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Pediatric audiology > Exam #1 > Flashcards

Exam #1 Flashcards

1
Q

Ectoderm

A
  • outer skin layers, nervous system, sense organs

- inner ear

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2
Q

Mesoderm

A
  • bones of middle ossicles
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3
Q

Endoderm

A
  • digestive canal and respiratory organs
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4
Q

embryology

A

the branch of biology that deals with the formation, early growth, and development of living organisms

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5
Q

Embryo

A

Up until the 8th week

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6
Q

Fetus

A

After the 8th week of development

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7
Q

Three Germ Layers

A

Endoderm, Ectoderm, Mesoderm

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8
Q

Full term

A

37 - 40 weeks

- we measure in terms of gestational period, starts from the first day of your last menstral cycle

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9
Q

Neural tube

A

gives rise to the spinal cord and brain

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10
Q

Neural crest

A

gives rise to a number of different cell types and neurons

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11
Q

notochord

A

direts formation of the neural tube - primitive spinal chord

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12
Q

3 Week Gestational Age

A
  • notochord forms
  • neural groove (future spinal chord) forms
  • brain bulge at end of embryonic disc
  • somites form, precursor to genitalia
  • primitive heart tube forms
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13
Q

4 Weeks Gestational Age

A
  • heart begins to beat
  • branchial arches (form face and neck) form
  • Neural tube closes **
  • Otic Pit form (precursor to ears)
  • arm buds visible
  • First sign of lungs, mouth & liver appear

(this is when cleft lip & palate happen)

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14
Q

When is the earliest you can get an ultrasound?

A

6 weeks - wait until then because you should be able to see a heartbeat by then

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15
Q

What is anacephaly?

A
  • born without a brain

- you can have live birth, but they will die

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16
Q

Spina Bifida

A
  • different lobes of brain, there are different ventricles, you have a build up of cerebrospinal fluid in 4th ventricle
  • put in a shunt to solve problem
  • both the problem, and the shunt can cause HL
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17
Q

5 Weeks Gestational Age

A
  • Eye begins to develop
  • Brain divides into 5 vesicles
  • Legs and hands begin to form
  • Rudimentary blood begins to move through vessels
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18
Q

7 Weeks Gestational Age

A
  • All essential organs have at least begun to form

- generally know you are pregnant by now

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19
Q

8-10 Weeks Gestational Age

A
  • now FETUS (no longer embryo after 8 weeks)
  • face is well formed
  • eyelids formed - closed and will re-open around week 28
  • genitals appear, but you can’t find out gender until 20 weeks
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20
Q

When do fetus’ eyes open?

A

28 weeks

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21
Q

When can you find out the gender of your baby?

A

20 weeks

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22
Q

25 Weeks Gestational Age

A
  • brain develops rapidly
  • cochlea developed, fully developed by 20 weeks
  • respiratory system developed enough to support gas exchange, makes it feasible for baby to be born here and have a chance at breathing
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23
Q

Toxic Susceptibility Week 0-2:

A
  • Pre organogenesis
  • you can’t impact the heart and lungs etc yet because they aren’t there yet, and there is no umbilical chord
  • not sensitive to malformation
  • significant exposure is lethal
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24
Q

Toxic Susceptibility Weeks 3-8:

A
  • Embryonic Period
  • start being susceptible to toxicity issues
  • greatest sensitivity to environmental exposures
  • fetal mass increases 2.5 million fold first trimester
  • major malformations occur (heart, lungs, liver, neural tube)
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25
Q

Toxic Susceptibility Weeks 9-38:

A
  • Fetal Period
  • decreasing sensitivity
  • functional defects and minor malformations occur
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26
Q

What is the most common addiction for newborns?

A
  • pain medication - moms don’t think it is effecting the baby
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27
Q

Which auricular hillocks come from the first arch?

A
  1. Tragus

2. Crus of Helix

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28
Q

What is the only part of the ear that doesn’t form from hillocks?

A

The ear lobe - “lobule”

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29
Q

Which auricular hillocks come from the second arch?

A
  1. Ascending helix
  2. Upper Helix, Scaphoid & Antihelix
  3. Descending Helix, Middle Scaphoid, Antihelix
  4. Antitragus
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30
Q

Three layers of the TM

A
  • Inner layer, endoderm
  • middle layer, mesoderm
  • outer layer, ectoderm
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31
Q

At what point is the pinna fully developed/adult size?

A

about 9 years of age

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32
Q

What is the first pharyngeal arch called?

A

Mackel’s cartilage

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33
Q

What is the second pharyngeal arch called?

A

Reichert’s cartilage

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34
Q

What forms from the first pharyngeal arch?

A
  1. Head of malleus, body and short process of incus
  2. Tensor tympani muscle
  3. Trigeminal nerve (V): the mandibular branch supplies tensor tympani muscle
  • When you see a problem on the pinna in a spot that has come from the 1st arch - there may something with one of these as well.
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35
Q

What forms from the second pharyngeal arch?

A
  1. long process of incus, handle of malleus, stapes superstructure and tympanic surface of footplate
  2. stapedius muscle
  3. facial nerve (VII): stapedial nerve
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36
Q

Auditory experience promotes…

A

myelination of afferent fibers

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37
Q

When is frequency discrimination mature?

A

Frequency discrimination is adult like by 6 months postnatally, but thresholds mature through childhood

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38
Q

How many babies are born with hearing loss

A

3/1000

- NICU causes bigger issues, approx 2.5/100

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39
Q

idiopathic

A
  • no idea what happened
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40
Q

Environmental

A
  • drug exposure during birth, the chord wrapped around the neck, we know what happed to cause issues
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41
Q

Alport

A
  • progressive SNHL
  • renal disease (kidney) eye anomalies, mild to severe (bilateral) physical deformities, chance that loss will progress with age
  • more males than females
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42
Q

NF2

A
  • progressive SNHL
  • neurofibromatosis 2 slowly progressive loss, tumors on auditory nerve (acoustic neuroma or vestibular schwanoma) when you remove them, hearing is last with no chance to help, tumors come back
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43
Q

Usher type 3

A
  • Progressive SNHL
  • usher 1 & 2 born with hearing loss, only difference
  • retinitis pigmentosa (leads to blindness) usually hearing goes first
44
Q

BOR

A
  • branchio-oto-renal

- lungs, ear, kidney, any type of loss, outer ear malformations, pits/tags/cysts, 90% have hearing loss

45
Q

Apert (CHL)

A
  • congenital HL
  • similar to alport, but born with loss
  • physical & skeletal abnormalities, a lot have spina bifida, tend to have cognitive impairments, conductive HL, more common with older adult parents (late in life pregnancies)
46
Q

CHARGE

A
  • congenital HL

- hole in eye, heart problems, narrowing of nasal passage, malformation of genitals, renal issues, and hearing loss

47
Q

Jervell & Lange-Nielson

A
  • congenital profound SNHL
48
Q

Pendred

A
  • Congenital SNHL

- thyroid problems

49
Q

Usher types 1 & 2

A
  • congenital SNHL
50
Q

Waardenburg

A
  • congenital SNHL
  • genetic
  • pretty significant loss, wide flat nose, 2 different colored eyes, may have gray or white hair spot, more physical not so much mental problems
51
Q

Nonsyndromic Pendred Syndrome/DFNB4

A

–

52
Q

Mitochondrial

A

–

53
Q

AN

A

–

54
Q

Connexin

A

–

55
Q

aquired

A

trait or condition develops later in life

56
Q

congenital

A

trait or condition present from birth

57
Q

nonsyndromic hearing impairment

A

hearing deficit associated in absence other medical problems

58
Q

syndromic hearing impairment

A

hearing deficit associated with other medical problems

59
Q

dominant

A

a mutation in a gene that is strong enough to make a person affected even if the person also has a normal copy of the gene

60
Q

recessive

A

a mutation in a gene that is not strong enough to make a person affected even if the person also has a normal copy of the gene

61
Q

Why do infants hear better in high frequencies (than adults)?

A
  • infants have smaller ear canals (amplify those frequencies with smaller “tube”)
  • infants ME impedance favors highs (mass dominated)
  • adults lose hearing sensitivity in highs as they age
  • frequency-specific differences in localization processes
62
Q

From birth the four months, what dB level can elicit a moro reflex

A

baby will startle at 65 dB

63
Q

How does a baby respond to sound from birth to four months?

A
  • reflexive auditory responses (eye blinks, eye widening)
  • highly variable responses
  • moro response (startle)
  • 3-4 months can demonstrate slow head turn toward a sound
64
Q

At what age should a baby start being about to sit up without support?

A

4-9 months

65
Q

At what age should a baby start standing with assistance?

A

5-11.5 months

66
Q

At what age should a baby start hands & knees crawling?

A

5-13 months

67
Q

At what age should a baby start walking with assistance?

A

6-14 months

68
Q

At what age should a baby start standing alone?

A

7-17 months

69
Q

At what age should a baby start walking alone?

A

8-18 months

70
Q

How does a baby respond to sound from 4 - 7 months?

A
  • more consistent head turn toward sound source, but wobbly
  • by 7 months, can turn to either side well
  • localization only on the lateral plane
  • any reaction counts for testing, they may turn to the wrong side, but it counts as a response
71
Q

How does a baby respond to sound from 7 - 9 months?

A
  • precise localization occurs (quick, sharp head turn)

- may not yet have localization about the plane of the head, but much better with correct side (right vs left)

72
Q

How does a baby respond to sound at 9 -13 months?

A
  • by the end of 13th month, can localize in all directions
  • considered to have reached full maturation of auditory development
  • one year olds can be measured at threshold level
  • can make different expressions, follow simple commands, interested in sounds, definite localizations include up and down, communication behaviorally, they can imitate sounds
73
Q

Auditory Skills Hierarchy

A
  • Detection/ Awareness & Attention
  • Discrimination
  • Recognition
  • Comprehension/Understanding
74
Q

Comprehension/Understanding

A
  • words and phrases with cues
  • words and phrases auditory only
  • sentences
  • conversation
75
Q

Speech Perception

A
  • goes beyond threshold detection

- determine auditory capacity/functional hearing

76
Q

Milestones in Language Development: 0-6 Mos

A
  • produces only “vegetative” sounds
  • cooing, imitation of vowels only
  • responds to name
  • responds to human voices without visual cues by turning head and eyes
  • responds appropriately to friendly and angry tones
77
Q

Milestones in Language Development: 6-12 months

A
  • babbling begins in earnest (CV, CVC)
  • comprehension of spoken language evident
  • single words begin to be produced
  • uses one or more words with meaning (this may be a fragment of a word)
  • understands simple instructions, especially if vocal or physical cues are given
  • practices inflection
  • is aware of the social value of speech
78
Q

What are the 4 stages of babbling?

A
  • Marginal
  • reduplicated/canonical
  • nonreduplicated/variegated
  • jargon
79
Q

Marginal babbling stage

A
  • 4-6 months

- CV or VC only (ba or ab)

80
Q

Reduplicated/Canonical

A
  • 6-8 months
  • alternation of consonants and vowels (babababa)
  • deaf babies will do this, but it starts to drop off after this point
81
Q

Non-reduplicated/Variegated

A
  • 8-10 months
  • alternating consosnants and vowels (babigatadaba)
  • mimics adult intonation
82
Q

Jargon

A
  • 9-12 months

- strings of syllables that mirror adult stress patterns

83
Q

Milestones in Language Development 2 months of age:

A
  • startles to loud sound(moro)
  • quiets to familiar voices (in quiet environments)
  • makes vowel sounds like “ohh” “ahh” (reflexive sounds)
84
Q

Milestones in Language Development 4 months of age:

A
  • look for sound sources (on lateral plane)
  • starts babbling (CV, CVC)
  • uses variety of voice sounds, squeals and chuckles
85
Q

Milestones in Language Development 6 months of age:

A
  • turns head toward loud sound (consistently)
  • begins to imitate speech sound
  • babbles (“baba” “mama” “gaga”)
86
Q

Milestones in Language Development 9 months of age:

A
  • imitates speech sounds of others
  • understands “no-no” or “bye-bye”
  • turns head toward soft sounds
  • This is good for testing, more able to test near threshold when they will react to softer sounds
87
Q

Milestones in Language Development 12 months of age:

A
  • correctly uses “mama” or “dada”
  • gives toy when asked
  • responds to singing or music
  • readily turns toward all sounds
88
Q

Milestones in Language Development 12- 18 months of age:

A
  • has vocabulary of approximately 5-20 words (reaches 50 word stage by 18 months on avg)
  • vocabulary made up chiefly of nouns
  • some echolalia (repeating word or phrase over and over)
  • much jargon with emotional content
  • is able to follow simple commands
89
Q

Milestones in Language Development 18-24 months:

A
  • vocabulary “spurt” /acceleration
  • begins to use relational words (verbs, adjectives)
  • using multi-word utterances
  • can name a number of objects common to his surroundings
  • combines words into a short sentence - largely noun-verb combos (mean) length of sentences is given as 1.2 words
  • approx 2/3 of what child says should be intelligible
  • vocab of approx 2/3 of what child says should be intelligible
  • vocab of approx 150 - 300 words
  • volume and pitch of voice not yet well- controlled
  • responds to such commands as “show me your eyes (nose, mouth, hair)
90
Q

Milestones in Language Development 24 - 36 months

A
  • Inflectional morphology (possessives, past tense)
  • sentence structure complexity increases
  • is using some plurals and past tense
  • knows chief parts of body and should be able to indicate these if not name
  • handles three word sentences easily
  • has in the neighborhood of 900 - 1000 words
  • about 90% of what child says should be intelligible
  • verbs begin to predominate
  • understands most simple questions dealing with his environment and activities
91
Q

Milestones in Language Development 48 months

A
  • knows names of familiar animals
  • names common objects in picture books or magazines
  • knows one or more colors
  • can repeat 4 digits when they are given slowly
  • can usually repeat words of four syllables
  • demonstrates understanding of over and under
  • has most vowels and diphthongs and the consonants p, b, m, w, n, well established
  • often indulges in make-believe
  • extensive verbalization as he carries out activities
92
Q

Red Flags - by 12 months

A
  • no differentiated babbling or vocal imitation
93
Q

Red Flags - by 18 months

A

no use of single words

94
Q

Red Flags - by 24 months

A

less than 10 single words

95
Q

Red Flags - by 30 months

A
  • fewer than 100 words
  • no 2 word combos
  • unintelligible speech
96
Q

Red Flags - by 36 months

A
  • fewer than 200 words
  • no telegraphic sentences
  • clarity of speech less than 50%
97
Q

Red Flags - by 48 months

A
  • fewer than 600 words
  • no use of simple sentences
  • clarity of speech less than 80%
98
Q

Milestones in Language Development 60 months

A
  • can use many descriptive words spontaneously, both adverbs and adjectives
  • knows common opposites: big-little, hard-soft, heavy-light, etc
  • can count to ten
  • speech should be completely intelligible , in spite of articulation problems
  • should be able to repeat sentences as long as nine words
  • should be able to follow three commands given without interruptions
  • should know his age
  • speech on the whole should be grammatically correct
99
Q

What are the 5 aspects of language?

A
  • phonology
  • morphology
  • syntax
  • semantics
  • pragmatics
100
Q

Phonology

A
  • system of rules that govern sounds and their combination
  • phoneme: smallest linguistic unit of speech that signals a difference in meaning (p@t vs b@t)
  • rules - don’t start a word with RS or NG
101
Q

Morphology

A
  • rules that govern internal word formation
  • morphemes: smallest linguistic unit that carries meaning, they cannot be broken into smaller parts that have meaning: ball, happy, play vs balls, unhappy, played
102
Q

Syntax

A
  • rules that govern sentence structure: specifies word order
  • English is SVO, the boy (s) hit (v) the ball (o)
  • Allows user to transform sentences according to rules of the language
    • Did the boy hit the ball? (interrogative)
    • The ball was hit by the boy. (passive)
    • Hit the ball was by the boy (not allowed)
103
Q

Semantics

A
  • word meanings and how they are related
  • word meanings evolve over time - doggie
  • relationships mature over time - car
104
Q

Pragmatics

A
  • rules that govern the use of language in social contexts
  • intension, goal of speaker
  • needs of listener
  • organization of content of a conversation
  • easiest for deaf people to understand
  • personal space, interrupting, reading facial expressions, turn taking, knowing if the needs of listeners are not being met, figure out how to change this
105
Q

Hearing loss and language effects

A
  • severity
  • configuration
  • duration
  • stability
  • age at onset, identification
  • age at intervention
  • extent/type of intervention
  • type and timing of amplification
  • other handicapping conditions
  • cultural and family support
106
Q

Issues in Intervention

A
  • age at time of identification, amplification and intervention
  • parental involvement
  • type of intervention

Pediatric audiology (2 decks)

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