VestibulocochlearOrgan

前庭蝸器

GeneralFeatures

ThreepartsExternalear

外耳:collectssoundwavesMiddleear

中耳:transmitssoundwavesInternalear

內(nèi)耳:containingtheorgansofhearingandbalanceExternalEar外耳Auricle耳廓Externalacousticmeatus外耳道Tympanicmembrane

鼓膜

Auricle耳郭

ExternalAcousticMeatus外耳道AslendercanalthatextendsfromexternalacousticporetotympanicmembraneTwopartsCartilaginouspart－lateral1/3Bonypart－medial2/3LinedbyalayerofthinskinThisS-shapedpassagemedially,atfirstforwardandupward,thenbackwardand,finallyforwardanddownwardInbabyhood,itisshorterand

morehorizontalthaninadult

MiddleEar中耳

Tympaniccavity鼓室Auditorytube咽鼓管Mastoidantrum乳突竇

andmastoidcells乳突小房TympanicCavity鼓室Anair-containingcavityinthepetrousportionoftemporalboneandislinedwithmucousmembraneHassixwalls

WallsofTympanicCavity

Roofortegmentalwall

蓋壁

Floororjugularwall

頸靜脈壁Medialwallorlabyrinthinewall

迷路壁PosteriorWallormastoidwall

乳突壁Anteriorwallor

carotidwall

頸動脈壁Lateralwallor

membranouswall

鼓膜壁WallsofTympanicCavityLateralwallormembranouswall鼓膜壁TympanicmembraneBonylateralwallofepitympanicrecess鼓室上隱窩superiorlyTympanicMembrane鼓膜

Athinovalmembrane,about1cmindiameterLyingobliquelybetweenexternalacousticmeatusandtympaniccavityTwopartsFlaccidpart松弛部:upper1/4Tensepart緊張部:lower3/4,pearlygrayUmbooftympanicmembrane鼓膜臍Coneoflight

光錐outersurfaceofskin,innersurfaceofmucousmembraneNormalappearanceofthetympanicmembraneAcuteotitismediawitheffusion.ThetympanicmembraneisinjectedbutlandmarksarestillclearlyvisualizedAcuteotitismedia.Thetympanicmembraneisbulgingandhyperemic,andyellowpurulentfluidisseeninthemiddleearPerforation,inflammationortrauma鼓膜穿孔（炎癥或外傷）WallsofTympanicCavityRoofortegmentalwall蓋壁FormedbytegmentympaniSeparatestympaniccavityfrommiddlecranialfossaFloororjugularwall頸靜脈壁Narrowthinplateoftemporalboneoverlyingsuperiorbulbofinternaljugularvein

WallsofTympanicCavityAnteriorwallorcarotidwall頸動脈壁

Consistsathinlayerofbonethatseparatestympaniccavityfromcarotidartery

Upperpart:liestwoopeningsUpperopening：semicanalfortensortympanimuscle鼓膜張肌半管Loweropening：semicanalforauditorytube咽鼓管半管WallsofTympanicCavityMedialwallorlabyrinthinewall

迷路壁Promontory

岬Fenestravestibuli前庭窗:coveredbybaseofstapesFenestracochleae

蝸窗:closetedbysecondarytympanicmembrane

第二鼓膜Prominenceoffacialcanal

面神經(jīng)管凸WallsofTympanicCavityPosteriorwallormastoidwall乳突壁Aditusofthemastoidantrum乳突竇入口Pyramidaleminence錐隆起AuditoryOssicles聽小骨

Consistsofchainofthreebones:Malleus錘骨

Incus砧骨

Stapes鐙骨

ArticulatebysynovialjointsTransmitvibrationoftympanicmembranetofootplateofstapesinfenestravestibuliMusclesofAuditoryOssiclesTensortympani鼓膜張肌Stapedius鐙骨肌AuditoryTube咽鼓管About3.5~4.0cmlong,extendsfromtheanteriorwalloftympaniccavitydownward,forward,andmediallytothenasopharynxTwopartsBonypart:posterolateral1/3Cartilaginouspart:anteromedial2/3FunctionstoequalizeairpressureoneithersideoftympanicmembraneInchildhood,itisshorter,widerandmorehorizontalthaninadultMastoidAntrumandMastoidCells

乳突竇和乳突小房

Mastoidantrum乳突竇

AsmallchamberbetweentympaniccavityandmastoidcellsMastoidcells乳突小房

AseriesofcommunicatingcavitieswithinthemastoidprocessoftemporalboneContinuousabovewiththemastoidantrumandthetympaniccavityInternalEar內(nèi)耳

GeneralfeaturesLieswithinthepetrousportionoftemporalboneKeycontentsofinternalearBonylabyrinth

骨迷路

Containsperilymph

Membranouslabyrinth

膜迷路IsfilledwithendolymphandcontainsthesensoryorgansBonyLabyrinth骨迷路

Cochlea耳蝸

Vestibule前庭Bonysemicircularcanals

骨半規(guī)管Vestibule前庭

HollowbonyspaceContainsutricle橢圓囊

andsaccule球囊InitslateralwallarethefenestravestibuliandfenestracochleaeVestibule前庭

Vestibulacrest前庭嵴Ellipticalrecess橢圓囊隱窩Sphericalrecess球囊隱窩Internalapertureofvestibularaqueduct前庭水管內(nèi)口Cochlearrecess蝸管隱窩MedialwallofvestibuleBonySemicircularCanals

骨半規(guī)管SemicircularductineachCanalatrightanglestoeachotherTwobonycruraineachcanalAmpullarbonycrura壺腹骨腳Bonyampullae

骨壺腹Simplebonycrus

單骨腳Commonbonycrus

總骨腳BonySemicircularCanals

骨半規(guī)管

AnteriorbonysemicircularcanalVerticallywiththelongaxisofthepetrousportionoftemporalboneLateralbonysemicircularcanalNearlyhorizontalPosteriorbonysemicircularcanalParallelstothelongaxisofthepetrousportionoftemporalboneCochlea耳蝸Itsomewhatresemblesasnail’sshellCupulaofcochlea蝸頂

FacesanterolaterallyBaseofcochlea蝸底FacesposteromediallyCochlea耳蝸Modiolus蝸軸Osseousspirallamina骨螺旋板Helicotrema蝸孔

contain

cochlearganglion蝸神經(jīng)節(jié)Cochlearspiralcanal

蝸螺旋管

Makestwoandone-halfspinalturnsaroundthemodiolus

Scalavestibuli

前庭階Scalatympani

鼓階MembranousLabyrinth膜迷路

Cochlearduct蝸管Utricleandsaccule橢圓囊和球囊Semicircularducts膜半規(guī)管MembranousampullaeSacculeUtricleMembranousLabyrinth膜迷路

Cochlear

ductUtricleandSaccule橢圓囊和球囊Utriculosaccularduct橢圓球囊管Endolymphaticduct內(nèi)淋巴管Endolymphaticsac內(nèi)淋巴囊Ductusreuniens連合管Utricle橢圓囊Saccule球囊UtricleandSaccule橢圓囊和球囊ContentMacularutriculi橢圓囊斑

Macularsacculi球囊斑Endorgansofbalance,whichrespondtolinearaccelerationanddeceleration,staticofgravitySemicircularDucts膜半規(guī)管

ContainedinbonysemicircularcanalsEachducthasamembranousampullae膜壺腹Containingcristaampullaris

壺腹嵴,receptorsofbalancethatrespondtorotationalaccelerationinthreedifferentplanesCochlearDuct蝸管Spinallyarrangedtube,withinofcochleaspiralcanalEnclosedbytympanicandvestibularwallswithscalavestibuliaboveandscalatympanibelow

Vestibularwall(membrane)ofcochlearduct蝸管前庭壁(前庭膜)Tympanicwallofcochlearduct(basilarmembrane)蝸管鼓壁(基底膜)Externalwallofcochlearduct蝸管外壁CochlearDuct蝸管Containsspinalorgan

螺旋器Soundreceptorsliesontympanic(basilar)wallofcochlearductStimulatedbythemovementofendolymphintheduct

聲波的傳導(dǎo)

Conductionofsound1.airconductionofsound氣導(dǎo)：

腦可分為氣導(dǎo)和骨導(dǎo)兩條途徑鼓膜聽小骨鏈前庭窗前庭階的外淋巴蝸孔螺旋器蝸神經(jīng)外耳道聲波蝸管的內(nèi)淋巴鼓階的外淋巴神經(jīng)沖動

聲波外耳道鼓膜鼓室內(nèi)的空氣蝸窗的第二骨膜鼓階的外淋巴蝸管的內(nèi)淋巴和螺旋器神經(jīng)沖動蝸神經(jīng)腦（聽骨鏈損傷時）2.

Bony-conductionofSound骨導(dǎo)：是指聲波直接振動顱骨，引起骨迷路的外淋巴的振動，蝸管內(nèi)淋巴的振動，進(jìn)而刺激基底膜上的螺旋器，引起聽覺。傳導(dǎo)性耳聾：中耳的鼓膜或聽骨鏈的損傷或障礙，引起的聽力下降。

神經(jīng)性耳聾：螺旋器、蝸神經(jīng)和中樞神經(jīng)出現(xiàn)病變。Teachingoutline

1.Mastertheposition,featureanddivisionsoftheexternalacousticmeatus,theposition,featureanddivisionsofthetympanicmembrane.2.Masterthecompositionofthemiddleear,thepositionofthet