EAR

DAY 1

General organization:

DIAGRAM OF HUMAN EAR

1.External Ear : Pinna ( Auricle ) , External Auditory Canal ( External

auditory meatus ), Tympanic membrane

( Ear drum )

2. Middle Ear( Tympanic cavity ): Ear ossicles, Ear muscles, Eustachian

tube( pharngotympanicor auditory tube )

3. Internal ear: Cochlea, Vestibuli and Semicircular

Pinna:
 • Made up ofYellow elasticCartilage.
• Pinna helps in concentration of diffuse sound.
Other elastic carytilage @4E- Ear Pinna, External Auditory canal,
Epiglotis, Eustachain tube

External auditory canal:

• Outer cartilaginous part and inner bony part.

• Hair follicles, sweat gland, ceruminous glands and sebaceous
glands are present inOuter cartilaginous Part

Cerminous glands( Modified sweat gland ) produce cerumen(earwax).

Ear wax prevents entry of foreign bodies.

Tympanic membrane(eardrum):

• originated from all three germ layer ( i.e. ectoderm, mesoderm

and endoderm )
• Inflammation of tympanic membrane is Myringitis
• Perforated ear drum – Treatment Myringoplasty

Ear Ossicles:

Ossicles Shape Modification of

Malleus Hammer Articular
Incus Anvil Quadrate
Stapes (smallest Stirrup Hyomandibular
bone )
@MIS HAS AQUA HOUSE

Ear muscles:

• Stapedius (smallest muscle)attached to Stapes bone

• Tensor tympani muscle attached to Malleus Bone .
• These muscles protect our ear from loud sound.

Eustachian/Auditory/Pharyngotympanic tube:

• connects middle ear and nasopharynx

• opensduringswallowing andYawning
• It equalizes pressure on both sides of tympanic membranes.
• Chances of otitis media following pharyngitis is
more in infant than in adult. Why?
Eustachian tube is short, wide and horizontally located.
• Infection of middle ear is Otitis media.
• Otitis media is common in Infants ( Children )

Eustachian Tube VS Eustachian Valve

Day 2

Internal ear(labyrinth)

• Consists of outer bony labyrinth which contains PerilymphAnd

inner membranous labyrinth which containsEndolymph
• It is divided into cochlea(hearing part)and
 vestibular apparatus(balancing part consisting
saccule,utricle and semicircular canals)
Cochlea:

Fig. Cochlea
• Scala vestibule and scala tympani contains Perilymph.

and scala media ( cochlear duct) contains Endolymph.

• A narrow slit through which scala vestibule and scala tympani

communicate is Helicotrema

Organ of corti: present in …Scala media

 Fig. Organ of corti

contains 2 types of cells.

a.hair cells

b.supporting cells

Supporting cells in organ of corti are: @PCB HD

a. P= Pillar cell.

b. C = Claudius cell

C. B =Boettcher cell

d. H =Hensen cell

e. D =Deiters cell

Hensen cell VS Hansen Disease ( Leprosy )

 • Hair cells of organ of corticontain stereocilia which are embedded
in Tectorial membrane.
• Sound waves transmitted in the fluid of internal ear

causes the movement of hair cells which generate

action potential in the bipolar neurons of cochlea.

• Action potential is due to the influx of Potassium (K+ )

• the neurotransmitter involved is Glutamate.
• Audible range is 20 Hz to 20,000Hz.
• Most sensitive is 2 KHz to 3 KHz.

Vestibule:

Fig. Macula

• It consists saccule and utricle.It is concerned with static

equilibrium.Sensory patches found in this part is called macula.
 • Macula consists 2 types of cells:
• Hair cells and supporting cells.
• Hair cells in macula contains sterocilia and kinocilium which are
embedded in Otolithicmembrane.

Otolithic membrane contains Calcium carbonate

crystals calledOtoconia or Otoliths or Statoliths.

Semicircular canals:

Fig. Cristae

• Concerned with dynamic equilibrium.

• semicircular canals which are at right angle to each other i.e.
anterior posterior and lateral.
• Dilated base on one side of each canal is called Ampulla.
• Ampulla contains sensory part of the semicircular.
 • Ampulla of Fallopian Tube Vs Ampulla of Vater Vs Ampulla of
Semicircular canal
• Vestibulo- cochlear nerve – Eighth cranial nerve

canals which are calledCristae.

Crus Commune is non ampullated ends of anteriorand

posteriorSemicircular canals.

DAY 3

Eye

1. Accessory structure 2. Eyeball

a.Eyelid, Eyebrow, Eyelashes a. Tunica fibrosa
b.Conjunctiva b. Tunica vasculosa
c. lacrimal gland c. Tunica nervosa
d. extraocular muscle of eye

Eyelid:
 Fig. Eyelid

• Skin( thin skin ) subcutaneous tissue orbicularis oculi

muscle Tarsal plate tarsal gland conjunctiva
• Glands of eyelid:Tarsal gland ( Membomian gland T)
Gland of moll and gland of zeis
• Inflammation of gland of zeis is stye.
• Infection of tarsal gland is Chalazion.

Conjunctiva:
• Thin protective mucus membrane of eye.
• Lined by non keratinzed stratified squamous epithelium with
Goblet cell.
• Contains palpebral conjunctiva lining the eyelid and bulbar
conjunctiva lining sclera.
Lacrimal glands:
• Located at the superolateral part of orbit.
• Secrete tear which contains water, mucus, lipid, IgA salts
lysozyme enzyme (bactericidal) tear is isotonic to blood
and0.9%NaCl solution.
• Opens into the nasal cavity by nasolacrimal duct.
• Inflammation of lacrimal sac Dacryocystitis.
Extraocular muscles of eye:
 Muscles Nerve Supply
a. Superior rectus 3rd cranial nerve ( Oculomotor nerve )
b. Inferior rectus 3rd cranial nerve ( Oculomotor nerve )
c. Medial rectus 3rd cranial nerve ( Oculomotor nerve )
d. Lateral rectus 6th cranial nerve ( Abducent nerve ) @LR6
e. Superior oblique 4th cranial nerve ( Trochlear nerve ) @SO4
f. Inferior oblique 3rd cranial nerve ( Oculomotor nerve )

DAY 4

Eyeball:
Tunica fibrosa:

• Anterior part is called cornea( 1/6 part ) and posterior part

iscalled Sclera ( 5/6 part )

Cornea:
 • Transparent layer made up of 5 layers.
• Lined by stratified squamous Epithelium
• Major site of refraction and refractive power 43 D
• Part of the eye used in eye donation(keratoplasty)

Because it is avascular.Itderives its nutrition from theaqueous

humor by diffusion.

• Inflammation of cornea is called Keratitis

Sclera-fibrous opaque protective layer of eyeball.

Tunica vasculosa :

Iris
 • Gives color to the eye due to the pigment melaninproduced by
melanocytes.
• Central Aperture formed by the iris is called Pupil
• Contains outer Radial ( OR) muscle and inner circular muscle( IC ).
Contraction of radial muscle causes dilation of pupil and
contraction of circular muscle causes constriction of pupil.

Ciliary body

Consists; ciliary muscle,ciliary process,andsuspensory ligaments.

• Suspensory ligaments(Zonules of Zinn or zonular fiber )hold the

lens.
• Ciliary process produce aqueous humor.
• Ciliary muscle responsible for accommodation of eye.
Lens
• Avascular structure Origin Ectoderm
• Elastic in nature
• Biconvex in shape
• Transparent, refractive power about 20D

Chambers of eye ;

• Lens of the eye separates the eyeball into Aqueous chamber in

the front and Vitreous chamber in the back.
• Iris separated aqueous chamber in Anterior Chamber and
Posterior chamber.
• Aqueous humor is produced by ciliary process in the

posterior chamber and it flows to the anterior chamber and

isdrained through Canal of Schlemm.
Choroid:

• Pigmented vascular layer which absorbs the

diffused light entering the eyeball.

Day 4

Tunica Nervosa(Retina)

• Retina is made up of Ten layers.

 Fig. Retina

• Consists of:

a. Pigmented layer

b. Nervous tissue layer

• Bipolar cell layer which consists bipolar cell, amacrine cell and
horizontal cell
• Ora Serrata: is peripheral termination of Retina.

Rods and cones

• 6 million cones and 120 million rods.
• Rod cells contain rhodopsin as photo pigment and cone cells
contain idopsin as photo pigment.
• Cones are of three types: Red, Green and Bluecones.
• Rods are associated with dim light vision and cones

are associated with color vision.

• Axons from the ganglion cell layer collect to form

optic nerve and exit through optic disc or blind spot

where rods and cones are absent.

• Macula lutea (yellow spot)contains the central

Depression called Fovea Centralis which has cones cells only. It is

the area of highest visual acuity or sharpest vision.

• Normal visual acuity is 6/6.

• Vision cortex ( Occipital lobe )
• Optic nerve – second cranial nerve
 Fig. Visual acuity Chart

Disorders of eye

1.Myopia or short sightedness: cannot see far objects due to

elongation of eyeball and corrected byconcave lens ( Diverging lens )
2.Hypermetropia or long sightedness;cannot see near objects due to
shortening of eyeball and corrected by Convex lens ( converging lens )

3.Astigmatism: Multiple images on Retina due to irregular curvature of

cornea or lens and corrected by Cylindrical lens.

4.Presbyopia:decrease in ability to see near objects in old age and

corrected by bifocal lens

5.Glaucoma; Increase in intraocular pressure. Normal intraocular

pressure is 12 to 20 mm of Hg. Intraoculatr pressure is measured by
Tonometer.

6.Cataract : Opacity of lens. Surgical treatment replacing natural lens

by artificial lens.

7.Trachoma: Bacterial infection Chlamydia trachomatis

8.Xerophthalmia ; Dryness of eye

9. Conjunctivitis ( pink eye ): Inflammation of conjunctiva.

Integumentary system

• Largest organ of human body. Is also called the master organ or

jack of all trades because of its diversity in function.
• Origin Epidermis Ectoderm Dermis mesoderm
• Dermatology : study of skin
• Dermatitis: Inflammation skin
• Types of skin
• Thick and Thin skin; thick skin is present in Palm of Hand and Sole
of foot.

（A)Layers of Epidermis: Epidermis is avascular.

Phagocytic cell of skin is Langerhans cell

• Stratum germinativumor Malpighian layer or

Stratum cylindricum or Stratum basale:

• Stratum spinosum ( prickle cell layer )

• Stratum granulosum

• Stratum lucidum( clear layer )

• Stratum corneum(Horny layer):

（B)Dermis:

• Consists of blood vessels, sweat gland, sebaceous gland,root of

hair follicle, cutaneous receptors, erector pilli muscle.
Cutaneous receptors
a. Free nerve ending: Pain
b. Meissner’s corpuscles: Light touch ( MEssi fine touch )
c. Pacianian corpuscles: Pressure
d. Merkel’s disc: Tactile discrimination
e. Krau’s end bulb: cold
f. Ruffini’s end organ: heat
g. Nocireceptoror Algesireceptor: Pain
Function of skin

（a)Protection.

（b)Maintenanceofbody shape

（c)Barriertoinfection

（d)Maintenance ofwaterbalance

（e)Excretion
 （g)Secretion

（h)Chemicaldefences

（i)Sensation

（j）Storage

（k) Regulationofbody temperature

（l)Nourishment

（m)Colour

（n)Absorption

MCQ

1.Short sightedness or myopic vision is corrected by

wearing:［BP 2004]

（a)Convex lenses (b)Concave lenses

（c)Convex mirrors (d)Concave mirrors

2.Point of greatest visual acuity［IOM-1999]

（a)Macula lutea (b) Fovea centralis

（c) optic disc （d)Optic chiasm

3.Which of following is incorrect regarding Cornea? ( KU
2017 )

(a) Cornea is avascular (b) contains 5 layers

(c) cornea is middle part of eyeball (d) anterior part of

eyeball

4.A person who cannot see the near objects clearly is

likely to use:［BP 2007]

（a)Convex lens（b)Concave lens

（c)Bifocal lens (d)Cylindrical lens

5.The tears of healthy girl would have osmotic

pressure isotonic to NaCI solution of:［BPKIHS-2003]

（a)0.74%（b)0.90%

（c)7.40%（d)9.00%

6.Which part of ear is responsible for hearing?［BPKIHS-

2010]

（a)Cochlea（b)Utricle

（c)Saccule （d) Semicircular ducts

7.Which cell is used to see colour?［IOM-2001]

（a)rod cells （b) cone cells

（c) corneal cells （d)iris

8. Ora Serrata is part of ( IOM 2017 )

(a) retina (b) Choroid

(c) iris (d) cornea

9.Eustachian tube connects [MOE 2008,IOM-2009]

（a)pharynx with middle ear

（b) middle ear with external ear

（c)Middle ear with internal ear

（d)external ear with internal ear.

10.Meibomian glands are present in

［IOM-2009 ]

（a)ears（b)skin

（c)eyes（d)lungs

11.A person(>55 years)can not see the near objects,

the defect is［IOM-2009,MOE-2008]

（a)Myopia （b) Hypermetropia

（c)Presbyopia (d)Astigmatism

12.In infernal ear sensory patches are situated

in............［IOM-2011]

（a)membranous labyrinth （b) cochlea

（c)Stapedial plate （d)Fenestra ovalis

13.The disease caused by bacteria in human eye is

known as.....［MOE-2011]

（a)Protanopia （b)Xerophthalamia

（c)Glaucoma （d)Trachoma

14.Organ of Corti cells are related to..［IOM-1996]

（a)sight （b)hearing

（c)equilibrium （d)taste

15.Tear from eye is drained into［IOM-2006]

（a)Oral cavity （b)Nasal cavity

（c)Ear （d)Maxillary sinus

16.Which is the correct sequence of transmission of

vibrations from the air to the auditory nerve in

mammal?［MOE 2058]

（a)Earbones,cochlea,tympanic membrane

（b) Tympanic membrane,cochlea,ear.bones

（c)Cochlea,earbones,tympanic membrane

（d)Tympanicmembrane,earbones,cochlea

17.Sensory spot in ampulla is called [MOE 2009]

（a)Macula （b) Otolith

（c)Crista （d)Organ of Corti

18. Vision cortex lies in [ IOM 2018 ]

(a) Frontal lobe (b) Temporal lobe

(c) Occipital lobe (d) Parietal lobe

19.The enzyme that is present in tears is [KUMET ]

（a)Lysozyme （b)Ptyline

（c)Amylase (d)Lipase

20,Hensen's cell is found in [BPKIHS 2008 ]

（a)Eye （b) Ear

（c)Botha&b （d)Spleen

21.Ceruminous glands are situated [BPKIHS-2071]

（a)Around anus （b)In external auditory meatus

（c)In eye-lids（d)In arm-pits

22.Organ of Corti lies inside the [BPKIHS 2005|

（a)Tympanum (b) Scala vestibuli

（c)Scala tympani (d)Scala media

23.Meissner's corpuscles are located in

［BPKIHS 2004|

（a)Skin （b)Teeth

（c)Nail （d)Hair

24.Cochlea is mainly responsible for [BPKIHS 2004]

（a)Balance only （b) Hearing only

（c)Both balance and hearing （d)Perception of colour

25.A man was suddenly jerked but he managed to

balance his body.What worked there?［BPKIHS 2001]

（a)Otolith （b)Endolymph of semicircular
canals

（c)Organ of Corti （d)Ear ossicles

26.The part of the ear that distinguish different

pitches is the:［IOM 2004]

（a)Organ of corti (b) Tympanic membrane

（c)Semicircular canal (d)Auditory nerve

27.Tectorial membrane is present in: [CEE 2022) |

（a)ear of mammal (b)eye of mammal

（c)ear of frog (d)eye of frog

28.Yellow spot is found in:［IOM 1996]

（a)Cones （b)Rods

（c)Retina （d)Choroid

29. Intraocular pressure is measured by ( CEE 2024 )

a. Tonometer b. Glucometer

c. Thermometer d. Sphygmomanometer

30.Function of Semi circular canal ( CEE 2021 )

a. Hearing

b. Balancing

c. Decision

d. Hearing and balancing

31. Hearing of sound is related to (CEE 2022)

a. Tectorial membrane and tympanic membrane

b. Tectorial membrane and Basilar membrane

c. Ressiner’s membrane and Basilar membrane

d. Ressiner’s membrane and tympanic membrane