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Summary ENT physiology and pathology.

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Goes into detail about normal physiological function of the ear, nose and throat. Discussing both the vestibular and cochlear systems of the ear. Also discusses common pathology of the ear and nose, detailing the clinical presentations, investigations and management of these conditions.

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December 31, 2021
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Written in
2021/2022
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Anatomy
Ear anatomy:
Ear can be divided into 3 parts:

1. Outer ear

2. Middle ear

3. Inner ear

Outer ear:
The external ear can be split into two further
parts:

1. The auricle/pinna

The function of the auricle is to capture and
direct sounds towards the external acoustic
canal
Most of the structures are formed of cartilage
except for the lobule

Important structures: helix, tragus, concha and
lobule

Accumulation of blood between cartilage
and perichondrium (fibrous tissue that
covers cartilage) can disrupt blood supply
to the cartilage. Untreated this can lead to
avascular necrosis resulting in "cauliflower
ear"

2. The external auditory canal




Anatomy 1

, Extends from the concha to the tympanic
membrane
This canal is s-shaped, so pulling back auricle
will straighten this
Outer 1/3 is made from cartilage and produces
wax, inner 2/3 is bone



Tympanic membrane:
Represents the border between external ear
and middle ear.
Tympanic membrane is translucent that allows
visualisation of middle ear structures

Handle of the malleus meets at "umbo",
deepest concavity of the tympanic
membrane

Superior to this point is the lateral process
of the malleus

Pars flaccida is the weakest point of the
tympanic membrane and is flaccid

Light shining from otoscope on tympanic
membrane is called the light reflex:

light reflex at 5 o'clock is a right sided ear

light reflex at 7 o'clock is a left sided ear
(image to the right)


Middle ear:
1. One nerve

Facial nerve runs through middle ear, damage
to this can result in facial paralysis.




Anatomy 2

, 2. Two muscles

Tensor tympani and stapedius attach to
ossicles and restrict their movement when
necessary

This is useful for protecting the ear from
loud noises

Tensor tympani innervated by trigeminal
nerve

Stapedius innervated by facial nerve
(affected in bells palsy)

3. Three bones

Three smallest bones in the body called the
ossicles

Composed of malleus, Incus and Stapes
These bones oscillate when vibrations pass
through tympanic membrane, transfers
vibrations from tympanic membrane → inner
ear

Mastoid process:

This is the area of temporal bone, that contains air cells
that both protects the ear and can equalise ear pressure

These mastoid air cells are sat posterior to the middle
ear ——————————————>

Vulnerable to infection from the middle ear



Eustachian tubes:
Middle ear is full of air however does not have contact
with outside atmosphere due to tympanic membrane




Anatomy 3
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