Transcript Auricular analyzer

Introduction. History of
otorhinolaryngology. Current
achievements and problems of
Otorhinolaryngology. Influence of
occupational factors internal and external
environment on the development of ENT
diseases. Physiology of the auditory and
vestibular analyzers.
Department of ENT diseases of
Tashkent Medical Akademy
www.tma.uz
Otorhinolaryngology
 special clinical discipline that studies the
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morphological and physiological features of
the pathology of the ear, upper respiratory
tract and adjacent areas.
Its name comes from two Greek words: otos
- ear.
rhinos - the nose,
laryngos - larynx
logos - teaching.
The founders of
Otolaryngology
 Simanovsky Nikolai Petrovich (18541922)
 Voyachek Vladimir Ignatovich (18761971) Academician
 Transfiguration of Boris Sergeevich
(1892-1970) Academician
The founders of
otorhinolaryngology in
Uzbekistan
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Professor Stein, GS (1920 1922)
Shumsky Zigzmund Ignatevich (1946 1954)
Affectionate Izrael Y. (1954 1967)
Miraziz Kuchkar Djuraevich (1967 1997)
Muminov Akram Ibrahimovic (1975 1992)
Ibragimov Gairat Tulanovich (1975 1995)
Dadamukhamedov Abdumalik Nazirovich
The tasks of modern
otorhinolaryngology
 Studies on the effect of factors external
and internal environment to the ENT
organs
 The development of microsurgery of
ear and upper respiratory tract
infections;
 Problems ENT oncology;
 Cochlear implantation
Anatomy of the Ear
STRUCTURE OF THE BODY OF
HEARING
Tympanic membrane
Tympanum
Eustachian tube
The inner ear
BLOOD SUPPLY OF
INTERNAL EAR
APPEARANCE bony labyrinth
1. Canales semicirculares
ossei
2. Crura ossea ampularis
3. Crus osseum simplex
4. Crus osseum commune
5. Vestibulum
6. Fenestra vestibuli
7. Fenestra cochleae
8. Cochlea
9. Canalis spiralis cochleae
10. Cupula cochlea
Structure of the membranous
labyrinth
1. Ductuli semicirculare
membranacea
2. Crista ampularis
3. Utriculus
4. Macula utriculi
5. Sacculus
6. Macula sacculi
7. Ductus utriculasaccularis
8. Ductus endolymphaticus
9. Saccus endolymphaticus
10. Ductus reuniens
11. Ductus cochlearis
BONE SNAIL
1. Сanalis spiralis
cochleae
2. Cupula cochlea
3. Basis cochlea
4. Modiolus
5. Basis modioli
6. Lamina modioli
7. Lamina spiralis
ossea
8. Scala vestibuli
9. Scala tympani
The cut bone snails
1. Сanalis spiralis cochleae
2. Cupula cochlea
3. Basis cochlea
4. Modiolus
5. Basis modioli
6. Lamina modioli
7. Lamina spiralis ossea
8. Scala vestibuli
9. Scala tympani
10. Helicotrima
11.Canalis longitudinalis modioli
12. Canalis spiralis modioli
13. Meatus acusticus internus
Scheme of the cochlea duct
1. Canalis spiralis ossea
cochlea
2. Modiolis
3. Lamina spiralis ossea
5. Canalis spiralis
cochlearis
6. Canalis spiralis modioli
7. Ganglion spirale
8. Paries tympanicus
9. Organum spirale
10. Paries vestibularis
11. Paries externus ductus
cochlearis
12. Scala vestibuli
13. Scala tympani
14. Cavum ductus cochlearis
Auditory and vestibular analyzer
 Auditory and vestibular analyzers located in
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the maze.
Maze is divided into three sections:
A - Snail (anterior)
B - threshold (middle section)
B - the semicircular canals (back office)
Auricular analyzer
 Auditory analyzer auditory analyzer - an
integrated system, originated from the
outer ear and ends in the cerebral cortex.
Each section of the system characterized
by a certain function, which is a violation at
any level leads to partial or complete
hearing loss.
Auricular analyzer
 Adequate stimulus of the auditory analyzer
is the sound - these are the mechanical
vibrations of gaseous, solid or liquid
medium, which, acting on the auditory
analyzer, causing it to specific
physiological process, subjectively
perceived as a sensation of sound.
Auricular analyzer
 The air speed of sound is 332m / s.
 Hearing range of human hearing within 16 20 000 Hz.
 Infrasound - sound less than 16 Hz.
 Ultrasounds - the sounds of more than 20
000 Hz.
 Bone-conducting tissue - ultrasounds to
225 Hz.
Auricular analyzer
 Auditory analyzer is divided into
conductive and sound is perceived
apparatus.
 By soundconducting include the outer and
middle ear, peri-and endolymphatic space
of the inner ear, basilar membrane plate
and preddverno cochlea.
Auricular analyzer
 Sound is perceived apparatus represented a
peripheral receptor organ spiral.
 Sound conducting apparatus - is used to
deliver sound to the receptor.
 Sound is perceived device converts
mechanical vibrations into neural excitation
process.
Methods of hearing
 The study of hearing with live speech.
 Whispered and colloquial speech
 Kamertonal research
 Elektroaudiometry(threshold and abovethreshold, speech audiometry,
Methods of hearing
 Objective audiometry
 Study of unconditioned reflexes
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auropupillyarny, auropalpebralny etc.
Investigation hearing with conditioned
reflexes to sound
Play audiometry
Impedansometry
Elektrokohlegrafy
Registration of auditory evoked potentials
Otoacoustic emission study
STRUCTURE BODY
BALANCE
Vestibular analyzer
 Vestibular analyzer - an organ of
balance, muscle tone control that
supports a given position of the body
and delivered to the cerebral cortex,
information about the position and
movement of the body in space.
Vestibular analyzer
 Adequate stimulus for the semicircular
canals - the angular acceleration.
 Adequate stimulus for the otolith
apparatus - the beginning and end of the
straight-line motion, its acceleration or
deceleration
Vestibular analyzer
 centrifugal force, the change in head
position and body in space
 force of gravity, which acts on the otolithic
apparatus, even during complete rest of
the body.
Laws Ewald:
 The movement of the endolymph in the
horizontal semicircular duct of the feet to
vial causes nystagmus towards the
stimulated ear. The movement of the
endolymph of the ampoule to the leg is in
the direction of nystagmus is not stimulated
ear.
Laws Evald:
 The movement of the endolymph to the
ampulla (ampulopetalny) is a strong irritant
horizontal semicircular duct, endolymph
than the current from an ampoule
(ampulofugalny).
 For the vertical channels, these laws
reversed.
"Iron Laws" Voyachek
 The plane of the nystagmus is always
coincide with the plane of rotation.
 Nystagmus is always opposite to the direction
"Iron
Laws" Voyachek
of the shift of the
endolymph.
 Nystagmus - a rhythmic jerking of the
eyeballs, consisting of slow and fast
components.
 The direction of nystagmus is defined by its
fast component.
Nystagmus
 Depending on the stimulus, spontaneous
nystagmus distinguish between
(endogenous), caloric, rotational, postrotational, pressor,
 electroplating.
 The direction of nystagmus: right, left, up,
down.
 Plane-horizontal, vertical, rolling nystagmus.
Nystagmus
 The strength of nystagmus - I, II, III
degree.
 - The amplitude of nystagmus - small,
medium and krupnoraz-mashisty.
 The frequency of nystagmus (number of
shocks for to define a time interval, usually
10 seconds) - a lively, sluggish.
Position of the patient
in the study of the semicircular canals:
A - lateral (tilt the head
forward -30 °);
B - anterior (head tilt
forward - 90 °);
B - posterior (lateral head
tilt - 90 °).
Methods of investigation of
the vestibular apparatus
 Caloric and rotational tests and
videookulography nistagmography;
 Static and dynamic stabilography;
 EEG.
Methods of investigation of
the vestibular apparatus
 Videokulografphy using special glasses
 Electronystagmography is the primary
method to identify both spontaneous and
experimental nystagmus.
Methods of investigation of
the vestibular apparatus
Department of ENT
diseases of Tashkent
Medical Academy
www.tma.uz