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AUDE 5410 Aud-Vestib Disorders > Lecture 1 > Flashcards

Lecture 1 Flashcards

1
Q

divides the brain into superior and inferior parts

A

horizontal/axial slice

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2
Q

another name for horizontal slice

A

axial slice

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3
Q

describe the horizontal slice

A

divides the brain into superior and inferior parts

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4
Q

like slicing bread

A

coronal slice

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5
Q

how is a CT/MRI image viewed

A

as if you are looking at the PT
as if the PT is lying on their back and their feet are directed towards you (you are standing at the PT’s feet)f

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6
Q

why are the eyes dark on imaging

A

there is fluid present in them

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7
Q

divides the body into left and right

A

sagittal slice

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8
Q

any vertical plane that divides the body into front and back

A

coronal/frontal slice

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9
Q

can audiologists order imaging

A

no
we can refer to the physician and recommend the tests are ordered for xyz reasons

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10
Q

Lab tests are helpful in

A

evaluating the health status of an individual

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11
Q

if your readings are abnormal, does that mean it is actually abnormal?

A

not necessarily
5% of healhty PT’s falls outside the normal range

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12
Q

reasons for abnormal results

A

Race
Diet
Age
Gender
Menstrual cycle
Degree of physical activity
Problems with collection/handling of the specimen
Use of non-prescription drugs
Use of prescription drugs
Alcohol intake
Illnesses

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13
Q

why are the norms based off of caucasians?

A

a lot of medical testing and research is done in first world countries and that is why data is based off of caucasians

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14
Q

what do blood tests test for

A

Blood sugar levels
Cholesterol levels
Infections
Electrolyte (potassium, chloride, etc.) imbalance
Minerals (e.g., calcium and phosphate)
Hemoglobin levels
Cardiac function
Renal function
Hepatic function
Markers for some diseases such as cancers and arthritis
Genetic tests

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15
Q

why is genetic testing performed in humans

A

Diagnose/rule out a genetic condition

Diagnose/rule out viral infection such as the novel Corona virus

Presymptomatic or predictive testing
Identifies the presence of variant genes that cause disease or increase disease risk, even if someone appears to be healthy

Establish risk factors for inherited diseases

Establish paternity

Prenatal diagnosis of genetic conditions

Medico-legal cases

Pharmacogenomics testing to predict the response to certain medications

Transplantation testing to determine whether an organ or tissue is a match for the transplant between a donor and recipient

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16
Q

what is A1C

A

hemoglobin test
blood cells replenish every 180 days so extra glucose is in your blood, because they have this turn around, it tells the avg of glucose over this period, more accurate marker for diabetes, gives a dynamic range

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17
Q

what can be an effect in elderly with low potassium if electrolytes are out of whack

A

affects the heart
& hearing

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18
Q

do they test an entire genome?

A

no
have to look for a specific gene and they will say whether you have it or not

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19
Q

How do you know if you have corona?

A

looked at genetics of the virus to see what you have

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20
Q

what is pharmacogenomics testing

A

talor making medicine to suit chemical makeup -
this will work for me or it won’t
asthma medicine will close the airways instead of opening them up during an attack

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21
Q

new branch of medicine combining genetics & pharmacology to create the best outcomes of medicine -

A

pharmacogenomics testing

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22
Q

Urine test/analysis is used to detect

A

Urinary tract infection
Kidney and bladder disease
Drug use/abuse, etc.

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23
Q

long term diabetes affects structures that have

A

capillaries (tiny blood vessels) & high blood flow (very vascular)

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24
Q

kidney failure is one of the major symtpms of this

A

diabetes

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25
Q

what is albumin in your urine

A

low levels can indicate kidney dysfunction

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26
Q

protein uria =

A

kidneys are not fxning well

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27
Q

risk averse in america, why?

A

because Dr. can be sued
so they go for the more expensive tests to make sure they do not miss anything

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28
Q

why do Dr.s choose MRI over an ABR for vestib schwanomas?

A

they will choose an MRI over the ABR (sensitivity is not as high in ABR than an MRI) and insurance would pay for the MRI but not ABR

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29
Q

what deters good medicine in the us?

A

transportation and cost

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30
Q

cheapest, around for a long time, limited use because of the other ones that give more info

A

x ray

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31
Q

3 main imaging techniques

A

x ray
ct
mri

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32
Q

which imaging has radiation

A

ct & xray

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33
Q

when you get a mammogram, is that a screening or diagnostic?

A

screening test
screen, mri, then biopsy

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34
Q

what is a biopsy

A

anything that is removed from the body to find the presence, cause or extent of a disease

examination of tissue, such as liver, bone, and tumors, removed from the body to discover the presence, cause, or extent of a disease

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35
Q

what is the GOLD STANDARD

A

biopsy

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36
Q

what is the most expensive and invasive test

A

biopsy

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37
Q

why do patient’s postpone procedures?

A

they do not have the $ to cover it

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38
Q

form of electromagnetic radiation, like visible light

A

x ray

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39
Q

have higher energy and can pass through most objects, including the body

A

x rays

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40
Q

what are medical x rays used to do

A

used to generate images of tissues and structures inside the body

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41
Q

How does an image form on an x ray

A

x ray travels through the body and passes through the x ray detector on the other side of the PT, creating an image that represents a shadow formed by objects in the body

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42
Q

what structures are the best for x ray. why

A

bony structures
it is hard so it weakens the light and shines as a lighter shadow and makes it more clear on an x ray

43
Q

if you suspect a fracture of ossicles or otosclerosis they will do what

A

a CT
not an x ray because they are so tiny you cannot see on this

44
Q

what is a CT

A

combines a series of X-ray images taken from different angles around the body

45
Q

how does a ct work

A

uses computer processing to create cross-sectional images (slices) of the bones, blood vessels and soft tissues inside the body

46
Q

what does ct stand for

A

computerized tomography

47
Q

what is a ct used for

A

diagnose disease or injury, and to plan medical, surgical, or radiation treatment

48
Q

Each CT rotation yields

A

several images of thin slices of the body part being investigated

49
Q

what is a CT with a contrast

A

iodine injected in the veins and shows up differently
is there a blockage?

50
Q

drawback of CTs

A

exposed to more radiation

51
Q

explain contrast done in ct

A

Contrast material blocks X-rays and appears white on images, which can help emphasize blood vessels, intestines, or other structures

52
Q

how can contrast be taken

A

mouth
iv
enema

53
Q

can contrast material cause allergic reactions?

A

yes, iodine based material

54
Q

what does a ct image depend on

A

density of the tissue

55
Q

what color is air on ct

A

black

56
Q

what is more black on ct

A

fat

57
Q

shades of grey on ct

A

fluid, blood, muscle, soft tissues

58
Q

what is white on a ct

A

bone

59
Q

what are the advantages of ct

A

Usually, a higher resolution than X-ray or MRI
Bone is seen better with CT for example, ossicles
Bone and air are well differentiated with CT
It is cheaper and faster
Better tolerated

60
Q

what are some disadvantages of ct

A

Ionizing radiation; same risk as X-rays
Metal can present as artifact
Poorer soft tissue contrast, for example, nerves
More adverse reactions to the IV CT iodine-based contrast material used; greater risk of allergic reactions and renal problems
CT images are acquired only in the axial/horizontal plane

61
Q

use extremely powerful magnets combined with electromagnetic fields and coils which produce radio waves, to produce detailed images of organs and tissues in the body

A

MRI

62
Q

what does mri stand for

A

magnetic resonance imaging

63
Q

based on the magnetization properties of atomic nuclei

A

mri

64
Q

what is the cheapest option

A

x ray

65
Q

What is T1 weighted MRI

A

Enhances the signal of the fatty tissue and suppresses the signal of the water

66
Q

what is t2 weighted MRI

A

Enhances the signal of the water

67
Q

how can you easily differentiate T1 & T2

A

by looking at the CSF

68
Q

CSF is dark

A

T1

69
Q

CSF is bright

A

T2

70
Q

colors

A

fMRI

71
Q

more blood flow to the area

A

more color on fMRI

72
Q

Fat is bright and fluid is dark

A

T1

73
Q

Fluid is bright on

A

T2

74
Q

which is ideal for picking up tissue edema

A

t2

75
Q

what is used in fmri

A

t2

76
Q

what is the fmri

A

allows visualization of neural activity in the brain by detecting areas of increased blood flow

77
Q

Bone and air are dark on

A

all sequences

78
Q

Bone marrow is bright on

A

T1

79
Q

what is the unit of measurement quantifying strength of magnetic field of an MRI

A

tesla (T)

80
Q

what are the tesla ranges

A

.5-3.0 T
1.5 T is most common

81
Q

what is the highest strength in humans of an mri

A

10 T (university of minnesota in 2018)

82
Q

what are higher teslas available for

A

research

83
Q

how are CIs affected by MRIs

A

have to take off the external magnet, the internal magnet and put the Cochlear Nucleus Implant bandage & splint kit you can go into a 1.5T
if you have to go up to 3 T you have to have the implanted magnet removed surgically

84
Q

how are BAHA affected by mri

A

remove sound processor
new device approved for up to 3 T

85
Q

what disorder is an ABI used for

A

Bilateral schwanomas = NF2 = sacrifices both cochlear nerves, so ABI is the procedure

86
Q

the only FDA approval use for ABI

A

NF2
(neurofibromatosis)

87
Q

how is ABI affected by MRI

A

outer magnet is removed and can withstand up to 1.5T
it is designed to be compatible with mri
higher level mri is contraindicated and unable to perform because it will cause tissue damage

88
Q

advantages of mri

A

most used in neurology and neurosurgery (head and neck issues)

escellent tissue contrast

contrast material (dye-iodine vs. gadolinium) detection is superior to the CT scan, also non-iodine-based gadolinium causes less allergic reactions and renal problems

visualize anatomy in all three planes; axial (horizontal), sagittal, and coronal

posterior fossa is more easily visualized on MRI than CT

No ionizing radiation required; no radiation risks

Non-invasive

More sensitive for tumor detection and detection of small soft tissue structures than CT scan

Detection of acute ischemic stroke (within 12 hours of onset)

Sensitive to detection of old blood, e.g., hemorrhagic strokes

89
Q

higher teslas are more expensive

A

yes

90
Q

disadvantages of mri

A

Expensive
It cannot distinguish between air and compact bone
Longer exam time than CT - no movement for 3 to 7 minutes
Metal artifacts
Patients may suffer from claustrophobia

91
Q

are open mri units as sensitive

A

may not be

92
Q

blood vessel ruptures and blood pools into the brain & more common

A

hemmorragic

93
Q

blood supply to part of the brain is blocked or reduced & less common

A

ischemic

94
Q

what are contraindications of MRI

A

implanted electrical devices such as pacemakers, CIs, & ABIs

95
Q

if you are suspecting an acoustic neuroma, what do you do

A

recommend an MRI

96
Q

nerve visualization

A

MRI

97
Q

Congenital bony anomalies, dehiscence, bone lesions (osteospongiosis), otosclerosis

A

CT

98
Q

Cholesteatoma and middle ear tumors

A

both ct and Mri

99
Q

Pre-operation evaluation for cochlear implant

A

Usually CT but MRI can be used too

100
Q

Trauma such as skull fractures

A

CT

101
Q

Mastoiditis, malignant otitis, strokes, cholesterol granuloma, arterial and venous anomalies, pulsatile tinnitus

A

CT & MRI

102
Q

what is pulsatile tinnitus

A

tinnitus that follows the heart beat

103
Q

i hear my heart in my ears

A

pulsatile tinnitus

104
Q

why is pulsatile an issue?

A

it is not an ear problem
it is a blood vessel problem
Carotids obstruction etc. can lead to heart issues, strokes, etc.

AUDE 5410 Aud-Vestib Disorders (18 decks)

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