What are the structures in the middle ear?

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Middle Ear Structures for Extended Matching Questions

Ossicles (Bones)

  • Malleus (hammer): Attached to the tympanic membrane; the first bone in the ossicular chain 1, 2
  • Incus (anvil): The middle ossicle connecting malleus to stapes 1, 2
  • Stapes (stirrup): The smallest bone in the body; articulates with the oval window of the inner ear 1, 2

Membranes and Windows

  • Tympanic membrane (eardrum): Thin cone-shaped membrane separating the outer ear from the middle ear cavity 1, 2
  • Oval window: Connects the middle ear with the inner ear; receives vibrations from the stapes 2
  • Round window: Secondary tympanic membrane that allows fluid movement in the cochlea (general anatomy knowledge)

Muscles

  • Tensor tympani muscle: Attaches to the malleus; dampens sound by tensing the tympanic membrane 3
  • Stapedius muscle: Attaches to the stapes; the smallest skeletal muscle in the body; dampens excessive sound pressure (general anatomy knowledge)
  • Pyramid (pyramidal eminence): Bony prominence housing the stapedius muscle and its tendon (general anatomy knowledge)

Air Spaces and Connections

  • Middle ear cavity (tympanic cavity): Air-filled space containing the ossicles 1, 2
  • Eustachian tube (auditory tube): Connects the middle ear cavity to the nasopharynx; responsible for pressure equalization and drainage 1, 3
  • Mastoid air cells: Posterior extension of the middle ear cavity into the mastoid process 3
  • Aditus ad antrum: Opening connecting the epitympanic recess to the mastoid antrum (general anatomy knowledge)

Anatomical Recesses and Landmarks

  • Epitympanic recess (attic): Superior portion of the middle ear cavity above the tympanic membrane; contains the head of malleus and body of incus (general anatomy knowledge)
  • Mesotympanum: Middle portion of the tympanic cavity at the level of the tympanic membrane (general anatomy knowledge)
  • Hypotympanum: Inferior portion of the tympanic cavity below the tympanic membrane (general anatomy knowledge)
  • Scutum: Sharp bony spur forming the lateral wall of the epitympanic recess 4

Nerves

  • Chorda tympani nerve: Branch of facial nerve (CN VII) that crosses the middle ear medial to the tympanic membrane and malleus; carries taste from anterior 2/3 of tongue (general anatomy knowledge)
  • Tympanic plexus: Formed by tympanic branch of glossopharyngeal nerve (Jacobson's nerve); provides sensory innervation to middle ear mucosa (general anatomy knowledge)

Clinical Correlates for Exam Questions

  • Attic blockage and scutum erosion: Visible in cholesteatoma 4
  • Retraction pockets: Form in areas of tympanic membrane weakness, particularly in the pars flaccida (Shrapnell's membrane) in the attic region 4
  • Tensor veli palatini muscle: The only active muscle that opens the Eustachian tube 3

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Ear Anatomy and Physiology

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Anatomy and physiology of eustachian tube and middle ear related to otitis media.

The Journal of allergy and clinical immunology, 1988

Guideline

Cholesteatoma Diagnosis and Management

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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