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AUDE 6220 (TIN, MIS, & HYPER) > Lecture 1 > Flashcards

Lecture 1 Flashcards

1
Q

“tinnitus” is derived from the Latin word _______, which means “to ring.”

A

tinniere

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2
Q

what was the first sign of tinnitus and how it was interpreted

A

consider ears buzzing a sign of love
if you are in love with someone expect that your ears will start ringing

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3
Q

figures known in history who experienced tinnitus
f

A

Martin Luther King
Tinnitus & severe headaches around 44yrs
“When I try to work, my head becomes filled with all sorts of whizzing, buzzing, thundering noises, and if I did not leave off in the instant, I should faint away.” “We should live high and drink wine when we are not well.”

Beethoven’s deafness
Didn’t affect his ability to write music
Age 29 his started to lose it and also complained of noises in his ears and head
“my ears hum and buzz continuously day and night. I can tell you that I lead a miserable existence”

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4
Q

tinnitus is a disease

A

FALSE it is a symptom

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5
Q

what is tinnitus

A

perception of sound occurring in the ear(s) and/or the head when no external sound is present; phantom auditory perception.

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6
Q

phantom auditory perception

A

tinnitus

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7
Q

where can tinnitus occur

A

Perceived in one ear, both ears, inside the head, or even
outside the head

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8
Q

forms of auditory phantom perceptions

A

Auditory imagery, auditory hallucinations, and musical hallucinations

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9
Q

what differs from tinnitus

A

Auditory imagery, auditory hallucinations, and musical hallucinations (auditory phantom perceptions)

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10
Q

what should you ask patients for tinnitus

A

Is it one or two ears?
When did it start?
What does it sound like?

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11
Q

ability to imagine sounds; recalling music or phone #s; can occur consciously or involuntarily; generally normal cognitive function

A

auditory imagery

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12
Q

describe auditory imagery

A

ability to imagine sounds; recalling music or phone #s; can occur consciously or involuntarily; generally normal cognitive function

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13
Q

perceptions of sound that are experienced as real like voices or noises without any external source; can occur in both psychiatric & nonpsychiatric populations; can arise from various life experiences

A

auditory hallucinations

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14
Q

describe auditory hallucinations

A

perceptions of sound that are experienced as real like voices or noises without any external source; can occur in both psychiatric & nonpsychiatric populations; can arise from various life experiences

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15
Q

specific type of auditory hallucination involving the perception of music or melodies that are not present; often in older adults w/ HL and not necessarily linked to mental health issues

A

musical hallucinations

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16
Q

describe musical hallucinations

A

specific type of auditory hallucination involving the perception of music or melodies that are not present; often in older adults w/ HL and not necessarily linked to mental health issues

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17
Q

30% of people will experience tinnitus during their lifetime.

A

true

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18
Q

10% of people live with persistent tinnitus. _____ of these are significantly impacted by tinnitus in their daily life.

A

10%

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19
Q

_________ of people suffering from tinnitus also have some degree of hearing loss.

A

80%

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20
Q

13-18%

A

depression

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21
Q

35%

A

anxiety

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22
Q

25%

A

psychiatric disorder

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23
Q

what is epidemiology

A

study of how diseases and health-related conditions are distributed within populations

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24
Q

Serves as foundation for interventions made in public health & preventive medicine

A

epidemiology

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25
Q

prevalence of tinnitus

A

of people who suffer from tinnitus at any given time

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26
Q

incidence of tinnitus

A

of new cases per fiven time period (usually a year)
Harder to estimate

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27
Q

HL can cause tinnitus to be worse because the mechanisms are related

A

true

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28
Q

what percentage of those with HL also have tinnitus

A

80-90%

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29
Q

PT may come in with primary complaint of tinnitus and they do not experience HL but chances are they will

A

true

30
Q

why do epidemiology measurements vary

A

Fluctuating symptoms over time which complicates consistent assessment
Descriptions of symptoms are different bw people
Different diagnosis approaches that leads to varied results
Tinnitus & hyperacusis are often underreported especially in kids & adolescents which leads to gaps in understanding their prevalence and impact

31
Q

prevalence increases with

A

age and severity of HL

32
Q

factors related to prevalence

A

HL
age
gender
genetic predisposition
socioeconomic status & occupation

33
Q

Other factors - increases risk of having tinnitus

A

Ototoxic medication
Stressful life events
Noise exposure
Alcohol consumption
Coffee consumption
Smoking

34
Q

Single most common predictor especially HFHL

A

HL factor

35
Q

how does age impact tinnitus

A

tinnitus increases with increasing age
Highest in ages >85yrs
Annoyance of it is a function of age

36
Q

gender impact on tinnitus

A

Some show no differences
Others show more common in females than males but not a significant difference

37
Q

Monogenic disorders associated with secondary chronic tinnitus

A

`Neurofibromatosis type II
Von-Hippel-Lindau Syndrome
Low frequency sensorineural hearing loss
Osteogenesis imperfecta type I
Autosomal dominant non-syndromal hearing loss

38
Q

describe socioeconoic status & occupation

A

Those who are professionals have tinnitus vs unskilled classes - could be because you have more access to healthcare and aware of health so you go and check the things that bother you
Just because you are not professional doesn’t mean you dont have it, just means you may not have access to healthcare like those who are professionals

39
Q

definite risk factors examples

A

acoustic neuroma

age
drugs/meds
otsc
meniere’s
ear infections
sudden deafness
presbycusis etc

40
Q

possible risk factors

A

alcohol
anxiety
depression
health status
heavy weight
smoking

41
Q

sounds of tinnitus descriptions

A

ringing, buzzing, hissing, whistling, swooshing, screeching, clicking, cicadas, crickets, winds, falling tap water, grinding steel, musical tinnitus/musical hallucinations

42
Q

what can tinnitus be

A

Acute or chronic
Bothersome or not
Centered in head or localized outside of head
Constant, pulsing or intermittent
Variable in pitch or loudness
Present in one or both ears

43
Q

when is tinnitus becoming louder significant

A

Louder at night - not significant this is because you become aware of it and the environment is quiet
Significant if it is during the day or activities

44
Q

Majority are monaural

A

true

45
Q

is tinnitus only one sound

A

no
can hear one or two or more

46
Q

what is the point of tinnitus assessment

A

learns what they are experiencing as a PT but not diagnosing their tinnitus

47
Q

tinnitus origin

A

within auditory nervous system (somatic)
outside the auditory nervous system (sensorineural tinnitus)

48
Q

somatic tinnitus

A

has nothing to do with hearing; for ex TMJ that can cause tinnitus
type of subjective tinnitus in which the frequency or intensity is altered by body movements such as clenching the jaw, turning the eyes, or applying pressure to the head and neck.
They can manipulate their muscles which causes the tinnitus to change in frequency or intensity
Capable of moving and doing something to change the tinnitus (TMJ, head and neck, etc.)
Refer and if they get treated usually can go away

49
Q

what is associated with somatic tinnitus

A

vascular, muscular, skeletal, respiratory, or located in the temporomandibular joint.

50
Q

types of somatic tinnitus

A

Pulsatile tinnitus: Pulses in synchrony with the heartbeat; most common type.
Beats with the heart
Need accurate intake from the PT to understand what is going on and refer if needed
Nonpulsatile somatosounds: Arise from nonvascular sources (e.g., muscle spasms, patulous eustachian tube).

51
Q

Neurophysiologic tinnitus

A

Majority
Originates in the auditory nervous system
The cochlea is often implicated, as damage from noise exposure frequently leads to tinnitus.
Numerous theories about the pathophysiology of sensorineural tinnitus exist!

52
Q

Majority
Originates in the auditory nervous system
The cochlea is often implicated, as damage from noise exposure frequently leads to tinnitus.
Numerous theories about the pathophysiology of sensorineural tinnitus exist!

A

neurophysiologic tinnitus

53
Q

type of subjective tinnitus in which the frequency or intensity is altered by body movements such as clenching the jaw, turning the eyes, or applying pressure to the head and neck.
Associated with vascular, muscular, skeletal, respiratory, or located in the temporomandibular joint.

A

somatic tinnitus

54
Q

objective tinnitus

A

Not only PT who can hear it but also you
Due to vascular disturbance
Rare
Used to describe sounds that are generated within the body; can be audible to another person.
may be vascular or mechanical in origin
Always a somatosound with an internal acoustic source.

55
Q

Not all somatosounds are detectable by the examiner, so they may not qualify as objective tinnitus.

A

true

56
Q

subjective tinnitus

A

not necessarily something physical causing it and you cannot hear it just the PT
Most common
Perceived only by PT
source of this type of tinnitus is often complex or difficult to determine as a variety of factors may be involved.
It is unique to each patient; tinnitus can be bothersome, significantly affecting quality of life, or nonbothersome, having minimal impact.

57
Q

acute tinnitus

A

Short duration, less than 3 mos
Associated w/ recent exposure triggers (e.g. loud noise, ear injury, meningitis etc.)
Higher chance of spontaneous recovery

58
Q

Short duration, less than 3 mos
Associated w/ recent exposure triggers (e.g. loud noise, ear injury, meningitis etc.)
Higher chance of spontaneous recovery

A

acute tinnitus

59
Q

Persists for 3-6 mos or longer
Involves sustained neurobiological changes & may require ongoing management
HL
Less chance of spontaneous recovery

A

chronic tinnitus

60
Q

chronic tinnitus

A

Persists for 3-6 mos or longer
Involves sustained neurobiological changes & may require ongoing management
HL
Less chance of spontaneous recovery

61
Q

recent onset tinnitus

A

Lasts weeks to a few months
Vestib schwannoma, stress, noise exposure
Often fear serious conditions - need + counseling

62
Q

Lasts weeks to a few months
Vestib schwannoma, stress, noise exposure
Often fear serious conditions - need + counseling

A

recent onset

63
Q

delayed onset tinnitus

A

Weeks, months or years after triggering event
Loud noise exposure, traumatic brain injury
Need detailed hx to explore all possible causes - mostly for legal reasons

64
Q

Weeks, months or years after triggering event
Loud noise exposure, traumatic brain injury
Need detailed hx to explore all possible causes - mostly for legal reasons

A

delayed onset

65
Q

what is the economic burden of tinnitus

A

substantial burden on society with health costs exceeding billions of dollars annually
Tinnitus is the most common VA disability claim

66
Q

how does tinnitus affect quality of life

A

can be devastating and can include adverse effects like:
Sleep disorders
Working memory impairment
Mental fatigue
Depression & anxiety
Psychological distress
Suicide or suicidal behaviors

67
Q

what are common complaints of tinnitus

A

Very tired, slow, fatigued
Difficulty concentrating
Persistent sad mood
Doesn’t enjoy things like before
restless/irritable
Nervousness
Persistent headaches, stomach aches or chronic pain
Sleeping and/or eating less
Excessive crying
Hopelessness - Life isn’t worth living
Absence of pleasures or joys

68
Q

audiologist role with tinnitus

A

Case history
Appropriate referral
Comprehensive audiologic assessment
Validated tinnitus questionnaires
Hearing aid assessment
Fitting of hearing aids and combination instruments
Brief tinnitus education
Follow-up assessment with relevant questionnaires at least 1 month following any device fittings

69
Q

audiologist responsibility

A

Assess, diagnose, and manage tinnitus and hyperacusis.
Provide clinical and educational services, including diagnosis and intervention.
Promote hearing wellness through education and prevention.
Educate other professionals about audiologists’ roles in tinnitus management.
Collaborate with interdisciplinary teams.
Identify individuals with bothersome tinnitus or hyperacusis.
Conduct comprehensive assessments of hearing and related systems.
Screen for mental health issues as needed.
Refer patients for further evaluation and care.
Fit and orient patients with hearing technologies.
Recommend sound therapy and tinnitus maskers.
Counsel patients and families on management strategies.
Document findings and use outcome measures to evaluate interventions.
Advocate for individuals with tinnitus and hyperacusis.

70
Q

barriers of tinnitis

A

Lack of knowledge
No objective testing
No standardized measures to assess improvement after intervention
No universal subjective outcome measures
Many treatments are available but lack evidence from high-quality research

71
Q

why do we need tinnitus reserach

A

What management strategies are most effective beyond audiological care?
Is Cognitive Behavioral Therapy (CBT) delivered by audiology professionals effective?
What management strategies are most effective for improving tinnitus-related insomnia?
Do any of the available complementary therapies improve outcome for people with tinnitus?
What type of digital hearing aid or amplification strategy provides the most effective tinnitus relief?
What is the optimal set of guidelines for assessing children with tinnitus?
How can tinnitus be effectively managed in people who are Deaf or have a profound hearing loss?
Are there different types of tinnitus and can they be explained by different mechanisms in the ear or brain?
What is the link between tinnitus and hyperacusis (over-sensitivity to sounds)?
Which medications have proven to be effective in tinnitus management?

72
Q
A

AUDE 6220 (TIN, MIS, & HYPER) (8 decks)

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