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1、Clinical anatomy&physiology of the ear,Anatomy of ear,Located On both sides of cranial bone.Close with parietal bone,sphenoid bone and occipital boneComposition:squamaous,tympanic,mastoid and petrous parts+styloid process,Temporal bone,Temporal bone and its abutment1.Occipitomastoid suture 2.Squamos
2、omastoid suture3.Occipital bone4.Parietomastoid suture5.Squamous suture6.Parietal bone 7.Temporal bone8.Sphenosquamosal suture9.Frontal bone10.Spheoid bone11.Zygomatic bone12.Mandible 13.External acoustic meatus,External surface of left tymporal bone in adult1.External acoustic meatus 2.Suprameatal
3、trinangle3.Squamous part 4.Mastoidale5.Tympanomastoid fissure6.Zygomatic process 7.Mandibular fossa8.Tymporal line 9.Tympanosquamous fissure 10.Styloid process,Internal surface of left tymporal bone in adult11.Sulcus for middle meningeal artery12.Petrous bone 13.Inner acoustic meatus 14.Sigmoid sulc
4、us15.Sulcus for superior petrosal sinus16.Sulcus for inferior petrosal sinus17.Petrous apex 18=Arcuate eminence19=Inner orifice of internal carotid canal,9.Notch of rivinus 10.Suprameatal spine11.Suprameatal triangle12.Temporal linef 13.Parietal notch 14.External acoustic foramen15.Mastoid part16.Oc
5、cipital margin17.Sutura mastoideosquamalis18.Mastoid foramen19.Tympanomastoid fissure,External surface of tymporal bone,1.Margo parietalis2.Squamous part3.Temoral surface 4.Margo sphenoidalis 5.Processus retroarticularis6.Zygomatic process7.Articular tubercle8.Mandibular fossa,20.Mastoid notch 21.Ma
6、stoid22.Petrotympanic fissure 23.Tympanic part24.Styloid process,Internal surface of tymporal bone,5.Posterior branch sulcus of middle meningeal artery6.Arcuate eminence 7.Groove for superior perosal sinus8.Internal auditory foramen 9.Styloid process,1.Sutura petrosquamosa 2.Sigmoid sulcus 3.Mastoid
7、 foramen 4.Orifice of vestibular aqueduct,Inferior surface of tymporal bone,1.Caroticotympanic canals2.Carotid canal 3.Tympanic canaliculus for jacobson nerve4.Sulcus of mastoid canaliculus 5.External aperture of aqueduct of cochlea6.Mastoid canaliculus for arnold nerve 7.Jugular fossa,8.Zygomatic p
8、rocess9.Articular tubercle 10.Articular fossa of mandible 11.Tympanosquamous fissure12.Tympanic part 13.Styloid process 14.External acoustic foramen15.Styloimastoid foramen 16.Mastoid 17.Mastoid notch18.Sulcus for occipital artery 19.Mastoid part,Anatomic relationship of fundus of internal acoustic
9、meatus,3.Area of facial nerve4.Superior vestibular area5.Vertical crest6.Inferior vestibular area7.Haplopore8.Central canal of cochlea,1.Transverse crest2.Cochlear area（Tractus spiralis foraminosus）,External ear,Anatomy of external ear,Pinna of ear anterior notch of ear External acoustic meatus2.5-3
10、.5cmLateral 1/3:cartilage;medial 2/3:bone2 stenosis：Juncture between bone and cartilage Isthmus of external acoustic meatus,Anatomy of external ear,1.Triangular fossa2.Cymba of auricular concha 3.Cavity of auricular concha4.Auricular concha5.Anterior incisure of ear 6.Tragus7.Intertragic notch8.Ear
11、lobe,9.Helix10.Superior crura of antihelix 11.Inferior crura of antihelix12.Auricular tubercle 13.Scaphoid fossa 14.Antihelix 15.Crus of helix 16.External acoustic meatus19.Antitragus,Middle ear,Anatomy of middle ear,Tympanic cavityEustachian tubeTympanic sinusMastoid,Anatomy of middle ear,Delimitat
12、ion according to membrane tensa,Attic,Mesotympanum,Hypotympanum,Internal surface of tympanic lateral wall,1.Incudomallear articulation2.Superior ligament of malleus 3.Head of malleus 4.Tympanic attic5.Processus anterior mallei 6.Anterior fold of tympanic membrane 7.Anterior fossa of tympanic membran
13、e 8.Cord of tympanum9.Eustachian tube,12.Body of incus13.Short crus of incus14.Tympanic antrum 15.Posterior ligament of incus in incudal fossa16.Posterior fold of tympanic membrane 17.Long crus of incus 18.Posterior fossa of tympanic membrane 19.Lenticular process of incus 20.Tympanichordal pathway,
14、10.Limbus membranae tympani 11.Pars tensa,21.Tensor tympani muscle 22.Handle of malleus,Tympanic membrane,Tympanic membrane(TM)semi-transparent film,9*8*0.1mm3 flaccid part，tensa part 3 layered structure:Epithelial lamina Fibrous lamina Mucous lamina,TM1.Flaccid part 2.Short process of malleus3.Hand
15、le of malleus4.Tensa part 5.Light cone,Internal wall of tympanum,Internal wall of middle ear=lateral wall of inner ear Center-Promontorium tympani Posterosuperior vestibular window(oval window)-vestibule Posteroinferior cochlear window(round window)-Scala tympani Superior of vestibular window horizo
16、ntal part of fallopian aqueduct Posterosuperior of fallopian aqueduct prominence of lateral semicircular canal Anterior of vestibular window cochleariform process,Internal wall of tympanum,Aditus ad antrum,Anterior wall of tympanum,Anterior wall of middle ear=carotid wall separated inferiorly by car
17、otid 2 orifices in superior part:orifice of canalis tensor tympani(superior)orifice of semicanalis eustachii(inferior),Anterior wall of tympanum,1.Tympanic attic 2.Stapes 3.Tegmen tympani 4.Tendon of tensor tympani muscle5.Cochleariform process6.Greater superficial petrosal nerve7.Lesser petrosal ne
18、rve 8.Bony septum of eustachian canal 9.Tensor tympani muscle10.Eustachian tube11.Carotid wall of tympanum12.Labyrinthine wall of tympanum,13.Head of malleus 14.Superior ligament of malleus 15.Neck of malleus 16.Anterior process and ligament of malleus 17.Lateral process of malleus(short process of
19、malleus)18.Handle of malleus19.Umbo of tympanic membrane20.Limbus membrane tympani,21.Fibrocartilaginous ring 22.Tympanic sulcus,Posterior wall of tympanum,Posterior wall-mastoid wall Superior orifice aditus ad antrum Incudal fossa posterior junction of horizontal and vertical segment of fallopian a
20、queduct Height of vestibular window pyramidal eminence facial recess posterior tympanic approach,Posterior wall of tympanum,1.Stapes 2.Incus 3.Chorda tympani nerve 4.Facial recess 5.Chorda tympanic crest 6.Chorda tympanic eminence 7.Pyramidal eminence 8.Lateral sinus tympani9.Styloid process eminenc
21、e,10.Malleus 11.Sinus tympani 12.Fossula of cochlear window,Superior and inferior wall of tympanum,Superior wall-tegmen tympani separated with temporal lobe in middle cranial fossa Petrosquamous suture in infant is not close yet-infection of middle ear invade into cranium,Posterior wall-Jugular wall
22、 separated with glomus jugulare if deletion of posterior wall blue drum,Content of tympanum,Auricular bone(the smallest bone):Malleus,incus,stapes ossicular chainLigament of auricular boneTympanic muscle:tensor tympani muscle,stapedius muscleChorda tympani nerve,1.Superior ligament of malleus 2.Ante
23、rior ligament of malleus3.Tensor tympani muscle,4.Superior ligament of incus5.Posterior ligament of incus6.Stapedius muscle,Eustachian tube,Passway between tympanum and nasopharynx.Lateral 1/3:bony part,medial 2/3：cartilaginous parJunction between bony and cartilaginous:isthmusRegulate tympanic pres
24、sure,1.Incus2.Tympanic membrane 3.Mandibular fossa4.Styloid process5.Carotid artery,6.Tensor tympani muscle7.Pharyngeal opening of auditory tube,Tympanic antrum,1.Tympanic antrum2.Tygmen tympani 3.Lateral semicircular duct4.Fallpian aqueduct5.Vestibular window6.Canal for tensor tympani muscle7.Bony
25、septum of eustachian canal8.Hiatus canalis facialis9.Carotid canal10.Bony part of auditory tube11.Promontorium tympani12.Pyramidal eminence13.Cochlear window14.Tympanic sulcus15.Stylomastoid foramen16.Mastoid air cell,Mastoid,Mastoid:intratemporal cellsTyping:pneumatic type,dipoetic type,sclerotic t
26、ype,mixed typeDistribution:mastoidale group,perisigmoid group,antrodural group,perilabyrinthine group,epidural group,zygomatic group,perifacial group.,Anatomy of inner ear,labyrinth，including receptor of auditory and equilibratory sensationContain：bony and membrane labyrinthPerilymph：between bony an
27、d membrane labyrinth,KNaEndolymph:in endolymphatic labyrinth,KNa,Anterolateral view of bony labyrinth,Bony labyrinth:vestibule,semicircular canals,cochlea,1.Anterior semicircular canal 2.Common crus 3.Lateral bony ampulla 4.Crura ampullaria 5.Crus simplex 6.Lateral semicircular duct 7.Vestibular win
28、dow 8.Posterior semicircular canal 9.Posterior bony ampulla,10.Anterior bony ampulla11.Utricle 12.Sacculus13.Vestibule 14.Cupula of cochlea15.Cochlear middle cycle16.Cochlear top cycle 17.Cochlear basic cycle18.Vestibular crest19.Cochlear window,Internal view of bony labyrinth,1.Anterior semicircula
29、r canal2.Common crus 3.Lateral semicircular canal4.Posterior semicircular canal5.Pars ampullaris6.Orifice of vestibular aqueduct 7.Cochlear recess,8.Orifice of common crus9.Utricular recess 10.Vestibular crest 11.Spherical recess 12.Cochlea 13.Scala tympani 14.Bony spiral lamina 15.Scala vestibuli 1
30、6.Orifice of cochlear aqueduct17.Cochlear window,Vestibule,Located between cochlea and semicircular canalsSpherical recess,utricular recessLateral wall:vestibular window,stapedial footplate,Bony semicircular canals,3 curved bony canals,perpendicularly,lateral,superior,posterior semicircular canals.C
31、ommon crus:superior and posterior canalsPosition of semicircular canals,Membranous labyrinth,Composition:Utricle,sacculus,membranous semicircular canals and membranous cochlear canal,1.Anterior semicircular canal2.Common crus 3.Semicircular canal isthmus 4.Posterior semicircular canal5.Lateral semic
32、ircular canal6.Endolymphatic sac,7.Pars ampullaris8.Utricle 9.Utricle duct10.Saccule 11.Saccule duct12.Union duct13.Vestibular cecum14.Semicircular canal sinus15.Pars ampullaris,Membranous labyrinth,UtricleSacculusMembranous semicircular canals,Membranous cochlear canal:between bony spiral lamina an
33、d lateral wall of bony cochlear duct,18.Basilar membrane 19.Cortis tunnel 20.inner and outer pillar cell 21.Scala tympani 22.tympanic pic 23.inner spiral sulcus,1.Spiral limbus 2.Vestibular lip 3.Internal beam of spiral ganglion4.Spiral ganglion 5.Scala vestibuli 6.Vestibular membrane,7.Inner hair c
34、ells 8.Outer hair cell 9.Tectorial membrane 10.Hensen cell11.Claudius cell,12.Vestibular membrane crest 13.Stria vascularis 14.Spiral prominence 15.External spiral sulcus 16.Basilar membrane 17.Spiral ligament of cochlea,Membranous labyrinth,Basilar membrane,11.Claudius cell 12.Deiters cell 13.outer
35、 pillar cell 14.Cortis tunnel15.Basilar membrane 16.spiral vessel 17.inner pillar cell 18.tympanic lip 19.nerve fibers 20.arcuate zone 21.Pectinate zone,1.Spiral limbus 2.Vestibular lip 3.Tectorial membrane4.Outer hair cell 5.Outer tunnel 6.Henson cell7.Inner spiral sulcus 8.Marginal cell 9.Inner ha
36、ir cell10.NueI interspace,Membranous labyrinth,Model of acoustic transduction,1.Medial longitudinal bundle 2.Superior nucleus 3.Lateral nucleus 4.Medial nucleus5.Inferior nucleus 6.Vestibulospinal tract 7.Vestibular ganglion,Model of acoustic transduction,1.Auditory cortex 2.Dorsal acoustic striae3.
37、Middle acoustic striae 4.Gastral acoustic striae5.Reticular formation 6.Medial geniculate body7.Inferior colliculus 8.Nucleus dorsalis9.Lateral lemniscus 10.Ventralis anterior11.Superior olivary nuclear complex 12.Cochlear dorsal nucleus13.Cochlear gastral nucleus,Central passway of vestibular nerve
38、,1.Auditory cortex 2.Brachium quadrigeminum inferius 3.Cochlea 4.Medial geniculate nucleus 5.Nucleus of inferior colliculus6.Nucleus of lateral lemniscus 7.Superior olivary nuclear complex8.Cochlear nucleus,Physiology of ear,Auditory perceptionEquilibratory sensation,Sound afferent passway,Air condu
39、ction：sound wave pinna of ear external acoustic meatus auditory ossicles vestibular window perilymph,endolymph Spiral organ of Corti acoustic nerve different levels of nucleus acoustic center,Sound afferent passway,Bone conduction translatory mode of bone conduction compressonal mode of bone conduct
40、ion,Physiology of external ear,Sound collectionDistinguish directionSympathetic vibrationProtection Sound pressure amplification,Physiology of middle ear,Sound transformation and gain of middle earSound transmission and transformation structure:tympanic membrane and ossicular chain,Physiology of mid
41、dle ear,Effective vibrative aera:55 mm2,2/3 of anatomic area.Stapedial footplate area:3.2 mm2,1/17 of effective vibrative area,Pressure=Force/areaArea of tympanic membrane 17 area stapesGain of area ratio 24 dB,Function Middle ear:amplification from area ratio,Energy loss at air-fluid interface-99.9
42、%loss(-30 dB)Malleus longer than incus-amplify pressure 1.7X(+2 dB),Function of Middle earpressure amplification-ossicles,Physiology of tympanic muscle,Stapedius muscleTensor tympani muscle,Physiology of eustachian tube,Maintains pressure balance between middle ear and outsideDrainage Prevent retrog
43、rade infectionPrevent strong sound,Auditory physiology,Sound transductionSound perception,Basilar membrane displacement for a 1 kHz tone,Basilar membrane displacement for a 250 Hz tone,Basilar membrane displacement for a 4 kHz tone,Cochlear mechanical response due mass and stiffness gradient,Cortis
44、organ responds OHCs electromotion,OHC,Physiology of quilibrium,Equilibrium is the state of balance of the body.An erect standing human has a highly unstable equilibrium.Through a variety of sensory inputs(vestibule,visual and so forth)and postural reflexes(proprioception),the body is maintained in its erect posture.Vestibule:Recognize linear acceleration by otolithic macula(utricle+saccule)Semicircular canal:receptor of positive and negateive angular acceleration,Thanks for your attention,
