AUDITORY SYSTEM

WHAT IS THE STRUCTURE, FUNCTION & LOCATION OF INDIVIDUAL COMPONENTS OF THE OUTER, MIDDLE, & INNER EAR?
OUTER MIDDLE INNER
*Auricle/Pinna *Ossicles – Maleus, Incus, & Stapes *Cochlear
*External Auditory Meatus *Tympanic Membrane *Vestibulocochlear Nerve
*Air Conduction *Vestibular System *Neural Conduction
*Bone Conduction

 Outer Ear
o Has Ear Wax=Cerumen
 Mix of ceruminous & sebaceous gland secretions
 Thick & waxy
 Hydrophobic & acidic
 Helps to lubricate skin, stop foreign particles & water entering
o CLINICAL CORRELATE: OTIS EXTERNA “SWIMMER’S EAR”
 Inflammation of external ear
 Mild-severe pain
 Caused by bacteria (humidity, excess moisture, or contaminated water)
 Middle Ear
o Cavity filled w/ air in petrous temporal bone
o Lined w/ mucous membrane
o Has communication w/ nasopharynx via Auditory (Eustachian) Tube
o Has Tympanic Membrane – separates Middle Ear from Outer Ear
 Semi-transparent
 Externally – thin skin, Internally – thin mucous membrane
o Has Ossicles which are connected via synovial joints; covered w/ simple squamous epithelium; Stapes vibrates oval window
which will vibrate fluid in cochlea
o CLINICAL CORRELATE: OTIS MEDIA
 Inflammation of middle ear
 Persistent & severe earache
 Caused by pathogens traveling from
nasopharynx to middle ear; no
treatment=HEARING LOSS
 Inner Ear
o Has Cochlea which has 3 compartments:
 Scala Media=Cochlear Duct
 Filled w/ endolymph
 Scalar Vesitbuli – starts @ oval window
 Filled w/ perilymph
 Scalar Tympani – ends @ round window
 Filled w/ perilymph
o Scala vestibuli & tympani talk via helicotrema (small opening @ cochlear apex)
o Nerve fibers meet toward spiral ganglion in modiolus
 o Reissner’s Membrane has 2 layers of simple squamous epithelium; they separate the Scalar Media from Scala Tympani; will see
Organ of Corti
o Organ of Corti
 Mechanoreceptor of sound vibrations
 1 row of inner hair cells
 3 rows of outer hair cells
 Cochlear hair cells=specialized auditory receptor
cells
 From base, have afferent nerve fibers that
synapse w/ base of hair cells
 Tectorial Membrane=gelatinous cuticular sheet
made of glycoprotein that covers over hair cells
 Stria Vascularis=found @ lateral border of
cochlear duct; richly vascularized
pseudostratified epithelium; secretes
endolymph
 Spiral Ligament – thickened periosteal lining of bony cochlea

BE ABLE TO ID REGIONS & CELL TYPES PRESENT IN A MICROGRAPH OF THE EAR

INNER COCHLEAR HAIR CELLS INNER EAR

WHAT IS THE BASIC MECHANISM OF SOUND PERCEPTION & ANALYSIS?

 1ST: sound waves enter external auditory meatus & travel to
tympanic membrane
 2ND: sound waves vibrate the ossicles which is transmitted to
the oval window via Stapes
 3RD: movement of Stapes makes compression waves w/in
perilymph; then from perilymph to endolymph via vibrations
of the basilar membrane
 4TH: vibrations are turned into nerve impulses via hair cells in
organ of Corti & sent to brain via Cochlear Nerve
 HIGH FREQUENCY SOUNDS=max vibration of basilar
membrane near base of cochlea
 LOW FREQUENCY SOUNDS=max displacement near apex of
cochlea
 Sound intensity is proportional to degree of displacement in
basilar membrane
 Hearing is processed by the Primary Auditory Cortex (found in Temporal Lobe, BA 41, 42)
  Tonotopic Organization:
o Starts in cochlea – HIGH=vibrate closer to base, LOW=vibrate towards apex
o Same tonotopic organization preserved in spiral ganglion,
auditory nerve, cochlear nucleus & primary auditory cortex
 LOW=more anterior
 HIGH=more posterior
 There is Sound Intensity & Pain Threshold
o Measured in units of decibels (dB)
o 0 dB=softest
o 120 dB=pain threshold
 Anything greater than this is dangerous
 @ 150 dB tympanic membrane can rupture
 Sound Localization
o Done by Superior Olivary Complex
o Gets input from both Cochlear Nuclei
o Sound is localized in 2 ways:
 Interaural time delay=difference in arrival time of sound b/w
the two ears
 i.e. if sound is directed @ right ear, it takes longer for
the sound to reach left ear
 More effective @ lower frequencies
 Interaural intensity difference=sound level difference b/w ears
for sounds of high frequency
 Due to shadowing effect of head
 More effective @ higher frequencies

WHAT IS THE AUDITORY PATHWAY?

1. Auditory Nerve bring signal into brainstem; synapses in Cochlear Nucleus
2. Fibers cross in trapezoid body
3. Fibers synapse ipsilaterally & contralaterally in Superior Olivary Nucleus
a. Superior Olivary Nucleus receives input from both ears
b. 1st place where binaural processing is possible
4. Output from Superior Olivary Nucleus travels up in the Lateral Lemniscus
5. Synapse in Inferior Colliculus in midbrain
6. Projections travel up to Medial Geniculate Nucleus (MGN) in thalamus
7. Thalamic afferents reach superior temporal gyrus via Internal Capsule

WHAT ARE THE SIMILARITIES & DIFFERENCES OF CONDUCTING & SENSORINEURAL HEARING
LOSS?
CONDUCTING HEARING LOSS SENSORINEURAL HEARING LOSS
*Impairment to Middle Ear *Impairment to inner ear, cochlear, cochlear nerve or central auditory pathway
WHAT ARE THE BASIC AUDIOTRY EXAMINATION METHODS?
Rinne Test Weber Test
*Compares AC vs. BC *Looks @ lateralization
*Normal=AC > BC *Conductive Hearing Loss=louder in affected ear
*Conductive Hearing Loss=BC > AC *Sensorineural Hearing Loss=louder in normal ear
WHAT ARE THE THERAPIES FOR HEARING LOSS?
Conductive Hearing Loss Sensorineural Hearing Loss
*treated w/ surgery (i.e. replace stapes) *Hard to treat; can be treated w/ cochlear implants
 Can also treat w/ hearing aids that amplify sound

WHAT ARE THE PATHOLOGIES ASSOCIATED W/ HEARING DAMAGE?

 Tinnitus=”ringing” in ears
o Pathophysiology not really understood
o Could be due to cochlear & vestibular end-organs being
damaged
o Some drugs induce tinnitus w/ toxic doses
 Acoustic Neuroma=tumor starting in myelin sheath; forms on vestibular nerve from inner ear to brain
o Can expand out of internal auditory canal & displace cochlear, facial & trigeminal nerves in the cerebellopontine angle
o Can compress brainstem

o Small acoustic Neuroma  Impaired balance=vertigo

 Loss of hearing or tinnitus in IPSILATERAL o Large Acoustic Neuroma
ear  Hearing loss in IPSILATERAL ear
 Headaches
 Numbness/pain on one side of face
 Problems w/ limb coordination on one
side of body
 May have muscle weakness & may have
changes to voice or difficulty swallowing