East Tennessee State University

Quillen College of Medicine

Middle ear learning objectives• be able to visualize the location of the middle ear• know the structures within the middle ear cavity, their

arrangement and function• learn the relationship of structures that surround the

middle ear, and understand their significance

Pharyngeal Arch I(mand. – CN V3, mm of Mast.)Pharyngeal Arch II(hyoid – CN VII, mm of Facial Exp.)

Pharyngeal Arch III(CN IX, stylopharyngeus m.)

Pharyngeal Arch IV/VI(laryng. carts. – CN X, mm of larynx & pharynx)

Stomodeum (mouth)

Pharyngeal Cleft I(external auditory meatus)

Cleft 1 (External Auditory Meatus)

Pharyngeal Pouch 1 (middle ear cavity)

Pharyngeal Pouch 1 (middle ear cavity)

Auditory tube

Tympanic memb.

Nasopharynx

External auditory meatus (Pharyngeal cleft I)

Membrane between Pharyngeal Arch I & Cleft I

Middle ear cavity and eustachian tube(from Pharyngeal pouch I)

Cone of light

MalleusChorda tympani

Taste – ant. 2/3 of tonguePSNS – submand./subling. gls.

Dissection procedures:

2 cuts and a chisel

CN VII

Geniculate gang.

CN VII

Ch. Tymp.

Gr. Petrosal n.

CN VIII

Internal auditory meatus

CN VIII

Malleus

Incus

Stapes

CN VII

Chord. Tymp.

Tensor tymp. m.

On a routine visit to your clinic, a 53 year old male patient presented with the following symptoms that sequentially appeared over a nine month period of time.

-ringing (tinnitus) in his right ear that was occasional initially, worsening in frequency and severity over time.

-periodic dizziness.

-episodes of falling without any apparent reason. These occurrences have also increased recently.

-fluids draining out of the right corner of his mouth while drinking.

What is his problem?

Larynx learning objectives• be able to visualize the location of the larynx• know the “skeletal structures” within the middle larynx,

their arrangement and function• learn the attachments of the laryngeal muscles and their

function• describe the innervation of the laryngeal muscles and

mucosa

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?

Internal br. of Sup. Lary. br. of CNX

Recurrent Laryn. br. of CNX

Hyoid

Thyroid

Cricoid

Epiglottis

Arytenoid

Cricoid

Arytenoid

Muscular process

Vocal process

Vocal lig.

Cricothyroid memb.

Vocal fold

Cricothyroid m. - tense(Ext. Laryn. br. of Sup. Laryn. br. of X)

Thyroarytenoid m. - relax

Lat. cricoarytenoid m. - adduct

Transverse arytenoid m. - adduct

Aryepiglottic m. – “close airway”

Post. cricoarytenoid m. - abduct

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A 65 y/o man comes to the clinic with a raspy/hoarse voice. He did not know how long he has had the problem, but feels that it has worsened over the last 3 weeks.

He has not been sick. He has no reported allergies.

He was in the military for 30 years, and was a heavy smoker over that time.

What do you suspect is the source of his problem?

What can you do to help confirm your diagnosis?

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East Tennessee State University

Quillen College of Medicine