Без темы
<<  ASSIGNED PROTECTION FACTORS AND ISO PROTECTION LEVELS Auditting iPhone and iPad applications  >>
Auditory and balance apparatus
Auditory and balance apparatus
Auditory and vestibular apparatus
Auditory and vestibular apparatus
External ear (Auris externa)
External ear (Auris externa)
Boltec
Boltec
Ligaments: lig
Ligaments: lig
Earbolt – supply
Earbolt – supply
Auditory canal (Meatus acusticus externus)
Auditory canal (Meatus acusticus externus)
Auditory canal (Meatus acusticus externus) supply
Auditory canal (Meatus acusticus externus) supply
Eardrum (Membrana tympanica, Myrinx)
Eardrum (Membrana tympanica, Myrinx)
Eardrum - composition
Eardrum - composition
Eardrum Otoskopy
Eardrum Otoskopy
Auditory and balance apparatus
Auditory and balance apparatus
Eardrum - supply
Eardrum - supply
Middle ear (Auris media)
Middle ear (Auris media)
Middle ear cavity (Cavitas tympani)
Middle ear cavity (Cavitas tympani)
Auditory and balance apparatus
Auditory and balance apparatus
Middle ear cavity paries labyrinthicus
Middle ear cavity paries labyrinthicus
Middle ear cavity - supply
Middle ear cavity - supply
Middle ear ossicles (Ossicula aditus)
Middle ear ossicles (Ossicula aditus)
Middle ear ossicles (Ossicula aditus)
Middle ear ossicles (Ossicula aditus)
Middle ear joints and ligaments (Articulationes ossiculorum auditus)
Middle ear joints and ligaments (Articulationes ossiculorum auditus)
Middle ear ligaments (Ligg
Middle ear ligaments (Ligg
Middle ear muscles
Middle ear muscles
Middle ear
Middle ear
Auditory and balance apparatus
Auditory and balance apparatus
Auditory and balance apparatus
Auditory and balance apparatus
Mastoid cavity (Antrum mastoideum)
Mastoid cavity (Antrum mastoideum)
Auditory tube (Tuba auditiva) Tuba auditoria, tuba pharyngotympanica,
Auditory tube (Tuba auditiva) Tuba auditoria, tuba pharyngotympanica,
Auditory tube (Tuba auditiva)
Auditory tube (Tuba auditiva)
Auditory tube (Tuba auditiva) Tuba auditoria, tuba pharyngotympanica,
Auditory tube (Tuba auditiva) Tuba auditoria, tuba pharyngotympanica,
Auditory tube (Tuba auditiva)
Auditory tube (Tuba auditiva)
Inner ear (Auris interna)
Inner ear (Auris interna)
Auditory and balance apparatus
Auditory and balance apparatus
Auditory and balance apparatus
Auditory and balance apparatus
Bony labyrinth (labyrinthus osseus) forechamber (vestibulum)
Bony labyrinth (labyrinthus osseus) forechamber (vestibulum)
Membranous labyrint (Labyrinthus membranaceus) Vestibular labyrinth
Membranous labyrint (Labyrinthus membranaceus) Vestibular labyrinth
Otolitic organs saculus et utriculus
Otolitic organs saculus et utriculus
Bony labyrint (Labyrinhtus osseus) Semicircular canals (Canales
Bony labyrint (Labyrinhtus osseus) Semicircular canals (Canales
Auditory and balance apparatus
Auditory and balance apparatus
Semicircular canals
Semicircular canals
Hairy cells
Hairy cells
Bony labyrint (Labyrinhtus osseus) Snail (Cochlea)
Bony labyrint (Labyrinhtus osseus) Snail (Cochlea)
Bony labyrint (Labyrinhtus osseus) Snail (Cochlea)
Bony labyrint (Labyrinhtus osseus) Snail (Cochlea)
Auditory and balance apparatus
Auditory and balance apparatus
Bony labyrint (Labyrinhtus osseus) Inner acustic meatus (Meatus
Bony labyrint (Labyrinhtus osseus) Inner acustic meatus (Meatus
Auditory and balance apparatus
Auditory and balance apparatus
Membranous labyrint (labyrinthus membranaceus) Labyrinhtus cochlearis
Membranous labyrint (labyrinthus membranaceus) Labyrinhtus cochlearis
Snail (Cochlea)
Snail (Cochlea)
Scala media
Scala media
Corti organ (Organum spirale)
Corti organ (Organum spirale)
Endolymph and perilymph
Endolymph and perilymph
Inner ear – blood supply
Inner ear – blood supply
Inner ear - nerves
Inner ear - nerves
Auditory and balance apparatus
Auditory and balance apparatus
VIII
VIII
VIII
VIII
Auditory path I
Auditory path I
Auditory and balance apparatus
Auditory and balance apparatus
Auditory path II
Auditory path II
Auditory path
Auditory path
Auditory path III
Auditory path III
Auditory path – 3D
Auditory path – 3D
Vestibular path I
Vestibular path I
Auditory and balance apparatus
Auditory and balance apparatus
Vestibular path II
Vestibular path II
Vestibular path III
Vestibular path III
Vestibular path III
Vestibular path III
Vestibular path III
Vestibular path III
Examination
Examination
Symptoms and ilnesses
Symptoms and ilnesses
Development of auditory and vestibular system
Development of auditory and vestibular system
Development of external eae
Development of external eae
Development of external ear
Development of external ear
Development of middle ear
Development of middle ear
Auditory and balance apparatus
Auditory and balance apparatus
Development of middle ear
Development of middle ear
Development of membrana tympani
Development of membrana tympani
Development of inner ear
Development of inner ear
Auditory and balance apparatus
Auditory and balance apparatus
Auditory and balance apparatus
Auditory and balance apparatus
Development of inner ear
Development of inner ear
Auditory and balance apparatus
Auditory and balance apparatus
Development of inner ear
Development of inner ear
Auditory and balance apparatus
Auditory and balance apparatus
Casuistic 1
Casuistic 1
Casuistic 1 - diagnosis
Casuistic 1 - diagnosis
Casuistic 2
Casuistic 2
Casuistic 2 - diagnosis
Casuistic 2 - diagnosis
Casuistic 3
Casuistic 3
Cazuistic 3 - diagnosis
Cazuistic 3 - diagnosis

Презентация: «Auditory and balance apparatus». Автор: JonMMx 2000. Файл: «Auditory and balance apparatus.ppt». Размер zip-архива: 5978 КБ.

Auditory and balance apparatus

содержание презентации «Auditory and balance apparatus.ppt»
СлайдТекст
1 Auditory and balance apparatus

Auditory and balance apparatus

Morphology and embryology Auris, is = Us, oton

2 Auditory and vestibular apparatus

Auditory and vestibular apparatus

External ear (Auris externa) Middle ear (Auris media) Inner ear (Auris interna) = Organum vestibulo- cochleare

3 External ear (Auris externa)

External ear (Auris externa)

Earbolt (Auricula, Pinna) elastic cartilage External meatus (Meatus acusticus externus) Eardrum (Membrana tympanica, Myrinx)

4 Boltec

Boltec

Helix crus, spina, cauda (tuberculum auriculare Darwini, apex auriculae) Antihelix crura, fossa triangularis Scapha Concha auriculae cymba, cavitas Tragus Antitragus Incisura intertragica Lobulus auriculae Posterior facet = negative ventral image

5 Ligaments: lig

Ligaments: lig

auriculare ant., sup., post. Earbolt muscles - innervation: n. facialis External muscles = mimic mm. auriculares (ant., sup., inf.) m. temporoparietalis Proper muscles: rudimentary m. tragicus + antitragicus m. helicis major+minor m. obliquus + transversus auriculae, m. pyramidalis auriculae Cartilage: Cartilago auriculae - elastic Skin: back side free, ventrally firmly attached to perichondrium - othematom

6 Earbolt – supply

Earbolt – supply

Arteries: rr. auriculares ant. ? a. temporalis superficialis a. auricularis post. ? a. carotis externa Veins: v. jugularis ext. Lymph: n.l. parotidei, mastoidei Nerves: sensitive nn. auriculares ant. z n. auriculotemporalis (upper ventral 2/3) r. auricularis n. X. (concha) n. occipitalis minor (posterior up) n. auricularis magnus (down) motoric: n. VII.

7 Auditory canal (Meatus acusticus externus)

Auditory canal (Meatus acusticus externus)

porus acusticus externus ? diagonally ventromed. ? med. ? again diagonally ventromed. (totally it converges forth 160? and it declines convex, length approx. 22 mm) external 2/3 – hyaloid cartilage open forth and down (incisurae Santorini), lamina tragi (forth) transition – narrowest place – foreign bodies !!! inner 1/3 – bony – incisura tympanica Rivini glandulae ceruminosae + sebaceae ? ear wax (cerumen) – protection tragi (after 30. years of age) Skin attached to perichondrium – even small inflamation very painful !!! Anterior wall: relation to gl. parotis and art. temporomandibularis

8 Auditory canal (Meatus acusticus externus) supply

Auditory canal (Meatus acusticus externus) supply

Arteries: same as earboltc + a. auricularis prof. ? a. maxillaris veins: v. temporalis superf., v. auricularis post. lymph: n.l. parotidei, mastoidei nerves: r. auricularis n.X. (posterior caudal part), n. auriculotemporalis ? r. meatus ac. externi

9 Eardrum (Membrana tympanica, Myrinx)

Eardrum (Membrana tympanica, Myrinx)

10 Eardrum - composition

Eardrum - composition

Sulcus tympanicus, incisura tympanica Rivini 9x10 mm, thickness 0,1 mm, area 55 mm2 Anulus fribrocartilagineus External surface - weakened epidermis (ectoderm) Layer of thick collagenous tissue (mesenchyme) Inner surface – single layer cuboid epithelium (endoderm)

11 Eardrum Otoskopy

Eardrum Otoskopy

umbo m.t. stria mallearis prominetia mallearis plica mallearis ant. + post. light reflex – trigonum Wilde (= cone of light, light reflex, Politzer's luminous cone) Bezold trias: prominentia + stria + reflex pars flaccida Shrapnelli (5 mm2) x pars tensa - Declination of eardrum (50? sagitally) - Inclinationof eardrum (45 ? transverzally) Paracentesis: lower posterior quadrant

12 Auditory and balance apparatus
13 Eardrum - supply

Eardrum - supply

Arteries: a. auricularis prof. ? a. maxillaris (external surface) aa. tympanicae (inner surface) Lymph: n.l. mastoidei, parotidei Nerves: a. auricularis n.X. n. auriculotemporalis ? r. membranae tympani

14 Middle ear (Auris media)

Middle ear (Auris media)

Middle ear cavity (Cavitas tympani) Middle ear ossicles (Ossicula aditus) Middle ear joints (Articulationes ossiculorum auditus) Middle ear muscles (Musculi ossiculorum auditus) Auditory tube (Tuba auditiva Eustachii)

15 Middle ear cavity (Cavitas tympani)

Middle ear cavity (Cavitas tympani)

paries tegmentalis paries jugularis: prominetia styloidea paries mastoideus: aditus ad antrum mastoideum, prominetia canalis semicircularis lat. + n. VII., eminetia pyramidalis, fossa incudis, apertura tympanica canaliculi chordae tympani, antrum mastoideum (cellulae m.) paries caroticus paries membranaceus paries labyrinthicus

16 Auditory and balance apparatus
17 Middle ear cavity paries labyrinthicus

Middle ear cavity paries labyrinthicus

promontorium – first coil of cochlea sulcus promontorii – plexus tympanicus fenestra vestibuli (= ovalis) – basis of stapes + membrana stapedia fenestra cochlae (= rotunda) – membrana tympani secundaria

18 Middle ear cavity - supply

Middle ear cavity - supply

Arteries: 4 aa. tympanicae, rr. caroticotympanici Veins: do plexus pterygoideus + sinus petrosus sup. Lymph: n.l. parotidei, mastoidei, cervicales profundi, retropharyngei Nerves: n. tympanicus (n.IX) – sensitive + parasympatic (ganglion tympanicum) r. pharyngeus (n.V2) for cartilagenous part of auditory tube nn. caroticotympanici (sympatic)

19 Middle ear ossicles (Ossicula aditus)

Middle ear ossicles (Ossicula aditus)

Malleus (Malleus, Hammer) caput collum manubrium processus lateralis processus anterior

20 Middle ear ossicles (Ossicula aditus)

Middle ear ossicles (Ossicula aditus)

Incus (Incus, Anvil) corpus crus longum processus lenticularis crus breve Stapes (Stapes, Stirrup) caput (collum) crus ant. + post. basis

21 Middle ear joints and ligaments (Articulationes ossiculorum auditus)

Middle ear joints and ligaments (Articulationes ossiculorum auditus)

art. incudomallearis (seddle bag) art. incudostapedia (ball shape like) syndesmosis tympanostapedialis otosclerosis – ossification Sometimes both joints are replaced by syndesmosis

22 Middle ear ligaments (Ligg

Middle ear ligaments (Ligg

ossiculorum auditus)

lig. mallei ant. (spina o.s.)+ sup.+ lat. lig. incudis sup. (fossa i.) + post. membrana stapedialis (fenestra vestibuli) lig. anulare stapediale (fenestra vestibuli) membrana tympani secundaria = secondary eardrum (fenestra cochleae)

23 Middle ear muscles

Middle ear muscles

m. tensor tympani semicanalis m.t.t. processus cochleariformis manubrium mallei innervation: n.V3 m. stapedius eminetia pyramidalis collum stapedis innervation: n.VII n. stapedius from pars mastoidea canalis nervi facialis

24 Middle ear

Middle ear

Shape of sand clock – 2 mm narrow by eardrum (= mesotympanon) recessus epitympanicus (= atticus, epitympanon, epitympanum) – 6 mm recessus hypotympanicus (hypotympanon)– 4 mm plicae malleares ant., post.? recessus ant., sup., post. (= Prussak space) plica chordae tympani, incudialis, stapedialis mucosa – single layer cuboid epithelium (different height) Cup cells only by opening of auditory tube !!! No glands !!!

25 Auditory and balance apparatus
26 Auditory and balance apparatus
27 Mastoid cavity (Antrum mastoideum)

Mastoid cavity (Antrum mastoideum)

aditus ad antrum mastoideum cellulae mastoideae (development postnatally – 6th year) Type pneumatic Type diploic Type sclerotic cellulae tympanicae Flat 1 layer epithelium Close to sinus sigmoideus mastoidectomy

28 Auditory tube (Tuba auditiva) Tuba auditoria, tuba pharyngotympanica,

Auditory tube (Tuba auditiva) Tuba auditoria, tuba pharyngotympanica,

salpinx, tuba Eustachii

ostium tympanicum pars ossea (= semicanalis t.a.) – cellulae pneumaticae pars cartilaginea – cartilago (lamina med.+ lat., lamina membranacea) – under mucosa of tonsilla tubaria Gerlachi When enlarged tonsilla – lesion of ventilation (especially in kids) ? inflammation of midlle ear cavity ostium pharyngeum (v ?rovni meatus nasi inf.)

29 Auditory tube (Tuba auditiva)

Auditory tube (Tuba auditiva)

30 Auditory tube (Tuba auditiva) Tuba auditoria, tuba pharyngotympanica,

Auditory tube (Tuba auditiva) Tuba auditoria, tuba pharyngotympanica,

salpinx, tuba Eustachii

Equilibrates pressure in pharynx and middle ear cavity thickness 2 mm, length 40 mm Transition of multilayer cylindrical epithelium in single layer cylindrical glandulae tubariae, cup cells – in cartilagenous part In kids more horizontal, shorter and wider Catetrization via nasal cavity

31 Auditory tube (Tuba auditiva)

Auditory tube (Tuba auditiva)

opening: m. tensor tympani m. salpingopharyngeus ? role of m. levator veli palatini not clear ? Ostmann adipose body

32 Inner ear (Auris interna)

Inner ear (Auris interna)

organum vestibulocochleare Bony labyrint (labyrinhtus osseus) forechamber (vestibulum) Semicircular canals (canales semicirculares) snail (cochlea) Inner acustic meatus (meatus acusticus internus) spatium perilymphaticum Membranous labyrinth (labyrinthus membranaceus) labyrinthus vestibularis labyrinthus cochlearis spatium endolymphaticum

33 Auditory and balance apparatus
34 Auditory and balance apparatus
35 Bony labyrinth (labyrinthus osseus) forechamber (vestibulum)

Bony labyrinth (labyrinthus osseus) forechamber (vestibulum)

recessus ellipticus (utricularis) apertura int. canaliculi vestibuli macula cribrosa superior crista vestibuli (pyramis vestibuli) recessus sphericus (saccularis) recessus cochlearis macula cribrosa media macula cribrosa inferior

36 Membranous labyrint (Labyrinthus membranaceus) Vestibular labyrinth

Membranous labyrint (Labyrinthus membranaceus) Vestibular labyrinth

(Labyrinhtus vestibularis)

Utriculus (Elipsoid sac) Sacculus (Spherical sac) Ductus semicirculares (ampullae, crura) Ductus utriculosaccularis, reuniens Macula utriculi, sacculi – membrana statoconiorum (statoconium, striola) Crista ampullaris (sulcus, cupula)

37 Otolitic organs saculus et utriculus

Otolitic organs saculus et utriculus

macula Hairy cells Supportive cells Gelatinous layer otoconia - crystals CaCO3 (otoliths – term for crystals in reptiles)

38 Bony labyrint (Labyrinhtus osseus) Semicircular canals (Canales

Bony labyrint (Labyrinhtus osseus) Semicircular canals (Canales

semicirculares)

Canalis semicircularis anterior (parallel to the pyramid axis) – eminentia arcuata Canalis semicircularis posterior (vertical) Canalis semicircularis lateralis (horizontal) – prominentia c.s.l. ampulla ossea (3) crus commune (ant. + post.), simplex (lat.)

39 Auditory and balance apparatus
40 Semicircular canals

Semicircular canals

Membranous inside bony Receptors in ampulas cristae ampullares Crest 90° to canal axis cupula – gelatinous substance Hairy cells Support cells

41 Hairy cells

Hairy cells

Two types On apical surface: 1 kinocilia Several stereocilias bazally - synapse with nerve fibers

42 Bony labyrint (Labyrinhtus osseus) Snail (Cochlea)

Bony labyrint (Labyrinhtus osseus) Snail (Cochlea)

cupula, basis (2 a ? coil) scala vestibuli ? helicotrema ? scala tympani canalis spiralis cochleae lamina spiralis ossea lamella vestibularis + spiralis hamulus l.s. (end in helicotrema) lamina spiralis secundaria (only in first coil) apertura interna canaliculi cochleae

43 Bony labyrint (Labyrinhtus osseus) Snail (Cochlea)

Bony labyrint (Labyrinhtus osseus) Snail (Cochlea)

Spindle (Modiolus) basis lamina canalis spiralis – ganglion cochleare canales longitudinales – n. cochlearis

44 Auditory and balance apparatus
45 Bony labyrint (Labyrinhtus osseus) Inner acustic meatus (Meatus

Bony labyrint (Labyrinhtus osseus) Inner acustic meatus (Meatus

acusticus internus)

porus acusticus internus fundus m.a.i. crista transversa + verticalis area n. VII. area cochlearis – tractus spiralis foraminosus area vestibularis sup. + inf. foramen singulare

46 Auditory and balance apparatus
47 Membranous labyrint (labyrinthus membranaceus) Labyrinhtus cochlearis

Membranous labyrint (labyrinthus membranaceus) Labyrinhtus cochlearis

scala media = ductus cochlearis paries vestibularis: membrana vestibularis Reissneri paries externus: stria vascularis, prominentia spiralis, vas prominens, lig. spirale paries tympanicus (= membrana spiralis): crista basilaris, lamina basilaris, vas spirale limbus spiralis: labium limbi tympanici, labium limbi vestibularis, (dentes acustici) membrana tectoria Organum spirale Corti membrana reticularis, sulcus spiralis internus + externus

48 Snail (Cochlea)

Snail (Cochlea)

49 Scala media

Scala media

Contain endolymph on lamina basilaris is Corti organ Covered by membrana tectoria Bony lamina spiralis ligamentum spirale

50 Corti organ (Organum spirale)

Corti organ (Organum spirale)

Hairy cells outer (3-4 rows) and inner (1 row) On surface stereocilia Apices sank inside membrana tectoria Between them Nuele space Supportive cells pillars (Cortiho) – border inner tunnel phalangeal (Deiters) – cover hairy cells Outer supportive – cylindrical Hensen and cuboid Claudius

51 Endolymph and perilymph

Endolymph and perilymph

Endolymph: similar to intracellular fluid stria vascularis ? scala media ? ductus endolymphaticus ? saccus endolymphaticus (blind) ? veins Perilymph: similar to CSF canalicus cochleae connected with subarachnoid space

52 Inner ear – blood supply

Inner ear – blood supply

Arteries: a. basilaris ? a. inf. ant. cerebelli ? a. labyrinthi Veins: vv. labyrinthi ? sinus petrosus inf. v. aqueductus vestibuli, v. aqueductus cochleae Lymph: replaced by endolymph and perilymph

53 Inner ear - nerves

Inner ear - nerves

Nervus vestibularis – ggl. vestibulare Scarpae pars superior n. utriculoampullaris pars inferior n. saccularis n. ampullaris posterior Nervus cochlearis – ggl. cochleare Corti !!! Bipolar neurons !!!

54 Auditory and balance apparatus
55 VIII

VIII

- Nervus vestibulocochlearis examination

Tuning fork exams (Rinn?, Weber, Schwabach) Examination of nystagmus (9 directions acc to Hering) Romberg – standing and close eyes Hautant – sitting and arms rising forward Unterberger – close eyes and walking on spot 30s

56 VIII

VIII

- Nervus vestibulocochlearis irritation / palsy

Lesion of hearing (= hypacusis ? anacusis ) deafness (= surditas) Ear lisps (= tinnitus) – humming, whistling, ringing… giddiness (= vertigo) By will not affectable eyeball movements (= nystagmus) Slow component – stronger side pushes weaker side Fast component – compensatory movement back – according to it is described direction of nystagmua Defects of gait and walking (= ataxie)

57 Auditory path I

Auditory path I

Projection ? Ascending ? Sensory 4 – neuronal Crossed as well as not crossed 1. neuron: Bipolar cell in ganglion cochleare Corti in shape of spiral ? n. cochlearis ? n. VIII ? tract divides into 2 parts into nuclei cochleares ant. + post.

58 Auditory and balance apparatus
59 Auditory path II

Auditory path II

2. neuron: pons Cells in nucleus cochlearis posterior (depth of tones) et anterior (intenzity of tones) – separated by pedunculus cerebellaris inferior ? crossing ? lemniscus lateralis ? colliculus inferior Side tract: nucleus olivaris superior (? contralaterally is inhibited from ncl. v corpus trapezoideum) ? estimation of space orientation of hearing

60 Auditory path

Auditory path

61 Auditory path III

Auditory path III

3. neuron: mesencephalon cells in colliculus inferior ? brachium coll.inf. tonotopic organization commissura colliculi inferioris 4. neuron: diencephalon - metathalamus cells in corpus geniculatum mediale ? lobus temporalis - gyrus temporalis transversus Heschli, area 41, 42

62 Auditory path – 3D

Auditory path – 3D

63 Vestibular path I

Vestibular path I

Projection ? Ascending ? Sensory 3-neuronal, crossed 1. neuron: bipolar cell ganglion vestibulare Scarpae ? n. vestibularis ? n. VIII Part of fibers runs as tractus vestibulocerebellaris directus w/o interconnection into cerebellum 2. neuron: cells nuclei vestibulares pontis ? axons into different structures

64 Auditory and balance apparatus
65 Vestibular path II

Vestibular path II

– where to?

Cerebral cortex cerebellum RF ? facilitatory descending system spine Nuclei of eyeball moving muscles Via paramedial pontine RF reflex head-eyeball

66 Vestibular path III

Vestibular path III

– into cortex

3. neuron: cells nuclei ventrales thalami ? cerebral cortex lobus parietalis - gyrus postcentralis (area 2) – primary cortex parieto-inzular cortex (gyrus insularis longus) + lobus temporalis - gyrus temporalis transversus Heschli (area 41,42)

67 Vestibular path III

Vestibular path III

– into cerebellum

Tractus vestibulocerebellaris directus vestibulum ? corpus juxtarestiforme (v PCI) ? nodulus + uvula (ipsilat.) Tractus vestibulocerebellaris indirectus vestibulum ? ncl. vestibulares ? corpus juxtarestiforme (v PCI) ? lobulus flocclulonodularis + vermis (bilat.)

68 Vestibular path III

Vestibular path III

– into spine

Ncl. fastigii cerebelli ? ncl. vestibularis lat. Deitersi (bilat.) ? tr. vestibulospinalis lateralis ? alfa + gama-motoneurons of extensors Ncl. vestibularis medialis + inferior ? fasciculus longitudinalis medialis ? interneurons (+ and -) in cervica spine reflex head-eye

69 Examination

Examination

otoscopy, otomicroscopy – tympanice membrane paracentesis, gromets Tuning fork examinations Vestibuloocular reflex – nystagmus vestibulospinal reflex (Romberg, Unterberger test) X-ray (projection Stenvers – meatus acusticus intenrus, Sch?ller – proc. mastoideus), CT, angiography audiometry BER/BERA (ERA, AEP, ABR) otoacustic emision (from external hairy cells) nystagmus – ENG (PENG), calory test

70 Symptoms and ilnesses

Symptoms and ilnesses

Eye pain = otalgia giddiness = vertigo humming / whistling = tinnitus nystagmus = fast synkinetic movements Cloth ears - hypacusis deafness = surditas morbus Meni?re – ionic dysbalance Aterosclerosis of a. lybyrinthi meningitis – most common reason for acquired deafness Treatment: vazodilatation

71 Development of auditory and vestibular system

Development of auditory and vestibular system

3 sources + nerve fibers 1. branchial arch, cleft and membrane Mezenchyme of 1st and 2nd branchial arch Surface ectoderrm of the head Fibers from mezencephalon

72 Development of external eae

Development of external eae

meatus acusticus externus 1st branchial cleft After delivery short (danger of lesion) pinna 6 auricular tubercles (mezenchyme) Mostly 2nd branchial arch (but also 1st) appendices preauriculares

73 Development of external ear

Development of external ear

74 Development of middle ear

Development of middle ear

1st branchial exagination tuba auditiva et cavum tympani 1. branchial arch malleus, incus lig. mallei anterius m. tensor tympani 2. branchial arch stapes m. stapedius

75 Auditory and balance apparatus
76 Development of middle ear

Development of middle ear

antrum mastoideum Are not present cellulae mastoideae after delivery Appears in 2nd year Finished pneumatization cca in 6th year

77 Development of membrana tympani

Development of membrana tympani

Outer epithelium from 1st branchial cleft Inner epithelium from 1st branchial exagination mezenchyme of 1st and 2nd branchial arch

78 Development of inner ear

Development of inner ear

Start at 4th week - otic placode (ektoderm) Auditory pit Auditory sac (otocyst) Extension for ductus + saccus endolymphaticus Dorzal part utricular Ventral part saccular

79 Auditory and balance apparatus
80 Auditory and balance apparatus
81 Development of inner ear

Development of inner ear

From utricular part Discoid extensions - ductus semicirculares Widening into ampula and origin of crests From saccular part divertikulum ductus cochlearis (convoluted) Origin of ductus reuniens Corti organ (from the wall of d. cochlearis) Origin of ganglion spirale

82 Auditory and balance apparatus
83 Development of inner ear

Development of inner ear

Surrounding mezenchyme changes into cartillagenous capsula otica There appears cavities and thus originate perilymphatic spaces in 20. - 22. week cartillagenous model ossifies

84 Auditory and balance apparatus
85 Casuistic 1

Casuistic 1

male, 28 years Returned from vacation in Egypt otalgia 3 days Pain during palpation objective examination: palpatory sensitive tragus otoscopy: oedematic and reddish auditory canal with white cellular detrite

86 Casuistic 1 - diagnosis

Casuistic 1 - diagnosis

otitis externa Ilness of summer monthes and swimming complications: especially in DM ? perichondritis or destruction of temporal bone

87 Casuistic 2

Casuistic 2

female, 3 years In the night burning pain of right ear, crying, cannot ease, 2 days runny nose In the waiting room vomiting temperature 38,3°C otoscopy: tympanic membrane reddish, smeared, protruding backside

88 Casuistic 2 - diagnosis

Casuistic 2 - diagnosis

otitis media acuta l. dx. treatment: paracentesis complications: perforation of tympanic membrane mastoiditis ? trombosis of sinus sigmoideus labyrinthitis (chronic otitis media)

grometa

89 Casuistic 3

Casuistic 3

female, 34 let Pressure in left ear, sudden cloth ear, humming tinnitus, rotatory vertigo, vomitus Vertigo disappeared, the rest is still there Objective examination: harmonic vestibular events (= dominance of on labyrinthus) audiometry: perceptive cloth ear apicocochlearly treatment: vazodilatation

90 Cazuistic 3 - diagnosis

Cazuistic 3 - diagnosis

Meni?r ilness hydrops of the labyrinth Mont after patient returns with the same problems dif.dg.: circulatory problems, aterosclerosis, sclerosis multiplex, neurinom of the n. VIII

«Auditory and balance apparatus»
http://900igr.net/prezentacija/anglijskij-jazyk/auditory-and-balance-apparatus-133234.html
cсылка на страницу
Урок

Английский язык

29 тем
Слайды