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AUDE 5410 Aud-Vestib Disorders > INNER EAR > Flashcards

INNER EAR Flashcards

1
Q

What is homeostasis

A

he ability of an organism or a cell to maintain internal equilibrium by adjusting its physiological processes

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2
Q

what is inner ear homeostasis

A

he process by which chemical equilibrium of inner ear fluids and tissues is maintained”

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3
Q

For proper inner ear function, a tight control of what is necessary

A

ion movement across the cell membranes

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4
Q

what could be disrupted if you do not have inner ear homeostasis

A

hair cell fxn
regulation of extracellular endolymph and perilymph
conduction of nerve impulses

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5
Q

The major ions involved in inner ear homeostasis include

A

Sodium (NA+)
Potassium (K+)

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6
Q

Significant roles also are played by

A

Chloride (Cl-)
Calcium (CA2+)

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7
Q

which ion channels are disrupted in connexins

A

potassiu

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8
Q

Before sound can be perceived it has to be converted to______, a process mediated by the cilia of the inner ear hair cells

A

electrical impulses in the auditory nerve

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9
Q

bring about transduction mechanism and allows nerves to integrate the signal

A

ihc

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10
Q

The sound-induced excitatory deflection of the stereocilia causes a mechanoelectrical transduction (MET) current to depolarize the hair cells and initiate _______ in the auditory nerve or vestibular nerve in response to acceleration/gravity changes

A

action potentials

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11
Q

The endolymph and perilymph are the ________ support system for hair cell function just as the cochlear partition traveling wave and tectorial membrane are the ______ support system for hair cell function

A

metabolic
mechanical

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12
Q

where is EP at its highest

A

it is higher at basilar end than apical end
higher in cochlear than vestibular system

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13
Q

high K+ concentration in the endolymph creates a +80 mV endocohlear potential (EP) that couples with a -80 mV hair cell intracellular potential to create a differential potential of +160 mV

A

80 mV – (-80mV) = 160 mV

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14
Q

Stereocilia are laterally displaced either by

A

Shearing movement of the tectorial membrane (outer hair cells) or
Motion of the endolymphatic fluid (inner hair cells)

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15
Q

what if eno and perino EP had the same ion composition?

A

no EP becuase there is no difference

endolymphatic hydrops - causes excessive endolymph causing the two to mix and causes the fluctuating HL in Meneire’s

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16
Q

specialized intercellular connection between a multitude of animal cell-types. It directly connects the cytoplasm of two cells, which allows various molecules and ions to pass freely between cells.

A

gap junction or nexus

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17
Q

Any cochlear disorder that disrupts the strial cell layers, channels, transporters, or gap or tight junctions will reduce the EP and result in a

A

permanent snhl

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18
Q

proteins embedded in the cell membrane that regulate the flow of water

A

aquaporins

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19
Q

part of the blood-brain barrier and probably the blood-labyrinth barrier

A

aquaporins

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20
Q

Active water transport b/w cells occurs through

A

aquaporin channels

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21
Q

Hearing loss can result from

A

increased or decreased activity of the strial process

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22
Q

Increased K+ transport in the endolymph or increased endolymph production

A

endolymphatic hydrops (too much endolymph - Meneire’s - progressive fluctuating snhl)

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23
Q

Decreased K+ transport in the endolymph or decreased endolymph production

A

endolymphatic xerosis (decrease in endolymph - connexin, JLNS - permanent snhl)

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24
Q

Genetic disorders associated with ion transport and pathways are often associated with

A

permanent hearing loss

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25
Q

Majority of non-syndromic genetic hearing loss is due to alteration of

A

proteins that prevent movement of K+ from the organ of corti to the lateral wall and into the stria

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26
Q

which condition are KCNE1 KCNQ1?

A

jlns

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27
Q

connexin genes

A

abnormalities result in abnormal connexin gap junction proteins
responsible for itself for >50% of nonsyndromic HL

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28
Q

Several cochlear and vestibular disorders are transient and recover spontaneously, such as

A

Sudden-onset hearing loss
Diuretic otoxicity (e.g., Furesmide) recovery after stopping drugs
Autoimmune labyrinthitis, which can have transient symptoms
Meniere’s disease, which exhibits intermittent symptoms

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29
Q

The fact that these disorders manifest temporary hearing loss and recovery indicates that the damage is not to the hair cells but to

A

the ion homeostatic process

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30
Q

generally, if it is the inner ear involvement, HL type is always

A

SNHL

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31
Q

what are symptoms of cochlear disorders

A

usually SNHL
speech perception difficulties
loudness recruitment
aural fullness
tinnitus
Sound tolerance conditions – abnormal/excessive response to sounds

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32
Q

inner ear nerves or synapse is affected = neural involvement or severe sensory you have issues with speech perception
why

A

because you do not hear with your ears you understand with your brain and it isnt getting to the brain correctly
especially in noise

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33
Q

what can tinnitus be in cochlear disorders

A

ringing that sounds like roaring, hissing, buzzing, music (mysophonia)
soft, loud, high, low pithed
unilateral or bilateral
constant or intermittent
can change in pitch, loudness, frequency

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34
Q

unilateral tinnitus clinically

A

alert to this
pathology because bilateral is more systemic, aging etc. but uni is looking more at pathology

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35
Q

Sound tolerance conditions – abnormal/excessive response to sounds

A

hyperacusis

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36
Q

physical discomfort/pain when a sound is loud but would be tolerable for most people

A

hyperacusis

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37
Q

Intense emotional reactions to certain sounds (e.g., body sounds like chewing and sniffing) that are not perceived as loud

A

misophonia

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38
Q

increased reactivity to sounds including general discomfort and annoyance regardless of its loudness

A

noise sensitivity

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39
Q

Anticipatory fear of sound. Can cause a comorbid condition (e.g., tinnitus) to get worse

A

phonophobia

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40
Q

most common causes of SNHL

A

Aging (presbycusis)
Exposure to toxic levels of noise – Noise-induced hearing loss

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41
Q

other causes of SNHL

A

Genetic syndromic and non syndromic SNHL
Ototoxicity
Infections of the inner ear
Autoimmune conditions that affect the inner ear

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42
Q

Most infections of the inner ear are caused by

A

viruses

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43
Q

Bacteria also can cause serious diseases such as

A

meningitis

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44
Q

what are two types of viruses

A

RNA and DNA viruses

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45
Q

rna in their genome

A

rna viruses

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46
Q

example of rna viruses

A

covid 19 and flue

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47
Q

why is it hard to make effective long lasting vaccines

A

not as stable as dna viruses
viruses mutate quickly and the vaccines no longer work because they change

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48
Q

more stable and dna in their genome

A

dna viruses

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49
Q

examples of dna viruses

A

smallpox
herpes
chicken pox

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50
Q

how can viruses cause irreversible HL in vitro

A

through transmission in the placenta or during infancy

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51
Q

how did we come up with covid vaccine so fast?

A

because of HIV vaccines they had the tech and used it to make this
without hiv we wouldn’t have had a covid vaccine as fast

52
Q

what does the virus do to the cochlea?

A

destructs cochlea at the basal turn and would see hf snhl
hair cells damaged
issues with potassium and affects homeostasis
tectorial membrane is shriveled or rolls up
Reissner’s membrane is collapsed

53
Q

what is the biggest rna virus

A

rubella virus

54
Q

what is rubella responsible for

A

german measles

55
Q

Rubella has a greater effect on the auditory system if contracted by the mother during the ________ when the auditory system is developing

A

1st or initial part of the 2nd trimester

56
Q

rubella can lead to

A

congenital hearing loss
congenital cataracts
cardiovascular cataracts
possible intellectual disability

57
Q

responsible for mumps

A

paramyxovirus

58
Q

inflammation of carotid glands
boys - can cause infertility because it affects the sperms

A

mumps

59
Q

infection of salivary glands, primarily parotid gland

A

paramyxovirus

60
Q

what is the hl seen in paramyxovirus

A

Acquired permanent SNHL, typically unilateral

61
Q

common double-stranded DNA virus that belongs to the herpes virus family

A

cytomegalovirus (CMV)

62
Q

what does cmv stand for

A

cytomegalovirus

63
Q

what can cmv result in

A

result in decreased life expectancy
It can cause hepatomegaly & splenomegaly
It can result in a rash – “blueberry muffin” (reddish blue to magenta) rash

64
Q

found in other mammals as well such as chimpanzees
It is one of the most common viral diseases of the human race
It is common all-over North America

A

cmv

65
Q

CMV can result in decreased immunity, like immunity to flue vaccine, because

A

it has a very large genome
immune system uses energy to fight this virus all of our lif

66
Q

most common viral disease among the newborn

A

cmv

67
Q

do all newborns with cmv have a hl

A

no
the risk is very high,
About 20% of newborns diagnosed with CMV will develop hearing loss
75% babies born with CMV can manifest delayed onset SNHL even as adults

68
Q

what is teratogenic

A

impacts development of the fetu

69
Q

if cmv goes through the placenta to the fetus,

A

mother shows common cold/flu symptoms

70
Q

In 2023, Minnesota became the first state to screen ____ newborns for CMV

A

ALL

71
Q

CMV causes a ________ HL with the final stage generally being reached by ~ 3 to 5 years

A

progressive profound permanent SNHL

72
Q

many children with progressive profound permanent SNHL from cmv are candidates for

A

CI

73
Q

Many newborns with CMV are not detected for congenital SNHL through newborn screening because of

A

later-onset or progressive SNHL

74
Q

In infants, older children, and adults, CMV infection maybe “silent” or symptoms may mimic a common cold and cause no permanent damage

A

true

75
Q

infected newborns are generally considered contagious

A

true

76
Q

CMV may cause only a hearing loss, or it may cause significant neurological and other complications depending on when the infection occurred in vitro, such as

A

Cardiovascular problems
Neurological and motor deficits
Blindness
Intellectual disability

77
Q

can cmv be passed through breastmilk? can it cause snhl?

A

yes
no evidence that it produces snhl past 3 weeks of age

78
Q

how can cmv be diagnosed

A

Urine polymerase chain reaction (PCR) is the gold standard

histologic exam

CT scan

79
Q

what can ct reveal for cmv

A

intracranial calcification

80
Q

what is gold standard for cmv diagnosis

A

urine PCR

81
Q

where are human cmv inclusion bodies commonly seen

A

salivary glands and lung tissue

82
Q

what is PCR

A

look at dna of virus, urine sample is taken and run through this, machine produces millions copies of dna and you study to see if it is from the CMV virus and can tell if child has it or not

83
Q

are inclusion bodies only seen in cmv

A

NO
shown in many viruses

84
Q

proteins that stain pink

A

inclusion bodies

85
Q

what does aids stand for

A

acquired immunodeficiency syndrome

86
Q

caused by the microbe human immunodeficiency virus (HIV)

A

aids

87
Q

retrovirus

A

HIV

88
Q

what is a retrovirus

A

rely on reverse transcriptase to perform reverse transcription of its genome going from RNA to DNA

89
Q

disease & virus of AIDS & HIV

A

disease is aids
virus is HIV

90
Q

why can HIV not be removed

A

RNA goes to DNA
DNA embeds itself into the cell of the host’s genome
replicates as it is a part of your cell’s system which is why you cannot get rid of it because you would remove your own cells

91
Q

Retroviruses rely on their enzyme

A

reverse transcriptase

92
Q

patient may be HIV+ and not express signs/symptoms of AIDS

A

true

93
Q

HIV is neurotropic

A

true
attacks the nervous sytem

94
Q

HIV also is lymphotropic and immunotropic

A

true
It attacks the lymph glands, both T and B cells, and the immune system

95
Q

For populations at risk for HIV, the condition must be considered in all cases of

A

sudden bilateral or unilateral HL
also adult pt that has a lot of otitis media otitis externa because they cannot fight off these infections

96
Q

older medications for hiv used to be

A

ototoxic

97
Q

what are some otologic signs/symptoms with AIDS

A

OME with or without CHL; SNHL (during later disease stages)
Otalgia
Vertigo
Tinnitus
Aural fullness
Reduced OAEs (OHCs affected)
Delayed ABR interwave latencies (central effects)

98
Q

Auditory symptoms also may be secondary to

A

Ototoxic effects of the AIDS drugs
Recurrent/chronic OME and other opportunistic infections that attack the ear due to the suppressed immune system

99
Q

how can pediatric aids occur

A

HIV can be transmitted through the placenta

100
Q

why is pediatric aids increasing

A

cases of AIDS in women is increasing

101
Q

anytime you see adult with chronic otitis externa or media, there is an underlying pathology that is causing the issue. why?

A

not common for adults to have these infections

102
Q

There is no latent or dormant period for the virus with congenital or early-appearing encephalopathy/encephalitis that can damage the brain and CNS why

A

with adults it takes awhile for disease to manifest itself
have it but not full blown

different for newborns because it is in their bloodstream and immune system is not developed
born very sick

103
Q

Greater incidence of otitis media with poorer prognosis in children with AIDS due to

A

compromised immune system

104
Q

how can aids in children affect their innume system

A

Higher rate of recurrence of infection
Higher failure rate of response to treatment

105
Q

will see full blown hl and recurrent otitis media in kids with PAIDS

A

true

106
Q

what is meningites

A

inflammation of meninges that surrounds brain and spinal cord

107
Q

where are meninges

A

duramater, arachnoid mater, and pia mater) surrounding the brain and spinal cord

108
Q

where does meningitis come from

A

various virus
bacterial, including mycobacterium tuberculosis

109
Q

mycobacterium tuberculosis
Haemophilus influenza; most common cause
Pneumococcus pneumoniae

A

meningitis

110
Q

purulent (pus filled) otomastoiditis that can lead to secondary meningitis

A

Pneumococcus pneumoniae

111
Q

two ways to get meningitis

A

primary
secondary

112
Q

primary meningitis

A

disease starts in meninges

113
Q

secondary meningitis

A

OME leads to mastoiditis/labyrinthitis then meningitis
cholesteatoma that spreads to the meniinges

114
Q

what does Pneumococcus pneumoniae look like

A

stained dark purple, looks like chromosomes

115
Q

what does Mycobacterium tuberculosis look like

A

looks like rice
stained green, yellow

116
Q

vacuum cleaners of the cell

A

macrophage cell

117
Q

what does Haemophilus influenza look like

A

look like blackberries

118
Q

symptom of meningitis

A

fever
neck rigidity
head ache
malaise
sick & vomiting

119
Q

malaise

A

feeling unwell

120
Q

severe and untreated meningitis can lead to

A

blindness
paralysis because motor centers of brain is damaged
HL/deafness
vertigo & balance problems

121
Q

One of the most significant causes of acquired sensorineural hearing loss

A

meningitis

122
Q

can cause permanent abnormal cochlear bone formation

A

meningitis

123
Q

what is treatment of meningitis

A

antibiotics that are appropriate to the organism so start with broad spectrum

mastoidectomy if infection relates to middle ear disease and antibiotics dont resolve

amplificcatioin or CI if severe/profound HL occurs

124
Q

what decreaes success rate of CIs

A

the bony growth continuing after CI that can compromise the implant

125
Q

what is important for post meningitis CI candidates

A

make sure there is enough space in cochlea for the implant due to the abnormal bony growth

AUDE 5410 Aud-Vestib Disorders (18 decks)

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