Final Flashcards

1
Q

Tragus

A

Goats beard. Small triangular protrusion which points slightly backwards and forms the anterior portion of the auricle

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2
Q

External auditory canal

A

Same at external auditory meatus

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3
Q

Cerumen

A

Earwax. From sebum secretions from sebaceous glands

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4
Q

Condyle

A

Protrusion of the mandible, comes to rest where inner and outer ear canals meet when jaw is at rest (osseocartilagenous junction)

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5
Q

Temporomandibular joint syndrome

A

Whe mandible overrides normal position and condyle presses into (osseocartilagenous) junction causing pain

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6
Q

Otalgia

A

Ear pain

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7
Q

Auricle

A

Same is Pinna

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8
Q

Myofacial pain dysfunction syndrome (mpd)

A

Sometimes used to describe pain in the temporomandibular joint, along with headaches;grating sounds; dizziness; and back, neck, and shoulder pain. Can be related to emotional stress

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9
Q

Crepitus

A

Hearing grating sounds

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10
Q

Tympanic membrane

A

Ear drum, At end of ear canal, protected from trauma and kept at constant temp and humidity. Ear canal filters frequencies and is a resonator for frequencies 2000-7000hz

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11
Q

Three layers of tympanic membrane from eac

A

1) skin
2) tough,fibrous, connective tissue-ability to vibrate with sound waves
3) mucous membrane that lines middle ear space

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12
Q

Malleus

A

Largest bone of the middle ear. Imbedded in fibrous portion of Tympanic membrane

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13
Q

Umbo

A

The point of greatest retraction of the ear drum caused by the malleus pulling it inward

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14
Q

Annulus

A

Ring of tissue that holds the tympanic membrane in position

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15
Q

Pars tensa

A

The greatest surface area of the tympanic membrane. It is taut and thus the name

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16
Q

Pars flaccid a

A

Aka shrapnell’s membrane. At the top of the tympanic membrane above the malleus where the tissues are looser because they contain only the epidermal and mucous membrane layers

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17
Q

Pharyngeal arches

A

Bulges that begin to appear on either side of the human embryo 28 days after conception which will become the head and neck (first three: mandibular, hyoid, and glossopharyngeal arches)

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18
Q

Three layers of pharyngeal arches

A

Ectoderm-outer layer
Entoderm - inner surface
Mesoderm- inner core

Each arch has artery, muscle, and cartilage from mesoderm and nerve from ectoderm

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19
Q

Development of ear from pharyngeal arches

A

First two arches-auricle
First arch-Tragus
Helix and antitragus- second arch

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20
Q

Mesenchyme

A

A network of embryonic tissue that later forms the connective tissues of the body and blood vessels and lymphatic vessels. This forms middle layer of tympanum

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21
Q

Microtia

A

Very small ears (Pinna)

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22
Q

Anotia

A

Entirely absent Pinna

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23
Q

Atresia

A

When ear canal never forms (otic atresia)

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24
Q

CHARGE syndrome

A
Genetic disorder
C- coloboma
H- heart disorders
A- atresia choanae
R- retarded growth and development
G- genitourinary abnormalities
E- ear abnormalities
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25
Q

External otitis

A

Infection of skin of the external auditory canal (swimmers ear)

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26
Q

Otomycosis

A

Fungal ear infections, rare

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27
Q

Furunculosis

A

Infection of hair follicles, may begin with infection of a single hair in the lateral third of the external auditory canal and spread to involve the entire area

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28
Q

Myringitis

A

Inflammations of the tympanic membrane

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29
Q

Osteitis and osteomyelitis

A

Caused by routine infections of skin of EAC, can be massive bone destruction of ears. These are when it has spread to the tymporal bone though and are often fatal

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30
Q

Exostoses

A

Outward projections for the surfaces of bone. Can be confused with osteomas which are bony tumors. Neither of which cause hearing loss typically

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31
Q

Pressure-equalizing tubes (PE tubes)

A

Aka tympanostomy tube, inserted through an incision in the tympanic membrane to keep the middle ear patent

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32
Q

Cerumenolytic

A

A chemical substance known to soften earwax safely

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33
Q

Myringoplasty

A

Surgical repair of a perforated tympanic membrane

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34
Q

Tympanosclerosis

A

Calcium plaques which add mass to the tympanic membrane and interfere with its vibration but sometimes cause no noticeable hearing loss

Don’t respond well to surgical treatment

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35
Q

Jugular bulb location

A

Below the floor of the middle ear

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36
Q

Carotid artery location

A

Behind the anterior wall of the middle ear

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37
Q

Mastoid process location

A

Behind the posterior wall of the middle ear

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38
Q

Epitympanic recess

A

The space in the middle ear above the tympanic membrane

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39
Q

Nasopharynx

A

The area where the back of the throat and the nose communicate. Middle ear is connected to this by Eustachian tube

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40
Q

Two other names for Eustachian tube

A

Auditory tube and pharyngotympanic tube

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41
Q

Middle ear cleft

A

Formed by the Eustachian tube and the middle ear

Lined by musous membrane

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42
Q

Mucous membrane

A

Same lining found in the nose and paranasal sinuses. Lines the middle ear cleft including the surface of the tympanic membrane

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43
Q

Cilia

A

Small hairlike projections that provide a motion similar to that of a wheat field in the wind. Cilia in middle ear create a wiping action that helps to cleanse the middle ear by moving particles down and out of the Eustachian tube

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44
Q

Pneumatic mastoid

A

Formed by the cells of the skull bones which surround the ear. These cells are not solid but honeycombed with air cells. Theses cells are lined with non ciliated mucous membrane. Part of temporal bone

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45
Q

Aditus ad Antrum

A

The middle ear opens up, back, and outward in an this area to communicate with the mastoid

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46
Q

Promontory

A

Protrusion of the bony portion of the inner ear which extends into the middle-ear space. Caused by the basal turn of the cochlea.

Separates two connections between the middle and inner ear

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47
Q

Oval window

A

Above the promontory, filled by a membrane that supports the base of the stapes, the tiniest bone in the human body

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48
Q

Round window

A

Below the promontory, covered by a very thin, but tough and elastic, membrane

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49
Q

Ossicles

A

The three small bones of the middle ear

Malleus, incus, and stapes

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50
Q

Manubrium of the malleus

A

Is embedded in the middle (fibrous) layer of the tympanic membrane. Extends from the upper portion of the t.m. to its approximate center (the Umbo)

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51
Q

Parts of the incus

A

Head of malleus is connected to body of incus. Incus has long process (crus) which turns abruptly to a very short crus, the lenticular process. The end of the lenticular process sits squarely on the head of the stapes

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52
Q

Parts of the stapes

A

Head, neck, and two crura. Posterior crus is longer and thinner than anterior to aid in its rocking motion. The base or footplate of the stapes occupies the space in the oval window

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53
Q

Fallopian canal

A

A bony channel covered with mucous membrane. Passes through the middle ear as a protrusion on its medial wall. Contains a portion of the facial nerve (CN VII)

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54
Q

Facial nerve

A

Runs beside the auditory nerve (CN VIII) as the two travel to the brainstem

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55
Q

Chorda tympani

A

A branch of the facial nerve that passes through the middle eat space. This nerve carries info about the sensation of taste from the anterior 2/3 of the tongue. Can act as an obstruction during middle ear surgery

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56
Q

Stapedius muscle

A

Originates in the posterior (mastoid) wall of the middle ear. When contracted the stapes moves to the side and tenses the membrane in the oval window, reducing the amplitude of vibration. Innervates by facial nerve.
Length 7 mm, cross section 5 mm squared
Responds to loud sounds

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57
Q

Tensor tympani muscle

A

Encased in a small bony cavity. Inserts in manubrium of malleus, contracts to move the malleus so that the tympanic membrane becomes tense. Innervates by the trigeminal nerve (CN V)
Length 25 mm, cross section 5 mm squared
Air to eye =contraction

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58
Q

Politzerization

A

One way to pressurize middle ear when tympanum is retracted and no fluid is present.
One nostril is closed while an olive tip, connected to a tube or nebulizer, is held tightly in the other nostril. The patient elevated the soft palate by saying “k,k,k” and then swallows

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59
Q

Valsalva

A

Maneuver where patient auto inflates the Eustachian tube by increasing pressure via forced expiration with the nostrils held shut

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60
Q

Toynbee maneuver

A

Accomplishes Eustachian tube opening when the patient closes the jaw, holds the nose, and swallows

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61
Q

Otitis media

A

Infection of the middle ear space. Most common disorders of the middle ear causing conductive hearing loss. 70% us. Holden before age 2

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62
Q

Barotrauma

A

Sudden changes in air pressure as when flying or diving

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63
Q

Purulent

A

Pus-producing. These organisms are when makes it possible for full-blown infections of the middle ear occurring so fast after first symptoms

64
Q

Suppurative otitis media

A

The mucosa becomes filled with excessive amounts of blood, the superficial cells break down, and pus accumulates

65
Q

Necrosis

A

Death of mucosa, submucosal and tympanic membrane caused by compression of small veins and capillaries by pressure of pus

66
Q

Mastoiditis

A

When pus can’t find its way out of the middles ear and invades the mastoid. Causes a breakdown of the walls separating the air cells. May result in meningitis or death

67
Q

Chronic otitis media

A

Condition is long standing

68
Q

Acute otitis media

A

Develops rapidly. Include swelling, redness, and bleeding

69
Q

Hemotympanum

A

Bleeding in the middle ear from any cause

70
Q

Meniscus

A

When the middle ear becomes a vacuum the fluids secreted by the lining of the middle ear can be sucked into the middle ear space. As the fluid levels rise, a fluid line can be seen through the tympanic membrane this is the meniscus

71
Q

Myringotomy or myringostomy

A

Incision into the tympanic membrane, used to relieve the fluid pressure and suction out the remaining fluid

72
Q

Physical volume test (PVT)

A

Test the patency of pressure-equalizing tubes. When this value is bigger than 5 cm cubed that means you are measuring ear canal with the middle ear so a perforation of the ear drum exists

73
Q

Mucous otitis media

A

When mucoid secretions are forced through the Eustachian tube (blowing nose) and accumulate in middle ear. They thicken and darken

74
Q

Tympanosclerosis

A

Calcium deposits that form on tympanic membrane. Removal may be pointless because it tends to recur

75
Q

Cholesteatoma

A

A pseudotumor resulting when skin is introduced to the middle ear cleft. Form in a sac with onion like concentric rings if keratin and such. Highly erosive

76
Q

Mastoidectomy

A

Surgical procedure sometimes the only treatment for mastoiditis.

77
Q

Tympamoplasty

A

Surgical reconstruction if the middle ear auditory apparatus.

78
Q

Subluxations

A

Partial dislocations of the ossicular chain, cause high frequency conductive hearing loss

79
Q

Autophony

A

The “head in a barrel” feeling, happens in some patients whose Eustachian tube is chronically open (patent). Own voice is perceived as loud

80
Q

Serous effusion

A

Blocked Eustachian tube

81
Q

Patulous Eustachian tube

A

Chronically open

82
Q

Otosclerosis

A

Common cause of hearing loss in adults, originates in bony labyrinth of inner ear, causes conductive hearing loss, appears as new growth of spongy bone usually over the footplate of the stapes. Some call this otospongiosis

83
Q

Schwartze sign

A

When the promontory becomes very vascular resulting in a rosy glow that can be seen through the tympanic membrane. Sign of otosclerosis as is tinnitus

84
Q

Paracusis willisii

A

Symptom of otosclerosis. Speech is earlier to understand in the presence of background noise. Opposite of normal hard of hearing.

85
Q

Lombard voice reflex

A

Increase of vocal loudness in noisy environments

86
Q

Carhart notch

A

Bone-conduction readings are poorer than true sensory/neural sensitivity by 5db at 500hz, 10 at 1000, 15 at 2000, and 5 at 4000

87
Q

Fenestration

A

Surgery to free immobilized stapes, complete closure of air bone gap is impossible with this procedure and usually 25db conductive hearing loss remained.

88
Q

Stapes mobilization

A

Much better than Fenestration. Ossicular chain can remain intact

89
Q

Stapedectomy

A

Removal of stapes. Procedure of choice for otosclerosis today

90
Q

Fistula

A

Leaks of inner ear fluids into the middle ear

91
Q

Labyrinth

A

Term use for inner ear because it is similar to an intricately winding cave

92
Q

Vestibule

A

The immediate entryway to the inner ear

93
Q

Perilymph

A

Fluid which fills the vestibule

94
Q

Cerebellum

A

Controls interactions between several body systems needed to maintain balance

Visual, proprioceptive, and vestibular

95
Q

Somatosensory stimuli

A

Stimuli from tissues such as muscles and tendons which allow perception of body part position, important in proprioception

96
Q

Utricle and saccule

A

Membranous sacs within the vestibule, surrounded by perilymph and contain endolymph, saccule is slightly larger, utricle end organ for balance is at bottom and saccule eob is on the side.

97
Q

Semicircular canals

A

Arise from utricle, 3- superior, lateral, and posterior, are membranous and contain endolymph. Surrounded in larger bony cavern by perilymph, arranged perpendicularly to one another to cover all dimensions in space

98
Q

Ampullae

A

Enlarged areas where each of the semicircular canals return to the utricle. Each contain an end organ (christa) which provides a sense of equilibrium

99
Q

Linear acceleration is detected by what

A

Utriculosaccular mechanism

100
Q

Angular acceleration is measured by what

A

Semicircular canals

101
Q

Nystagmus

A

Rapid rocking movements of the eyes. Always comes about with vertigo, but can occur on its own

102
Q

Caloric test

A

Stimulation of the labyrinth is accomplished by washing cold or warm water or air against the tympanic membrane, with temps actually varying only slightly above or below normal body temp. On normal person cold causes nystagmus with rapid eye movement away from irrigated ear and slow movement back. Warm is opposite
(COWS- cold opposite, warm same)

103
Q

Electronystagmograph

A

Measures the changes in potential produced by nystagmus and increases the objectivity of vestibular testing. Measures rate and direction of nystagmus

104
Q

Rotary chair testing

A

Patient is placed in a chair capable of mechanically controlled rotation. Following rotation the eyes are examined for nystagmus. Computers have allowed for the reintroduction of this

105
Q

Computerized dynamic posturography (CDP)

A

Assesses the ability to coordinate movement by measuring vestibulospinal reflexes. Gives a quantitative assessment of upright balance through stimulation of conditions encountered in daily life. Ability to maintain balance

106
Q

Vestibular-evoked myogenic potential (VEMP)

A

A sound evoked muscle reflex believed to be generated from acoustical stimulation of the saccule, one of the vestibular end organs that sense linear acceleration. The purpose of this reflex may be to stabilize the head in response to unpredictable movements. Tells about the persons vestibular system. Can be measured through many muscles such as trapezius and sternocleidomastoid whe someone turns head to noise

107
Q

Cochlea

A

Snail. 1 cm wide and 5 mm base to apex

108
Q

Scala vestibuli

A

Beyond the oval window within the cochlea, contains perilymph

109
Q

Scala tympani

A

At bottom of cochlea, begins at round window, contains perilymph

110
Q

Helicotrema

A

A small passageway at the apex of the cochlea. Has perilymph. For frequencies above 60 hz there is little movement of fluid through helicotrema because energy is transmitted through the fluids of the cochlea by movement of the membranes

111
Q

Scala media (aka cochlear duct)

A

Lies between the scala vestibuli and and scala tympani. Organ of corti lies along the full length and resides on the basilar membrane. It is full of endolymph which is continuous with that in the saccule, utricle, and semicircular canals through the ductus reuniens

112
Q

Reissners membrane

A

Separates the scale media from the scale vestibuli

113
Q

Basilar membrane

A

Separates the scala media from he scala tympani

114
Q

Spiral ligament

A

Supports scala media and also the stria vascularis, extends from a shelf made from the bony labyrinth

115
Q

Stria vascularis

A

Produces the endolymph and supplies oxygen and other nutrients to the cochlea

116
Q

Modiolus

A

The central core of the cochlea around which it is wound, this is hoe blood and nerve supply enter the organ of corti

117
Q

Corti’s arch

A

Is what separates the inner and outer hair cells on the basilar membrane

118
Q

Stereocilia

A

Hair-like projections located on the top of each hair cell

119
Q

Tectorial membrane

A

A gelatinous flap that is fixed on its inner edge and possibly on its outer edge as well. Stereocilia tips on the outer hair cells are embedded here.when he basilar membrane moves up and down in response to fluid displacement from movement of stapes, the hair cells are sheared(twisted) in a complex manner

120
Q

Cochlear microphonic (CM)

A

The action of the cochlea as a transducer to convert sound waves into an energy form useful to the auditory nerve. Result of changes in polarization by the bending back and forth of hair cell cilia

121
Q

Action potential

A

A change on the electrical potential which occurs on the surface of each neuron at the moment that auditory neurons are stimulated by the hair cells that rest on them

122
Q

Afferent

Efferent

A

Afferent- body to brain
Efferent- brain to body

Cochlea has efferent too to monitor the cochlea

123
Q

Resonance theory of hearing (helmholtz)

A

The structures within he cochlea consist of many tiny resonators, each tuned to a specific frequency

Disproved, but first to place higher frequency at base and lower at apex

124
Q

Place theory of hearing

A

Early belief that every tone that could be heard was assigned to its own specific place in the cochlea. This idea breaks down when it attempts to explain why pitch discrimination if so poor close to auditory threshold

125
Q

Two of the frequency based theories which attempted to place the analysis of pitch in the retrocochlear area

A

Volley theory of hearing, resonance-volley theory

126
Q

Traveling wave theory

A

Put forth the explanation recognized today as the basis for cochlear pitch perception. Developed in the middle of the 20th century by békésy

127
Q

Three hypotheses for hair cell transduction

A

Mechanical- the pressure that moves the hair cells stimulates the nerve endings directly

Chemical- when the hair cells are deformed, a neurotransmitter substance is released the stimulated nerve endings

Electrical- cochlear potential stimulates nerve endings

128
Q

Otoscoustic emissions (OAE)

A

Microphones in the eac can pick up weak acoustic signals generated by the motility of the outer hair cells

129
Q

Spontaneous otoscoustic Emissions

A

Can be detected without external stimulation, occur in 40-60% of normal ears

130
Q

Transient evoked otoacoustic emission

A

A signal that is known to emanate from the cochlea between 5-20 ms after the presentation of a stimulus introduced to the external ear

131
Q

Psychophysical tuning curve

A

Tuning becomes sharper with frequency increases he,ps with speech recognition

132
Q

Auditory placode

A

Formed in embryonic development. Has a saccular division which the cochlea comes from and a utricular division from which the semicircular canals are formed

133
Q

Otocyst

A

The auditory vesicle or sac that is formed by the utricle, saccule, and endolymphatic duct. Begins formation at end of first month of gestation

134
Q

Dyacusis

A

Speech recognition problem common with sensory/neuro losses where it’s not so much they can’t hear but that they have difficulty understanding speech

135
Q

Hypacusis

A

A loss of sensitivity to sound

136
Q

Diplacusis binauralis

A

Happens in patients with unilateral losses that a pure tone of a given frequency will have a different pitch in each ear

137
Q

Diplacusis monauralis

A

Lack if perception of tonal quality of a pure tone. Sounds like frying bacon instead of music

138
Q

Hereditodegenerative hearing loss

A

Inherited the tendency for abnormalities to occur after birth

139
Q

Complications of rh baby

A

Hearing loss and possibly cerebral palsy amongst others

140
Q

Athetosis

A

Patient exhibits an uncontrolled writhing or squirming motion, has long been associated with hearing loss

141
Q

Anoxia

A

Oxygen deprivation. May result in damage to important cells of the cochlea

142
Q

Cytomegalovirus

A

A major cause if prenatal sensory hearing loss, asymptomatic illness that is a member of the helper group

143
Q

Perinatal causes

A

Occur during the birth process itself

144
Q

Bacterial meningitis

A

Inflammation of the menengies that may cause total deafness because that labyrinth fills with pus and is replaced by bone

145
Q

Labyrinthitis

A

Infections if labyrinth that may affect auditory and vestibular systems

146
Q

Temporary vs permanent threshold shifts

A

Temporary are when hearing thresholds improve after an initial impairment following noise

Permanent are irreversible losses

147
Q

Acoustic trauma notch

A

Hearing is poorest in range 3000-6000 hz and then recovers at 8000hz. From noise induced hearing loss. Suggests damage to the portion of the basal turn of the cochlea related to that frequency range

148
Q

Damage-risk criteria

A

Set up by OSHA and use sound level meters to measure the intensity if sound in noisy areas

149
Q

Sudden idiopathic sensory/neural hearing loss

A

Hearing loss, usually unilateral of at least 30 degrees that occurs in A few days (normally under 3)

150
Q

Vasospasm

A

Veins? Immediate hospitalization, cause for sudden hearing loss

151
Q

Ménière’s disease

A

Also cause for sudden hearing loss. Problems with endolymph

152
Q

Vestibular neuritis

A

Inflammation of the auditory nerve

153
Q

Semicircular canal dehiscence syndrome

A

Mimics symptoms of other otologic pathologies. Vertigo, patulous Eustachian tube

154
Q

Autoimmune inner-ear disease

A

Specifically attacks the inner ear . Sensory loss and tinnitus, aural fullness, epvertigo. Potentially reversible

155
Q

Presbycus

A

Hearing loss due to aging

156
Q

Phonemic regression

A

Characteristic of presbycusis, significant difficulty in speech recognition, understand speech better when people speak slowly than when they speak loudly