Ronald Allan Cruz, MD

Department of Physiology
FEU-NRMF Institute of Medicine

External ear

Pinna

External auditory
cannal

Cerumen

Middle ear

Tympanic membrane

Sensitive
Periodic
Well damped
Distorts sound waves
>45 db

Middle ear

Ear ossicles

Malleus, incus, stapes

Reinforce sound
waves
Impedance
matching
High amplitude-low
pressure sound
waves converted to
low amplitude-high
pressure waves
Sensitive: 300-3000
cps

Middle ear

Tensor tympani

Stapedius

Eustachian tube

Middle ear

Acoustic reflex

Attenuation reflex
tension dampens
vibrations

by 30-40db

sensitivity to own
speech
Protects the cochlea
from loud tones
Loud low tones
Masks low tones

Middle ear

Impedance matching

Tympanic membrane,
oval window, ossicles
the force and
pressure of waves
going to the oval
window: 22x
the sensitivity of
hearing

Internal ear

Vestibule

Semi-circular canals

Cochlia

Internal ear

Cochlea

Scala vestibuli

Scala media
Scala tympani

Oval window

Round window

Endolymph
Perilymph
Reisners membrane
Basilar membrane

Internal ear

Endocochlear
potential

Endolymph K, Na

Perilymph K, Na
Positive scala media

80 mv electrical
potential

Bodies of hair cells:

perilymph, -70 mv
Apex of hair cells:
endolymph, -150 mv

Internal ear

Organ of Corti

Basilar membrane,
basilar fibers
Rods of Corti, reticular
lamina
Hair cells

Inner hair cells

Outer hair cells

Tectorial membrane

CN VIII

Steriocilia
Kinocilium

Vibration of bodies
which can evoke an
auditory sensation
Molecular motion in
the direction of
energy transmission
Rarefaction in
pressure

length

rarefaction

amplitude

compression

pressure

Propagated with specifiable velocity

according to the characteristics of the
medium and independently of the intensity

density of the medium, velocity

Air

1000 ft/sec

Water

4700 ft/sec

Wood

13000 ft/sec

Steel

16500 ft/sec

Distance travelled by
sound in one period
W=V/F

W wavelength
V velocity of sound
F frequency

500 cycle tone in air

has a wavelength of 2
ft

Absorption

Properties of sound

Frequency

Pitch

Intensity

Loudness

Reflection
Refraction
Diffraction

Quality of the sensation that permits a sound

to be classified in the scale from high to low

Determined by the frequency of the sound

waves

Hertz

Amplitude modifies pitch

1000-3000 cps: frequency, pitch

amplitude of high frequency waves, pitch

Pitch does not change perceptively with changes in

intensity
>3000 cps: intensity, pitch

amplitude of low frequency waves, pitch

<1000 cps: intensity, pitch

Telephone theory

Pitch is a function of
the auditory center
Basilar membrane
moves more as a
unit

Place theory

Pitch is a function of
the cochlea
Pitch is determined by
the vibrating portion
of the basilar
membrane
Helmholtzs resonance
theory
Bekesys travelling
wave theory

Helmholtzs Resonance Theory

Basilar membrane has fibers of different lengths

and diameter
Basilar fibers

Length from oval window to helicotrema

Diameter from oval window to helicotrema

Fibers vibrate selectively to tones of different

frequencies

Short fibers near the oval window vibrate to higher

frequencies
Long fibers near the apex vibrate to lower frequencies

Bekesys Travelling Wave Theory

The cochlea is a tuned structure

Width of the basilar membrane increases from base to

helicotrema
The basilar membrane exhibits graded stiffness
Mass of organ of Corti increases towards the apex

Resonant frequency of cochlear partition is

highest at the stapes, and decreases along its
length

high frequency: displacement at the stapes

low frequency: displacement at the apex
Short wavelengths will die out more quickly

Bekesys Travelling Wave Theory

Length and diameter of hair cells

Decreasing elasticity coefficient of basilar fibers
from the oval window to the apex
Place principle

Frequencies are detected based on the area of the basilar

membrane that is most stimulated

20-20000 cps

500-5000 cps at
60db
50-8000 cps at old
age

Presbycusis

Loudness

Psychologic reaction
to the intensity of
the sound wave

amplitude,
intensity

Intensity

Force or strength of
sound
Depends on
amplitude

Inner and outer hair

cells are stimulated
More nerve impulses
are produced

Spatial summation

Stimulation of hair
cells on the fringes of
the resonating portion
of the basilar
membrane

Amplitude modifies pitch

amplitude of high frequency waves, pitch

>3000 cps: intensity, pitch

amplitude of low frequency waves, pitch

<1000 cps: intensity, pitch

1000-3000 cps: pitch does not change perceptively with

changes in intensity

Loud sounds cause the width of the resonating membranes

to increase in oscillations
Outer hair cells are stimulated with louder sounds

I = log E1/E2

I intensity
E1 intensity of
observed sound
E2 intensity of
reference sound

If intensity of sound A
is 10x that of sound B

Ratio is 10:1
Log of ratio is 1
The intensities differ
by 1 bel

0.1 bel = 1 decibel

1 decibel = 1.26x

1 bel = 10 decibel

10 decibel = 12.6x

Least intensity that

can be heard by the
average person

Varies for each

frequency within the
pitch range

500 cps: threshold is highest

2048 cps: threshold is lowest
<1000 cps: pitch ,
Low frequency: vibratory
pressure
threshold
>3000 cps: pitch ,
High frequency: pain
threshold
1000-3000 cps: minimal threshold
Threshold increase for tones higher and lower than this
frequency

120 decibels
Highest intensity of
sound that can be
heard without pain
1000000 times the
lowest auditory
threshold
db
hrs

60

Normal conversation

90

Shouting at 2 ft

100

LRT train passing

120 <0.2

Jet take-off,

Louder sounds:

Evoke vibrations of
greater amplitude in
the basilar membrane
and hair cells, thus
nerve endings are
stimulated at faster
rates

Some hair cells are

stimulated only when
a certain intensity is
reached

Spatial summation

Timbre

Quality of sound
Relative amplitudes of the various harmonics
yield a unique wave form for each sound source

Property of complex sounds

Enables us to distinguish musical
instruments, voices, etc

Musical

Regularly repeated
wave patterns

Noise

Non-periodic
vibrations

Spatial pattern of neuronal stimulation

Medial superior olivary nucleus

Difference in time arrival of the sound waves to each

ear
Difference in the phase of the sound waves to each ear:

Lateral superior olivary nucleus:

For low pitch sound

Difference in intensities of the sound waves to each ear:

Localization is difficult for continuous sounds,

pure tones, and noises

Ossicular route

Air route conduction

Osseous route

Cochlea

Temporal lobe
BA 41, 42:
6 tonotopic maps,
isofrequency
columns
BA 22: Wernickies
area
Auditory
radiation

Cochlear nuclei of
restiform body
Dorsal nuclei
Ventral nuclei

CN VIII

Superior
olivary
complex
nucleus
Medial
geniculate
body

Lateral
lemniscus

Inferior
colliculus

Crossing-over in the
brain stem

Trapezoid body
Lateral lemniscus

Commissure of Probst

Inferior colliculi

Reticular activating
system of the brain
stem
Vermis

Retrograde pathways

Cortex to cochlea

Superior olivary nucleus

to organ of Corti

Final pathway

Inhibitory: 15-20 db

Tuning of the receptor

system

Brain stem to hair cells

Shortening of outer hair
cells
Change in stiffness of
outer hair cells

Whisper test

Maximum distance
at which sound can
be heard is
determined and
compared with that
which can be heard
by the normal ear
Expressed as a
fraction of the
normal
Whisper: 30ft

Tuning fork test

Test fork is held close

to the ear
Time from the moment
the fork is struck until
the sound becomes
inaudible is determined
It is compared with the
normal time
Degree of hearing loss
is determined by the
difference

Audiometry

Precise testing for auditory function

Tones of varied intensity and pitch are generated
Tests air and bone conduction

Conduction deafness

Otosclerosis
Otitis media
Perforated tympanic
membrane
Trauma

Central deafness

Psychologic
CVA

Sensory-neural
deafness

Ototoxic drugs
Presbycusis
Tumors
Trauma

Webber test

Tuning fork at
midline
Check for laterality

Rinne test

Tuning fork at ear

with lateralized sound
Tuning fork at
mastoid process then
at pinna
Air conduction > bone
conduction

Im gonna be wounded
Im gonna be your wound
Im gonna bruise you
Youre gonna be my bruise
- Steven Sater
Frank Wedekind
Spring Awakening