Auditory System Flashcards

includes anatomy and physiology, audiometic testing, audiogram, and tympanometry

1
Q

peripheral auditory nervous system

A

outer, middle, inner ear

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2
Q

central auditory nervous system

A

cochlear nucleus to primary auditory cortex

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3
Q

outer ear

A

acoustic process

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4
Q

outer ear components

A
  • pinna
  • external auditory meatus
  • terminates at tympanic membrane (eardrum)
  • cerumen (earwax)
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5
Q

pinna

A

sound localization

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6
Q

external auditory meatus

A
  • sound amplifier
  • ear canal
  • open at 1 end/closed at other
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7
Q

cerumen

A
  • earwax
  • traps and repels
  • protects ear from foreign items
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8
Q

outer ear: function

A

resonator and amplifier

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9
Q

middle ear

A

mechanical process

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10
Q

middle ear components

A
  • tympanic membrane
  • ossicular chain
  • middle ear muscles
  • eustachian tube
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11
Q

tympanic membrane

A

layers:
1. epidermal
2. fibrous
3. membranous

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12
Q

ossicular chain

A
  • malleus
  • incus
  • stapes
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13
Q

middle ear muscles

A
  • stapedius (CN VII)
  • tensor tympani (CN V)
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14
Q

eustachian tube

A
  • valve-like
  • opens to equalize pressure
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15
Q

middle ear function

A

conduction, protection

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16
Q

inner ear

A

hydromechanical, chemical process

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17
Q

inner ear components

A
  • temporal bone
  • cochlea
  • basilar membrane
  • organ of corti
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18
Q

temporal bone

A

petrous portion

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19
Q

cochlea

A
  • osseous bony cochlea
  • membranous cochlea
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20
Q

organ of corti

A
  • outer hair cells
  • inner hair cells
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21
Q

outer hair cells

A

3-5 rows, 12,000 cells

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22
Q

inner hair cells

A

single row, 3,500 cells

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23
Q

inner ear function

A

converts mechanical sound waves to electrical activity and neural impulses

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24
Q

auditory nerve CN VIII

A
  • neural process
  • transmits auditory and vestibular information from ear to brain
  • spiral ganglion: collection of auditory nerve fibers
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25
Q

auditory cortex

A
  • within the cerebrum at highest level
  • temporal lobes (bilaterally)
  • Heschl’s gyrus: all information reaching cerebrum from lower pathways arrives first at the primary auditory cortex
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26
Q

audiometry

A

testing that measures the range and sensitivity of an individual’s hearing

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27
Q

pure tone testing

A

air conduction testing

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28
Q

air conduction testing

A

sounds go through outer and middle ear

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29
Q

pure tone testing: frequencies tested

A

250, 500, 1000, 2000, 4000, and 8000 Hz

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30
Q

pure tone testing: presentation

A

headphones, external

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31
Q

pure tone testing: response modes

A
  • adults: raise hand, push button, etc.
  • children: visual reinforcement, startle response, play audiometry
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32
Q

pure tone testing: identify threshold

A

use method down 10 dB, up 5 dB

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33
Q

air conduction masking

A

when air conduction threshold in one ear exceeds bone conduction threshold in contralateral ear by 40 dB HL or more

34
Q

bone conduction testing: tonal stimuli

A

sound through bone vibration direct to cochlea/inner ear

35
Q

bone conduction testing: frequencies tested

A

500, 1000, 2000, and 4000 Hz

36
Q

bone conduction testing: presentation

A

bone oscillator behind the ear instead of headphones

37
Q

auditory brainstem response (ABR)

A

used with children who can’t complete a normal hearing screen and/or if hearing loss is suspected in the brain/brain pathway

38
Q

audiogram

A

graphic display of hearing test

39
Q

audiogram: threshold

A

intensity at which signal is barely detectable 50% of time

40
Q

audiogram: identifies

A

type, degree, and configuration of hearing loss

41
Q

audiogram: frequency range

A

125-8000 Hz

42
Q

audiogram: intensity range

A

-10-110 dB HL

43
Q

otoacoustic emissions (OAEs): testing

A

used to determine hair cell function

44
Q

otoacoustic emissions (OAEs): presentation

A
  • earphone/probe inserted into ear (that makes sounds)
  • OAEs record the response to that sound by vibration
45
Q

frequency limits

A
  • 16 Hz-20,000 Hz
  • most sensitive to mid frequency 500-4000 Hz
46
Q

Carhart’s notch

A

dip in audiogram at 2000 Hz to stapes fixation

47
Q

pure tone average (PTA)

A

average of 500, 1000, and 2000 Hz thresholds

48
Q

Fletcher average

A
  • if sharply sloping loss, use fletcher average
  • average of the 2 best thresholds at 500, 1000, and 2000 Hz
49
Q

type of hearing loss

A
  • identifies the site of damage of the auditory system
  • conductive, sensorineural, and mixed
50
Q

degree of hearing loss

A
  • refers to the severity of the hearing loss
  • normal, slight, mild, moderate, mod-severe, severe, profound
51
Q

configuration of hearing loss

A
  • refers to the extent and pattern of loss across frequencies
  • flat, rising, sloping, low frequency, high frequency, precipitous
52
Q

conductive hearing loss

A
  • outer and middle ear
  • air-bone gap greater than 10 dB
  • bone threshold within normal limits (sounds cannot get through outer and middle ear)
53
Q

sensorineural hearing loss

A
  • inner ear and/or CN VIII
  • air + bone thresholds are equal
  • both display a hearing loss (inner ear damage/problems with nerve pathways)
54
Q

mixed hearing loss

A

combination of sensorineural hearing loss and conductive hearing loss components

55
Q

degrees of hearing loss: -10-15 dB

56
Q

degrees of hearing loss: 16-25 dB

57
Q

degrees of hearing loss: 26-40 dB

58
Q

degrees of hearing loss: 41-55 dB

59
Q

degrees of hearing loss: 56-70 dB

A

moderately severe

60
Q

degrees of hearing loss: 71-90 dB

61
Q

degrees of hearing loss: 91+ dB

62
Q

configuration of loss: flat

A

AC thresholds within 20 dB of each other

63
Q

configuration of loss: rising

A

AC thresholds for low frequencies at least 20 dB poorer than for high frequencies

64
Q

configuration of loss: sloping

A

AC thresholds for high frequencies at least 20 dB poorer than for low frequencies

65
Q

configuration of loss: low frequency

A

hearing loss only found in the low frequencies

66
Q

configuration of loss: high frequency

A

hearing loss only found in the high frequencies

67
Q

configuration of loss: precipitous

A

high frequency thresholds worsen by at least 20 dB per octave

68
Q

tympanometry

A

measurement of eardrum immittance as a function of air pressure in the ear canal

69
Q

tympanometry: procedure

A

a soft rubber tip (probe) is inserted into the ear canal, changing the pressure in the ear canal

70
Q

tympanogram

A

the resulting graph is a tympanogram

71
Q

tympanogram measures

A
  • static admittance
  • tympanic peak pressure
  • tympanic width
  • canal volume
72
Q

static admittance

A
  • the admittance of the middle ear system (mobility)
  • height of peak
  • higher is more mobile
73
Q

tympanic peak pressure

A

the point at which air pressure is equal on either side of tympanic membrane

74
Q

tympanic width

A

describes the steepness and shape of the slope of the tympanogram, near the peak

75
Q

canal volume

A

estimates volume of the air medial to the probe

76
Q

tympanogram types

A
  • type A
  • type As
  • type Ad
  • type B
  • type C
77
Q

tympanogram: type A

78
Q

tympanogram: type As

A
  • shallow compliance
  • reduced peak height, normal pressure
  • indicates: middle ear fluid, otosclerosis
79
Q

tympanogram: type Ad

A
  • deep compliance
  • greater than normal peak height, normal pressure
  • indicates: ossicular disarticulation, TM scaring
80
Q

tympanogram: type B

A
  • flat: no pressure or compliance
  • no discernible peak shown (NP = no peak)
  • indicates: middle ear effusion, perforated TM, cerumen occlusion
81
Q

tympanogram: type C

A
  • negative pressure
  • any height, normal mobility
  • indicates: negative pressure TM or middle ear, eustachian tube dysfunction