Lecture of Hearing
Lecture of Hearing
Lecture of Hearing
OBJECTIVES
At the end of this interaction, the
learners are expected to:
Identify different parts of the ear with their
function.
Explain how sound waves transmit through
different parts of the ear.
Describe transduction and stimulation of
auditory nerve.
Explain auditory pathway.
Distinguish abnormalities of hearing.
Identify various hearing tests.
2
Auditory system (Sensation of
hearing)
Function
Sound discrimination,
Frequency
Intensity
Localization of the source,
Language comprehension or
perception.
3
INTRODUCTION
The ear
Receives sound waves, discriminates
their frequencies, and transmits
auditory information into the CNS,
where its meaning is discerned.
Anatomically, has three parts i.e.
external, middle and internal.
Houses receptors for two sensory
modalities i.e. for hearing and
equilibrium.
The receptors for hearing and
equilibrium are hair cells.
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Auditory structures
Hearing apparatus are divided into 3 parts:
1. External ear
a. Pinna (Auricle) : collect sound wave from air and
directs them into auditory meatus.
b. Auditory meatus: Allows entry of sound waves into
the auditory canal
c. An auditory canal that conducts sound wave into
the tympanic membrane.
It contains hairs and glands:
Prevent passage of foreign materials
to the tympanic membrane.
d. Tympanic membrane/ear drum:
Is a thin cone-shaped membrane with 1cm in
diameter
Separates external ear from the middle ear
Conducts sound wave without changing the
frequency to the middle ear.
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Its rupture results in deafness.
Fig. Anatomy of the Ear 6
Auditory apparatus (cont’d)
2. Middle Ear:
Is air filled chamber in the temporal bone.
Contains:
3 bony ossicles: Malleus, Incus & Stapes (out-inward)
The are 2 small skeletal muscles in the middle ear:
Tensor tympani muscle
Innervated by the trigeminal nerve.
Its contraction pulls the manubrium of
the malleus medially.
Stapedius muscle
It is innervated by the facial nerve.
Its contraction pulls the foot plate of the
stapes out of the oval window.
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Articulation of the auditory ossicles
Connections of malleus, incus and
stapes
The handle of the malleus is connected to
the inner surface of the tympanic
membrane
The head of malleus is articulated with the
incus
The other end of incus is articulated with
the head of stapes
The footplate of stapes connects to the
membrane of oval window of cochlea.
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Auditory tube also called Eustachian tube
Connects middle ear to the nasopharynx.
Function
Helps in equalization of air pressure on both
sides of the eardrum, which is necessary for
normal hearing.
Renewal of air in the middle ear
Nerve fibres:
Branch of the trigeminal nerve that innervates Tensor
tympani muscle.
Branch of facial nerve that innervates the stapedius
muscle.
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Tympanic reflex
When loud sounds are transmitted through the
ossicular system and from there into the CNS, a
reflex occurs after period of 40 to 80 ms to cause
contraction of the stapedius muscle and, tensor
tympani muscle.
The contraction of tensor tympani muscle pulls
the handle of the malleus inward while the
stapedius muscle pulls the stapes outward.
These two forces oppose each other causing the
entire ossicular system to develop increased
rigidity.
Greatly reduces the ossicular conduction of low-
frequency sounds (by 30 to 40 decibels), mainly
frequencies below 1000 cycles per second.
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Center for this reflex is inferior colliculus
of the MB.
↑ Sound intensity (loud sound) →
contraction of tensor tympani and
stapedius muscles →Pull malleus inward &
stapes outwards → ↓Vibration of ossicular
bones →↓Intensity of sound perceived by
CNS→ ↓Sound transmission.
The function of this reflex:
To protect the cochlea from damaging
vibrations caused by excessively loud sound.
To mask low-frequency sounds in loud
environments.
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Auditory apparatus (cont’d)
3. Inner Ear (Labyrinth)
Is the fluid filled cavity with in the temporal bone.
Is made up of 2 components:
A.The Bony Labyrinth
Is formed by a network of cavities in the temporal bone
Inside these channels, there is a fluid called perilymph,
which surrounds the membranous labyrinth.
B.Membranous Labyrinth
Is the membranous tube with in the bony labyrinth
Is filled with a fluid called endolymph
Has high concentration of K+.
The inner ear contains auditory labyrinth (cochlea)
and vestibular labyrinth (saccule and utricle).
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Cochlea (so called from
the
snail-shell shape).
The cochlea is a system of
coiled tubes.
• A spiral organ with about 1000-
4000 inner hair cells. The tip is
low frequency.
Necessary for hearing
Contains a bony core and a
thin bony shelf that winds
around the core like threads
of a screw.
Transduces sound waves in to
nerve impulse
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Cochlea cont’d…
Cochlea has two bony cavities: scala vestibuli and scala tympani
that are filled with perilymph.
The 2 bony cavities are divided by a membranous structure called
scala media that is filled with endolymph
At the base of the cochlea, scala vestibuli ends at the oval window,
which is connected to the foot plate of the stapes.
Scala tympani ends at the round window that is covered by a
flexible secondary tympanic membrane.
Scala media is also called cochlear duct
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Cochlear fluid composition
Perilymph
The fluid with in the scala vestibuli and scala tympani
It has similar ionic composition as ECF with high Na+ and low K+
Endolymph
The fluid with in the scala media has similar ionic composition as
ICF with high K+ and low Na+
Endolymph is electropositive in comparison to
perilymph
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Cochlear fluid composition
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Mechanism of depolarization of hair cells
Movement of K+ into the hair cells
• The electrochemical gradient favours the movement of K+ into the
cells.
• Endolymph contains high K+ because of continuous transport of
K+ into the scala media by the stria vascularis
• Bending of hair cells cause K+ channels to open or close to build
up receptor potential called endocochlear potential
• When organ of corti moves up, K+ channels open → K+ flows into
hair cells → membrane depolarization.
• When organ of corti moves down , K+ channels close
→Hyperpolarization.
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Release of synaptic Deformation of Cilia Opens
transmitters Ion channels
• K+ influx →hair cells
depolarization →opening
of Ca2+ channels →Ca2+
initiates release of NTs
(glutamate and aspartate)
which stimulate auditory
nerve fibers.
• Cell bodies of auditory
nerve fibers are located
with in the spiral ganglia.
• Their axons join those
from the vestibular
apparatus to form the
vestibulocochlear nerve
(CN VIII)
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Properties of Sound Wave
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Intensity of sound
The intensity of sound is measured in terms of bells (B) or
decibells (dB). 1 dB = 0.1 B
Intensity of sound in bells after Grams Bell, the inventor of
telephone, equals the log10 of the ratio of intensity of sound
to that of a standard reference sound.
Intensity of the given sound
Sound Intensity = log10
Intensity of the standard sound
The standard reference sound is a sound having a
frequency of 1000 Hz and intensity which is audible in
young adults (hearing threshold)
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Intensity of sound of different conditions
Ordinary conversation = 50 dB, 5 bells
Noisy factors = 100 dB (10 bells)
Sound intensity above 120 dB produces pain
Intensity of sound of jet plane = 160 – 180 dB
High intensity sound with high frequency (100,000Hz),
ultrasonic waves cause tissue destruction.
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Encoding of auditory information
1. Encoding of frequency
The frequency of sound that activates a particular hair cell
depends on the location of the hair cell along the basilar
membrane.
The basilar membrane is narrowest and stiffest at the base of
the cochlea (near the oval and round windows), and widest
and most compliant at the apex of the cochlea (near the
helicotrema)
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Encoding freq. cont’d
A. The energy contained in high
frequency sounds passes through
the organ of Corti near the base of
the cochlea, because the stiff
portion of the basilar membrane
resonates with high frequencies
B. In contrast, the energy in low-
frequency sounds pass through the
organ of Corti near the apex of the
cochlea, because the compliant
portion of the basilar membrane
resonates with low frequencies.
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2. Encoding of intensity
As intensity of the sound wave increases:
The frequency of firing in an auditory nerve fiber
increases.
larger portion of the basilar membrane is vibrated
Auditory nerves are activated.
Thus, sound intensity is encoded by the number of
auditory nerve fibers that are active.
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3. Encoding of Locality
It depends upon:
The time lag between the entry of sound
into one ear and into the opposite ear.
This factor discriminates the direction
more exactly than other factors.
The difference between the intensities of
sound in the two ears.
The mechanism operates best at
higher frequencies.
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Mechanism of hearing
1. Sound waves are collected by pinna, directed by the
auditory meatus,
2. Sound wave cause vibration of the tympanic membrane by
the same frequency,
3. Vibration of the tympanic membrane is transmitted and
amplified by the bony ossicles of the middle ear and oval
window.
4. As the stapes vibrate moving back and forth, it pushes the
oval window in and out against the cochlea, thus
transmitting sound wave to the cochlear fluid.
5. Mov’t of the oval window sets up waves in the perilymph
6. As oval window bulges inward, it pushes the perilymph of
the scala vestibuli to form and propagate waves into the
scala tympani through helicotrema.
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Mechanism of hearing cont’d
7. The mov’t of the perilymph in the scala vestibuli compresses
the vestibular membrane pushing the endolymph inside the
scala media.
8. Mov’t of endolymph causes the basilar membrane to move up
and down at pattern of freq and intensity of sound.
9. Mov’t of the basilar membrane causes mov’t of hair cells
against the tectorial membrane.
10. Mov’t of hair cells produce receptor potential which initiates
nerve impulse in the cochlear nerve.
Therefore, mov’t of the basilar membrane is essential
for the stimulation of hair cells of organ of corti.
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Auditory pathway
1. Sound wave is converted into nerve impulse by the hair
cells. Nerve impulse is transmitted from hair cells to the
cochlear nerve. These primary afferent neurons have their
cell bodies in the spiral ganglia like that of spinal DRG.
2. Nerve fibres from the spiral ganglia enter the dorsal or
ventral cochlear nuclei in the medulla, where the 2 nd order
neurons begin
3. Second order neurons pass mainly to the superior olivary
nucleus in medulla of the opposite side. Crossing occurs b/n
those fibres from both sides forming the trapezoid body.
4. From the cochlea nuclei (2nd order neurons), auditory
impulses pass via variety of ways to end on medial
geniculate body in the thalamus.
5. From the medial geniculate body of thalamus, auditory
information is projected to auditory center in the temporal
lobe of the cortex.
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Nerve Pathway
cont’d
First order sensory
neurons in the cochlea
branch of each
vestibulocochlear(VIII)
nerve terminate in the
cochlear nuclei of the MO
on the same side.
From there, axons
carrying auditory signals,
projects to the superior
olivary nuclei in the pons
on the same side. 34
Nerve Pathway
cont’d
From both the cochlear
nuclei and the olivary
nuclei, axons ascend to
the inferior colliculus in
the midbrain and then to
the medial geniculate
nucleus of the thalamus.
Slight difference in the
timing of impulse arriving
from the two ears at the
olivary nuclei allow us to
locate the source of a
sound.
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Nerve Pathway cont’d
From the thalamus ,
auditory signals projected
to the primary auditory
area in the superior
temporal lobe of the
cerebral cortex
(Broadmann's areas 41
& 42).
Site of sound Perception.
Since many auditory axons
cross over in the medulla,
the right and left primary
auditory areas receive
nerve impulse from both 36
Nerve Pathway cont’d
Temporal lobe: It contains:
1. Auditory areas (areas-41 & 42)
Receive sensory fibers from cochlea
which is primary auditory center.
2. The auditory association or
interpretation area (areas 20, 21 & 22).
Site of interpretation &
association of auditory and visual
information.
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Auditory pathway
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Hearing Abnormalities
Deafness is usually divided into two:
1.Nerve deafness: is caused by
impairment of the cochlea or impairment
of the auditory nerve.
If either the cochlea or the
auditory nerve is destroyed, the
person becomes permanently deaf.
2.Conduction deafness: is caused by
impairment of the physical structures of
the ear that conduct sound waves to the
cochlea.
12/ 28 / 2009 39
Hearing Abnormalities cont’d
1. Conductive deafness
Interference with transmission of vibrations to
the inner ear.
May be due to plugging of the external auditory
meatus with cerumen or changes in the eardrum
or auditory ossicles:
Accumulation of wax in the external auditory
canal.
Eardrum may harden as a result of disease
and be less responsive to sound waves.
Perforation of membrane.
Destruction of part of the ossicular chain of
loss of its mobility (osteosclerosis).
Perforation of the eardrum.
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Hearing abnormalities cont’d
2. Nerve deafness
Damage to the cochlea, auditory nerve
or auditory nerve pathways.
Can be caused by :
loud sounds, tumors in the CNS,
brain damage as a result of vascular
accidents or use of certain drugs.
Lesion in the auditory pathways as
a result of toxins, streptomycin,
inflammation, vit.B deficiency,
exposure to high level of sound
intensity.
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Hearing abnormalities cont’d
Tinnitus
It is a ringing sensation in the ears
caused by irritative stimulation of either
the inner ear or the vestibulocochlear
nerve.
These noises may come and go or may
always be present.
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Hearing abnormalities cont’d
Labyrinthitis
Inflammation of the labyrinth.
Usually caused by a viral infection, occasionally
bacterial infection .
Symptoms include reduced hearing or distortion,
ringing in the ear, dizziness, imbalance, nausea and
vomiting.
Often follows common cold.
Appropriate antibiotic for bacterial cause
Anti-nausea medication can be prescribed
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Hearing abnormalities cont’d
Meniere’s Disease
Inner ear disorder that causes ringing in the ears,
increased sensitivity to sounds, dizziness, and
hearing loss.
Is a problem with the inner ear, which is the part of
the ear responsible for balance as well as hearing.
Too much endolymph (fluid) backs up in the canals,
a condition called endolymphatichydrops.
Extra fluid causes pressure to build up, so the
canals swell and can’t work right.
This leads to problems with the ear’s
hearing and balance systems.
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Hearing abnormalities cont’d
Otitis media
Inflammation of the middle ear,
May be acute or chronic
Bacterial or viral infection usually occurs
following URTI.
Otosclerosis
Formation of spongy bone in the inner
ear, which often causes deafness by
fixing the stapes to the oval window.
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Audiometry
Measurement of auditory acuity for
various frequencies of sound waves.
Audiometer: Is an instrument used to measure
auditory acuity.
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Hearing tests
There are tests used to differentiate conduction deafness
and nerve deafness.
Done using Tuning Fork
1. Rinne’s test:
The base of a vibrating tuning fork is placed on the
mastoid process until the subject no longer hears
vibration.
Then the fork is held in air near the ear.
a. In normal subjects, sound is heard in air after bone
conduction is over.
b. In conduction deafness, sound is not heard in air after
bone conduction.
c. In nerve deafness, both bone and air conduction are
impaired.
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Hearing tests cont’d
2. Weber’s test:
• The base of the vibrating tuning fork is placed on the vertex
of the forehead.
a. In normal subjects, sound is heard in both ears.
b. In conductive deafness, vibration is heard better in the
diseased ear.
c. In nerve deafness, sound is heard better in the normal ear.
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