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audiology > audio-exam 1 > Flashcards

audio-exam 1 Flashcards

1
Q

prevalence HL

A 
In U.S., ≈ 10% with hearing loss
≈ 26 million hard-of-hearing (HOH)
Hearing loss makes communication difficult since speech is primary means of communication
≈ 2 million “deaf” individuals
Severe-to-profound bilateral hearing loss
Prevalence increases with age
17 in 1000 children under age 18
40 – 50% ≥ 75 years
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2
Q

audiology vs otology

A

audiology- ear aids life

otology- life risked by ear?

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3
Q

audiology specialties- PRIME

A

medical- evals, ototoxic monitoring, screenings
rehab- hearing aids, AR
pediatric- minimize effect, special kid/parent skills
educational- screen, eval, collab w teachers/SLP, rehab, consult (rm acoustics)
industrial- prevent HL by reducing, educating, protective etc

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4
Q

peripheral vs central auditory

A

peripheral: outer =>middle => inner => cranial nerve 8

central- Cochlear nucleus in brainstem to auditory cortex

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5
Q

branchial arches and grooves

A 
5 arches=> head and neck
1st & 2nd=> inner ear, pinna
1st: mandible, malleus and incus
1st groove: Concha/ external auditory meatus/ TM outer layer
2nd:  face muscles, hyoid, stapes
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6
Q

___derms

A

endoderm- middle ear space LINING, E tube
mesoderm- middle ear space, ossicles
ectoderm- outer ear covering

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7
Q

outer ear: pinna parts and fn

A

cartilage and skin
from top: helix, triangular fossa, tragus, lobe, antitragus, concha cavum, anti helix, concha cymba
fn: acoustic imprint & resonance; localize, catch & direct sound into EAM

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8
Q

outer ear: EAM size, parts, fn

A

pinna=> Tm
25 cm L by 9mm H by 6.5mm D
fn: protect, provide resonance
outer: cartilaginous, cerumen, sebaceous, hair
inner: osseous, tympanic portion of temporal bone

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9
Q

outer ear: cerumen fn- TOCRAM

A

Repel water
Trap dust, sand particles, micro-organisms, and other debris
Moisturize epithelium in ear canal
Odor discourages insects
Antibiotic, antiviral, antifungal properties
Cleanse ear canal

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10
Q

outer ear: EAM problems

A

osseocartilaginous junction of two: mandible fits into temporal bone TMJ=> otalgia
stenosis
fungal/bacterial infex- swimmers ear, wax impaction
all cause a CONDUCTIVE HL

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11
Q

outer ear: tympanic membrane size, fn

A 
border btw inner/middle ear
90mm^2, 17.5 mm diameter
conical loudspeaker- middle ear transformer system
middle ear pressure regulation
rich blood supply
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12
Q

outer ear: tympanic membrane divisions

A

annulus- holds TM in place
pars flaccida- Top 15% of the TM, no fibers
pars tensa- all three layers Gives conical shape- cone of light reflection, Malleus

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13
Q

outer ear: tympanic membrane layers

A

outer: extensionf of EAM, Cutaneous stratum, skin over osseous meatus
Fiberous stratum: tough CT, concentric and radial fibers
inner: Mucosa Stratum=> middle ear

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14
Q

outer ear: tympanic membrane landmarks

A 
manubrium (long portion) of malleus
cone of light
umbo- most depressed part of TM,
long process of incus
stapes
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15
Q

outer ear: resonance

A

air filled cavities have natural/resonant frequencies
each structure increases the sound pressure of said frequency by 10-12 dB
primary structures: concha (10 dB, best @ 5 kHz) and EAM (10dB, best @ 3 kHz) = 20 dB amplification

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16
Q

outer ear: localization

A

outer ear “encodes” vertical elevation of sound source in the amplification of the sound (+15 degrees azimuth= greater amp)
efficiency of sound collection encodes horizontal location (azimuth)- attenuation from back

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17
Q

examination HOP

A

history: trauma, allergy/sick, fly/dive, dizzy, hearing, duration
observation: red, swell, drain, object, cuts etc
palpation: press on tragus, traction on lobe and helix

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18
Q

otoscopic assessment procedure

A

1: sit, head down and away, cocked
2: largest comfortable speculum- snug, rest against
tragus
3. stabilize otoscope w ring and little finger “hammer or pencil”
4. pinna up and back to straighten canal
5. approach canal, watching through lens
6. rotate speculum to see TM
7. inspect color clarity position
8. identify landmarks
9. look for abnormalities

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19
Q

otoscopic assessment points

A

color: pearly gray
clarity: semitransparent
position: neither retracted nor bulging
landmarks: malleus, manubrium, short process, umbo, light reflex (cone), pars flaccida and tensa, annulus, stapes, incus
abnormalities: fluid, perforations

20
Q

middle ear: parts and fn

A

chamber
bones- malleus incus stapes=> impedance match
muscles- stapedial, tensor tympani=> protection, compression of loud sounds (acoustic reflex)
ET (tensor/levator veli palatini)=> equalize air pressure, drainage

21
Q

TM innervation

A

trigeminal>mandibular>Auriculo temporal nerve
Vagus nerve
Medial- glosspharyngeal nerve
Damage to facial nerve– may affect hearing as well
Damage to ear drum can also affect facial nerve- taste etc

22
Q

middle ear bones (ossicles)

A

malleus- contacts TM
incus- middle
stapes- smallest, inner most, footplate rests in membranous oval window
suspended by axial ligaments

23
Q

middle ear muscles: O, I, Fn

A

stapedius- O: posterior mastoid wall of tympanic cavity; I: stapes; CN 8-V; contracts w loud sound
tensor tympani- origin: anterior wall of cavity; insertion- malleus; CN 5-T; contracts with touch to lateral face, air pressure changes in EAM

24
Q

ET specs

A

1/3 bone, 2/3 cartilaginous, 35 mm L, 45 degree angle

smaller, less steep in kids= poor drainage/opening= infex

25
Q

impedance matching mechanism

A

30dB sound loss air sound to fluid sound, must be transformed thru middle ear “machine”
1) TM movement/lever= not much
2) malleus/incus lever 1.3:1
3) area ratio, TM: nail head as footplate: nail point, 17:1 area ratio but doesnt move as one unit (membrane)
P increase at stapes = 27.4 dB gain vs initial 30 dB loss

26
Q

amplified frequencies

A

Little pressure amplification occurs for frequencies below 100 Hz or above 2000 to 2500 Hz, but 100-2500Hz is amplified
The outer ear amplifies sound energy by 20 dB for frequencies from 2000 to 5000 Hz (3000)

27
Q

middle ear muscle contraction- acoustic reflex

A 
in response to loud sound/touch
results in attenuation of sounds by:
1) tightened TM
2) reduced trasnmission
3) draw malleus back
consensual- both ears respond 
.03s-.04s delay
28
Q

inner ear: parts

A 
petrous portion of temporal bone
osseous labyrinth- bony outer casing
semicircular canals (sup, lat, pos)
vestibule> oval window & round window
cochlea
29
Q

inner ear: balance

A

utricle and saccule: linear motion

semi circular canals: rotary/angular motion

30
Q

inner ear: cochlea fn

A

end organ for hearing
breaks complex sounds into pure tones
tune and amplify incoming sounds
transmit info to central auditory nerve

31
Q

inner ear: cochlea parts

A

snail shell, 2.5 turns around bony modiolus
bony labyrinth>membranous labyrinth>
three canals:
scala vestibuli (PL)> oval window, reisner’s mem
scala media (EL)> reisner’s mem, spiral ligament (clips), organ of corti, stria vascularis, basilar mem
scala tympani (PL)> round window
helicotrema port connects SV and ST

32
Q

inner ear>cochlea>organ of corti

A

hearing organ
supporting cells- pillar, deiters, henson, claudius
sensory cells- single row of inner hair, more outer hair
under tectorial membrane above basilar membrane

33
Q

inner ear>cochlea>tectorial membrane

A

90% water, gelatinous
projects from spiral limbus
longest sterocilia projections from OHC embed here

34
Q

sound transmission

A

stapes footplate>oval window vibrates and establishes wave along basilar membrane> wave crests and decreases> depression of SM >BM displaced, shear the tectorial-embedded cilia of OHC> contracts and pulls Tect Mem down which in turn presses IHC> electrochemical processes> auditory nerve fibers
lower frequencies move/travel entire membrane- stimulates most responsive place
rate of discharge increases with intensity, but maxes at 30-40 dB, then recruits other neurons to express loudness up to 140 dB, density of action potentials encodes loudnes

35
Q

inner ear>cochlea>basilar membrane

A

varies in width/stiff from base to apex
narrower and stiffer at base
creates tonotopic map

36
Q

OHC vs IHC

A

OHC- more #, weak afferent, strong efferent, motor

IHC- fewer, sensory

37
Q

central pathway- cannibals

A 
Eighth nerve- aud branch
Cochlear nuclear complex
Superior olivary complex
Lateral lemniscus
Inferior colliculus
Medial geniculate body
Primary auditory cortex
38
Q

cranial nerves- viking

A 
Olfactory
Optic
Oculomotor
Trochlear
Trigeminal
Abducens
Vestibulocochlear
Glossopharyngeal
Vagus
Accessory
Hypoglossal
39
Q

auditory nerve

A

cylindrical bundle
outer- basal turn of cochlear (high freq)
inner- apical turn (low freq)

40
Q

cochlear nuclear complex- tooonic

A

dorsal
ventral
leave in 3 stria
fibers: onset, offset, onset/offset, tonic

41
Q

super olivary complex-Soccer ball

A

relay
reflex- stapedius, tensor tympani
bilateral input
localization (from time/intensity differences)

42
Q

lateral lemniscus- lilac

A

Ipsilateral IC projections but some to contra IC
lower brainstem Pathway
Afferent portion of auditory pathway
Connects SOC to IC

43
Q

inferior colliculus- SMITS

A 
SOCs stim
midbrain
ipsi MGB projection
tonotopic 400k
synapse- 2nd oblig
44
Q

medial geniculate body- thick pac

A

thalamic nuc
422k tonotopic cells
primary aud cortex

45
Q

primary auditory cortex- million TReeS

A

temporal lobes
representation of freq
10 million tonotopic cells
sylvian fissure

audiology (3 decks)

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