耳的临床解剖学及生理学研究报告.pptVIP

耳的应用解剖学及生理学;耳聋是人类最大的苦难之一;为什么听力非常重要？;;位于颅骨二侧，与顶骨、蝶骨、枕骨相接， 由鳞部、鼓部 、乳突部和岩部组成+茎突;成人左侧颞骨外面观 1 = 外耳道； 2 = 道上三角； 3 = 颞骨鳞部； 4 = 乳突尖； 5 = 鼓乳裂； 6 = 颧突； 7 = 下颌窝； 8 = 颞线； 9 = 岩鼓裂； 10 = 茎突； ;9.鼓切迹 10. 道上棘 11.道上三角区 12.颞线 13.顶切迹 14.外耳门 15.乳突部 16.枕缘 17.乳突鳞缝 18.乳突孔 19.鼓乳裂 20.乳突切迹 21.乳突 22.岩鼓裂 23.鼓部 24.茎突;右侧颞骨内面观;右侧颞骨下面观;内听道底解剖关系（右侧）;外耳;外耳解剖;外耳解剖;中耳;中耳解剖;中耳解剖-鼓室划分;中耳解剖-鼓室外壁内面观;中耳的解剖-外壁-鼓膜;中耳解剖-鼓室内壁;中耳解剖-鼓室内壁;中耳解剖-鼓室前壁;中耳解剖-鼓室前壁;中耳解剖-鼓室后壁;中耳解剖-鼓室后壁;中耳解剖-鼓室上壁、下壁;中耳解剖－鼓室内容物;中耳解剖－咽鼓管;中耳解剖－鼓窦;中耳解剖－乳突;内耳解剖;内耳解剖－骨迷路前外侧观;内耳解剖－骨迷路内面观;内耳解剖－前庭;内耳的解剖－骨半规管;内耳解剖－膜迷路;内耳解剖－膜迷路;膜蜗管 位于骨螺旋板与骨蜗管外壁之间，亦在前庭阶与骨阶之间，内含内淋巴。;基底膜：起自骨螺旋板游离缘。其上的螺旋器(Corti器)是由内、 外细胞等组成的听觉感受器。;人听觉传导径路模型;人听觉传导径路;前庭神经的中枢通路;耳的生理学;声音传入内耳的途径; ;声音传入内耳的途径;声音传入内耳的途径;外耳的生理;中耳的生理;中耳生理－鼓膜的生理功能;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;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;中耳生理－咽鼓管的生理功能;听觉生理;Basilar membrane displacement for a 1 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 ;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”;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 i