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Auditory and vestibular system

Auditory and vestibular system. Auris , is = Us , oton. Auditory and vestibular system. external ear ( auris externa ) middle ear ( auris media ) internal ear ( auris interna ) = organum vestibulo - cochleare. External ear ( Auris externa ).

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Auditory and vestibular system

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  1. Auditory andvestibularsystem Auris, is = Us, oton

  2. Auditory andvestibularsystem • externalear (aurisexterna) • middleear (auris media) • internalear (auris interna) = organum vestibulo- cochleare

  3. Externalear (Aurisexterna) • auricle(auricula, pinna) • elasticcartilage • externalacousticmeatus (meatusacusticusexternus) • tympanicmembrane (membranatympanica, myrinx)

  4. Auricle • helix • crus, spina, cauda • (tuberculumauriculareDarwini, apex auriculae) • antihelix • crura, fossatriangularis • scapha • conchaauriculae • cymba, cavitas • tragus • antitragus • incisuraintertragica • lobulusauriculae posteriorsurface = negative image oftheanteriorone

  5. ligaments: lig. auriculare ant., sup., post. muscles - innervation: n. facialis • extrinsic muscles = facial muscles • mm. auriculares (ant., sup., inf.) • m. temporoparietalis • intrinsic muscles: rudimentary • m. tragicus + antitragicus • m. helicismajor+minor • m. obliquus + transversusauriculae, m. pyramidalisauriculae cartilage:cartilagoauriculae - elastic skin: dorsally more loosen, ventrally firmly fixed to perichondrium - othematoma

  6. Auricle – supply • arteries: rr. auriculares ant. a. temporalissuperficialis a. auricularis post. a. carotisexterna • veins: v. jugularisext. • lymph: nn.ll. parotidei, mastoidei • nerves: sensory • nn. auriculares ant. from n. auriculotemporalis (ventrocranial 2/3) • r. auricularis n. X. (concha) • n. occipitalisminor (dosrocranial) • n. auricularismagnus (cudal) motor: n. VII.

  7. Externalacousticmeatus(meatusacusticusexternus) • porusacusticusexternus oblique ventromed.  med.  again oblique ventromed. (totally converging ventrally 160º and convex descending, length about 22 mm) • outer 2/3 – hyalinne cartilage opened ventrally and caudally (incisuraeSantorini), lamina tragi (ventrally) • transition – the narrowest point (isthmus) – foreign bodies !!! • inner1/3 – osseous– incisuratympanicaRivini • glandulaeceruminosae + sebaceae cerumen – protection • tragi (afterage 30) • skin adheresfirmly to perichondrium – littleinflammationispainful !!! • anteriorwall: realtion to gl. parotis and art. temporomandibularis

  8. Externalacousticmeatus(meatusacusticusexternus)supply • arteries: similar to auricle + a. auricularis prof.  a. maxillaris • veins: v. temporalissuperficilais, v. auricularis post. • lymph: nn.ll. parotidei, mastoidei • nerves: r. auricularisn.X. (dorsocaudal part), n. auriculotemporalis  r. meatusacusticiexterni

  9. Tympanicmembrane(Membranatympanica, Myrinx)

  10. Tympanicmembrane - structure • sulcustympanicus, incisuratympanicaRivini • 9x10 mm, thickness 0,1 mm, surface 55 mm2 • anulusfribrocartilagineus • outersurface - thinned epidermis (ectoderm) • layerofdenseconnectivetissue (mesenchyme) • innersurface – simplecuboidepitlelium (endoderm)

  11. TympanicmembraneOtoscopy • umbo m.t. • striamallearis • prominetiamallearis • plicamallearis ant. + post. • light reflex – trigonumWilde • (= coneoflight, light reflex, Politzer's luminouscone) • Bezold‘s trias: prominentia + stria + reflex • parsflaccidaShrapnelli (5 mm2) x parstensa • - declination (50ºsagitally) • - inclination (45 ºtransversally) • paracentesis: dosrocaudalquadrant

  12. Tympanicmembrane - supply • arteries: • a. auricularis prof.  a. maxillaris(outersurface) • aa. tympanicae (innersurface) • lymph: nnl.l. mastoidei, parotidei • nerves: • a. auricularisn.X. • n. auriculotemporalis  r. membranaetympanicae

  13. Střední ucho (Auris media) • Středoušní dutina (Cavitas tympani) • Středoušní kůstky (Ossicula aditus) • Středoušní klouby (Articulationes ossiculorum auditus) • Středoušní svaly (Musculi ossiculorum auditus) • Sluchová trubice (Tuba auditivaEustachii)

  14. Tympaniccavity (Cavitastympani) • pariestegmentalis • pariesjugularis: prominetiastyloidea • pariesmastoideus: aditus ad antrum mastoideum, prominetiacanalissemicircularis lat. + n. VII., eminetiapyramidalis, fossaincudis, apertura tympanicacanaliculichordaetympani, antrum mastoideum (+ cellulaemastoideae) • pariescaroticus • pariesmembranaceus • parieslabyrinthicus

  15. Tympaniccavity parieslabyrinthicus • promontorium– firstthreadofcochlea • sulcuspromontorii – plexus tympanicus • fenestravestibuli (= ovalis) – basis stapedis + membranastapedia • fenestracochlae (= rotunda) – membranatympanisecundaria

  16. Tympaniccavity - supply • arteries: 4 aa. tympanicae, rr. caroticotympanici • veins: do plexus pterygoideus + sinus petrosus sup. • lymph: nn.ll. parotidei, mastoidei, cervicalesprofundi, retropharyngei • nerves: • n. tympanicus (n.IX) – sensory + parasympathetic (ganglion tympanicum) • r. pharyngeus (n.V2) forcartilagineous part of auditory tube • nn. caroticotympanici (sympathetic)

  17. Auditory ossicles (Ossiculaaditus) Malleus(Hammer) • caput • collum • manubrium • processuslateralis • processusanterior

  18. Auditory ossicles (Ossiculaaditus) Incus(Anvil) • corpus • cruslongum • processuslenticularis • crus breve Stapes(Stirrup) • caput • (collum) • crus ant. + post. • basis

  19. Juncturesandarticulations(Articulationesossiculorumauditus) • art. incudomallearis (saddle-shape) • art. incudostapedia (ballandsocket) • syndesmosis tympanostapedialis otosclerosis – ossification sometimesbothjoints are replacedwith syndesmosis

  20. Ligaments(Ligg. ossiculorumauditus) • lig. mallei ant. (spina o.s.)+ sup.+ lat. • lig. incudis sup. (fossa i.) + post. • membranastapedialis (fenestravestibuli) • lig. anularestapediale (fenestravestibuli) • membranatympanisecundaria (fenestracochleae)

  21. Musclesof auditory ossicles • m. tensor tympani • semicanalis m.t.t. • processuscochleariformis • manubriummallei inervace: n.V3 • m. stapedius • eminetiapyramidalis • collumstapedis innervation:n.VII n. stapedius z parsmastoideacanalis nervi facialis

  22. Tympaniccavity • shapeofhourglass– 2 mm atleveloftympanicmembrane (= mesotympanon) • recessusepitympanicus (= atticus, epitympanon, epitympanum) – 6 mm • recessushypotympanicus (hypotympanon) – 4 mm • plicaemalleares ant., post. recessus ant., sup., post. (= Prussak‘s space) • plicachordaetympani, incudialis, stapedialis • mucosa – simplecuboidepitlelium (variousheight) • mucouscellsolnyclose to theositumtubaeauditivare!!! • no glands !!!

  23. Mastoid antrum(Antrum mastoideum) • aditus ad antrum mastoideum • cellulaemastoideae (developingpostnatally – 6th yearofage) • pneumatic type • diploic type • sclerotic type • cellulaetympanicae • simpleflatepithelium • closelyrelated to sinus sigmoideus • mastoidectomy

  24. Pharyngotympanic / auditory tube (Tuba auditiva)Tuba auditoria, tuba pharyngotympanica, salpinx, tuba Eustachii • ostium tympanicum • parsossea (= semicanalist.a.) – cellulaepneumaticae • parscartilaginea – cartilago (lamina med.+ lat., lamina membranacea) – tonsillatubariaGerlachilocatedunderthemucosa • in hypertorphyoftonsillapharyngealis ventilation disturbance (mainly in children)  mesotitis • ostium pharyngeum (atlevelofmeatusnasiinf.)

  25. Pharyngotympanic / auditory tube (Tuba auditiva)

  26. Pharyngotympanic / auditory tube (Tuba auditiva) Tuba auditoria, tuba pharyngotympanica, salpinx, tuba Eustachii • equalizespressure in pharynxand in tympaniccavity • width 2 mm, length 40 mm • transitionofpseudostrstifiedcolumnarepitheliumintosimplecolumnar • glandulaetubariae, mucouscells – in cartilagineous part • in children: more, horizntal, shorterandwider • cathetrizatino via nasalcavity

  27. Pharyngotympanic / auditory tube(Tuba auditiva) • opening: • m. tensor tympani • m. salpingopharyngeus • ? role ofm. levatorvelipalatiniunclear ? • Ostmann‘s fatpad

  28. Internalear (Auris interna) • organum vestibulocochleare • osseouslabyrinth(labyrinhtusosseus) • vestibule (vestibulum) • semicircularcanals (canalessemicirculares) • cochlea • internslacousticmeatus (meatusacusticusinternus) • spatiumperilymphaticum • membranouslabyrinth (labyrinthusmembranaceus) • labyrinthusvestibularis • labyrinthuscochlearis • spatiumendolymphaticum

  29. Osseouslabyrinth (labyrinthusosseus)vestibule (vestibulum) • recessusellipticus (utricularis) • apertura int. canaliculivestibuli • maculacribrosa superior • cristavestibuli (pyramisvestibuli) • recessussphericus (saccularis) • recessuscochlearis • maculacribrosa media • maculacribrosainferior

  30. Membranouslabyrinth(Labyrinthusmembranaceus)Vestribularlabyrinth (Labyrinhtusvestibularis) • utricle (utricuus) • saccule (sacculus) • semicircularducts (ductussemicirculares) • ampullae, crura • ductusutriculosaccularis, reuniens • maculautriculi, sacculi – membranastatoconiorum (statoconium, striola) • cristaampullaris (sulcus, cupula)

  31. Otolithicorganssaculusetutriculus • macula • haircells • supportingcells • gelatinouslayer • otoconia – crystalof CaCO3 • (otoliths – term forcrystal in reptiles)

  32. Osseouslabyrith (Labyrinhtusosseus)Semicircularcanals (Canalessemicirculares) • Canalissemicircularisanterior (parallelwith axis ofpetrosal bone) – eminentiaarcuata • Canalissemicircularisposterior (perpendicular) • Canalissemicircularislateralis (horizontal) – prominentiac.s.l. ampullaossea (3) cruscommune (ant. + post.), simplex (lat.)

  33. Semicircularcanalsandducts • membranousducts in bony canals • receptors in ampullae • cristaeampullares • perpendicular to axis ofcanal • gelatinousmass • haircells • supportingcells

  34. Haircells • twotypes • apicalsurface: • 1 kinocilia • more stereocilia • basally – synapsiswith nerve fibers

  35. Osseouslabyrinth (Labyrinhtusosseus)Cochlea • cupula, basis (2 and ¾ thread) • scalavestibuli helicotrema  scalatympani • canalisspiraliscochleae • lamina spiralisossea • lamellavestibularis + spiralis • hamulus l.s. (ends in helicotrema) • lamina spiralissecundaria (in firstthreadonly) • apertura interna canaliculicochleae

  36. Osseouslabyrinth (Labyrinhtusosseus)Cochlea Modiolus • basis • lamina • canalisspiralis – ganglion cochleare • canaleslongitudinales – n. cochlearis

  37. Osseouslabyrinth (Labyrinhtusosseus)Internalacousticmeatus (Meatusacusticusinternus) porus acusticus internus fundus m.a.i. crista transversa + verticalis area n. VII. area cochlearis – tractus spiralis foraminosus area vestibularis sup. + inf. foramen singulare

  38. Membranouslabyrinth (labyrinthusmembranaceus)Cochlearlabyrinth(Labyrinthuscochlearis) scala media = ductuscochlearis • pariesvestibularis: membranavestibularisReissneri • pariesexternus: striavascularis, prominentiaspiralis, vasprominens, lig. spirale • pariestympanicus (= membranaspiralis): cristabasilaris, lamina basilaris, vasspirale • limbus spiralis: labium limbitympanici, labium limbivestibularis, (dentesacustici) • membranatectoria • Organum spiraleCorti • membranareticularis, sulcusspiralisinternus + externus

  39. Cochlea

  40. Scala media • containsendolymph • lamina basilariswithCorti‘s organ • membranatectoriacoversCorti‘s organ • osseous lamina spiralis • ligamentumspirale

  41. Corti‘s / spiral organ (Organum spirale) • haircells • external (3-4 rows) andinternal (1 row) • stereocilia on surface • endsinserted in membranatectoria • Nuel‘s spacein between • supportingcells • pillarcells (Corti )– laytheinternaltunnel • phalangeal (Deiters)– coverhaircells • outersupporting – columnar (Hensen) andcuboid (Claudius)

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