle Inner
Cranial Brain
Ear Ear Ear
Nerve
 Summary: How Sound
Travels Through The Ear
Acoustic energy, in the form of sound waves, is
channeled into the ear canal by the pinna. Sound waves
hit the tympanic membrane and cause it to vibrate, like
a drum, changing it into mechanical energy. The
malleus, which is attached to the tympanic membrane,
starts the ossicles into motion. The stapes moves in and
out of the oval window of the cochlea creating a fluid
motion, or hydraulic energy. The fluid movement causes
membranes in the Organ of Corti to shear against the
hair cells. This creates an electrical signal which is sent
up the Auditory Nerve to the brain. The brain
interprets it as sound!
 FUNGSI PENDENGARAN

Gelombang suara MAE menggetarkan

mbr.tympani ossiculae auditiva fenestra
vestibuli menggetarkan perilymph (scala
vestibuli) diteruskan mbr. vestibuli ke
endolymph (scala media)
Gerakan endolymph menggerakkan membrana
basilaris naik turun shgg menggerakkan cilia pd
Organon Corti
Pergerakkan cilia merangsang sel sensoris dan
pelepasan impuls saraf
 HEARING MECHANISM :

OUTER EAR : acoustic to kinetic energy

MIDDLE EAR : causes increase in kinetic energy
INNER EAR : kinetic to hydraulic energy then
hydraulic to electrical energy
UDITORY PATHWAY
 ASPEK KLINIS
Hearing loss :
Penurunan pendengaran : ringan total
temporer irreversibel
Ada 2 jenis :
1. Tuli konduksi
Gangguan transmisi getaran suara sampai ke auris interna
Contoh : cerumen, ruptur mbr.tympani, otitis media
2. Tuli persepsi
Gangguan pada hair cell/ organon corti atau saraf
Contoh : occupational disease (musisi,teknisi mesin)
FUNGSI KESEIMBANGAN
1. KESEIMBANGAN STATIS
Kecepatan linier
Aksi gravitasi
Macula saculi dan
macula utriculi

2. KESEIMBANGAN
DINAMIS
Kecepatan angular
Perubahan posisi
kepala
Crista ampullarisi
 KESEIMBANGAN STATIS

MACULA UTRICULI
MACULA SACULI

OTOLITH
MBR. OTOLITH

HAIR CELL
SUPORTING CELLI
KESEIMBANGAN DINAMIS

AMPULLA
CRISTA AMPULLARIS

HAIR CELL
CUPULA

SUPORTING CELL
VESTIBULAR PATHWAY