Page:EB1911 - Volume 08.djvu/819

 of the helix and antihelix. The pinna can be slightly moved by the anterior, superior and posterior auricular muscles, and in addition to these there are four small intrinsic muscles on the external surface, known as the helicis major and minor, the tragicus and the antitragicus, and two on the internal surface called the obliquus and transversus. The external auditory meatus (fig. 1, 𝑛) is a tube running at first forward and upward, then a little backward and then forward and slightly downward; of course all the time it is also running inward until the tympanic membrane is reached. The tube is about an inch long, its outer third being cartilaginous and its inner two-thirds bony. It is lined by skin in its whole length, the sweat glands of which are modified to secrete the wax or cerumen.

The middle ear or tympanum (fig. 1, 𝑝) is a small cavity in the temporal bone, the shape of which may perhaps be realized by imagining a hock bottle subjected to lateral pressure in such a way that its circular section becomes triangular, the base of the triangle being above. The neck of the bottle, also laterally compressed, will represent the Eustachian tube (fig. 1, 𝑙), which runs forward, inward and downward, to open into the naso-pharynx, and so admits air into the tympanum. The bottom of the bottle will represent the posterior wall of the tympanum, from the upper part of which an opening leads backward into the mastoid antrum and so into the air-cells of the mastoid process. Lower down is a little pyramid which transmits the stapedius muscle, and at the base of this is a small opening known as the iter chordae posterius, for the chorda tympani to come through from the facial nerve. The roof is formed by a very thin plate of bone, called the tegmen tympani, which separates the cavity from the middle fossa of the skull. Below the roof the upper part of the tympanum is somewhat constricted off from the rest, and to this part the term “attic” is often applied. The floor is a mere groove formed by the meeting of the external and internal walls. The outer wall is largely occupied by the tympanic membrane (fig. 1, 𝑜), which entirely separates the middle ear from the external auditory meatus; it is circular, and so placed that it slopes from above, downward and inward, and from behind, forward and inward. Externally it is lined by skin, internally by mucous membrane, while between the two is a firm fibrous membrane, convex inward about its centre to form the umbo. Just in front of the membrane on the outer wall is the Glaserian fissure leading to the glenoid cavity, and close to this is the canal of Huguier for the chorda tympani nerve. The inner wall shows a promontory caused by the cochlea and grooved by the tympanic plexus of nerves; above and behind it is the fenestra ovalis, while below and behind the fenestra rotunda is seen, closed by a membrane. Curving round, above and behind the promontory and fenestrae, is a ridge caused by the aqueductus Fallopii or canal for the facial nerve. The whole tympanum is about half an inch from before backward, and half an inch high, and is spanned from side to side by three small bones, of which the malleus (fig. 1, &#8202;) is the most external. This is attached by its handle to the umbo of the tympanic membrane, while its head lies in the attic and articulates posteriorly with the upper part of the next bone or incus (fig. 1, &#8202;). The long process of the incus runs downward and ends in a little knob called the os orbiculare, which is jointed on to the stapes or stirrup bone (fig. 1, &#8202;). The two branches of the stapes are anterior and posterior, while the footplate fits into the fenestra ovalis and is bound to it by a membrane. It will thus be seen that the stapes lies nearly at right angles to the long process of the incus. From the front of the malleus a slender process projects forward into the Glaserian fissure, while from the back of the incus the posterior process is directed backward and is attached to the posterior wall of the tympanum. These two processes form a fulcrum by which the lever action of the malleus and incus is brought about, so that when the handle of the malleus is pushed in by the membrane the head moves out; the top of the incus, attached to it, also moves out, and the os orbiculare moves in, and so the stapes is pressed into the fenestra ovalis. The stapedius and tensor tympanic muscles, the latter of which enters the tympanum in a canal just above the Eustachian tube to be attached to the malleus, modify the movements of the ossicles.

The mucous membrane lining the tympanum is continuous through the Eustachian tube with that of the naso-pharynx, and is reflected on to the ossicles, muscles and chorda tympani nerve. It is ciliated except where it covers the membrana tympani, ossicles and promontory; here it is stratified.

The internal ear or labyrinth consists of a bony and a membranous part, the latter of which is contained in the former. The bony labyrinth is composed of the vestibule, the semicircular canals and the cochlea. The vestibule lies just internal to the posterior part of the tympanum, and there would be a communication between the two, through the fenestra ovalis, were it not that the footplate of the stapes blocks the way. The inner wall of the vestibule is separated from the bottom of the internal auditory meatus by a plate of bone pierced by many foramina for branches of the auditory nerve (fig. 1, &#8202;), while at the lower part is the opening of the aqueductus vestibuli, by means of which a communication is established with the posterior cranial fossa. Posteriorly the three semicircular canals open into the vestibule; of these the external (fig. 1, &#8202;) has two independent openings, but the superior and posterior (fig. 1, '&#8202; and '&#8202;) join together at one end and so have a common opening, while at their other ends they open separately. The three canals have therefore five openings into the vestibule instead of six. One end of each canal is dilated to form its ampulla. The superior semicircular canal is vertical, and the two pillars of its arch are nearly external and internal; the external canal is horizontal, its two pillars being anterior and posterior, while the convexity of the arch of the posterior canal is backward and its two pillars are superior and inferior. Anteriorly the vestibule leads into the cochlea (fig. 1, &#8202;), which is twisted two and a half times round a central pillar called the modiolus, the whole cochlea forming a rounded cone something like the shell of a snail though it is only about 5 mm. from base to apex. Projecting from the modiolus is a horizontal plate which runs round it from base to apex like a spiral staircase; this is known as the lamina spiralis, and it stretches nearly half-way across the canal of the cochlea. At the summit it ends in a little hook named the hamulus. The modiolus is pierced by canals which transmit branches of the auditory nerve to the lamina spiralis.

The membranous labyrinth lies in the bony labyrinth, but does not fill it; between the two is the fluid called perilymph, while inside the membranous labyrinth is the endolymph. In the bony vestibule lie two membranous bags, the saccule (fig. 2, S) in front, and the utricle (fig. 2, U) behind; each of these has a special patch or macula to which twigs of the auditory nerve are supplied, and in the mucous membrane of which specialized hair cells are found (fig. 3, 𝑝).

Attached to the maculae are crystals of carbonate of lime called otoconia. The membranous semicircular canals are very much smaller in section than the bony; in the ampulla of each is a ridge, the crista acustica, which is covered by a mucous