Ear

Question 1

The ear is split into 3 sections. What are these? [3]

Answer 1

The external ear
Middle ear
Inner ear

Question 2

What is the pinna and whats it made of?

Another name for the pinna

Answer 2

Also called the auricle[1] , its the visible part of the ear residing outside the head [1]

Its made of elastic cartilage [1]

Question 3

External auditory meatus or ear canal
Lateral 1/3rd - what is it made out of?
What does it produce [2]
Function [2]

Answer 3

Its made of skin and cartilage like the auricle [1]
It has ceruminous and sebaceous glands [1] that produce wax [1]

Acts as a protective/disinfectant barrier. Skin gets trapped here in the wax and sheds as a cleaning mechanism

Question 4

Describe why the inner 2/3 of the EAM [1]

Answer 4

The inner EAM is thin and hair-free

Question 5

How serious is an external ear obstruction by cerumen? [1]

Answer 5

Wax or other mechanical obstruction have a minimal effect on hearing loss compared to middle or inner ear problems

Question 6

What is the tympanic membrane? [2]

Answer 6

A triple layered membrane [1] dividing the external ear canal and the middle ear [1]

Question 7

Layers of the tympanic membrane? [3]

Answer 7

Outer layer - Continuous with the skin of the EAC, in fact its grows out from the umbo at the centre of the tympanic membrane

Middle layer - Fibrous

Inner Layer - Resp. epithelium (Ciliated Columna Epithelium + Goblet Cells)

Question 8

Landmarks - auriscope [4]

How do you know its the right ear [1]

Answer 8

Handle of the malleus
Cone of light
Pars tensa, pars flaccida
Attic

Look for the adjacent jaw bone - it will be on the right side

Question 9

Name the 3 ossicles from external to internal
What are the ossicles [2]
Where does the stapes sit?
What is another structure that loops around the malleus? [1]

Answer 9

The 3 ossicles:

• Small bones that carry sound from the tympanic membrane -> Inner ear
• Malleus -> Incus -> Stapes
• The stapes foot plate sits against the oval window through to the inner ear

The chorda Tympani comes from the facial nerve and loops around the short process of the malleus.

Question 10

What are the connections of the middle ear? [2]

Answer 10

Mastoid air cells

Nasopharynx via eustachian tube

Question 11

Problems of the external ear? [3]

Answer 11

• The ossicles can be damaged by trauma or osteosclerosis
• Otitis media
• Cholesteatoma

Question 12

What is a cholesteatoma? [2]

Answer 12

An invasion of keratinized squamous epithelium [1] through the tympanic membrane into the middle ear [1]

Question 13

What are the important relations of the middle ear? [7]

Answer 13

• Middle Cranial Fossa
• ICA
• Sigmoid Sinus
• IJV
• Meninges
• Facial Nerve
• Mastoid Cavity
• Inner Ear

Question 14

What are the segments of the facial nerve? [6]

Answer 14

• Intracranial
• Meatal (passing through the internal auditory meatus)
• Labyrinthine segment
• Tympanic Segment
• Mastoid Segment
• Extratemporal segment (section outside the stylomastoid foramen)

Question 15

What does the facial nerve do? [3]

Answer 15

• Innervates muscles of facial expression
• Special sensory innervation to the ant 2/3rds of the tongue via the chorda tympani
• Parasympathetic innervation of the submandibular/sublingual salivary glands

Question 16

What makes up the inner ear? [5]

Answer 16

A bony and membranous labyrinth[1] creating sections called the scali vestibuli, tympani & media.
They contain perilymph and endolymph. [1]

The organ of corti [1] contains hair cells that connect to the cochlear nerve [1]

Also the peripheral vestibular apparatus is important in balance [1]

Question 17

How does hearing occur in terms of the inner ear? [6]

Answer 17

Vibration of stapes

• > Transmitted through oval window
• > Produces pressure waves in cochlear fluid
• > Detected by hair cells in organ of corti
• > Transmitted to brainstem via cochlear nerve -> Vestibulocochlear nerve (CN VIII)

Question 18

What is the peripheral vestibular apparatus? [4]

Answer 18

Utricle: Detects linear Horizontal Acceleration

Saccule: Detects Linear Verticle Acceleration

Semicircular Canals:

• Detect head rotation
• Responsible for vestibulo-ocular reflux

Balance info is then transmitted to the brainstem by the Vestibulocochlear nerve (Cr N 8)

Question 19

What is the vestibulo-ocular reflex? [1]

Answer 19

The ability to fix vision on an object when the head is moving

Question 20

What are the key nerves of the ear? [4]

Answer 20

• Trigeminal Mandibular branch (CN V3) supplies pinna
• Facial nerve innervates anterior 1/2 of EAM
• Arnolds nerve is the auricular branch of the vagus and innervates the posterior half of the EAC
• Jacobsons nerve is the tympanic branch of the glossopharyngeal nerve and supplies the middle ear along with the chorda tympani (branch of CN 7)

Question 21

Why is shared innervation by different parts of the face/head important? [1]

Answer 21

Otalgia can occur with no obvious ear cause, i.e. it may be referred

Question 22

Branches of the facial nerve [5]

Answer 22

Temporal
Zygomatic
Buccal
Mandibular
Cervical