Anatomy and Physiology of the Outer and Middle Ears

 

I. Pinna

    A. Anatomy

        1. Parts (a series of ridges and depressions)

            a. Helix

            b. Antihelix

            c. Triangular Fossa

            d. Scaphoid Fossa

            e. Tragus

            f. Antitragus

            g. Concha

            h. Lobule

            i. Auditory Meatus

 

        2. Composition

            a. A plate of cartilage

            b. Covered with skin

 

        3. Muscles

            a. 3 extrinsic muscles

            b. 6 intrinsic muscles

 

    B. Physiology

        1. Localization

            a. Localization = determining direction of sound

                source

            b. Reception of high frequency sounds is necessary

            c. The pinna helps in sound localization as the pinna

                collects high frequency energy

 

            d. Reason:

                1) High frequency sounds have short wavelengths

                    and don’t bend around corners (especially

                    above 2000 Hz)

                2) Recall wavelength formula

                3) So pinna helps to collect high frequencies and

                    funnel into the ear

 

II. External auditory meatus and canal

    A. Anatomy

        1. Cartilaginous portion

            a. Outer (lateral) portion of canal

            b. Covered with skin

            c. Contains glands that produce cerumen

            d. Contains tufts of hairs called goatees

 

        2. Osseous portion

            a. Inner (medial) portion of canal

            b. Covered with skin

 

        3. Shape

            a. Most people’s are sideways s-shaped

            b. Usually pull pinna straight out to view tympanic

                membrane with an otoscope

            c. Weaknesses in cartilage (fissures of Santorini)

                allow you to do this

 

        4. Isthmus

            a. Point where canal switches from cartilaginous to

                osseous portion

            b. Usually about 6 mm from tympanic membrane

    B. Physiology

        1. Sound conductor

            a. Conducts sounds from pinna to tympanic membrane

 

        2. Resonator

            a. Resonance = enhancement of the intensity of certain

                frequencies as they are transmitted

            b. Frequencies enhanced are dependent on the length

                and diameter of the tube

            c. Increase in intensity of sound transmitted through

                external auditory canal is ~ 10-15 dB SPL for

                frequencies from 1500 – 7000 Hz with the peak

                resonance (best enhancement) occuring between

                2500 Hz – 3500 Hz depending on the canal

 

III. Middle Ear – air filled normally, about the size of an

        aspirin

    A. Anatomy

        1. Box depiction (Walls)

a. Membranous (lateral)

                    1) Most lateral wall

                    2) Primarily composed of tympanic membrane          

                b. Labyrinthine (Medial)

                    1) Behind this wall is the cochlea

                    2) Basically composed of bone

                    3) Landmarks

                        a) Oval window

                        b) Cochlear promontory (“bump” for basal

                        turn of cochlea)

                        c) Round window

 

                c. Tegmental (Superior)

                    1) Ceiling of the middle ear

                    2) Composed of a thin plate of bone called the

                        tegmen

 

                d. Jugular (Inferior)

                    1) Floor of the middle ear

                    2) Beneath is the jugular vein

 

                e. Mastoid (Posterior)

                    1) Behind the mastoid process of the temporal

                    bone

   

                f.  Carotid (Anterior)

                    1) Front wall

                    2) Internal carotid artery lies in front of this

                        wall

                    3) Eustachian tube found on this wall

 

        2. Tympanic membrane

            a. Characteristics

1) Relatively thin but fairly tough

2) Translucent and silvery grey

3) Roughly circular and approx 9mm in diameter

4) Good restorative power – can heal a small hole

       in about 24 hours

                5) Appears concave (drawn in slightly) in normal

                    ear

                6) Umbo is the point where tympanic membrane is

                    most drawn in towards middle ear space

            b. Layers and areas

                1) Has three layers

                2) Has two areas

                    a) Pars Tensa

                        i) More stiffness

                        ii) Comprises most of tympanic membrane

                    b) Pars Flaccida

                        i) Less stiffness

                        ii) Small portion at top of tympanic membrane

                            between ~ 11 and 1 o’clock positions

 

        3. Ossicles

            a. Malleus - most lateral

                1) Manubrium – long process attached to tympanic

                    membrane

                2) Head

                    a) Attaches to body of incus in a ball and socket

                        joint

                    b) Occupies most of the attic with connection of

                        incus

                3) Largest ossicle *

        4) Connected to tensor tympani muscle by tendon

            attached to manubrium

 

            b. Incus – middle ossicle

                1) Short process

                2) Long process – bends in laterally towards the

                    stapes; runs parallel to manubrium

                3) Lenticular process

                    a) Attaches to the stapes

                    b) Articulates with the head of the stapes

                4) Smaller than malleus, larger than stapes

 

            c. Stapes – smallest bone in the body; located most

                medially

                1) head- connected to lenticular process of incus

                    (incudostapedial joint)

                2) Neck –connected to stapedius muscle by tendon

                3) Crura (2) – legs

                4) Footplate – connected to oval window via the

                    annular ligament

 

        4. Middle ear muscles

            a. Tensor tympani

 

            b. Stapedius

 

        5. Eustachian Tube (not covered in much detail in this

            course)

            a. Primary purpose is to aerate the middle ear space

            b. Opens approximately 1000 x/day to accomplish this

 

    B. Physiology

        1. Movement of the tympanic membrane

            a. It is a sympathetic vibrator = vibrates at same

                frequency as signal source

                1) With a low frequency signal, moves as a unit

                2) With a high frequency signal, vibrates

                    segmentally

            b. It is heavily damped = stops vibrating once signal

                source stops

 

        2. The concept of impedance (z)

            a. Definition = the resistance to motion

           

            b. Calculation

                1) z = c x density (i.e. impedance = speed of sound

                    x density)

                2) Impedance in air-filled medium is low

                   

                    air à     density = 1.21 kg/m3

                            c = 343 m/s

                            z = (1.21 kg/m3)(343 m/s) = 415 Rayls

 

                3) Impedance in fluid filled medium is high

 

                    water à     density = 998 kg/m3

                                c = 1500 m/s

                                z = (998 kg/m3)(1500 m/s)

                                  = ~ 1,497,000 Rayls

 

            c. Impedance mismatch * (changed from web)

                1) Without help from the design of the middle ear, a

                    lot of energy would be reflected back due to the

                    differences in the impedances of the media

 

                2) Calculation

                    a) Energy transmitted = (4z1z2) / (z1 + z2)2

                    b) Using the above values, this results in an

                        answer of 0.001 or 0.1%

                    c) Converting to a dB value, we end up with

                        –30 dB SPL

 

                    d) That is we lose 30 dB SPL in the transmission

                        of sound from an air-filled medium to a fluid-

                        filled medium

                    e) The author of your text takes some issue with

                        this value à read this section

 

                3) Mechanisms to overcome impedance

                     mismatch

 

                    a) Areal effect - funneling pressure from large

                        area to smaller area

        1) Tymp memb = 55 mm2 effective area *

        2) Oval window = 3.2 mm2 area

        3) Ratio is 55/3.2 @ 17

        4) 20 log (17) = 24 dB increase

 

                    b) Leverage effect - effect (lever-ratio

                        hypothesis)

                        1) Long process of manubrium (of the malleus)

                             is longer than the long process of incus

        2) Difference in length between manubrium

             and incus produces a lever system with a

             gain in acoustic energy

        3) Ratio is 9/7 @ 1.3

        4) 20 log (1.3) = 2.3 dB increase (usually see

             rounded to 3 dB)

               

                    c) Curvature of the tympanic membrane

                        1) Has to do with curvature of the tympanic

                            membrane

                        2) Adds additional approx 6 dB increase *

        3. Ossicular chain movement

            a. Tympanic membrane receives acoustic pressure

                directed against the ear

                1) Causes movement of the tympanic membrane

                    a) It moves more in inferior portion than top (due

                        to pars flaccida)

                    b) Its movement is proportional to incoming

                        sound

 

                2) With positive pressure on the tympanic

                    membrane:

                    a) Manubrium of malleus moves medially, head

                        of malleus swings laterally and pulls head of

                        incus with it (rocking motion)

    b) This causes lenticular process of incus to move

        across the head of the stapes, causing the

        stapes to move in and out of the oval window

    c) Stapes movement causes oval window

        movement which causes inner ear fluid

        displacement

 

3) With negative pressure on the tympanic

    membrane all motion is reversed

 

            b. Motion of the stapes footplate changes with

                intensity and frequency of sound

 

                1) With moderate intensity (<70 dB SPL) anterior

                    portion of stapes footplate moves further into

                    oval window than posterior portion

 

                2) With high intensities (>70 dB SPL) and low

                    frequencies (< 150 Hz) :

                    a) Movement is perpendicular to previous motion

                    b) Top half of stapes footplate moves into oval

                        window while bottom is pulling out

                    c) This motion doesn’t effectively move cochlear

                        fluids (protective function?)

 

                3) With high intensities and mid-to-high frequencies

                    both motions occur simultaneously (still less

                    effective than 1)

 

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