TELINGA

ORGAN AUDITORIUS

N.Auditorius Telinga Cortex cerebri

(lobus temporalis)

AURIS EXTERNA AURIS MEDIA AURIS INTERNA

Auricula Cavum tympani Cochlea

Meatus acusticus Vestibulum
externus Udara Canalis semicirc.
Tulang
Membrana tympani Otot
 Membrana tympani
Cochlea
Auricula Cavum tympani
Vestibulum

Meatus acusticus externus

Canalis semicirc
 AURIS EXTERNA
1. AURICULA
Tdd. Tulang rawan
Menangkap gelombang suara Meatus
acusticus externus
Musculi intrinsik : M. helicis major
M. helicis minor
M. tragices
M. anti tragices
M. obliques auriculae
M. transversus auriculae
 Musculi ekstrinsik : M. auricularis anterior
M. auricularis posterior
M. auricularis superior

Innervasi Auricula:
sensorik : N. occipitalis minor
N. auricularis magnus
N. auricularis temporalis
R. auricularis nn. vagi
motorik : cabang n. vagus

Vascularisasi Auricula: A. auricularis posterior

A. temporalis superfisialis
 M. auricularis superior

M. auricularis anterior

M. helicis major

M. helicis minor

M. tragices
M. auricularis anterior
M. anti tragices
 2. MEATUS ACUSTICUS EXTERNUS

Tdp. kelenjar ceruminosa &

cebacea
Berakhir pd membrana tympani
Sebelah luar = cartilago
Sebelah dalam = tulang
Menyempit pada : perbatasan
cartilago dengan tulang, isthmus
Innervasi : N. auriculotemporalis
R. auricularis n. vagus
Vascularisasi :
A. auricularis posterior
A. temporalis superfisialis
 MEMBRANA TYMPANI
Melekat pd os temporalis
Memisahkan auris externa
dengan cavum tympani
Permukaan lateral cembung
pusatnya = Umbo
Permukaan medial melekat
malleus
Terdiri dari : pars tensa dan
pars flaccida
Bila terjadi ruptur membrana
tympani tuli
 AURIS MEDIA (CAVUM TYMPANI)
pars tegmentalis
Cavum tympani :
rongga udara di dalam os
temporal berisi tulang
pendengaran

Batas cavum tympani :

cranial : pars tegmentalis
caudal : pars jugularis Pars
coraticus
lateral : pars membranacea
medial : pars labyrinthicus
posterior : pars mastoidea
anterior : pars coraticus pars jugularis
 Isi Cavum Tympani :
- Udara
- Tulang pendengaran :
MALLEUS
INCUS
STAPES
- Otot : M. tensor tympani
M. stapedius

Foramen dalam cavum

Tympani :

- muara meatus acusticus

externus
- fenestra ovalis
- fenestra rotundum
- sinus mastoid
- tuba auditiva
 TUBA AUDITIVA :

Menghubungkan auris media nasopharynx

Menjaga tekanan pd membrana tympani
Sebagai jalan infeksi yg menyebar dari
tenggorokan auris media sinus mastoid
Tetap tertutup kecuali waktu
mengunyah/menelan
Bila terbuka udara dr hidung atau mulut
tekanan pd permukaan dalam membrana tympani
= tekanan pd permukaan luar membrana tympani
tidak terjadi ruptur membrana tympani
 Vascularisasi telinga tengah
A. tympanica anterior
A. auricularis posterior

Innervasi telinga tengah

N. auriculotemporalis
R. auricularis n. vagus
N. tympanicus
 AURIS INTERNA ( LABYRINTH )

Labyrinthus Osseus Labyrinthus Membranaceus

- dibtk oleh os petrossa - dlm labyrinthus osseus

- isi = perilymphe - isi = endolymphe

CANALIS SEMICIRCULARIS DUCTUS SEMICIRCULARIS

VESTIBULUM UTRICULUS
COCHLEA SACCULUS
DUCTUS COCHLEARIS
LABYRINTH OSSEUS

CANALIS SEMICIRCULARIS
VESTIBULUM
COCHLEA
1. CANALIS SEMICIRCULARIS
Ada 3 saluran (anterior/superior,posterior,lateral)
Ujung saraf pd AMPULLA terangsang oleh getaran cairan

three canals at right angles

ampulla
swelling of membranous
labyrinth that communicates
with the vestibule
crista ampullaris
sensory organ of ampulla
hair cells and supporting
cells
rapid turns of head or body 12-39
stimulate hair cells
2. VESTIBULUM Terdiri dari :
- UTRICULUS - SACULLUS
Serabut N. Vestibularis berakhir di utriculus danSacullus

Utricle
communicates with
saccule and membranous
portion of semicircular
canals
Saccule
communicates with
cochlear duct
Mucula
hair cells of utricle and
saccule
12-37
 Equilibrium

Static Equilibrium Dynamic Equilibrium

vestibule semicircular canals
sense position of sense rotation and
head when body is movement of head and
not moving body

12-36
 3. COCHLEA
Saluran berbentuk spiral

Membrana Basillaris

SCALA VESTIBULI SCALA TYMPANI

Membrana Vestibularis

SCALA VESTIBULI
SCALA MEDIA / DUCTUS COCHLEARIS
 Cochlea

Scala vestibuli
upper compartment
leads from oval window to
apex of spiral
part of bony labyrinth
Scala tympani
lower compartment
extends from apex of the
cochlea to round window
part of bony labyrinth

12-30
Alat Keseimbangan :
1. Macula utriculi
2. Macula sacculi
3. Crista ampullaris

Alat Pendengaran :
Organon Corti (di dasar dustus cochlearis)
Innervasi oleh N. VIII (N .vestibulocochlearis)
Vascularisasi oleh A. Auditiva Interna
 Inner Ear: structures + functions
Tulang Membranous Function of Membranous
Labyrinth Labyrinth Labyrinth
1. Semicircular Semicircular Equilibrium; rotational
canals ducts acceleration of head

2. Vestibule Utricle + Saccule Equilibrium; static equilib

+ linear equilib of head

3. Cochlea Cochlear duct Hearing

Noise Convection and Conduction
Operation of the Cochlea
Auditory Nerve Pathways

12-34
Summary of the Generation of
Sensory Impulses from the Ear

12-35
HIDUNG
 ORGANON OLFAKTUS

1. NASUS EXTERNUS
2. CAVUM NASI
3. SINUS PARANASALIS
 NASUS EXTERNUS
Dibagi dua bagian oleh Septum Nasi
Bagian Tulang :
- Os nasalis
- Proc. Nasalis os frontalis
- Proc. Frontalis os maxilla
Bag.tulang rawan :
Vascularisasi :
-Cartilago septalis Cabang a. facialis
-Cartilago lateralis Cabang a. opthalmicus
-Cartilago alaris major
- Cartilago alaris minor
Proc. Nasalis os frontalis

Os nasalis

Cartilago septalis

Proc. Frontalis os
maxilla

Cartilago lateralis

Cartilago alaris minor

Cartilago alaris
major

NASUS EXTERNUS
Innervasi kulit hidung:

Bag. Lateral :
R.infraorbitalis
N.maxillaris

Ujung hidung :
R. nasalis ext. N.
ethmoidalis ant.

Bag. Atas :
N. intratrochlearis +
N.supratrochlearis
 CAVUM NASI
Mulai dari : Nares Choane, terbagi menjadi :

1. Vestibulum
- Mulai Nares Apex nasi
- Tdp. kel.sebacea, kel. keringat, rambut

2. Regio olfactorius ( 1/3 superior )

- Pd. septum nasi superior & concha nasalis sup.
- tdp bundel serabut n. olfactorius lamina
cribrosa os ethmoidalis bulbus olfactorius

3. Regio respiratorius ( 2/ 3 inferior )

- Tunica mucosa, epithel bersilia
 DINDING CAVUM NASI
ATAP :
Os nasal
Os sphenoidalis
Os frontal
Lamina cribrosa
os ethmoidalis
DASAR :
Palatum durum
LATERAL :
Concha nasalis superior
Concha nasalis media
Concha nasalis inferior
Os maxilla
MEDIAL :
Os vomer
Lamina perpendicularis
os ethmoidalis
Cartilago septi
Concha nasalis superior
Concha nasalis
Media

Concha nasalis
inferior
 VASCULARISASI

PLEXUS KIESSELBACH

A. SPHENOPALATINA
A. ETHMOIDALIS ANTERIOR dinding lateral
A. ETHMOIDALIS POSTERIOR
A. PALATINA MAJOR SEPTUM NASI

A. SEPTALIS
A. ETHMOIDALIS ANTERIOR A. ETHMOIDALIS POSTERIOR

A. SPHENOPALATINA

A. SEPTALIS/
LABIALIS SUPERIOR

A. PALATINA MAJOR
 A. ETHMOIDALIS POSTERIOR

A. ETHMOIDALIS ANTERIOR

A. SPHENOPALATINA

A. SEPTALIS/
LABIALIS SUPERIOR

A. PALATINA MAJOR
 INNERVASI

- N. ethmoidalis anterior
- N. nasopalatinus
N. ethmoidalis anterior
- Rr. nasales posterior
superior
n.pterygopalatinus
- Rr. nasales posterior
inferior n.
pterygopalatinus
Rr. nasales posterior superior
n.pterygopalatinus

Rr. nasales posterior inferior

n. pterygopalatinus

N. nasopalatinus
 SINUS PARANASALIS

SINUS FRONTALIS MEATUS NASI SINUS

MAXILLARIS MEDIA
SINUS ETHMOIDALIS ANT.
SINUS ETHMOIDALIS POST. MEATUS NASI SUP.
SINUS SPHENOIDALIS RECCESUS SPHENO-
ETHMOIDALIS
 SINUS MAXILLARIS

Terbesar, bentuk piramid, tdp.pd. Corpus maxilla

Apex ke depan sampai os zygomaticus
Atap dari sinus dibentuk oleh dasar cavum orbita
Radix gigi M2 sering menonjol ke dasar sinus
Bermuara ke meatus nasi media
Letak muara lebih cranial dari dasar sinus
FISIOLOGI PENGHIDUAN
 Introduction
Smell and taste are generally classified as visceral
sense because of their close association with
gastrointestinal function
Physiologically they are related to each other
Flavors of various foods are in large part a
combination of their taste and smell
Food may taste different if one has a cold that
depresses sense of smell
 Introduction
Both smell and taste receptors are chemo-receptors
that are stimulated by molecules in solution in mucus
in the nose and saliva in the mouth
However, anatomically quite difference:
- Smell receptors are distance receptors
(teleceptors), and its pathways have no relay in
thalamus
- Taste pathways pass up brainstem to thalamus
and project to postcentral gyrus
 Olfactory Mucous Membrane

Is specialized portion of nasal mucosa

With yellowish pigmented
In which olfactory receptor cells are located
Is constantly covered by mucus which is produced by
Bowmans glands
In dogs and other animals in which sense of smell is
highly developed (macrosmatic animals)
Contains supporting cells and progenitor cells for
olfactory receptors
 Olfactory Receptors
Each olfactory receptor is a neuron
Each neuron has a short thick dendrite with expanded
end called an olfactory rod
From the rods, cilia project to surface of mucus
Each receptor has 10-20 cilia
Axon of the neurons pierce cribriform plate of
ethmoid bone and enter olfactory bulbs
Olfactory neurons are constantly being replaced with
a half-time of a few weeks
 Olfactory Bulbs

In olfactory bulbs, axons of receptors contact primary

dendrites of mitral cells and tufted cells to form
complex globular synapses called olfactory glomeruli
Olfactory bulbs also contain periglomerular cells
which are inhibitory neurons connecting one
glomerolus to another
Granule cells have no axons and make reciprocal
synapses with lateral dendrites of mitral and tufted
cells
 Olfactory Pathways
1. The very old olfactory system (medial olfactory area):
concerning with basic olfactory reflexes to olfaction,
such as licking the lips, salivation, and other feeding
responses caused by smell of food
2. The less old olfactory system (lateral olfactory area):
provides learned control of food intake (like / dislike
certain foods)
3. The newer olfactory system: other cortical sensory
systems and is used for conscious perception of
olfaction
 Olfactory Cortex

Axons of mitral and tufted cells pass posteriorly

through intermediate olfactory stria and lateral
olfactory stria to olfactory cortex
In humans, sniffing activates pyriform cortex
Smells activate lateral and anterior orbitofrontal gyri
of frontal lobe
Orbitofrontal activation is generally greater on right
side than left side
 Olfactory Cortex

Other fibers project:

- to amygdala, which is probably involved
with emotional responses to olfactory
stimuli,
- to entorhinal cortex which is
concerned with olfactory memories
 Olfactory threshold & Discrimination

Olfactory receptors respond only to substances that

are in contact with olfactory epithelium and are
dissolved in thin layer of mucus that covers it
Olfactory threshold remarkable sensitive to some
substances
Olfactory discrimination is remarkable
Humans can recognize 10,000 different odors
 Olfactory threshold & Discrimination

Determination of differences in intensity of any

given odor is poor
Concentration of odor-producing substance must
be changed by about 30% before a difference can
be detected
Comparable visual discrimination threshold is a 1%
change in light intensity
 Role of Pain Fibers in Nose

Naked endings of many trigeminal pain fibers are

found in olfactory mucous membrane
They are stimulated by irritating substances, and an
irritative
Trigeminally mediated component is part of
characteristic odor of such substances as
peppermint, menthol, chlorine
These endings also responsible for initiating
sneezing, lacrimation, respiratory inhibition, and
other reflex responses to nasal irritants
 Adaptation

When one is continuously exposed to even most

disagreeable odor, perception of odor decreases
and eventually ceases
This phenomenon is due to fairly rapid adaptation,
or desensitization that occurs in olfactory system
Mediated by Calcium ion acting via calmodulin on
cyclic nucleotide-gated (CNG)
When CNG is knocked out, adaptation is slowed
 Abnormalities

Anosmia : absence of sense of

smell
Hyposmia : diminished olfactory
sensitivity
Dysosmia : distorted sense of smell
Terima kasih