Auditory system
The auditory system is the sensory system for the sense of hearing. It includes both the sensory organs (the ears) and the auditory parts of the sensory system.[1]
System overview[edit]
The outer ear funnels sound vibrations to the eardrum, increasing the sound pressure in the middle frequency range. The middle-ear ossicles further amplify the vibration pressure roughly 20 times. The base of the stapes couples vibrations into the cochlea via the oval window, which vibrates the perilymph liquid (present throughout the inner ear) and causes the round window to bulb out as the oval window bulges in.
Vestibular and tympanic ducts are filled with perilymph, and the smaller cochlear duct between them is filled with endolymph, a fluid with a very different ion concentration and voltage.[2][3][4] Vestibular duct perilymph vibrations bend organ of Corti outer cells (4 lines) causing prestin to be released in cell tips. This causes the cells to be chemically elongated and shrunk (somatic motor), and hair bundles to shift which, in turn, electrically affects the basilar membrane's movement (hair-bundle motor). These motors (outer hair cells) amplify the traveling wave amplitudes over 40-fold.[5] The outer hair cells (OHC) are minimally innervated by spiral ganglion in slow (unmyelinated) reciprocal communicative bundles (30+ hairs per nerve fiber); this contrasts inner hair cells (IHC) that have only afferent innervation (30+ nerve fibers per one hair) but are heavily connected. There are three to four times as many OHCs as IHCs. The basilar membrane (BM) is a barrier between scalae, along the edge of which the IHCs and OHCs sit. Basilar membrane width and stiffness vary to control the frequencies best sensed by the IHC. At the cochlear base the BM is at its narrowest and most stiff (high-frequencies), while at the cochlear apex it is at its widest and least stiff (low-frequencies). The tectorial membrane (TM) helps facilitate cochlear amplification by stimulating OHC (direct) and IHC (via endolymph vibrations). TM width and stiffness parallels BM's and similarly aids in frequency differentiation.[6][7][8][9][10][11][12][13][14]
The superior olivary complex (SOC), in the pons, is the first convergence of the left and right cochlear pulses. SOC has 14 described nuclei; their abbreviation are used here (see Superior olivary complex for their full names). MSO determines the angle the sound came from by measuring time differences in left and right info. LSO normalizes sound levels between the ears; it uses the sound intensities to help determine sound angle. LSO innervates the IHC. VNTB innervate OHC. MNTB inhibit LSO via glycine. LNTB are glycine-immune, used for fast signalling. DPO are high-frequency and tonotopical. DLPO are low-frequency and tonotopical. VLPO have the same function as DPO, but act in a different area. PVO, CPO, RPO, VMPO, ALPO and SPON (inhibited by glycine) are various signalling and inhibiting nuclei.[15][16][17][18]
The trapezoid body is where most of the cochlear nucleus (CN) fibers decussate (cross left to right and vice versa); this cross aids in sound localization.[19] The CN breaks into ventral (VCN) and dorsal (DCN) regions. The VCN has three nuclei. Bushy cells transmit timing info, their shape averages timing jitters. Stellate (chopper) cells encode sound spectra (peaks and valleys) by spatial neural firing rates based on auditory input strength (rather than frequency). Octopus cells have close to the best temporal precision while firing, they decode the auditory timing code. The DCN has 2 nuclei. DCN also receives info from VCN. Fusiform cells integrate information to determine spectral cues to locations (for example, whether a sound originated from in front or behind). Cochlear nerve fibers (30,000+) each have a most sensitive frequency and respond over a wide range of levels.[20][21]
Simplified, nerve fibers' signals are transported by bushy cells to the binaural areas in the olivary complex, while signal peaks and valleys are noted by stellate cells, and signal timing is extracted by octopus cells. The lateral lemniscus has three nuclei: dorsal nuclei respond best to bilateral input and have complexity tuned responses; intermediate nuclei have broad tuning responses; and ventral nuclei have broad and moderately complex tuning curves. Ventral nuclei of lateral lemniscus help the inferior colliculus (IC) decode amplitude modulated sounds by giving both phasic and tonic responses (short and long notes, respectively). IC receives inputs not shown, including visual (pretectal area: moves eyes to sound. superior colliculus: orientation and behavior toward objects, as well as eye movements (saccade)) areas, pons (superior cerebellar peduncle: thalamus to cerebellum connection/hear sound and learn behavioral response), spinal cord (periaqueductal grey: hear sound and instinctually move), and thalamus. The above are what implicate IC in the 'startle response' and ocular reflexes. Beyond multi-sensory integration IC responds to specific amplitude modulation frequencies, allowing for the detection of pitch. IC also determines time differences in binaural hearing.[22] The medial geniculate nucleus divides into ventral (relay and relay-inhibitory cells: frequency, intensity, and binaural info topographically relayed), dorsal (broad and complex tuned nuclei: connection to somatosensory info), and medial (broad, complex, and narrow tuned nuclei: relay intensity and sound duration). The auditory cortex (AC) brings sound into awareness/perception. AC identifies sounds (sound-name recognition) and also identifies the sound's origin location. AC is a topographical frequency map with bundles reacting to different harmonies, timing and pitch. Right-hand-side AC is more sensitive to tonality, left-hand-side AC is more sensitive to minute sequential differences in sound.[23][24] Rostromedial and ventrolateral prefrontal cortices are involved in activation during tonal space and storing short-term memories, respectively.[25] The Heschl's gyrus/transverse temporal gyrus includes Wernicke's area and functionality, it is heavily involved in emotion-sound, emotion-facial-expression, and sound-memory processes. The entorhinal cortex is the part of the 'hippocampus system' that aids and stores visual and auditory memories.[26][27] The supramarginal gyrus (SMG) aids in language comprehension and is responsible for compassionate responses. SMG links sounds to words with the angular gyrus and aids in word choice. SMG integrates tactile, visual, and auditory info.[28][29]
Proper function of the auditory system is required to able to sense, process, and understand sound from the surroundings. Difficulty in sensing, processing and understanding sound input has the potential to adversely impact an individual's ability to communicate, learn and effectively complete routine tasks on a daily basis.[45]
In children, early diagnosis and treatment of impaired auditory system function is an important factor in ensuring that key social, academic and speech/language developmental milestones are met.[46]
Impairment of the auditory system can include any of the following: