Fuad Ridha Mahabot

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Anatomy of the Ear
Ear - organ of hearing and
maintaining equilibrium

3 parts:
external ear
middle ear
inner ear

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external ear
 pinna/auricle
 external auditory canal

 tympanic membrane

middle ear
 Eustachian tube
 tympanic cavity

 mastoid air cells

inner ear
 cochlea
 vestibular apparatus

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External Ear

Pinna
framework of a single piece of
cartilage covered with skin
(except for the lobule)
has lateral and medial surfaces
also has ridges and depressions
perichondritis – infection of the
perichondrium of pinna –
extremely painful

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External Auditory Canal
extends from the concha to
the tympanic membrane
24mm long
not a straight tube
2 parts
 outer 1/3 cartilaginous
(8mm)
 inner 2/3 bony (16mm)

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cartilaginous part
 continuation of cartilage from
the pinna
 skin coverings - thick, contain
ceruminous and pilosebaceous
glands  wax

bony part
 no hair/gland
 prox aspect - isthmus -
narrowing part
 FB/wax may get impacted in
the isthmus

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Tympanic membrane
(‘drumhead’)
forms partition between
EAC and middle ear
oblique in shape
divided into
 pars tensa - forms most of the
tympanic membrane
 pars flaccida - situated above
the lateral process of malleus

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Middle Ear
also called as tympanic cavity
between external and middle ear
functions
transmits sound wave from external ear to the inner ear
through the chain of ear ossicles
transforms air borne vibration  liquid borne vibration
increases intensity of sound by 10x without changing the
frequency

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contents of middle ear
three ossicles (malleus,
incus, stapes)
ligaments of ear ossicles
two muscles (tensor
tympani and stapedius)
vessels
nerve - chorda tympani
and tympanic plexus

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Eustachian Tube
 connects nasopharynx to the
tympanic cavity
 adult - runs in a oblique line
 child - straight line
 closed at rest
 2 parts
 posterolateral 1/3 - bony
 anteromedial 2/3 -
fibrocartilaginous

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functions
 regulation of middle ear
pressure
 protection against reflux of
nasopharyngeal secretions
 middle ear clearence of
secretions

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Inner Ear (Labyrinth)

important organ of
hearing and balance
consists of
bony labyrinth
membranous labyrinth

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Bony Labyrinth

complex spaces inside the

petrous part of the temporal
bone filled with perilymph
consists of
 vestibule
 semicircular canal
 cochlea

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Membranous labyrinth

delicate complex structures

seen inside the bony
labyrinth
contains endolymph
consists of
 cochlear duct
 utricle/saccule
 semicircular duct
 endolymphatic duct and sac

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Physiology of Hearing and Equilibrium
Divided into
mechanical conduction of
sound (conductive
apparatus)
transduction of
mechanical energy to
electrical impulses
conduction of electrical
impulses to the brain

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sound signal  collected by pinna  passes through EAC
 strikes the tympanic membrane
vibration of tympanic membrane transmitted to stapes
footplate through the chain of ossicles
movement of stapes footplate causes pressure changes
in labyrinthine fluid which moves basilar membrane
thus it stimulates hair cells of organ of Corti  acts as
transducer  conduct mechanical energy into electrical
impulses  travel along auditory nerve to the brain

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Physiology of Equilibrium
Balance of the various parts of the body during static or
dynamic positions are maintained by 4 organs
 Vestibular apparatus (inner ear)
 Eye
 Posterior column of the spinal cord
 Cerebellum

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Vestibular Apparatus

Vestibular apparatus of the

2 sides act as one unit
Vestibular fluids move with
head movements
Detects head position and
movements needed for
postural adjustments
Head movements can be
 Angular acceleration
 Semicircular canals: Cristae
 Linear acceleration
 Utricle and saccule:
Maculae

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Anatomy of the Nose
Nose
 respiratory passage
 organ of smell

External nose
 pyramidal in shape
 osteocartilagenous framework
covered by muscles and skin
 upper 1/3 - bony (nasal bone)
 lower 2/3 - cartilaginous

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Internal Nose
2 nasal cavities divided by
septum
communicates with the
exterior through the
nostrils and with
nasopharynx through the
choana

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Nasal Septum

3 parts:
Membranous: Medial
crura of alar cartilage
Cartilagenous:
Quadrilateral cartilage
Bony:
 Perpendicular plate of
ethmoid
 Perpendicular plate of the

vomer
 Nasal crest of maxilla

 Nasal crest of palatine

 Rostrum of sphenoid

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Little’s area
 Caudal part of the nasal
septum which has a rich
submucosal arterial network -
septal branches of
 Anterior ethmoidal
 Sphenopalatine
 Greater palatine
 Superior labial
 Prone for drying effect of
inspired air and to
microtrauma due to picking of
the nose
 Commonest cause and site of
epistaxis in children

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Lateral Wall of Nasal Cavity

marked by three projections

called turbinates or
conchae.
types
 inferior
 middle
 superior

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inferior meatus
 lowermost turbinates
 contains opening of
nasolacrimal duct
middle meatus
 rounded by bulge called bullae
ethmoidalis
 below the bullae - hiatus
semilunaris  leads to
ethmoidal infundibulum
superior meatus
 post 3rd of lateral wall
 contains opening through post
ethmoidal sinus

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Anatomy of Paranasal Sinuses
Air filled spaces in the facial
bones, lined by mucosa which
drains into the nasal cavity by
muco-ciliary function
Function
 air-conditioning
 resonance to voice
 thermal insulators
 lighten skull bone
Two groups

Anterior group: Drains into

middle meatus
 Maxillary, frontal and anterior
ethmoids

Posterior group: Drains into

superior meatus
 Posterior ethmoids and the
sphenoid
Physiology of Nose
Function of nose
respiration
air conditioning of inspired
air
protection of lower airway
vocal resonance
nasal reflex function
olfaction

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respiration
natural pathway of
breathing since newborn

air conditioning of
inspired air
acts as an ‘air-
conditioner’
filters and purifies air
adjusts its temperature
and humidity before it
passes onto the lungs

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protection of lower
airway
muco-ciliary mechanism
 secretes mucous secretion
 inspired bacteria, viruses

and dusty particles

entrapped into viscous
mucous  carried out to
the nasopharynx 
swallowed

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vocal resonance
phonating certain nasal
consonants (M/N/NG)

nasal reflexes
several reflexes which is
initiated in nasal mucosa
smell of food  reflex
secretion of saliva and
gastric juice
irritation of nasal mucosa
 sneezing

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olfaction (smell)
important for pleasure
and for enjoying the
tastes of food
when nose blocked, food
tastes bland and
unpalatable

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Anatomy of Larynx
larynx - organ of
production of voice
also an air passage
primary function
Protection of tracheo-
bronchial tree
secondary function
Phonation (generation of
sound)

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Framework of the larynx

Hyoid bone
Unpaired cartilages
 Epiglottis
 Thyroid cartilage
 Cricoid cartilage

Paired cartilage
 arytenoid cartilage
 corniculate cartilage
 cuneiform cartilage

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thyroid cartilage
 largest of all
 vocal cord attached to middle
of thyroid cartilage

cricoid cartilage
 ring shape below thyroid
cartilage

epiglottis
 located at the anterior wall of
laryngeal inlet
 ant surface connected to the
tongueand hyoid bone

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arytenoid cartilage
 pyramidal in shape
 base articulates with cricoid
cartilage
 has vocal process to give
attachment to vocal cord
corniculate cartilage
 articulates with apex of
arytenoid cartilage
cuneiform cartilage
 situated infront of corniculate
cartilage

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Vocal cords
two pearly white bands
extending from middle of
thyroid angle to vocal process
of arytenoid
for phonation
abductors - posterior
cricoarytenoid
adductors - lateral
cricoarytenoid, interarytenoid,
thyroarytenoid

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Laryngeal Joints

cricoarytenoid joint
 helps by abducting and
adducting vocal cord

cricothyroid joint
 between inferior cornu and
thyroid cartilage and at side of
cricoid cartilage
 for rotatory and glinding
movement

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 Posterior cricoarytenoid

Muscles of the Larynx

Lateral
Intrinsic cricoarytenoid

Extrinsic

Intrinsic - acts on vocal

cord / laryngeal inlet
 acting on vocal cords
 abductors - posterior
cricoarytenoid
 adductors - lateral

cricoarytenoid,
interarytenoid,
thyroarytenoid

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  acting on laryngeal inlet
 thyroepiglottic
 interarytenoid

 aryepiglottic

Extrinsic - attach larynx to

surrounding structures
 elevators - stylopharyngeus,
salphingopharyngeus,
palatopharyngeus,
thyrohyoid (primary);
mylohyoid, digastric,
 depressors - sternohyoid,
stylohyoid, geniohyoid
(secondary) sternothyroid, omohyoid

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Physiology of Larynx
Function of larynx
protection of lower
airways
phonation
respiration
fixation of the chest

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protection of lower airways
when food is swallowed, air entry into air passage is
prevented by closure of laryngeal opening
respiratory also ceased when food in contact with post
pharyngeal wall
if foreign body came in contact with laryngeal mucosa 
cough is commenced to expel/dislodge foreign particle

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phonation
adduction of vocal cord
increase infraglottic air
pressure from lungs
air force of open vocal
cord  vibration of vocal
cord  produces sound

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Sound Production
A) Vocal cords closed immediately prior to phonation (voice production).
B) Air Pressure develops below vocal cords due to air from lungs during exhalation.
C) Vocal cords separate briefly with the release of air. (1) Arrow points to the upper edge of the vocal cord.
D) Vocal cords re-approximate. (2) Arrow points to the lower edge of vocal cord.
E) Vocal cords together again.

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Thank You

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