VESTIBULOCOCHLEAR

CLINICAL ANATOMY

Dr.Adnan A,SpTHT,M.Kes

Fakultas Kedokteran Universitas Muhammadiyah Yogyakarta

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VESTIBULER

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PANCA INDERA

MATA

HIDUNG

LIDAH

TELINGA

KULIT

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Fungsi Telinga
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Wajah Manusia Yang Sempurna

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KOMPONEN UTAMA SISTEM
PENDENGARAN
TELINGA LUAR

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 Anatomi Telinga Manusia
OSSEOUS SYARAF VESTIBULAR &
MEMBRAN LABYRINTH & SYARAF AUDITORY
PINNA
TIMPANI COCHLEA

OSIKULA

EUSTACHIAN
CANAL

CANALIS 12
AUDITORY
 Struktur Telinga Luar
Auricle (Pinna)
Pengumpul suara
Melokalisasi suara
Frekuensi bunyi lebih
efisien ke membran
timpani

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 TELINGA LUAR
THE PINNA
KARTILAGO DAN KULIT
8 STRUKTUR

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 OUTER EAR
PINNA / AURICLE
CARTILEGE COVERED
WITH
PERICHONDRIUM
BOUND TO THE SKIN
AUDITORY MEATUS
2/3 CARTILEGE
1/3 BONE
STOPS AT THE
TYMPANIC
MEMBRANE

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CINTA

aIDIOPATHIC

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MEMBRAN TIMPANI
Pembatas telinga luar dan telinga tengah
Translusen
Keabu-abuan
Otoskop Cone of light
Bentuk Oval dan konkaf, pusat mallleus malleus

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Thin membrane
Forms boundary between outer and middle ear
Vibrates in response to sound
Changes acoustical energy into mechanical energy

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LAPISAN EPITELIAL

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KELAINAN MEMBRAN TIMPANI

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OSIKULA
A: Malleus
B: Incus
C: Stapes
Ossicles are smallest
bones in the body
Act as a lever system
Footplate of stapes
enters oval window of
the cochlea

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Malleus (hammer) one of the middle ear ossicles
3 parts
Umbo, manubrium short process, may show through the
drum
Lymphatic drainage of the external ear flows into
Parotid, mastoid, superficial cervical nodes

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KELAINAN OSIKULA

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Pendeteksian Gelombang Selama
Proses Mendengar Suara
Auditory Sound Waves Auditory Brain Response Waves

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MASTOID
Bony ridge behind the auricle
Provides support to the external ear and posterior
wall of the middle ear cavity

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TUBA EUSTACHIUS

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M.STAPEDIUS

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Cochlea

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Cochlea cross-section

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Organ of Corti

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Inner vs Outer Hair Cells

InnerHairCells OuterHairCells

Sensory Motor

Afferentnerves Efferentnerves

Singlerow c.3rows

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Inner hair cell

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Hair Cell
Stereocilia

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 Auditory nerve innervation

IHC (1) OHC (2)

radial afferent (blue) lateral spiral afferent (green)
efferent (pink) medial efferent (red)
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 PROPAGASI SINYAL PADA TELINGA
BAGIAN DALAM

Detail Organ of Corti

proses perubahan getaran
menjadi sinyal listrik
Pengiriman sinyal listrik
Bagian Cochlea dan Organ of Corti ke-otak melalui syaraf 37
PROSES EKSITASI SINYAL LISTRIK DALAM
ORGAN OF CORTI
Sinyal listrik

Getaran Spectrum
sinyal 1k Hz

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Proses pendengaran dan persepsi suara oleh manusia

(blok diagram fisiologi)

Auditory Sound Waves Auditory Brain Response Waves

Right Ear (R)

R R R L R L L
ED AC
EC BC BM HC CN SOC LLN IC MGB (R)

ED
EC BM HC CN SOC LLN IC MGB AC
BC
(L)
L L L R L R R

Left Ear (L) Sound Vibration Traveling Neural

wave wave wave wave

EC : Ear Canal ED : Ear Drum BC : Bone Conduction BM : Basilar Membrane HC : Hair Cell
CN : Cohlear Nucleus SOC : Superior Olivary Complex LLN : Lateral Lemniscus Nucleus
IC : Inferior Colliculus MGB : Medial Deticulate Body AC : Auditory Cortex 39
Function of hearing
3 levels
1. Peripheral ear transmits sound and converts its
vibrations into electrical impulses that can be
analyzed by the brain. The electrical impulses are
conducted by the auditory process of cranial nerve
VIII (Acoustic) to the brain stem
1. Amplitude=loudness
2. Frequency=pitch

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Sound waves cause the eardrum to vibrate
Vibrations travel via the ossicles thru the oval
window, the cochlea and are scattered against the
round window
The basilar membrane of the cochlea contain the
organ of Corti receptor hair cells that translate the
vibrations to electric impulses
The impulses go to the brainstem via Acoustic
nerve (VIII)

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2. Brain stem function is binaural interaction
permits identification of sound and locating the
direction of a sound in space. The acoustic nerve
(Cranial nerve VIII) sends signals from each ear to
both sides of the brain stem. Brainstem is sensitive
to intensity & timing from the ears depending on
head position

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Pathways of hearing
1. Air conduction (AC) normal pathway of hearing,
the most efficient
2. Bone conduction (BC) bones of the skull vibrate
and transmit vibrations to the inner ear and acoustic
nerve

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PARAMETER AKUSTIK YANG
DITANGKAP
Energi suara p [N/m2]
simpangan genderang telinga amplitudo vibrasi tulang-
tulang telinga amplitudo gelombang pada cairan dalam
cohlea amplituo sinyal listrik yang menuju otak
Frekuensi suara f [cps Hz]
Osilasi pada genderang telinga osilasi pada tulang-
tulang telinga osilasi pada cairan dalam cohlea
frekuensi sinyal listrik yang menuju otak
Waktu t [second] temporal phenomenon
Time history, time varying, time delay yang terjadi
bersamaan dengan perubahan energi dan frekuensi
Ruang atau posisi [x, y, z] spatial phenomenon
Lokasi atau perubahan koordinat sumber atau penerima

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Kemampuan Telinga Manusia
TELINGA MANUSIA adalah :
SUATU TRANDUSER BIOLOGIS
MAMPU MENGUBAH DAN MENGONTROL INPUT SINYAL SUARA :

MENGATENUASI INTENSITAS INPUT YANG TINGGI

MENINGKATKAN INTELLIGIBILITY SUARA LEMAH
MELAKUKAN ANALISIS FREKUENSI
MERUBAH ENERGI AKUSTIK - GETARAN LISTRIK
MELAKUKAN PENGENALAN POLA SINYAL SUARA
MELAKUKAN PERSEPSI INFORMASI YANG TERKANDUNG
MELAKUKAN TANGGAPAN TERHADAP SINYAL DAN INFORMASI

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Rentang Pendengaran Manusia & Hewan

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Hearing loss
1. Conductive mechanical dysfunction of the
external or middle ear resulting in partial hearing
loss (if amplitude to reach nerve elements in
inner ear, person can hear)
1. Causes= impacted cerumen, FB, perforated eardrum,
pus/bld in the middle ear, otosclerosis

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Hearing loss
2. Sensorineural ( perceptive) pathology of the inner
ear, acoustic nerve or auditory areas of the cerebral
cortex. amplitude may not help
1. Causes= Presbycusis, a nerve degeneration due to
aging (50yrs) or ototoxic drugs
3. Equilibrium labyrinth feeds info to the brain about
the bodys position in space, inflammation causes
vertigo.

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VESTIBULAR
Consists of three semi-
circular canals
Shares fluid with the
cochlea
Controls balance
No part in hearing
process

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Question ?

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