case 4

Question 1

children hearing test-audiometry

Answer 1

behavioural observation audiometry-6m. Visual reinforcement observation audiometry-6-24m. conditioned play audiometer-24-42m. conventional audiometry-3.5y.

Question 2

speech

Answer 2

way we say something

Question 3

language

Answer 3

acquisition of form meaning and use of words and utterance.

Question 4

formants

Answer 4

Formants are chunks of energy clustered in certain frequency areas. In the case of vowels, the first two formants (F1 and F2) combined create a characteristic vowel and are most important for intelligibility

Question 5

phonology

Answer 5

sound units-phenomes

Question 6

morphology

Answer 6

units of meaning within words, the ways words are formed-morpheme.

Question 7

syntax

Answer 7

phrase and sentance structure, what makes sense-grammar

Question 8

semantics

Answer 8

the way language conveys meaning.

Question 9

pragmatics

Answer 9

Appropriate word choice and use in context to communicate effectively - social language use - using language for different purposes, changing language according to needs to listener or situation, following rules for storey-telling and conversation

Question 10

orthography

Answer 10

spelling patterns

Question 11

vocabulary

Answer 11

Knowledge of the meaning and pronunciation of words (lexicon)

Question 12

attenuation reflex

Answer 12

loud noise usually dampened by tensor tympani and stapedius. sudden loud noises arent protected against.

Question 13

organ or corti

Answer 13

haircells, rods of corti. stereocilla-kinocillium. hair cells synapse on neurons whose cell bodies are in spiral ganglia. tectorial membrane bends sterocilla. TRPA1/TPR1 channel open causing influx of K. tip link opens other cilium. activates Ca channels triggers glutamate activates spiral ganglion fibres. resting potential -45. basal end in perilymph so K through transduction channels into scala tympani. spiral ganglion cells are bipolar.

Question 14

types of hair cells

Answer 14

inner outer. one row inner. three rows outer. inner sensory receptors. outer amplify movement basilar membrane. protein called prestin allow to move.

Question 15

first site of convergence of sound from right and left ears

Answer 15

superior olivary complex

Question 16

otoacoustic emissions

Answer 16

usually inaudible sounds produced by the cochlea.
They are caused by vibrations of the outer hair cells that occur in response to sound waves and to signals from motor neurons. As they depolarize and repolarize, the outer hair cells rapidly shorten and lengthen. The outer hair cell vibrations set up a traveling wave that goes back toward the stapes and leaves the ear as an otoacoustic emission.

Question 17

auditory pathway

Answer 17

spiral ganglion, enter brain stem in VC nerve, dorsal or ventral cochlear nucleus in medulla. ventral go to superior olive, on both sides, olivary nucleus ascend in lateral lemniscus innervate inferior colliculus. dorsal bypass superior olive. all ascending pathways converge on inf colliculus. then to medial geniculate nucleus of thalamus then auditory cortex. discriminate location intensity and timing. ventral encodes intensity and timing. dorsal encodes pitch and quality. high frequencies medially. heschi gyrus decodes sound and language. SON can tell between time intervals localise sound. LLN acoustic reflexes. cochlear nucleus recieves input from one ear, all the rest from both. The anterior inferior cerebellar artery supplies the cochlear nuclei, and unilateral occlusion can produce deafness in one ear. MGN selective for frequencies and time intervals.

Question 18

monaural pathways

Answer 18

terminates in the nuclei of the lateral lemniscus on the contralateral side of the brainstem.
• These particular pathways respond to sound arriving at one ear only and are thus referred to as monaural.

Question 19

how is stimulus intensity detected

Answer 19

firing rates and number of active neurons. loudness correlated no active neurons and their firing rates.

Question 20

tonotopy

Answer 20

in basilar membrane MGN and auditory cortex, location of active neurons indication of frequency of sound.

Question 21

phase locking

Answer 21

respond to peak in sound pressure wave. when basilar mem moves up. diff neurons fire on successive cycles. provides temporal info from two ears, sound localisation.

Question 22

how are different frequencies represented

Answer 22

low frequencies phase locking. intermediate frequencies phase locking and tonotopy. high frequencies tonotopy.

Question 23

volley principle

Answer 23

• When a bunch of neurons fire at a peak of the sound wave, they need time to recover.
• This means that a second bunch of neurons fire action potentials at the second peak; a third bunch at the third peak; until eventually the first bunch of neurons has recovered.
• This cycle is repeated so that all the ‘peaks’ of a low-frequency sound wave (up to about 3-4kHz) are covered.

Question 24

localisation of sound in the horizontal plane

Answer 24

below 3hz interaural time differences, above interaural intersity differences.

Question 25

localisation of sound in the vertical plane

Answer 25

dependant on curvature of pinna. dorsal cochlear nucleus determine the elevation of sound.

Question 26

vestibular labrynth

Answer 26

otolith organs detect gravity and head tilts. semicircular canals are sensitive to head rotation. cell bodies of the vestibular nerve lie in scarpas ganglion.

Question 27

otolith organs

Answer 27

saccule and utricle, detect changes of head angle. linear accelaration. contain macula with hair cells, overlying the hair cells is otolith membrane with Ca carbonate - otoliths. gravity causes membrane to shift which displaces hairs. striola forms axis of mirror symetry, so that hair cells on opposite sides have opposing polarizations. saccula macula orientated vertically whilst utricular caula horizontally.

Question 28

semicircular canals

Answer 28

horizontal-rotation of head. anterior/superior-nodding head. posterior-head to shoulder. at its base has ampulla, houses crista which contain hair cells. hair bundles extend out crista into capula. superior canal on one side works with posterior on other to opose each other. When rotation is stopped, the inertia of the endolymph causes the cupula to bend in the other direction, generating an opposite response from the hair cells and a temporary sensation of counterrotation.

Question 29

vestibular occular reflex

Answer 29

eye movement counter head. produce stable image on retina. rotational (SSC), translational (OO) or ocular counter rolling VOR. (OO)
rotational VOR: SSC sense rotation, slow or fast/nystagmus phase reset. stimulate abducens nerve excite LRM inhibit MRM one eye opposite of other. project to medial and lateral vestibular nuclei. then to CN which actifvate eye movement. Nystagmus:• This is defined as a pattern of reflex eye movements.
• It consists of two phases: fast phase and slow phase.
• Nystagmus can be of several types: optokinetic (visual), vestibular, post-alcoholic

Question 30

veatibular reflexes

Answer 30

scarpas ganglia to vestibular nuclei, The main projections from these nuclei are to the spinal cord (controlling head and body position), to the three, extraocular motor nuclei (III, IV, VI, controlling eye movements), to the thalamus (VPI, eventually reaching the cortex and conscious perception of movement and gravity), and to the cerebellum (coordinating postural adjustments).

Question 31

vestibulocervical and vestibulospinal reflex

Answer 31

postural adjustments of head by VCR, body by VSR.
VCR involves medial vestibular nucleus, desend in medial longditudinal fasciculus, head position by stimulation of neck muscles in responce to stim of semicircular canals.
VSR: lateral vestibular nucleus. otolith organs to LVN sends axons in LVST to spinal cord. terminate on extensor motor neurons.

Question 32

vestibular pathways to thalamus and cortex

Answer 32

go to VPN of thalamus. go to somatosensory cortex or between sensory and motor. respond to proprioception and visual stim, perception of body orientation.

Question 33

otitis media

Answer 33

an inflammatory condition of the middle ear that results from dysfunction of the Eustachian tube as a result of inflammation of the mucous membranes/ adenoid tonsils in the nasopharynx, which in turn can be caused by a viral URI or possibly by allergies. the gas volume in the middle ear is trapped and parts of it are slowly absorbed by the surrounding tissues, leading to negative pressure in the middle ear. fluid from the surrounding tissues is sucked in to the middle ear’s cavity, causing a middle-ear effusion.may become infected by bacteria or viruses from the nasopharynx producing an acute (or sometimes chronic) infection of the middle-ear.

Question 34

acute otitis media

Answer 34

pathogens from the nasopharynx are introduced into the inflammatory fluid collected in the middle ear. Streptococcus pneumoniae is the most common bacterial cause.  Fluid in the middle ear is typically demonstrated or confirmed with pneumatic otoscopy.
 In the absence of fluid, the tympanic membrane moves visibly with the application of positive and negative pressure, but this movement is dampened when fluid is present.
 With bacterial infection, the tympanic membrane can also be erythematous (inverted), bulging, or retracted and occasionally can spontaneously perforate.
 The signs and symptoms accompanying infection can be local or systemic, including diminished hearing, fever, malaise or irritability.
amoxicillin often used if not gone in 72hr.

Question 35

recurrent acute otitis media

Answer 35

more than 3 episodes in 6 months or 4 in 12.

Question 36

otitis media with effusion

Answer 36

fluid is present for an extended period of time without infection.usually resolve in 2 weeks but can persist with significant hearing loss, in children impair language. should resolve in 3 months. tympanostomy tubes reserves until lasted longer than 3 months or significant hearing loss. a grommet will extrude itself.

Question 37

chronic otitis media

Answer 37

recurrent tympanic membrane perforation, infection can spread to mastoid bone or superiorly causing osteomyelitis of tegmen tympani. antibiotic drops used.

Question 38

tonsillitis

Answer 38

waldeyers tonsilar ring involves adenoid, tubal, palatine and lingual tonsils. pain headache loss voice throat reddened swollen glands. can cause otitis mediaswollen adenoid tonsils cause build up in eustachian tube. steroid spray.

Question 39

menieres disease

Answer 39

reccuring episodes of vertigo deafness tinitus. build up of endolymphatic fluid in the inner ear.

Question 40

types of hearing loss

Answer 40

conductiive: external or middle ear. problem conducting soundwaves. common causes-ear wax, TM perforation, otitis media.
Sensorineural: inner ear. causes-poor hair cell receptor growth, noise trauma above 85db, deafness gene. DFNB1 autosomal recessive.
central auditory dysfunction-lesion in brainstem. or auditory pathways produce dificulty in locating or discriminating sound.

Question 41

tests for hearing loss

Answer 41

tuning fork acoustic resonator tells between conductive or sensorineural between air and bone conduction. weber-forhead, louder in one ear.if conductive loud in that ear as not dampened by sounds in room. Rinnes test against mastoid bone, should hear after stop hearing it on bone, conductive wont.
audiometry, middle ear low frequency, inner ear high frequency loss. tympanometry-resistence to pressure of middle ear. changes pressure sound reflected bacl picked up, in problems TM stiff so more sound reflected back.
electric response audiometry, electrodes on auditory pathway, used in infants who cant respond to sound, or see if lying.
otoacoustic emmisions-if hearing loss dont produce.

Question 42

vestibular function test

Answer 42

helps see if balence problems are from ear. caloric test, cold or warm water in ear. cold opposite warm same.

Question 43

attention

Answer 43

 The pulvinar nucleus has reciprocal connections with most visual cortical areas of the occipital, parietal, and temporal lobes, giving it the potential to modulate widespread cortical activity.
 People with pulvinar lesions respond abnormally slow to stimuli on the contralateral side, particularly when there are competing stimuli on the ipsilateral side.