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Audiology-COMPS > Comps Flashcards-Aud > Flashcards

Comps Flashcards-Aud

1
Q

What are the 2 parts of the external ear?

A
  1. The Pinna: outer portion of ear visible on side of head

2. Ear Canal: extends from pinna to tympanic membrane (ear drum)

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2
Q

what are the 2 physiological functions of the external ear?

A

Acoustic & nonacoustic

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3
Q

What marks the boundry b/w the external and middle ear?

A

tympanic membrane

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4
Q

What is the fancy term for ear wax?

A

cerumen

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5
Q

Name 3 disorders of the external ear

A
  1. Foreign bodies (bobby pins, etc)
  2. Keratosis obturans (buildup of extra skin cells & flaky skin in external ear canal)
  3. Osteoma (pearl-like bony growth in external ear canal)
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6
Q

name 3 disorders of the middle ear

A
  1. Otitis media (most common)
  2. Perforated tympanic membrane
  3. Otosclerosis (hereditary disorder causing progressive deafness due to overgrowth of bone in the inner ear)
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7
Q

name 3 disorders of the inner ear

A
  1. Noise induced hearing loss
  2. Meniere’s disease (causes vertigo episodes with fluctuating hearing loss)
  3. Presbycusis (hearing loss due to effect of aging)

Others: viral infections, trauma

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8
Q

what are the 3 components of sound?

A
  1. Frequency (Hz): the # of completed cycles/second.
  2. Amplitude (dB): dependent upon intensity & loudness.
  3. Duration: time; how long was the sound present?/how long did it take to reach the ear/brain?/how long did it take to bring understanding?

*duration is like processing (old computers run slower than newer ones)

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9
Q

What is a narrow, air-filled chamber lined with mucous membrane and is situatied between the external auditory meatus and the inner labyrinth?

A

The middle ear/tympanic cavity

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10
Q

how does the middle ear/tympanic cavity communicate with the mastoidair cells and nasal pharynx?

A

via the Eustachian tube

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11
Q

What 2 structures makes up the ceiling and the floor of the tympanic cavity?

What 2 structures makes up the lateral wall and medial wall of the tympanic cavity?

What makes up the front wall and back walls of the tympanic cavity?

A 
Tegman tympani (ceiling)
Jugular Floor (floor)
Tympanic membrane (lateral wall)
Cochlear wall (medial wall)
Mastoid wall (back)
Carotid wall (front)
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12
Q

What do the ossicles (a chain of 3 tiny bones) of the middle ear do?

A

transmit sound to the inner ear & protect the inner ear from very loud sounds.

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13
Q

what 3 bones make up the ossicles?

A
  1. malleus (hammer)- the manubrium/handle of this bone is attached to the tympanic membrane.
  2. incus (anvil)- attached tot he malleus & to the stapes.
  3. stapes (stirrup)- smallest bone in human body; attached to the oval window of the cochlea.
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14
Q

what are the 4 functions of the tympanic cavity (middle ear)?

A
  1. transmit sound efficiently from air to fluid.
  2. the round window allows for fluid displacement in the cochlea.
  3. the Eustachian tube equalizes pressure.
  4. protection from hazardous noise.
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15
Q

what are the 2 muscles of acoustic reflex? (middle ear)

A

Tensor Tympani: regulates tension of tympanic membrane; innervated by CN V.

Stapedius: regulates motion of the stapes; innervated by CN VII

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16
Q

What is the most common type of conductive HL caused by?

A

Otitis Media- inflammation of the middle ear.

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17
Q

what is the most common type of conductive hearing loss caused by?

A

otitis media (inflammation of the middle ear)

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18
Q

list the stages of otitis media.

A

stage 1: Eustachian tube dysfunction: closed tube allows no new oxygen into the middle ear space.

stage 2: Negative middle ear pressure: TM pulled inward, vacuum created. negative pressure causes serous effusion (fluid accumulation)
–Fluid builds up, causes serous otitis media (otitis media with effusion)

stage 3: Serous otitis media: microbial growth occurs, fluid increases. Amber-colored fluid can build up.

stage 4: Purulent otitis media (pus-producing): EAR INFECTION! if bacterial growth exceeds the area of the TM, the TM may rupture.

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19
Q

how can a simple ear infection lead to death?

A

otitis media becomes suppurative (blood is present), pus accumulates which puts pressure on the mucosa, submucosa, and TM, causing necrosis. Necrosis leads to mastoiditis, which leads to meningitis, which leads to… DEATH!!!

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20
Q

What are the symptoms a person may experience if they have an ear infection (purulent otitis media)?

A

fever, earache, decreased hearing, & fluid in external ear canal.

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21
Q

what are some clinical signs of an ear infection (otitis media)?

A
  • Reddish tympanic membrane
  • Bulging tympanic membrane
  • Tenderness around ear
  • Conductive hearing loss
  • Flat tympanogram (Type B)
  • Fluid build up
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22
Q

How are ear infections treated in the U.S. vs. other parts of the world?

A

U.S. - With antibiotics

Other areas of the world: monitor infection to see if it improves on its own and monitor progression

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23
Q

How is recurrent otitis media treated?

A

Myringotomy (slicing of TM)

Tympanocentesis (needle and syringe for immuno deficient patients)

P.E. (pressure equalization) tubes

Pain medications

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24
Q

What is transformer action/impedance matching of the middle ear?

A
  • The inner ear is full of fluid.
  • Sound travels from air to fluid.
  • When sound waves reach fluid, most of the energy is reflected off the surface of the water.
  • The middle ear mechanism is needed to assist in this mismatch of air-to-water transformation of the sound waves.
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25
Q

What are the 2 main functions of the inner ear?

A
  1. Hearing (cochlea)

2. Balance (vestibule and semicircular canals)

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26
Q

Name some causes of cochlear hearing loss (inner ear HL).

A
  • Noise induced hearing loss
  • Endolymphatic Hydrops (primary endolymphatic hydrops = Meniere’s Disease)
  • Presbycussis (hearing loss due to effect of aging)
  • Genetic conditions
  • Viral infections
  • Trauma
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27
Q

What is the Central Auditory Pathway?

A

VSLIM (the path up the brainstem- bilateral pathway)

  • Ventral Dorsal Cochlear Nucleus
  • Superior Olivary Complex
  • Lateral Lemniscus
  • Inferior Colliculus
  • Medial Geniculate
28
Q

What are some disorders of the Auditory Nerve (CN VIII)?

A
  • Tumor (most are benign; Acoustic Neuroma)
  • Acoustic Neuritis (inflammation of the vestibular or cochlear nerve)
  • Multiple Sclerosis
  • Auditory Neuropathy (a disconnection between the peripheral hearing mechanism and the central mechanism)
  • Auditory Dys-Synchrony (A dysfunction of the connection between the peripheral hearing mechanism and the central hearing mechanism)
  • Kernicterus (bile along nerves that degenerates the cells with liver bile)
  • CVA
  • Anoxia
  • Higher Auditory Pathway Disorders
  • Auditory Processing Disorders (The principle function of the central auditory system: To organize concurrent or sequential auditory input into patterns)
29
Q

What is the primary function of the ear?

A

Equilibrium (the inner ear).

NOT hearing

30
Q

What is the responsibility of the vestibular system?

A

Controlling posture and movements of the body and eyes relative to the external environment.

31
Q

What does the Vestibular-Ocular Reflex (VOR) do?

A

Allows for gaze stabilitzation during active head movement.

32
Q

Where is the vestibular labyrinth located in the brain?

A

the temporal lobe.

33
Q

What are some vestibular disorders?

A
  • Benign Paroxysmal Positionial Vertigo (BPPV)
  • Endolymphatic Hydrops/Meniere’s Disease: caused by abnormal fluctuations in the fluid called endolymph which fills the hearing and balance structures of the inner ear.
34
Q

What are the 4 symptoms that must be present for a patient to be diagnosed with Meniere’s Disease? (all symptoms must be present)

A
  1. Aural fullness
  2. Tinnitus
  3. Vertigo
  4. Low frequency sensorineural hearing loss
35
Q

What is considered normal hearing?

A

0-20dB hearing loss (HL)

36
Q

What is considered mild hearing loss?

A

20-40 dB HL

37
Q

What is considered moderate hearing loss?

A

40-60 dB HL

38
Q

What is considered severe hearing loss?

A

60-80 dB HL

39
Q

What is considered profound hearing loss?

A

80 dB or greater HL

40
Q

What are the three phases of audiological assessment?

A
  1. Determine degree of hearing loss (dB)
  2. Determine type of hearing loss (conductive, sensorineural, mixed, or central)
  3. Determine configuration of hearing loss (bilateral vs. unilateral; symmetrical vs. asymmetrical; high-frequency vs. low frequency; flat vs. sloping vs.precipitous; progressive vs. sudden; & stable vs. fluctuating)
41
Q

What is psychoacoustics?

A

the science of the perception of sound.

42
Q

What is the “threshold”?

A

the softest sound a person can hear at least 50% of the time

43
Q

Who was the “Father of Audiology”?

A

Raymond Carhart

44
Q

What are 6 hearing loss risk factors?

A
  1. family history
  2. syndromes
  3. infections/viruses
  4. head trauma
  5. recurrent OME (otitis media w/effusion)
  6. ototoxic medications
45
Q

What are the (8) steps involved in an audiometric evaluation?

A
  1. Case history
  2. Otoscopy
  3. Tympanometry
  4. Pure-tone audiometry
  5. Speech testing
  6. Masking
  7. Interpretation
  8. Report
46
Q

What is the purpose of otoscopy?

A

To look for obstructions in the ear canal (foreign bodies, infection, cerumen) and to look at the health of the eardrum. Look for redness, fluid line, & retraction of eardrum.

47
Q

What is the purpose of tympanometry?

A

To look at the condition of the middle ear and the modbility of the tempanic membrane/eardrum and the conduction bones by creating variations of air pressure in the ear canal. Looks at middle ear function.

48
Q

What do the different types of tympanograms indicate (A, B, & C)?

A

Type A: indicate a NORMAL middle ear system, free of fluid or physiological anomalies which would prevent the admittance of sound from the middle ear into the cochlea.

Type B: a flat line is consistent with middle ear pathology (fluid or infection behind the ear drum). May indicate a hole in the ear drum: a larger ear canal volume indicates a perforation in the ear drum.

Type C: still shaped like a teepee, but are shifted negatively on the graph = Negative pressure in the middle ear space, often consistent with sinus or allergy congestion, or the end-stages of a cold or ear infection.

49
Q

What are the steps in conducting pure tone audiometry?

A
  1. Establish the threshold of hearing (softest sound which can be perceived in a controlled environment- usually start @ 25dB with 1000Hz)
  2. Pure tone audiometry w/tones starting at about 125 Hz and increasing by octaves, half octives, or third-octates to about 8000 Hz.

Right Ear –AD –Red –O
-Left Ear –AS –Blue –X

50
Q

what are the 3 mechanisms underlying bone conduction hearing?

A
  1. the inertial response of the middle ear ossicles & inner ear fluids.
  2. the distortional response of the cochlear bony labyrinth.
  3. radiation of sound energy into external ear canal.
51
Q

What is speech audiometry and what is it used for?

A

The audiologist provides the pt with a list of words to repeat to

  • Used to determine the patient’s Speech Reception Threshold (SRT), or how soft the patient is able to repeat common words.
  • Can be used to crosscheck the validity of pure tone thresholds.
52
Q

What is Masking? ***??

A

Noise is introduced to one ear while the other ear is tested with a tone (or speech signal) in order to keep the non-tested ear “busy.”

To indicate that the hearing thresholds were obtained using masking, masked threshold symbols are used on the audiogram.

53
Q

Pure tone audiology (PTA) and speech reception threshold (SRT) should be within +/- ___dB of each other.

A

10dB

54
Q

How do you interpret a “flat” audiogram?

A

+/- 5dB across frequency response.

Generally conductive HL

55
Q

What is considered a “sloping” audiogram? (sloping from better hearing to worse in the high pitches)

A

No more than 10 dB per octave

56
Q

Precipitously Sloping audiogram?

A

15 dB or more per octave

57
Q

Reverse slope audiogram?

A

More loss in the low frequencies than in the highs

58
Q

cookie bite audiogram?

A
  • Better to worse to better

* *Typical in noise induced loss or congenital hearing loss

59
Q

If air conduction threshold (ACT) is within normal limits and bone conduction threshold (BCT) for that same frequency is in normal limits and they do not differ from one another by 10 dB or more then this individual has ______ hearing.

A

Normal

60
Q

If ACT is in normal range and BCT is in normal range but differ from one another by 10 dB or more then there is ______ ______ and referral is required.

A

Conductive Dysfunction

61
Q

If ACT is outside normal limits and BCT is within normal limits and BCT is 10 dB or better than the ACT then the loss is ______ in nature.

A

conductive

62
Q

If the ACT is outside normal limits and the BCT is outside normal limits and they do not differ from one another by 10 dB or more then the loss is _____ in nature.

A

sensorineural

63
Q

What are the 6 referral criteria?

A
  • Any affirmatives on FDA required case history.
  • Malformation of external ear structures.
  • Cerumen occlusion.
  • Signs of infection or sores.
  • Conductive hearing loss.
  • Significant asymmetry either in speech or pure tone.
64
Q

What are the two types of hearing devices?

A
  1. Behind the Ear (BTE): receiver is in the ear.

2. In the Ear (ITE): full shell, half shell, canal, completely in the canal, or extended wear device.

65
Q

Describe the method for determining audiometric threshold that has been demonstrated in this audiology course?

A

Carhart-Jerger Modified Hughson-Westlake Procedure for Finding Threshold:

  1. Audible tone is presented in ear. For the patient with no apparent hearing loss, begin at 40 dB and 1000 Hz. If the patient is having difficulty we begin at 70 dB.
  2. If no response is obtained, increase by 20 dB increments until one gets a response.
  3. Now that there is a response, go down 10 dB until the patients does not respond.
  4. As the patient did not respond, increase the intensity by 5 dB until patient responds.
  5. Then decrease in 10 dB steps, and repeat.
  6. The ANSI requires for threshold to occur, a response has to occur 2 out of 3 times at each single level.

*After testing has taken place on the right ear, repeat all the steps on the left ear.

Audiology-COMPS (1 decks)

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