hearing disorders Flashcards
nerves that carry impulses from the periphery toward the brain
afferent
A condition associated with aging that accounts for some 60-70% of senile dementias and is associated with a variety of symptoms, most notably memory loss
Alzheimer’s disease
The widened end of each of the three semicircular canals where they return to the utricle. Each ampulla contains an end organ for the sense of equilibrium
ampulla
absence of the pinna
anotia
congenital closure of a normally open body orifice, such as the external auditory canal
atresia
the cartilaginous appendage of the external ear
auricle
paralysis of the peripheral branch of the facial nerve (VII)
bells palsy
an artifact in the bone-conduction audiograms patients with otosclerosis making it appear that their sensorineural sensitivity is slightly poorer than it truly is. It is most evident at 2000 Hz and often disappears following corrective surgery
carhart notch
that area at the base of brain at the junction of the cerebellum, medulla, and pons
cerebellopontine angle
a tumor, usually occurring in the middle ear and mastoid, that combines fats and epithelium from outside the middle ear space
cholesteatoma
loss of sound sensitivity produced by abnormalities of the outer ear and/or middle ear
conductive hearing loss
a series of arches made up of the rods of Corti in the cochlear duct
Corti’s arch
the impairment of cognitive and intellectual functions. It is usually progressive and age-related and characterized by disorientation, impaired memory, judgement, and intellect
Dementia
the smaller of two cochlear nuclei on each side of the brain; it receives fibers from the cochlea on the the ipsilateral side
dorsal cochlear nucleus
sometimes called “trisomy 21 syndrome,” _______ is characterized by a small, slightly flattened skull; low-set ears; abnormal digits; and other unusual facial and body characteristics
down syndrome
nerves that carry impulses from the brain toward the periphery
efferent
the fluid contained within the membranous labyrinth of the inner ear in both of the the auditory and vestibular portions
endolymph
infection of the outer ear. Also called otitis externa
External Otitis
an inability to perform socially useful functions due to hearing loss. A given disability may, or may not, present a handicap
hearing disability
the ways in which a hearing loss has a frustrating effect on individual roles or goals
hearing handicap
abnormality of structure or function that is physiological, psychological, or anatomical
hearing impairment
inflammation of the labyrinth, resulting in hearing loss and vertigo
labyrinthitis
process of the malleus embedded in the fibrous layer of the tympanic membrane
manubrium
an operation to remove infected cells of the mastoid. Mastoidectomies are termed as simple, radical, and modified radical, depending on the extent of surgery
mastoidectomy
infection of the mastoid
mastoiditis
the highest level of noise that can be presented to one ear through an earphone before the noise crosses the skull and shifts the threshold of the opposite ear
maximum masking
a disease of the inner ear whose symptoms include tinnitus, vertigo, and hearing loss (usually fluctuating and unilateral)
Meniere’s disease
procedures for testing the hearing function that do not require behavioral responses
objective audiometry
procedures for testing the hearing function that do not require behavioral responses
objective audiometry
the end organ of hearing found within the Scala media of the cochlea
organ of Corti
inflammation of bone caused by a purulent infection
osteomyelitis
pain in the ear
otalgia
any infection of the middle ear
otitis media
sounds emanating from the cochlea that can be detected in the external auditory canal with probe-tube microphones
otoacoustic emissions (OAEs)
The outer ear is responsible for
gathering sounds from the acoustical environment and funneling them into the auditory mechanism.
The ____develops from the first two pharyngeal arches
auricle
About 28 days after conception of the human embryo, bulges begin to appear on either side of the tissue that will develop into the head and neck.
pharyngeal arches
The _____forms from the first arch, and the __________form from the second arch.
tragus; helix and antitragus
The most noticeable portion of the outer-ear mechanism is the _____
auricle or pinna
The auricle is made entirely of______
cartilage
The bottom-most portion of the auricle is the _______
lobule, or ear lobe
This portion of the external ear aids in the human ability to localize the sources of sounds that come from in front of, behind, below, and above the head
middle ear
a tube, formed in the side of the head, beginning at the concha and extending inward at a slight upward angle for approximately 1 inch (2.5 cm) in adults.
The external auditory canal
The major product of these secretions is earwax, or _____
cerumen
The combination of ________ helps to keep foreign objects, such as insects, from passing into the inner two-thirds of the canal.
hairs and cerumen
The inner area of the EAC passes through the ____
tympanic portion of the temporal bone.
a protrusion of the mandible (jawbone),
comes to rest just below the osseocartilaginous junction when the jaw is closed
condyle
If the
mandible overrides its normal position, as in the case of missing or worn molar teeth or
a misaligned jaw, the condyle presses into the junction, causing pain. The term t________ has been coined for this neuralgia. The syndrome produces a referred pain, perceived in the ear, which constitutes a significant amount of otalgia (ear pain) in adults
temporo-mandibular joint (TMJ) syndrome
The EAC canal angles downward in children, rather than upward, and is at a more acute angle
true
The _______ is situated
at the end of the canal, where it is protected from trauma and where it can be kept at
constant temperature and humidity levels
tympanic membrane
The tympanic membrane is extremely thin, averaging about 0.07 mm and has been described as a small conical-shaped loudspeaker. I
true
largest bone of the middle ear
malleus
This reflection, known as _____ is sometimes referred to as a
hallmark of a healthy eardrum.
“the cone of light”
When conditions occur that interfere with or block the normal sound vibrations transmitted through the outer ear,______ hearing loss results
conductive
Congenital malformations of the auricle have also been associated with other disorders, such as____
Down syndrome
When the auricle protrudes markedly from the head, or when it is pressed tightly against the skull, a simple surgical procedure called ________may be performed.
otoplasty or pinnaplasty
______ the most common form of skin cancer,
can appear on the _____of the ear following too much exposure to the ultraviolet light of the sun
Basal cell carcinoma; helix
the cartilaginous portion, the bony portion, or the entirety of the external auditory canal has never formed at all. this lack of canalization is called
atresia
_______, involves the facial bones, especially the cheek and lower jaw; the auricle; and congenital atresia of the EAC
Treacher Collins syndrome
A number of abnormalities of the middle ear and temporal
bone are seen with Treacher Collins syndrome, making surgical correction quite difficult.
true
The ______ is often first noticed in children because of the obvious anomalies of the pinna and external auditory canal.
CHARGE syndrome
CHARGE syndrome stands for
This acronym stands for coloboma (a keyhole slot
in the retina, iris, or optic nerve), heart disorders, atresia choanae (blockage of the respiratory passages), retarded growth and development, genitourinary abnormalities, and ear
anomalies.
CHARGE syndrome occurs in
occurs in one out of every 10,000 to 15,000
births
Trauma to the outer ear may result in an unsightly blood
blister, called a
hematoma
a marked ______ or narrowing of the
canal
stenosis
Stenotic EACs do not produce hearing loss, as does atresia, although earwax or other debris can easily clog the very narrow lumen and thus cause a conductive problem
true
when an atresia is seen, it must be suspected that the tympanic membrane and middle ear may likewise be involved.
true
If a foreign object is pushed past the osseocartilaginous junction of the external ear canal, swelling at the isthmus formed by this junction may result
true
An infection that occurs in the skin of the external auditory canal is called
external otitis
The condition is often referred to as swimmer’s ear because it frequently develops in people who have had water trapped in their ears.
external otitis
another name for external otitis
swimmers ear
a fungal external-ear infection, which is rare and
may be caused by the overuse of eardrops.
otomycosis
an almost ideal environment for the development of bacterial growth because the skin is thin and the area is dark, warm, and often moist
external auditory canal
infection of hair follicles
Furunculosis
Inflammations of the tympanic membrane are called
myringitis.
This condition is particularly threatening to diabetic and elderly patients, and may result in massive bone destruction in the external, middle, and inner ears.
necrotizing or malignant external otitis
Bony tumors, called ______, do not present hearing problems unless their size is such that the lumen of the canal is occluded and conductive hearing loss results; however, they may result in serious infection of the EAC.
osteomas
the outward projections for the surfaces of bone, are sometimes seen in the ears of people who have done a great deal of swimming in cold water
exostoses
When the canal is small, cerumen may become blocked but will not cause a hearing loss.
false
Overzealous cleaning of the external ears, however, may result in cerumen being pushed from the cartilaginous canal into the bony canal, where natural cleansing cannot take place.
true
To facilitate cerumen removal, an approved _____chemical substance known to soften earwax safely, may be used.
cerumenolytic
An ancient technique purported to be effective for cerumen removal, which may go back nearly 5000 years, is called ear candling
true
A frequent cause of perforation is direct trauma from a pointed object such as a cotton swab or hairpin.
true
Surgical repair of a perforated tympanic membrane is called
myringoplasty
is a condition of calcification caused by either inflammation or infection,
tympanosclerosis
The ___ear carries vibrations from the outer ear to the inner ear by transferring the sound energy from the air in
the outer ear to the fluids of the inner ear.
middle
Below the floor of the middle ear is the _____, and behind the anterior wall is the ____
jugular bulb; carotid artery
The space in the middle ear above the tympanic membrane is called the
epitympanic recess
the middle ear is separated from the external auditory
canal by the
tympanic membrane
The middle ear is connected to the nasopharynx, the
area where the back of the throat and the nose communicate via the eustachian tube
true
the area where the back of the throat and the nose communicate
nasopharynx
eustachian tube is also called
auditory tube or pharyngotympanic tube
The entire middle-ear cleft is lined with ____
mucous membrane
like the outer ear the middle ear and eustachian tube form from the first two arches of the pharyngeal arch system
true
The oval window is formed by about the 47th gestational day.
true
Above the promontory is the _____window and below it the ____window, both of whose names are derived from their shapes
oval; round
The _____ window is covered by a very
thin, but tough and elastic, membrane.
round
The ___window is filled by a membrane that
supports the base of the stapes, the tiniest bone in the human body
oval
the middle ear contains a set of three very
small bones called .
ossicles
the ossicles are
malleus incus and stapes
Process of the malleus embedded in the fibrous
layer of the tympanic membrane.
manubrium
The ____ has a long process, or crus, which turns abruptly to a very short crus, the lenticular process.
incus
The average adult tympanic membrane is ______to ______ mm2
, but the effective vibrating area is only about 55 mm2
85 to 90
contains a portion of the facial (VIIth cranial) nerve, passes through the middle ear as a protrusion on its medial wall.
fallopian canal
The ______nerve is a branch of the facial nerve that passes through the middle-ear space. This nerve carries information about the sensation of taste from the anterior two-thirds of one side of the tongue.
chorda tympani nerve
The _____muscle (length 7 mm, cross section 5 mm2) originates in the posterior (mastoid) wall of the middle ear.
stapedius
Small muscle that is innervated by the trigeminal nerve and inserted into the malleus in the middle ear. It is one of two small muscles in the middle ear that contract in response to intense acoustic stimulation
tensor tympani muscle
Theoretically, bone-conduction hearing should be unchanged
from normal unless the inner ear becomes involved;
true
Many, although not all, middle-ear disorders arise from poor function of the
eustachian tube
Any condition that interferes with the eustachian tube’s function of equating air pressure between the middle ear and outer ear may result in a drop in pressure as the air trapped within the middle ear becomes absorbed by the tissues that line it without normal replenishment through the eustachian tube
true
Inflation of the middle ear via the eustachian
tube by forcing air through the nose
politzerization
The patient may auto-inflate the eustachian tube by increased pressure on forced
expiration with the nostrils held shut, a maneuver called
valsalva
____accomplishes eustachian tube opening when the patient closes the jaw, holds the nose, and swallows
toynbee mneuver
One of the most common disorders of the middle ear causing conductive hearing loss is infection of the middle-ear space, or
otitis media
It is seen in nearly 70 percent of children born in the United States before they are 2 years old, with more than half of these
children experiencing further episodes.
otitis media
Otitis media is more common in children than adults because
their eustachian tubes are horizontal and shorter, making the entrance of bacteria to the
middle ear easier
true
Otitis media is more common in children than adults because
their eustachian tubes are horizontal and shorter, making the entrance of bacteria to the
middle ear easier
true
sudden changes in air pressure, as when flying or diving
barotrauma
otitis media is most common in the ___months
winter
otitis media disease is more common in males than in females
true
the most commonly identified risk factor for otitis media is socioeconomic status
true
A major contributing cause of otitis media, especially in
children, is
exposure to tobacco smoke
In suppurative otitis media, the mucosa becomes filled with excessive amounts of blood, the superficial cells break down, and pus accumulates.
true
Bleeding in the middle ear from any cause is called
hemotympanum
___presents as a rapid onset of inflammation of the middle ear.
Acute otitis media
Incision of the tympanic membrane to relieve the fluid pressure and suction out the remaining fluid
myringotomy
Short tube or grommet placed through a myringotomy incision in a tympanic membrane to allow for middle-ear ventilation.
pressure equalizing tube
form as a sac, with onionlike concentric rings made up of keratin (a very insoluble protein) mixed with squamous
(scaly) epithelium and with fats such as cholesterol.
Cholesteatomas
Any discharge from the external auditory canal or
from the middle ear.
otorrhea
surgery operation to remove infected cells of the
mastoid.
mastoidectomy
Surgical reconstruction of the middle-ear auditory apparatus is called
tympanoplasty
Surgical reconstruction of the middle-ear auditory apparatus is called
myringoplasty
In some cases of chronic otitis media, the bony covering of the fallopian canal becomes eroded, exposing the facial nerve to the disease process. Damage to the facial nerve may
result in a flaccid paralysis of one side of the face.
bells palsy
A condition produced by some middle-ear or
eustachian tube abnormalities, in which individuals’ voices
seem louder than normal to themselves.
autophony
This condition is observed more often in females than in males and has been associated with pregnancy. Some patients have claimed that their distorted autophony causes an echoing effect that interferes with their speech production. Other annoying effects of patulous eustachian tube include the sound of breathing and noises during chewing as the sound travels up the tube.
patulous eustachian tube
The laying down of new bone in the middle ear, usually around the footplate of the stapes. When it interferes with stapedial vibration, it produces a progressive conductive hearing loss.
otosclerosis
a common cause of hearing loss in adults, is hereditary in at least 70 percent of all cases
otosclerosis
Red glow seen through the tympanic membrane and produced by increased vascularity of the promontory in some cases of otosclerosis.
schwartze sign
condition found among patients with conductive hearing loss in which they understand speech better in noisy than in quiet surroundings.
paracusis willisii
One interesting and peculiar symptom of otosclerosis is paracusis willisii. Patients with otosclerosis often exhibit a bluish cast to the whites of their eyes, similar to that found with certain other bone diseases.
true
Over 50 years ago, Carhart (1964) showed that the first symptom of otosclerosis is the
appearance of a low-frequency air-bone gap
true
Artifact in the bone-conduction audiograms
of patients with otosclerosis that makes it appear as though
their sensorineural sensitivity is slightly poorer than it truly
is. It is most evident at 2,000 Hz and often disappears following corrective surgery.
carhart notch
treatment of otosclerosis “removal of the stapes”
stapedectomy
To reduce risks in stapedectomy, many middle-ear surgeons today prefer to use a small fenestra (small hole in the bone between the middle and inner ear) and avoid the trauma to the inner ear caused by complete removal of the stapedial footplate.
true
The cavity of the inner ear containing the organs of
equilibrium and giving access to the cochlea
vestibule
The vestibule is filled with a fluid called
perilymph.
Differentiation of the inner ear begins during the ____
third week of gestation
The cochlear turns begin to develop at about the sixth week and are complete by
ninth or tenth week
known as the cone of light,
appears in the inferior/anterior quadrant of the
tympanic membrane
true
Because of connections in the brain between the vestibular
portion of the auditory nerve and the oculomotor nerve, a rapid rocking movement
of the eyes, called nystagmus, frequently occurs
