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Audiology Exam 2 > Acoustic Immittance > Flashcards

Acoustic Immittance Flashcards

1
Q

Acoustic immittance tests:

A

middle-ear function

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2
Q

Does acoustic immittance require a response from the patient?

A

No.

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3
Q

Acoustic immittance measurements help us to differentiate different types of _____________ disorders

A

Conductive

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4
Q

What can acoustic immittance identify?

A

A medically significant middle ear disorder that can be present without an air-bone gap evident in the audiogram

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5
Q

(T/F) Acoustic immittance measurements can be obtained during other tests.

A

FALSE. Acoustic immittance measurements yield information that cannot be obtained any other way.

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6
Q

What information does acoustic immittance tests provide?

A

Eardrum and middle ear problems
Differentiates type of disorder: conductive vs. cochlear vs. retrocochlear
Conformation of the pure tone audiometric results in terms of the type of less and an estimate of hearing sensitivity
Integrity of the facial nerve on the efferent pathway of the acoustic reflex arc.

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7
Q

What test is performed for acoustic immittance?

A

Tympanometry

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8
Q

What three acoustic reflexes are tested in acoustic immittance?

A

Ipsilateral
Contralateral
Reflex Decay

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9
Q

a term that refers collectively to acoustic impedance, acoustic admittance, or both

A

Acoustic immittance

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10
Q

The opposition to sound flow measured in acoustic ohm (obstruction to the flow - restricting)

A

Acoustic impedance

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11
Q

The easy with which sound flows measured in acousic mmhos (no opposition to flow - not restricting)

A

Acoustic admittance

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12
Q

Impedance and admittance are __________ terms.

A

reciprocal

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13
Q

What is the term for acoustic admittance measures

A

Ya (Y sub a)

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14
Q

What are the four tubes and what do they do in a tympanogram?

A
  1. Probe tip loudspeaker - presents a continuous tone (226 Hz at 85 dB SLP)
  2. Monitor Microphone - picks up reflected sound in the ear canal
  3. Pressure pump and manometer - pressure variation
  4. Ipsilateral reflex loudspeaker
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15
Q

Involves measuring the acoustic admittance of the ear with various amount of air pressure in the ear canal

A

Tympanometry/Tympanogram

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16
Q

Acoustic admittance is measured and plotted on a graph called a ________________.

A

tympanogram

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17
Q

What happens during a tympanogram?

A

A hermetic (airtight) seal is created at the opening of the ear canal by inserting an ‘ear plug’ into the opening of the ear canal
A tone of 226 Hz is generated by the loudspeaker
Air pressure is varied by the air pump
Reflection of sound is picked up by the microphone
The pressure within the ear canal is reduced below atmospheric pressure and a low-frequency tone is presented at 85 dB SPL continually

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18
Q

What are the five calculations that can be made from a tympanogram?

A
  1. Peak Ya - measurement plane tympanogram
  2. Peak Ytm - peak compensated static acoustic admittance (mmhos); compensated tympanogram
  3. TPP - tympanometric peak pressure (daPa)
  4. TW - tympanometric width (daPa)
  5. Vea/Vec/ECV - ear canal volume in cm^3
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19
Q

the total acoustic admittance (mmhos) at the peak

A

Peak Ya

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20
Q

(T/F) at the extreme high and low pressure levels, the Peak Ya is at zero.

A

False. It is not at zero because the ear canal itself offers a small degree of acoustic admittance

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21
Q

the contribution of the tympanic membrane alone

A

Peak Ytm

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22
Q

What is the unit of measurement for acoustic impedance?

A

acoustic ohm

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23
Q

What is the unit of measurement for acoustic admittance?

A

acoustic mmhos

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24
Q

In a tympanogram, which tube deals with pressure variation?

A

Pressure pump and manometer

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25
Q

In a tympanogram, which tube deals with picking up reflected sound in the ear canal?

A

Monitor microphone

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26
Q

In a tympanogram, which tube presents a continuous tone at 226 Hz, 85 dB SPL?

A

Probe tip loudspeaker

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27
Q

What is the formula for Ytm?

A

Ytm = Ya(peak) - Ya(tail)

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28
Q

The pressure at which Ya or Ytm is at its maximum value in daPa

A

TPP (tympanometric peak pressure)

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29
Q

the width of the tympanogram at 1/2 the high of Ytm (peak to tail)

A

TW (tympanometric width)

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30
Q

an acoustic estimate of the volume between the probe tip and the tympanic membrane - estimated from Ta at high or low pressure levels

A

Vea/Vec/ECV - ear canal volume

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31
Q

Large ear canal = _______ volume

A

High

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32
Q

Small ear canal = _________ volume

A

Low

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33
Q

What are the normal ear canal measurements for children (3-10)?

A

Peak Ytm - .25-1.05
TW - 80-159
Vea - .3-.9

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34
Q

What are the normal ear canal measurements for adults (>18)?

A

Peak Ytm - .30-1.70
TW - 51-114
Vea - .9-2.0

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35
Q

In a stiff ear, there is _________ admittance, ________ impedance.

A

low admittance

high impedance

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36
Q

If there is negative middle-ear pressure, the result is _________ admittance, ________ impedance.

A

low admittance

high impedance

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37
Q

If you have otitis media, you have _________ admittance, ________ impedance.

A

low admittance
high impedance
(it’s filled up with fluid)

38
Q

If you have pressure equalization (PE) tubes, the result is _________ admittance, ________ impedance.

A

high admittance

low impedance

39
Q

If there is a foreign object in the ear, the result is _________ admittance, ________ impedance.

A
  • normal or flat tympanogram

- in some cases, you would not perform the test

40
Q

If there is perforation of the TM or PE tubes, the ear canal volume will be ___________

A

abnormally large

41
Q

If there is a probe tube up against the wall of the ear canal, ear canal volume will be ________

A

abnormally small

42
Q

If you have otitis media limits with fluid, ear canal volume will be _________

A

within normal

43
Q

What are acoustic reflex measures?

A

a time-locked (time-locked to the presentation of the sound) contraction of the stapedius muscle in response to an acoustic signal of sufficient intensity level and duration; always at suprathreshold levels

44
Q

(T/F) The stapedius muscle doesn’t contract to soft sounds.

A

True

45
Q

When the stapedius muscle contracts is pulls the stapes _____ and ____ of the oval window and ___ the ossicular chain, which in turn, reduces the acoustic admittance at the TM by a measurable amount (otherwise it would be transmitted to the ear with no change and it would be a very loud sound)

A

pulls the stapes down and out of the oval window and stiffens the ossicular chain

46
Q

The acoustic reflex unilateral/bilateral.

A

bilateral

47
Q

The _______ is not part of the acoustic reflex arc. It contracts with swallowing, chewing, etc.

A

Tensor tympani

48
Q

The tensor tympani is a _______ muscle, with a _______ effect.

A

Large muscle with a small effect

49
Q

The stapedius muscle is a _______ muscle, with a _______ effect.

A

small muscle with a huge effect

50
Q

What is the normal pathway in which the acoustic reflex arc pathway travels?

A

Signal enters the (r/l) ear –>
travels through the outer, middle, and inner ear –>
along the VIII nerve, to the brainstem –>
cochlear nucleus in the brainstem –>
Right and left superior olivary complex and right and left facial nerve (VII) nuclei –>
to both facial nerves (VII) –>
contraction of both of the stapedius muscles.
Both stapes bones are pulled outward and downward in a direction away from the inner ear. This increases the impedance/decreases the admittance of the middle ear

51
Q

When a loud sound enters the normal human ear, the stapedius muscle contracts on ______ sides regardless of which ear is receiving the stimulus.

A

BOTH

52
Q

the level at which the first response is noted to the loud stimulus (activator signal); this is always at suprathreshold levels (70 dB to 100 dB HL)

A

acoustic reflex threshold (ART)

53
Q

The acoustic reflex threshold tests the integrity of the _______

A

brainstem

54
Q

if the stimulus and the measurement is recorded in the same ear

A

Ipsilateral response

55
Q

if the stimulus and the measurement is recorded in the opposite ear

A

Contralateral response

56
Q

In an acoustic reflex threshold, the ANSI specifies that the test ear (reference ear) is the one _____________.

A

receiving the stimulus

57
Q

The acoustic reflex threshold will be affected once the damage to the cochlea has reached a certain degree - up to ___ dB HL

A

50 dB HL

58
Q

Clinician Acoustic Reflex measures:

A
  1. Presence or absence of the acoustic reflex (ipsilateral or contralateral)
  2. Acoustic reflex threshold
  3. Acoustic reflex decay
59
Q

the level of the activator signal producing the smallest measurable change in acoustic admittance

A

The acoustic reflex threshold

60
Q

the amount by which the reflex amplitude (Ya) has decreased after 5 seconds for signals of 500 or 1000 Hz (only reliable at these two frequencies)

A

Acoustic reflex decay

61
Q

Acoustic Reflex Decay is tested at the signals of _____ or _____ because ________________

A

500 or 1000 Hz; because it’s only reliable at these two frequencies

62
Q

Abnormal reflex decay is a decrease in amplitude of _____ or more in ___ seconds or less.

A

50% or more in 5 seconds or less

63
Q

Acoustic immittance should be used as a part of a _________

A

battery of tests

64
Q

Acoustic immittance measurements (do/do not) measure hearing sensitivity

A

Do not

65
Q

Acoustic immittance measurements can _______ the findings of ‘traditional’ hearing measurements

A

substantiate

66
Q

When testing babies, a probe tone of ____ Hz is not recommended. _____ Hz is.

A

226; 1000

67
Q

Combined used of contralateral ARTs tells you about some _______________

A

neural integrity

68
Q

What are acoustic reflex measures?

A

a time-locked (time-locked to the presentation of the sound) contraction of the stapedius muscle in response to an acoustic signal of sufficient intensity level and duration; always at suprathreshold levels

69
Q

(T/F) The stapedius muscle doesn’t contract to soft sounds.

A

True

70
Q

When the stapedius muscle contracts is pulls the stapes _____ and ____ of the oval window and ___ the ossicular chain, which in turn, reduces the acoustic admittance at the TM by a measurable amount (otherwise it would be transmitted to the ear with no change and it would be a very loud sound)

A

pulls the stapes down and out of the oval window and stiffens the ossicular chain

71
Q

The acoustic reflex unilateral/bilateral.

A

bilateral

72
Q

The _______ is not part of the acoustic reflex arc. It contracts with swallowing, chewing, etc.

A

Tensor tympani

73
Q

The tensor tympani is a _______ muscle, with a _______ effect.

A

Large muscle with a small effect

74
Q

The stapedius muscle is a _______ muscle, with a _______ effect.

A

small muscle with a huge effect

75
Q

What is the normal pathway in which the acoustic reflex arc pathway travels?

A

Signal enters the (r/l) ear –>
travels through the outer, middle, and inner ear –>
along the VIII nerve, to the brainstem –>
cochlear nucleus in the brainstem –>
Right and left superior olivary complex and right and left facial nerve (VII) nuclei –>
to both facial nerves (VII) –>
contraction of both of the stapedius muscles.
Both stapes bones are pulled outward and downward in a direction away from the inner ear. This increases the impedance/decreases the admittance of the middle ear

76
Q

When a loud sound enters the normal human ear, the stapedius muscle contracts on ______ sides regardless of which ear is receiving the stimulus.

A

BOTH

77
Q

the level at which the first response is noted to the loud stimulus (activator signal); this is always at suprathreshold levels (70 dB to 100 dB HL)

A

acoustic reflex threshold (ART)

78
Q

The acoustic reflex threshold tests the integrity of the _______

A

brainstem

79
Q

if the stimulus and the measurement is recorded in the same ear

A

Ipsilateral response

80
Q

if the stimulus and the measurement is recorded in the opposite ear

A

Contralateral response

81
Q

In an acoustic reflex threshold, the ANSI specifies that the test ear (reference ear) is the one _____________.

A

receiving the stimulus

82
Q

The acoustic reflex threshold will be affected once the damage to the cochlea has reached a certain degree - up to ___ dB HL

A

50 dB HL

83
Q

Clinician Acoustic Reflex measures:

A
  1. Presence or absence of the acoustic reflex (ipsilateral or contralateral)
  2. Acoustic reflex threshold
  3. Acoustic reflex decay
84
Q

the level of the activator signal producing the smallest measurable change in acoustic admittance

A

The acoustic reflex threshold

85
Q

the amount by which the reflex amplitude (Ya) has decreased after 5 seconds for signals of 500 or 1000 Hz (only reliable at these two frequencies)

A

Acoustic reflex decay

86
Q

Acoustic Reflex Decay is tested at the signals of _____ or _____ because ________________

A

500 or 1000 Hz; because it’s only reliable at these two frequencies

87
Q

Abnormal reflex decay is a decrease in amplitude of _____ or more in ___ seconds or less.

A

50% or more in 5 seconds or less

88
Q

Acoustic immittance should be used as a part of a _________

A

battery of tests

89
Q

Acoustic immittance measurements (do/do not) measure hearing sensitivity

A

Do not

90
Q

Acoustic immittance measurements can _______ the findings of ‘traditional’ hearing measurements

A

substantiate

91
Q

When testing babies, a probe tone of ____ Hz is not recommended. _____ Hz is.

A

226; 1000

92
Q

Combined used of contralateral ARTs tells you about some _______________

A

neural integrity

Audiology Exam 2 (4 decks)

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