Tympanic membrane
Citation, DOI, disclosures and article data
At the time the article was created Jeremy Jones had no recorded disclosures.
View Jeremy Jones's current disclosuresAt the time the article was last revised Tariq Walizai had no financial relationships to ineligible companies to disclose.
View Tariq Walizai's current disclosures- Tympanic membrane (TM)
- Tympanic membranes
The tympanic membrane is a thin membrane that separates the external ear from the middle ear. It acts to transmit sound waves from air in the external auditory canal (EAC) to the ossicles of the middle ear.
On this page:
Gross anatomy
The tympanic membrane is shaped like a flat cone pointing into the middle ear. The deepest point at the center of the concavity is called the umbo.
It consists of three layers (from external to internal):
outer epithelial layer: stratified squamous epithelium continuous with the skin of the external auditory canal 4
middle fibrous layer (lamina propria): fibroelastic connective tissue containing blood vessels and nerves of the tympanic membrane 4
inner epithelial layer: non-keratinized simple cuboidal epithelium continuous with the mucosa of the middle ear 4
It attaches to a horseshoe-shaped incomplete bony ring along the wall of the external auditory canal, the tympanic annulus. The incomplete nature of its attachment results in two distinct portions of the membrane:
pars tensa: the larger tense portion of the membrane surrounded by the annulus, which extends from the anterior and posterior malleolar folds at the level of the lateral process of the malleus to the inferior edge of the membrane
pars flaccida: the smaller flaccid portion of the membrane where the annulus is deficient at the notch of Rivinus; it is located above the anterior and posterior malleolar folds
Quadrant separation
It is anatomically separated into four quadrants by drawing an imaginary straight line continuing from the manubrium to the tympanic edge and another straight line at the umbo perpendicular to the first line 4. The four quadrants are:
anterosuperior
anteroinferior
posteroinferior
posterosuperior
This is important because vessels and nerves (specifically the chorda tympani nerve) pass through the superior portion of the membrane. Additionally, the light reflex (cone of light) is specific to the anteroinferior portion of the membrane. Thus, when intervention is performed, the posteroinferior portion of the membrane is chosen.
Arterial supply
external surface: deep auricular artery (branch of maxillary artery)
-
internal surface
anterior tympanic artery (branch of maxillary artery)
stylomastoid branch of posterior auricular artery (branch of external carotid artery)
Innervation
The membrane has two distinct nerve supplies based on the different embryological origins of the internal and external surfaces.
-
external surface
predominantly the auriculotemporal nerve (CN V3)
greater auricular nerve (C2, C3)
some authors report some minor contribution from the auricular branch (Arnold's nerve) of the vagus nerve (CN X)
internal surface: tympanic branch (Jacobson nerve) of the glossopharyngeal nerve (CN IX)
Related pathology
conductive hearing loss: secondary to rupture or perforation
tympanic membrane bulging
See also
References
- 1, Loukas M, Carmichael SW, Colborn GL et-al. Gray's Anatomy Review, 1e. Churchill Livingstone. ISBN:0443069387. Read it at Google Books - Find it at Amazon
- 2. Clinically Oriented Anatomy. Lippincott Williams & Wilkins. ISBN:1451119453. Read it at Google Books - Find it at Amazon
- 3. Robert H. Whitaker, Neil R. Borley. Instant Anatomy. ISBN: 9780632054039
- 4. Alice Szymanski, Joseph Toth, Marin Ogorevc, Zachary Geiger. Anatomy, Head and Neck, Ear Tympanic Membrane. StatPearls Publishing. 2022. https://www.ncbi.nlm.nih.gov/books/NBK448117/ - Pubmed
Incoming Links
- Longitudinal vs transverse petrous temporal bone fracture
- Blast injury
- Auriculotemporal nerve
- External auditory canal atresia
- Tympanic membrane retraction
- Tympanostomy tube insertion
- Longitudinal temporal bone fractures
- Medial canal fibrosis
- Branchial apparatus
- Incudomalleolar joint
- Patulous tube syndrome
- Medical abbreviations and acronyms (T)
- Deep auricular artery
- Pars tensa
- Tensor tympani muscle
- Malleus
- Middle ear
- Mesotympanum
- Prussak space
- Middle ear ossicles
Related articles: Anatomy: Head and neck
- skeleton of the head and neck
-
cranial vault
- scalp (mnemonic)
- fontanelle
-
sutures
- calvarial
- facial
- frontozygomatic suture
- frontomaxillary suture
- frontolacrimal suture
- frontonasal suture
- temporozygomatic suture
- zygomaticomaxillary suture
- parietotemporal suture (parietomastoid suture)
- occipitotemporal suture (occipitomastoid suture)
- sphenofrontal suture
- sphenozygomatic suture
- spheno-occipital suture (not a true suture)
- lacrimomaxillary suture
- nasomaxillary suture
- internasal suture
- basal/internal
- skull landmarks
- frontal bone
- temporal bone
- parietal bone
- occipital bone
- skull base (foramina)
-
facial bones
- midline single bones
- paired bilateral bones
- cervical spine
- hyoid bone
- laryngeal cartilages
-
cranial vault
- muscles of the head and neck
- muscles of the tongue (mnemonic)
- muscles of mastication
-
facial muscles
- epicranius muscle
- circumorbital and palpebral muscles
- nasal muscles
-
buccolabial muscles
- elevators, retractors and evertors of the upper lip
- levator labii superioris alaeque nasalis muscle
- levator labii superioris muscle
- zygomaticus major muscle
- zygomaticus minor muscle
- levator anguli oris muscle
- malaris muscle
- risorius muscle
- depressors, retractors and evertors of the lower lip
- depressor labii inferioris muscle
- depressor anguli oris muscle
- mentalis muscle
- compound sphincter
-
orbicularis oris muscle
- incisivus labii superioris muscle
- incisivus labii inferioris muscle
-
orbicularis oris muscle
- muscle of mastication
- modiolus
- elevators, retractors and evertors of the upper lip
- muscles of the middle ear
- orbital muscles
- muscles of the soft palate
- pharyngeal muscles
- suprahyoid muscles
- infrahyoid muscles
- intrinsic muscles of the larynx
- muscles of the neck
- platysma muscle
- longus colli muscle
- longus capitis muscle
- scalenus anterior muscle
- scalenus medius muscle
- scalenus posterior muscle
- scalenus pleuralis muscle
- sternocleidomastoid muscle
-
suboccipital muscles
- rectus capitis posterior major muscle
- rectus capitis posterior minor muscle
- obliquus capitis superior muscle
- obliquus capitis inferior muscle
- accessory muscles of the neck
- deep cervical fascia
-
deep spaces of the neck
- anterior cervical space
- buccal space
- carotid space
- danger space
- deep cervical fascia
- infratemporal fossa
- masticator space
- parapharyngeal space
- stylomandibular tunnel
- parotid space
- pharyngeal (superficial) mucosal space
- perivertebral space
- posterior cervical space
- pterygopalatine fossa
- retropharyngeal space
- suprasternal space (of Burns)
- visceral space
- surgical triangles of the neck
- orbit
- ear
- paranasal sinuses
- upper respiratory tract
- viscera of the neck
- blood supply of the head and neck
-
arterial supply
-
common carotid artery
- carotid body
- carotid bifurcation
- subclavian artery
- variants
-
common carotid artery
- venous drainage
-
arterial supply
- innervation of the head and neck
-
cranial nerves
- olfactory nerve (CN I)
- optic nerve (CN II)
- oculomotor nerve (CN III)
- trochlear nerve (CN IV)
-
trigeminal nerve (CN V) (mnemonic)
- trigeminal ganglion
- ophthalmic division
- maxillary division
- mandibular division
- abducens nerve (CN VI)
- facial nerve (CN VII)
-
vestibulocochlear nerve (CN VIII)
- vestibular ganglion (Scarpa's ganglion)
- glossopharyngeal nerve (CN IX)
- vagus nerve (CN X)
- (spinal) accessory nerve (CN XI)
- hypoglossal nerve (CN XII)
- parasympathetic ganglia of the head and neck
- cervical sympathetic ganglia
- greater occipital nerve
- third occipital nerve
-
cervical plexus
- muscular branches
- longus capitis
- longus colli
- scalenes
- geniohyoid
- thyrohyoid
-
ansa cervicalis
- omohyoid (superior and inferior bellies separately)
- sternothyroid
- sternohyoid
- phrenic nerve
- contribution to the accessory nerve (CN XI)
- cutaneous branches
- muscular branches
- brachial plexus
- pharyngeal plexus
-
cranial nerves
- lymphatic drainage of the head and neck
- embryological development of the head and neck
Unable to process the form. Check for errors and try again.