In the

anatomy Anatomy () is the branch of morphology concerned with the study of the internal structure of organisms and their parts. Anatomy is a branch of natural science that deals with the structural organization of living things. It is an old scien ...

of humans and various other

tetrapod A tetrapod (; from Ancient Greek :wiktionary:τετρα-#Ancient Greek, τετρα- ''(tetra-)'' 'four' and :wiktionary:πούς#Ancient Greek, πούς ''(poús)'' 'foot') is any four-Limb (anatomy), limbed vertebrate animal of the clade Tetr ...

s, the eardrum, also called the tympanic membrane or myringa, is a thin, cone-shaped membrane that separates the external ear from the middle ear. Its function is to transmit changes in

pressure Pressure (symbol: ''p'' or ''P'') is the force applied perpendicular to the surface of an object per unit area over which that force is distributed. Gauge pressure (also spelled ''gage'' pressure)The preferred spelling varies by country and eve ...

sound In physics, sound is a vibration that propagates as an acoustic wave through a transmission medium such as a gas, liquid or solid. In human physiology and psychology, sound is the ''reception'' of such waves and their ''perception'' by the br ...

from the air to the ossicles inside the middle ear, and thence to the oval window in the fluid-filled

cochlea The cochlea is the part of the inner ear involved in hearing. It is a spiral-shaped cavity in the bony labyrinth, in humans making 2.75 turns around its axis, the modiolus (cochlea), modiolus. A core component of the cochlea is the organ of Cort ...

. The ear thereby converts and amplifies vibration in the air to vibration in cochlear fluid. The malleus bone bridges the gap between the eardrum and the other ossicles. Rupture or perforation of the eardrum can lead to conductive hearing loss. Collapse or retraction of the eardrum can cause conductive hearing loss or cholesteatoma.

Structure

Orientation and relations

The tympanic membrane is oriented obliquely in the anteroposterior, mediolateral, and superoinferior planes. Consequently, its superoposterior end lies lateral to its anteroinferior end. Anatomically, it relates superiorly to the middle cranial fossa, posteriorly to the

ossicle The ossicles (also called auditory ossicles) are three irregular bones in the middle ear of humans and other mammals, and are among the smallest bones in the human body. Although the term "ossicle" literally means "tiny bone" (from Latin ''ossicu ...

s and

facial nerve The facial nerve, also known as the seventh cranial nerve, cranial nerve VII, or simply CN VII, is a cranial nerve that emerges from the pons of the brainstem, controls the muscles of facial expression, and functions in the conveyance of ta ...

, inferiorly to the parotid gland, and anteriorly to the

temporomandibular joint In anatomy, the temporomandibular joints (TMJ) are the two joints connecting the jawbone to the skull. It is a bilateral Synovial joint, synovial articulation between the temporal bone of the skull above and the condylar process of mandible be ...

Regions

The eardrum is divided into two general regions: the pars flaccida and the pars tensa. The relatively fragile pars flaccida lies above the lateral

process A process is a series or set of activities that interact to produce a result; it may occur once-only or be recurrent or periodic. Things called a process include: Business and management * Business process, activities that produce a specific s ...

of the malleus between the Notch of Rivinus and the anterior and posterior malleal folds. Consisting of two layers and appearing slightly pinkish in hue, it is associated with Eustachian tube dysfunction and cholesteatomas. The larger pars tensa consists of three layers:

skin Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation. Other animal coverings, such as the arthropod exoskeleton, have different ...

, fibrous tissue, and mucosa. Its thick periphery forms a fibrocartilaginous ring called the annulus tympanicus or Gerlach's ligament. while the central umbo tents inward at the level of the tip of malleus. The middle fibrous layer, containing radial, circular, and parabolic fibers, encloses the handle of malleus. Though comparatively robust, the pars tensa is the region more commonly associated with perforations.

Umbo

The manubrium (Latin for "handle") of the malleus is firmly attached to the medial surface of the membrane as far as its center, drawing it toward the tympanic cavity. The lateral surface of the membrane is thus concave. The most depressed aspect of this concavity is termed the umbo (Latin for " shield boss").

Nerve supply

Sensation of the outer surface of the tympanic membrane is supplied mainly by the auriculotemporal nerve, a branch of the

mandibular nerve In neuroanatomy, the mandibular nerve (V) is the largest of the three divisions of the trigeminal nerve, the fifth Cranial nerves, cranial nerve (CN V). Unlike the other divisions of the trigeminal nerve (ophthalmic nerve, maxillary nerve) which ...

( cranial nerve V₃), with contributions from the auricular branch of the vagus nerve ( cranial nerve X), the

(cranial nerve VII), and possibly the

glossopharyngeal nerve The glossopharyngeal nerve (), also known as the ninth cranial nerve, cranial nerve IX, or simply CN IX, is a cranial nerve that exits the brainstem from the sides of the upper Medulla oblongata, medulla, just anterior (closer to the nose) to t ...

(cranial nerve IX). The inner surface of the tympanic membrane is innervated by the glossopharyngeal nerve.

Clinical significance

Examination

When the eardrum is illuminated during a

medical examination In a physical examination, medical examination, clinical examination, or medical checkup, a medical practitioner examines a patient for any possible medical signs or symptoms of a Disease, medical condition. It generally consists of a series of ...

, a cone of light radiates from the tip of the malleus to the periphery in the anteroinferior quadrant, this is what is known clinically as 5 o'clock.

Rupture

Unintentional perforation (rupture) has been described in blast injuries and

air travel Air travel is a form of travel in vehicles such as airplanes, jet aircraft, helicopters, hot air balloons, blimps, Glider (aircraft), gliders, Hang gliding, hang gliders, parachuting, parachutes, or anything else that can sustain flight.

, typically in patients experiencing upper respiratory congestion or general Eustachian tube dysfunction that prevents equalization of pressure in the middle ear. It is also known to occur in

swimming Swimming is the self-propulsion of a person through water, such as saltwater or freshwater environments, usually for recreation, sport, exercise, or survival. Swimmers achieve locomotion by coordinating limb and body movements to achieve hydrody ...

, diving (including

scuba diving Scuba diving is a Diving mode, mode of underwater diving whereby divers use Scuba set, breathing equipment that is completely independent of a surface breathing gas supply, and therefore has a limited but variable endurance. The word ''scub ...

), and

martial arts Martial arts are codified systems and traditions of combat practiced for a number of reasons such as self-defence; military and law enforcement applications; combat sport, competition; physical, mental, and spiritual development; entertainment; ...

. Patients with tympanic membrane rupture may experience bleeding,

tinnitus Tinnitus is a condition when a person hears a ringing sound or a different variety of sound when no corresponding external sound is present and other people cannot hear it. Nearly everyone experiences faint "normal tinnitus" in a completely ...

, hearing loss, or disequilibrium ( vertigo). However, they rarely require medical intervention, as between 80 and 95 percent of ruptures recover completely within two to four weeks. The prognosis becomes more guarded as the force of injury increases.

Surgical puncture for treatment of middle ear infections

In some cases, the pressure of fluid in an infected middle ear is great enough to cause the eardrum to rupture naturally. Usually, this consists of a small hole (perforation), from which fluid can drain out of the middle ear. If this does not occur naturally, a myringotomy (tympanotomy, tympanostomy) can be performed. A myringotomy is a surgical procedure in which a tiny incision is created in the eardrum to relieve pressure caused by excessive buildup of fluid, or to drain pus from the middle ear. The fluid or pus comes from a middle ear infection ( otitis media), which is a common problem in children. A tympanostomy tube is inserted into the eardrum to keep the middle ear aerated for a prolonged time and to prevent reaccumulation of fluid. Without the insertion of a tube, the incision usually heals spontaneously in two to three weeks. Depending on the type, the tube is either naturally extruded in 6 to 12 months or removed during a minor procedure. Those requiring myringotomy usually have an obstructed or dysfunctional Eustachian tube that is unable to perform drainage or ventilation in its usual fashion. Before the invention of antibiotics, myringotomy without tube placement was also used as a major treatment of severe acute otitis media.

Society and culture

The Bajau people of the

Pacific The Pacific Ocean is the largest and deepest of Earth's five oceanic divisions. It extends from the Arctic Ocean in the north to the Southern Ocean, or, depending on the definition, to Antarctica in the south, and is bounded by the cont ...

intentionally rupture their eardrums at an early age to facilitate diving and hunting at sea. Many older Bajau therefore have difficulties hearing.

Additional images

File:Anatomy of the Human Ear en.svg, Anatomy of the human right ear. File:Gray907.png, External and middle ear, right side, opened from the front (coronal section) File:Gray908.png, Horizontal section through left ear; upper half of section File:Gray912.png, The right membrana tympani with the hammer and the chorda tympani, viewed from within, from behind, and from above File:Gray915.png, Auditory tube, laid open by a cut in its long axis File:Gray919.png, Chain of ossicles and their ligaments, seen from the front in a vertical, transverse section of the tympanum (tympanic cavity) File:Gray909.png, Right eardrum as seen through a speculum File:Normal Left Tympanic Membrane.jpg, This is a normal left eardrum. File:Tympanic membrane viewed by otoscope.png, Tympanic membrane viewed by otoscope File:Traumatic Perforation of the Tympanic Membrane.jpg, The oval perforation in this left tympanic membrane was the result of a slap on the ear File:Subtotal Perforation of the right tympanic membrane.tif, A subtotal perforation of the right tympanic membrane resulting from a previous severe otitis media File:TM RIGHT NORMAL.jpg, A normal human right tympanic membrane (eardrum) File:Frog on leaf with eardrum.jpg, Frog on leaf showing tympanum

References

External links

Diagram at Georgia State University

{{Authority control Auditory system Ear Otorhinolaryngology Otology Human anatomy