NAME: Mugo Angela Wagithi

ADMISSION NUMBER: H09/1164/2024

YEAR: 2024/2025

PHYSIOLOGY OF HEARING
1. The auricle directs the sound waves into the external auditory canal.
As well as amplification of frequencies. Provides cues about the vertical
localization of a sound source(by the degree of sound wave reflection over
the pinna)
2. When sound waves strike the tympanic membrane, the alternating high to
low pressure of the air causes the tympanic membrane to vibrate back and
forth.
3. The central area of the eardrums connects to the malleus, which also starts to
vibrate. The vibration is transmitted from the malleus to the incus and then
to the stapes.
4. As the stapes moves back and forth, it pushes the membrane of the oval
window in and out.
Impedance matching occurs around this area to set up conduction of sound
waves from the air-filled middle ear to the fluid-filled inner ear. This is done
via three mechanisms:
i) Hydraulic action of tympanic membrane- effective vibratory area of
tympanic membrane (55mm2) is more than stapes footplate at the oval
window surface area(3.2mm2), thus by focusing sound pressure from a
large area of tympanic membrane to small area of oval window the
effectiveness of energy transfer between air to fluid of cochlea is
increased.
ii) Lever action of ossicles- The handle of the malleus is 1.3 times longer
than the long process of the incus providing mechanical leverage
advantage. This increases the force of movement of air by 1.3 times.
iii) Curved membrane effect- Movement of tympanic membrane is more
at the periphery than at the center where the malleus is attached. This
difference in movement allows the edges of the tympanic membrane
to vibrate more freely than the central portion. As a result, the
vibrations produced at the periphery are transferred more effectively
to the ossicles
 These mechanisms increased sound pressure by about 22 times
compensating the impedance mismatch
5. The movement of the oval window sets up fluid pressure waves in the
perilymph of the cochlea. As the oval window bulges inward, it pushes on
the perilymph of the scala vestibuli.
Phase differential between the oval and round windows-Sound doesn’t
reach both windows simultaneously, when oval window receives
compression, the round window receives rarefaction. There is preferential
pathway to oval window due to ossicular chain. This acoustic separation of
windows is achieved by intact tympanic membrane and a cushion of air
around the round window. If sound reaches both windows simultaneously
there will be no movement of perilymph fluid.
6. Pressure waves are transmitted from scala vestibuli to the scala tympani and
eventually to the round window, causing it to bulge outward into the middle
ear.
7. As the pressure waves deform the walls of the scala vestibuli and scala
tympani, they also push the vestibular membrane back and forth, creating
pressure waves in the endolymph inside the cochlear duct.
8. The pressure waves in the endolymph cause the basilar membrane to vibrate,
hair of the outer hair cells is embedded in tectorial membrane. As both
tectorial membrane and basilar membrane moves, they slide each other with
movement. As the organ of corti moves up, tectorial membrane slide
forward moving stereocilia away from limbus. As organ of corti moves
down , tectorial membrane slide backward stereocilia towards limbus.
Bending of stereocilia stimulates hair cells.
Depolarization-As stereocilia bend away from limbus, it opens
mechanically gated ion channels, allowing positively charged ions
(potassium) to flow into the hair cells
Hyperpolarization-As stereocilia bends towards limbus, closes the ion
channels, reducing ion influx
Membrane potential changes in hair cells-Change in membrane potential
is directly proportional to degree of displacement.
Endocochlear potential-Endolymph in scala media secreted by stria
vascularis has high concentration of Na K-ATPase& unique electromagnetic
potassium pump, hence high potassium concentration and electrically
positive to perilymph. Potential developed between endolymph and
perilymph is endolymphatic potential or endocochlear potential , typically
 around +80mV to +100mV. This potential is essential for sensory
transduction.
Mechanotransduction in hair cells- When the cilia are bent in the direction
of the limbus, the tips of the smaller stereocilia are tugged outwards. This
causes a mechanical transduction that opens about 200-300 cation-
conducting channels, allowing rapid movement of potassium ions from the
surrounding scala media fluid into the stereocilia, which causes
depolarization of the hair. The influx of potassium ions inside the cell causes
activation of calcium channels. This calcium drags the neurotransmitter
filled vesicle to fuse with cell membrane at the base of the cell.
Neurotransmitter(glutamate) releases and excites the dendrites of afferent
nerve fibers, generating cochlear microphonic potential briefly described
below:-
Action potential in hair cells/Cochlear Microphonic Potential-Gating of
potassium channels is controlled by movement of stereocilia. As stereocilia
bend away from limbus-potassium channels open-Depolarization. As
stereocilia bend towards limbus-potassium channels close-Hyperpolarization
9. Vestibulocochlear nerve transmits the impulses to the hearing area in the
cerebrum where sound is perceived and so various nuclei in the pons and the
midbrain.

Central Auditory Pathway

Cochlear nucleisuperior olivary complexnucleus of lateral lemniscus-
inferior colliculusmedial geniculate bodyauditory cortex
i) Cochlear nucleus-First relay station located in the pontomedullary
junction and has subdivisions: the anterior ventral cochlear nucleus,
dorsal cochlear nucleus, and the posterior ventral cochlear nucleus.
Nerve fibers from the spiral ganglion of corti enter the dorsal and
ventral cochlear nuclei. Second-order neurons pass mainly to the
opposite side of the brain stem to terminate in the superior olivary
nucleus.
ii) Superior olivary nucleus- The auditory pathway passes upward
through the lateral leminiscus.
iii) Lateral leminiscus- Formed by the three fibers tracts from the
cochlear nucleus
iv) Inferior colliculus- Located in the midbrain just caudal to the
superior colliculus . Receives projections directly from the cochlear
 nucleus and information about amplitude differences from the medial
superior olive and lateral superior olive. Process the information it
receives and sends fibers to the medial geniculate body of the
thalamus.
v) Medial geniculate body- Receives auditory information from the
inferior colliculus. Three divisions: ventral, dorsal and medial. Plays
an important role in sound localization and processing of complex
vocal communications, such as human speech.
vi) Auditory cortex- Main auditory portion of the cerebral cortex resides
in the temporal lobe. Primary auditory cortex is located on the
superior surface of the temporal lobe. The auditory association cortex
is also known as area A2. The primary auditory cortex is directly
excited by projections from medial geniculate body whereas the
auditory association area is excited by impulses from primary auditory
cortex.
Functions:-
a) Integrating and processing complex auditory signals, including
language comprehension
b) Auditory association cortex plays an important role in speech
perception
c) Auditory association cortex is located lateral to the primary cortex,
and it is part of a language reception area known as Wernicke’s
area
Attenuation reflex
When loud sounds are transmitted through the ossicular system and from
there into the CNS, a reflex occurs after a period of only 40-80ms to cause
contraction of the stapedius muscle and the tensor tympani muscle. The
tensor tympani muscle pulls the handle of the malleus inward while the
stapedius muscle pulls the stapes outward. These two forces oppose each
other and thereby causes the entire ossicular system to develop increased
rigidity, thus greatly reducing the ossicular conduction of low frequency
sound.