耳的临床解剖学及生理学概述.ppt

* * * * * * * * * * * * 此前为一学时 * * * * * * * * * * * * * * * * * * * * * * 中耳的生理 变压增益 传声变压结构：鼓膜与听骨链 中耳生理－鼓膜的生理功能 有效振动面积： 55 mm2 ，解剖面积的2/3。 镫骨底板面积：3.2 mm2 ，1/17倍 中耳功能—面积比的声放大作用 压强 = 压力/受力面积 鼓膜面积约为镫骨底板面积的17 倍 面积比的增益~24 dB 中耳生理－听骨链的生理功能 锤骨柄与砧骨长脚为杠杆的两臂，长度之比为1.3:1可使声压传到前庭窗时增加1.3 倍，故声波达到镫骨底板时可提高1.3×17=22.1倍，相当声强级27dB，声波从空气达内耳淋巴所衰减的30dB通过中耳的增压作用得到了补偿。 中耳功能—听骨链的增压作用 Energy loss at air-fluid interface-99.9% loss (-30 dB) Malleus longer than incus-amplify pressure ~1.3X (+2 dB) 中耳生理－鼓室肌的生理功能 镫骨肌：收缩时牵引镫骨头向后，使底板前部向外 跷起，导致外淋巴压力减低。 中耳生理－咽鼓管的生理功能 保持中耳内外压力的平衡 引流作用 防止逆行性感染的功能 防声作用 听觉生理 传音功能 感音功能 Basilar membrane displacement for a 1 kHz tone Basilar membrane displacement for a 250 Hz tone Basilar membrane displacement for a 4 kHz tone Cochlear mechanical response due mass and stiffness gradient Mass stiffness gradient gives rise to a so-called “traveling wave” Characteristic frequency—frequency which produces the largest amplitude of response Apex-maximum response to low frequencies Base maximum response to high frequencies Mass-increases from base (stapes) to apex Stiffness-increases from apex to base 1 2 3 4 Envelope of traveling wave Characteristic frequency Stereocilia on OHCs attached to tectorial membrane Stereocilia on IHCs free standing Motion of basilar membrane towards scala vestibuli deflects stereocilia in excitatory direction Tectorial membrane deflects OHC stereocilia Viscous fluid drag of fluid deflects IHC stereocilia Model: OHC contraction cause organ of Corti to distort as shown herer Cell motility feeds back enhancing basilar membrane motion thereby increasing traveling wave amplitude and making the “cochlea active” Cordi器负责外毛细胞电能动 OHC contracts in-phase with deflection of the hair bundle toward the tallest stereocilia. The current through the cell increases with deflection in this direction. If the current is modulated slowly (compared to 1 kHz), then the voltage across the lateral membrane will be in-phase with the current. Co