HEARING • Foot plate of the stapes is attached to the

annular ligament of the oval window

Ma. Noemi E. Jiao,MD,DPPS
Tympanic membrane acts as a resonator
Anatomy of the Ear
that reproduces the vibrations of the
3 Major Divisions: sound source

1. External/Outer Ear Motion in the Tympanic Membrane →

2. Middle Ear Rocking of the malleus → Vibrations are
3. Inner/Internal Ear transmitted to the incus

Outer/External Ear Incus transmits vibrations to the head of

the stapes → Swinging of stapes to and
1. Pinna – shell shaped surrounding the
from at the oval window → Causes sound
auditory canal
pressure against the perilymph filled
• Collects and directs sound waves in the scala vestibuli
auditory canal (function lost in humans)
2. External auditory canal – short narrow Lever action of the incus and malleus –
bone (the one that you clean to remove your multiplies the force of vibration by 1.3x
cerumen)
Tympanic membrane multiplies the force of
3. Ceruminous glands – found on the skin
vibration by 17x
lining the walls of the external auditory canal
• Secretes earwax or cerumen Sound pressure that arrives at the oval
4. Tympanic membrane – found at the end window is increased by 22x
external auditory canal (medial area)
• Only 60% of the sound energy in the
• Separates the outer ear from the middle
tympanic membrane is transmitted to
ear
the fluid in the cochlea
SOUND WAVES (enter the pinna) → EXTERNAL • Absence of the ossicular system and
AUDITORY CANAL → EARDRUM → VIBRATE the tympanic membrane results in
decrease in the sensitivity of hearing
Middle Ear
by 15-20 decibels
1. Tympanic Cavity – small, air-filled cavity • A medium voice is barely perceptible
within the temporal bone (heard as a whisper)

Boundaries: 2 Small Skeletal Muscles of the Middle Ear

• Laterally – eardrum (constitutes the 1. Tensor Tympani Muscle – contraction

lateral boundary) causes pulling of the manubrium of the
• Medially – oval window - round window malleus medially.
o membrane covered • Decreases the vibration from the
tympanic membrane
3 Auditory Ossicles 2. Stapedius muscle – contraction pulls the
1. Malleus: foot plate of the stapes out of the oval
a. Handle – manubrium, attached to the window
tympanic membrane Tympanic/Attenuation Reflex
b. Head – attached to the wall of the middle
ear • Contraction of tensor tympani and
c. Short process – attached to the incus stapedius muscles
2. Incus – articulates with the head of the • Decrease in sound transmission by
stapes 30-40 decibels
3. Stapes – resembles a stirrup
Tympanic/Attenuation Reflex

Function:

1. Protects the cochlea from damaging

vibrations caused by excessive loud sounds
2. Mask low frequency sounds in the loud
environment – removes background noise
3. Decrease a person’s sensitivity to his own
voice 3 Chambers of the Cochlea

Auditory tube – links the middle ear activity with the 1. Scala Vestibuli – upper chamber
throat • Contains the perilymph
• Communicates with scale
• Normally flat and close
tympani through the
• Opens during swallowing and yawning to Helicotrema
equalize the pressure in the middle ear with
• Ends at the oval window
the atmospheric pressure
at the base of the cochlea
Otitis Externa – Inflammation of the external ear 2. Scale Media – middle cochlear chamber
• Continuous with the
Otitis Media – fairly common results of sore throat membranous labyrinth
especially in children whose auditory tubes run more
• Contains endolymph
horizontally
• Bounded by the Reissner’s
• Eardrums bulges and often gets inflamed membrane on top and the
Basilar membrane below
Treatment of Otitis Media • Contains the Organ of Corti-
1. Antibiotics the receptor for hearing
2. Decongestants
3. Myringotomy

“Never prop a bottle or feed infants when they lying

flat”

Inner Ear (Labyrinth)

Made up of two parts (one within the other)

1. Bony labyrinth – a series of channels in the

temporal bone 3. Scala Tympani – ends at the round window
- Contains the perilymph • contains perilymph
- Encloses the Endolymph – fills the scala media
membranous
2. Membranous Labyrinth – duplicates the • Bathes the top of the hair cells
shape of the bony labyrinth • Produced by the stria vascularis
- Filled with endolymph • High in K+, low in Na+

Cochlea – a coiled tube in the labyrinth Perilymph - fills the scala tympani and the scala
vestibuli
- divided into 3 chambers by the Reissner’s
membrane and Basilar membrane • Bathes the base of the hair cells
• Formed from plasma
• Resembles the ECF
• High in Na+, low in K+
Basilar fibers can vibrate Hair cells are excited → Send impulses to
cochlear nerve endings → Spiral ganglion of
• Stiff short fibers are found near the oval
Corti → Send axons to the cochlear nerve
window and vibrates best at high frequency
• Long fibers are found near the tip of the
cochlea and vibrate best at low frequency
Transmission of Sound Waves in the Cochlea
Organ of Corti – located in the basilar membrane “the travelling wave”

• Receptor organ for hearing • Movement of the foot plate produces

• Contains hair cells which are auditory series of travelling waves in the
perilymph of the scal vestibuli
Hair Cells – generates nerve impulses in response • As the wave moves up the cochlea,
to sound vibration it’s height increases to a maximum
• With stereocilia which project from the hair then drops rapidly
cells and are embedded in the surface gel • Distance from the stapes to the point
coating of the tectorial membrane of maximum height varies with
• Bases synapse with cochlear nerve endings frequency of vibrations
• Upper ends are fixed on the reticular lamina High Pitch Sound/ High Frequency Sounds –
which are supported by rods of corti waves reach maximum height at the base of cochlea

Low Pitch Sound/ Low Frequency Sounds –

generates waves near the apex

Two Kinds of Hair Cells

1. Outer Hair Cells – controls the sensitivity of Determination of Sound Frequency – the place
the inner hair cells principle
2. Inner Hair Cells – where 95% of cochlear
nerve endings terminate Pitch is correlated with frequency
• more important in the detection of 1. Lower frequency sound – activation of the
sound basilar membrane near the apex
2. High frequency sound – activation near the
base
3. Spatial organization of the nerve fibers from
the cochlea to the cerebral cortex

Vibration of the oval window → Movement of the

basilar fibers → Rocking of the Rods of Corti →
Hair shears back and forth the tectorial
membrane
Specific neurons are activated by specific sound
frequencies

Hertz – unit for frequency

Decibel Unit – measurement of sound intensity

Determination of Loudness – correlated with

amplitude

1. Excitation of the nerve endings by the hair

cells at more rapid rates
2. Transmission of impulses through many
nerve fibers
3. Significant stimulation of the outer hair cells
through highly intensity vibration of the Auditory Cortex – Superior gyrus of the temporal
basilar membrane lobe

• Brodmann’s area 41
• With 2 separate areas
1. Primary Auditory Cortex –
directly excited by the projections
of the medial geniculate body
2. Secondary Auditory Cortex –
also known as association cortex

Secondary Auditory Cortex – excited by impulses

from the primary auditory cortex from the thalamic
association areas and areas adjacent to the medial
geniculate body
Determination of Sound Direction
Hearing Deficits
1. Depends upon the difference in the arrival
of the sound in the 2 ears Deafness – hearing loss of any degree
• Most important factor at 2 General Types of Deafness
frequency of < 3,000Hz
2. Louder on the side closest to the source 1. Conduction Deafness – results when
• Most important factor at something interferes with the conduction of
frequency > 3,000Hz sound vibrations to the fluids of the inner ears
3. Sounds coming from directly in front of the • Maybe caused by mechanical factors
individual differ in quality from those coming • Otosclerosis, ruptured eardrum, otitis
from behind because the external ears are media
turned slightly forward • May still be able to hear by bone
conduction even if ability to hear air
Central Auditory Mechanisms conducted sounds is lost
Cochlear Nerve → Dorsal and Ventral Cochlear • Hearing aid (use skull bones to
Nuclie (Medulla) → Fibers decussate to the opposite conduct sound vibrations) are helpful
side (Brainstem) → Contralateral Superior Olivary
Nucleus → Fibers pass through lateral lemniscus →
Inferior Colliculus → Medial Geniculate Nucleus →
Auditory Cortex
2. Sensorineural Deafness - occurs when there is
degeneration or damage to the receptor’s cells in the
organs of Corti, cochlear neve or neurons to the
auditory cortex

• Often results from extended listening to

excessively loud sounds
• A problem of nervous system structures
• Hearing aids are less helpful