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Audiological Evaluation 5 Flashcards

1
Q

AEP Testing Needs

A

Electrodes (to record signal)
-Can be placed in a variety of arrangements.
- Forehead, mastoid, earlobe, nape of neck, etc.

Transducer (to present stimulus)
- Insert phones
- Bone oscillator

Stimulus
- Click or toneburst

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2
Q

Auditory Evoked Potentials

A
  • An AEP is then the neural activitiy of the auditory system that occurs in response to a sound.
  • AEPs can be subdivided on the basis of when and where they occur.
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3
Q

What does the term latency mean?

A

It is the time period that elapses between the introduction of the stimulus and the occurence of the response.

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4
Q

Auditory Brainstem Responses (ABR)

A
  • Originates in the VIIIth cranial nerve and brainstem within 10 to 15 ms of the signal
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5
Q

Auditory Middle Latency Response (AMLR)

A

Originates in the cortext within 15 to 60 ms of the signal

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6
Q

Auditory Late Response

A
  • Originates in the cortext within 50 to 200 ms of the signal
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7
Q
A
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8
Q

Auditory Steady State Response (ASSR)

A
  • Continuous steady-state neural response; brainstem
  • Waveform follows the amplitude-modulated waveform of the ongoing stimulus
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9
Q

An ABR is a type of AEP….

A

It is the most widely-used, and widely-studied AEP so it is the one will focus on

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10
Q

ABR is also called:

A

BSER (Brainstem Evoked Response)
BAER (Brainstem Auditory Evoked Response)
BAEP (Brainstem Auditory Evoked Potential)

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11
Q

Threshold Estimation ABR

A
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12
Q

Who uses Threshold Estimation ABR?

A
  • Infants
  • Cognitively challenged individuals
  • Malingerers or individuals with functional hearing loss
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13
Q

How is the stimulus presented for Threshold Estimation ABR?

A
  • The stimulus is presented at a high intensity level, then reduced in intensity until Wave V is absent.
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14
Q

What is the threshold for the ABR?

A

It is the lowest intensity level where Wave V can be labeled.

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15
Q

Wave I

A

Distal portion of the VIIIth nerve

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16
Q

Wave II

A

Proximal portion of the VIIIth nerve

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17
Q

Wave III

A

Cochlear nucleus

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18
Q

Wave IV

A

Superior Olivary Complex

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19
Q

Wave V

A

Lateral Lemniscus

20
Q

Parameters of a Normal Adult ABR
Wave I occurs around……

A

1.5-2.0 ms

21
Q

Parameters of a Normal Adult ABR
Wave III occurs around……

22
Q

Parameters of a Normal Adult ABR
Wave V occurs around……

23
Q

What are the values of Wave I,III, V referred to as?

A

Absolute Latencies

24
Q

Time between Waves I&III is about…

25
Time between Waves III&V is about...
2.0 ms
26
Time between Waves I & V is about....
4.0 ms
27
Times Waves I&III Waves III & V Waves I&V Are referred to as?
Interpeak Latencies
28
How does hearing loss affect ABR resullts? Conductive Hearing Loss
- Lowest level where Wave V is present will correspond to hearing thresholds at 1K to 4KHz -Absolute latencies will occur later than expected - Interpeak latencies will be normal
29
How does hearing loss affect ABR resullts? Sensorineural Hearing Loss
- Lowest level where Wave V is present will correspond to hearing thresholds at 1K to 4KHz. -Wave I latency will be normal, but Wave V latency will be absent or delayed and interpeak latencies will be abnormal
30
What does the Neurodiagnostic ABR do?
- Tests the neural function of the structures in the auditory pathway; disorders will present poor morphology
31
The ABR procedure is useful in diagnosing:
- Acoustic Neuroma - Auditory Neuropathy - Auditory Brainstem Disorders
32
What are OAES?
Are sounds generated by the outer hair cells in the cochlea that can be measured in the ear canal They present in individuals with no middle ear function who have hearing thresholds of 30-35 dbHL or better
33
34
Evoked Otoacoustic Emissions
Sounds generated by the cochlea and recorded in the ear canal that follow the presentation of a stimulus (hence evoked, not spontaneous) - Transient Evoked (TEOAE) - Distortion Prodcut (DPOAE)
35
36
How are evoked OAES measured?
A probe is placed in the ear canal creating a tight seal. The test environment should be fairly quiet. A stimulus is then presented into the ear canal. - Clicks are used for evoking TEOAEs. - Pure tones are used for evoking DPOAEs
37
From the ____ ______, the stimulus goes through the ______ ________ and ______ _____, into the _______ _____.
From the ear canal, the stimulus goes through the tympanic membrane and middle ear, into the inner ear.
38
After stimulating the cochlea, the resulting evoked __________ exits out of the ear and is measured via the microphone on the ______ in the ear canal.
After stimulating the cochlea, the resulting evoked emission exits out of the ear and is measured via the microphone on the probe in the ear canal.
39
OAES assess what?
OAEs assess the function of the outer hair cells in the cochlea.
40
Present OAEs indicate hearing thresholds of what dBHL?
30-35 dbHL or better
41
OAEs will be absent if hearing thresholds are greater than...?
35 dBHL
42
Since the stimulus and emission travel through the middle ear, individuals with abnormal middle ear functionals (otitis media, etc.) will or will not have present OAEs
WILL NOT
43
What is TEOAEs?
A click stimulus is used to elicit the response
44
What do TEOAEs measure?
They measure the movement across a broad area of the basilar membrane in the cochlea.
45
A wave reproducibility of approx ____ percent and above indicates that the TEOAE is present
75 percent
46
TEOAEs test the frequency region from approximately ____ KHz to _____ KHz.
1 KHz to 5 KHz.
47
How many tones are used to stimulate the basilar membrane? What kind of tones? What are they called? What is the most robust distortion?
2 tones - distortions or distortion products 2f1-f2

Audiological Evaluation (4 decks)

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