Exam 2 Flashcards
A term used as an all-encompassing term to describe measurements made of TM impedance, compliance or admittance
Acoustic immittance
the total opposition to the flow of acoustic energy (in the plane of the TM)
Acoustic impedance
3 measurements at the plane of the TM
Static Acoustic Compliance/Admittance
Tympanometry
Acoustic Reflex
measurement of the contraction of the middle ear muscle (stapedius muscle) in response to intense sounds
Stiffens the middle-ear system by contracting and decreases its static acoustic compliance
Acoustic Reflex
the mobility of the TM in response to a given value of air pressure in the external ear canal
Essentially measuring the mobility of the TM
Static Acoustic Compliance/Admittance
a measurement of middle-ear pressure, determined by the mobility of the TM as a function of positive/negative pressure in the external ear canal
The more positive/negative the pressure is, the less mobile the middle-ear becomes
Tympanometry
Mass is important for what frequencies?
A) high
B) low
A) high
Stiffness is important for what frequencies?
A) Low
B) High
A) low
As stiffness increases, compliance _______?
A) increases
B) decrease
C) stays the same
B) Decreases
As frequency increases the total value of mass ____?
A) Also increases
B) decreases
C) Stays the same
A) Also increases
(opposition to a force) is determined primarily by the ligaments that support the ossicles
Resistance
What is determined primarily by the weight of these 3 tiny bones and the TM
Mass factor
What is primarily determined by the load of fluid pressure from the inner ear on the base of the stapes
Stiffness
The ear is a largely ______-dominated system, at least for the low frequency response
A) Stiffness
B) Mass
C)Both
A) Stiffness
In Pure-Tone Testing
Conductive losses usually have the greatest effect on the _____ frequencies in the initial and medial stages.
Middle ear pathology stiffens the middle-ear system (______ compliance)
Stiffness is lessened as the frequency _______ (gets higher)
Results are still dependent on a full battery of testing, but this is a general notion
A) Lower, Decreases, Increases
B)Lower, Increase, decrease
C) Higher, Decrease, Increase
A) Lower, Decreases, Increases
What are the primary components of an electroacoustic immittance meter: A) Speaker B)Microphone C)Air pressure pump D) A & B E) A, B & C
E) A, B & C
An occlusion in the Ear Canal can?
A) can alter test results
B)not effect the testing
A) Alter the test results
When the probe tip is pressed in the ear canal you need a ____ seal then ______ pressure is ____ with the air pump
A) tight, positive, and increased
B) tight, negative, and increased
C) tight, positive, and decreased
A) tight positive and increase
The ECV represents the compliance of the?
A) middle ear
B) outer ear
C) inner ear
B) outer ear
Static acoustic compliance represents?
A) outer and inner ear
B) middle and inner ear
C) Outer and middle ear
C) outer and middle ear
Research does agree on a set values that constitute normal static acoustic compliance
True or False
False
Research does not agree on a set values that constitute normal static acoustic compliance
Differences do not exist between adults and children and between the various probe tone frequencies
True or False
False
Differences exist between adults and children and between the various probe tone frequencies
Values cannot be considered abnormal unless one of the extremes is clearly exceeded
True or False
True
Even normal middle ears values vary with age and gender
True or False
True
fluid accumulation in the middle ear space,
immobility of the ossicular chain, reduced elasticity of the TM, and high compliance may result in?
A) Normal mobility
B) Reduced abnormal mobility
C) Hyperactive abnormal mobility
B) Reduced abnormal mobility
The range for children with normal compliance is
.25 - 1.05 mmho
The range for children with normal peak is
-150 - +50
The range for children with normal ECV is
.3 - 1.00
The range for adults with normal compliance
.3 - 1.7
The range for adults with normal peak
-150 - +50
The range for adults with normal ECV
.6 - 2.00
Definition: the measurement of middle-ear pressure, determined by the mobility of the membrane as a function of various amounts of positive and negative pressure in the external ear canal is?
Tympanometry
The purpose of _____ is to determine the point and magnitude of greatest compliance of the TM
tympanometry
The probe tip introduces air pressure equal to \_\_\_\_\_ daPa, measures its compliance and then re-measures compliance as the pressure is \_\_\_\_\_\_\_ A) +100, released B)+150 , increased C) +200, released D)+400, decreased
C) +200, decreased
For adults, it’s conducted with a low-frequency probe tone of \_\_\_\_Hz A) 200 B) 226 C) 400 D) 450
B) 226
For children 6 months and younger, a \_\_\_\_Hz probe tone is used A) 1000 B) 1050 C) 2000 D) 4000
A) 1000
On a Tympanogram the y-axis shows _______ (vertical) and _____ is on the x-axis in daPa (horizontal).
A) pressure, compliance
B) compliance and pressure
B) Compliance and pressure
A temp with normal pressure and normal compliance is a type
Type A
A temp with normal pressure but has a shallow peak is a
Type A sub s
A temp with normal pressure but a high peak is a
Type A sub d
A temp with a normal peak but an abnormal pressure is a
Type C
When the middle ear is filled with fluid it is a
Type B
What controls the pressure in the middle ear
Eustachian tube
Normal tymp and normal acoustic reflex indicate
A) Normal middle ear function
B) Normal outer ear function
C) Normal Inner ear function
A) Normal middle ear function
Definition: contraction of one or both of the middle ear muscles in response to an intense sound is
Acoustic Reflex
Muscles involved in acoustic reflex are?
A) tensor tympanic
B)stapedius muscle
C) both
C) both
Stapedius muscle ____ in response to intense sound
A) relaxes
B)contracts
C) not known
B)Contracts
the signal used to elicit the acoustic reflex Usually pure tones from 500-4000 Hz A)Ipsilateral Reflex B)Contralateral Reflex C) Reflex-Activating Stimulus
C) Reflex-Activating Stimulus
when the acoustic reflex stimulus is presented to one ear and a decrease in TM compliance is detected in the same ear
A)Contralateral Reflex:
B)Reflex-Activating stimulus
C)Ipsilateral Refelx
C) Ipsilateral Reflex
when the measurement is made in the opposite ear to the original stimulus
A)Ipsilateral Reflex
B)Contralateral Reflex
C)Reflex-Activating Stimulus
C) Contralateral Reflex
Auditory reflex test up to
Auditory cortex
What are the 2 classes of OAE’s?
Spontaneous and evoked
What type of OAE Occur during or immediately following acoustic stimulation
Evoked Otoacoustic Emissions (EOAEs)
Help differentiate a sensory versus neural hearing loss, hearing screenings for infants/difficult to test patients, can assess outer hair cell function for ototoxicity or noise exposure
EOAE
Two types of EOAE are?
Distortion Product
Transient Product
(Must have normal conductive pathways to acquire EOAE
Type of Evoked Otoacoustic Emissions (EOAE)
Produced by brief acoustic stimuli such as clicks or tone pips
(Responses should be present in nearly all individuals with normal outer, middle and inner ears
Responses should be present for cochlear hearing losses up to 40 dB)
Transient Evoked
An absent TEOAE indicates what
A hearing loss is present not what kind
Type of evoked Otoacoustic Emissions (EOAEs)
When 2 “primary tones” that vary in frequency by several hundred Hz (F1 and F2) are presented to the ear, the normal cochlea responds by producing energy at additional frequencies
(Varying the frequencies stimulates different areas of the cochlea
Responses often compare favorably with voluntary audiometric results, as long as a loss does not exceed 40 to 50 dB)
Distortion Product
Difference btw DPOAE and TEOAE are
Different probe tips
OAE can rule out what
A hearing loss no worse than a mild hearing loss
OAE present with SNHL means?
then outer-hair-cell function is intact and location of the disorder is thought to be past the cochlea (retrocochlear)
present OAE indicate?
Intact cochlea and clear conductive pathway
when a sound is heard, causing a change in ongoing electrical activity of the brain by recording the responses from the scalp using surface electrodes.
Auditory Evoked Potentials (AEPs)
the early AEPs that occur in the first 10 to 15 milliseconds after the signal introduction
Believed to originate from the VIIIth Cranial Nerve (auditory nerve) and brain stem
ABR
an AEP occurring from 15 to 60 milliseconds in latency
Originates in the cortex
Auditory Middle Latency Response (AMLR)
an instrument designed to pick up and amplify electrical activity, which originates in the brain, by electrodes placed on the scalp
Waveforms may be observed that aid in the diagnosis of auditory pathologies
Electroencephalograph (EEG)
Electroencephalograph (EEG) measure electrical responses from ____ ?
Cochlea
How many ABR waveforms?
7
What wave has largest amplitude?
Wave 5
ABR used to screen the ____ _____ _____
Central auditory Pathway
The _____is better in differentiation of the types of auditory dysfunction
ABR
The ____ is better at estimation of hearing for moderate to profound sensory/neural hearing loss
ASSR
The purpose of EHDI programs
is to identify children with hearing loss before the age of 3 months
APGAR
Appearance Pulse Grimace Activity Respiration
APGAR assign values __-___ and performed at ___, ___ and ____
1-10
1, 5 and 10 minutes after birth
Babies with a low APGAR should be suspected to have a
SNHL
AABR is used to (diagnose or Screen)
Screen
BOA is used on kids ____ months of age
6-8
The child is placed in the sound suite and 2 calibrated speakers are used for testing
(BOA)(pure tone)
Sound Field Audiometry
The use of sound field audiometry is still employed, but now with visual reinforcement to obtain responses
Visual Reinforcement Audiometry (VRA)
Performed before pure tone audiometry in behavioral assessment
May use spondaic words, point to picture tasks or pointing to body parts
Before using specific words, ask the parent if the child has the vocabulary to comprehend the words being used for the task
Demonstrate the behavior and then reward a correct response with reinforcement
Speech Audiometry
What test provides frequency-specific hearing loss information even when pure-tones cannot be obtained
/a/, /u/, /i/, /s/, /∫/, and /m/ are representative of all the speech sounds of English
Ling 6 Sound Test
Audibility of /m/, /a/, /u/, /i/ indicates useable hearing through ____ Hz
Audibility of /∫/ = hearing through ____ Hz
Audibility of /s/ = hearing through _____ Hz
1000
2000
4000
Play Audiometry
Conditioning may depend on the following:
Motivation
Contiguity (getting the stimulus and response together)
Generalization (across frequency/intensity)
Discrimination (ability to block out noise)
Reinforcement (letting the child know they are responding correctly)
