Methods and technique of

endoscopic research of ENT-

organs. Clinical anatomy and

physiology of auditory

analyzer

Study 1

Auditory analyzer consists of:

Auricle

Middle ear

Inner ear

Transmitting ways

Central part

Peripheral

Part

Central Part

Auricle

• Collects sounds

• Helps to identify the direction of sound

• Increases the high frequency sound sensibility

External auditory passage

(canal)

• 3 cm long

• S - Form

• 1/3 cartilaginous (membranous) ц2і3цosseous

• Cerumen (Earwax) glands

• Increases sounds

Middle ear

• Tympanic cavity

• Mastoid cells

• Auditory tube

Middle ear anatomy

Tympanic cavity

• Divided into 3 parts (floors)

• There are 6 walls

• There are 3 bones and 2 muscles

External auditory passage

(canal)

Tympanic membrane

lateral wall

Age anatomy of tympanic membrane

In adults In children

Tympanic membrane

• Is a thin membrane and consists of 3 layers

• Separates external auditory canal from the tympanic cavity

• Is vibrating under influence of sound waves and transmitting oscillations to osteones.

• Is the main increaser of transformational mechanism of middle ear.

Mastoid process

• Cells of mastoid are the passive air reserve of middle ear

Osteones

• A: malleus

• B: incus

• C: stapes

– Are the smallest bones of

human body

– Are functioning as a general

lever mechanism

– Increase the sound pressure to

the liquids of inner ear

– Defend the inner ear structures

from the loudest sounds

Слухо тру

• Consists of membranous and osseous parts

• Does the barofunction

• Opens during swallowing and gaping

Auditory (Eustachian) tube

Inner ear

Cochlea Sound waves endo- and perilymph vibration chemical reaction electric impulse

Or

T

Spiral (Corti) organ

• The sound-perceptive

part of auditory analyzer

• The transformation of

mechanical vibration into

the electric impulse

Hair cells Outer cells, inner cells

Outers 4 times less numerous than inners

Outer cells are more sensitive for sound vibrations (~40 dB)

Mechanic vibration leads to the affecting mediators, which correspond with reacting of nerve cells

Age anatomy of auditory tube

Adult’s Children’s

Frontal rhinoscopy

Oropharyngoscopy

Laryngoscopy

Auricle examination

Otoscopy

Auditory tube examination

• Normal picture of

auditory tube ostium

Auditory tube examination

• Adenoid vegetation

in auditory tube

ostium

Auditory tube examination

• Enlarged posterior

end of nasal

turbinate which

coved the auditory

tube ostium

Auditory tube examination

• Hypertrophy of

auditory tube tonsill

Auditory tube examination

• Allergic aedema in

mucose of auditory

tube ostium

Auditory and vestibular

analyzer research

Study 2

Tuning fork examination

Tuning fork examination

Inner ear anatomy

Auditory analyzer research

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Transmitting ways of auditory analiser

First neuron – bipolar cells of spiral ganglion

second neuron– ventral and dorsal nucleus of medulla

Third neuron– olive complex

Forth neuron– medial

geniculate body

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Anatomy and physiology of vestibular analyzer

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Vestibular apparatus

Vestibular apparatus

Hear cells - 50-100 steriocillies one kinocillium

Cupula

• Crista ampullaris consists from sensorial and supporting cells

Semicircular cells in rotation

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Otolitics apparatus and gravitation

Vestibular connections