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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
prevalence of tinnitus
of people who suffer from tinnitus at any given time
26
incidence of tinnitus
of new cases per fiven time period (usually a year) Harder to estimate
27
HL can cause tinnitus to be worse because the mechanisms are related
true
28
what percentage of those with HL also have tinnitus
80-90%
29
PT may come in with primary complaint of tinnitus and they do not experience HL but chances are they will
true
30
why do epidemiology measurements vary
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
prevalence increases with
age and severity of HL
32
factors related to prevalence
HL age gender genetic predisposition socioeconomic status & occupation
33
Other factors - increases risk of having tinnitus
Ototoxic medication Stressful life events Noise exposure Alcohol consumption Coffee consumption Smoking
34
Single most common predictor especially HFHL
HL factor
35
how does age impact tinnitus
tinnitus increases with increasing age Highest in ages >85yrs Annoyance of it is a function of age
36
gender impact on tinnitus
Some show no differences Others show more common in females than males but not a significant difference
37
Monogenic disorders associated with secondary chronic tinnitus
`Neurofibromatosis type II Von-Hippel-Lindau Syndrome Low frequency sensorineural hearing loss Osteogenesis imperfecta type I Autosomal dominant non-syndromal hearing loss
38
describe socioeconoic status & occupation
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
definite risk factors examples
acoustic neuroma age drugs/meds otsc meniere's ear infections sudden deafness presbycusis etc
40
possible risk factors
alcohol anxiety depression health status heavy weight smoking
41
sounds of tinnitus descriptions
ringing, buzzing, hissing, whistling, swooshing, screeching, clicking, cicadas, crickets, winds, falling tap water, grinding steel, musical tinnitus/musical hallucinations
42
what can tinnitus be
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
when is tinnitus becoming louder significant
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
Majority are monaural
true
45
is tinnitus only one sound
no can hear one or two or more
46
what is the point of tinnitus assessment
learns what they are experiencing as a PT but not diagnosing their tinnitus
47
tinnitus origin
within auditory nervous system (somatic) outside the auditory nervous system (sensorineural tinnitus)
48
somatic tinnitus
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
what is associated with somatic tinnitus
vascular, muscular, skeletal, respiratory, or located in the temporomandibular joint.
50
types of somatic tinnitus
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
Neurophysiologic tinnitus
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
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!
neurophysiologic tinnitus
53
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.
somatic tinnitus
54
objective tinnitus
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
Not all somatosounds are detectable by the examiner, so they may not qualify as objective tinnitus.
true
56
subjective tinnitus
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
acute tinnitus
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
Short duration, less than 3 mos Associated w/ recent exposure triggers (e.g. loud noise, ear injury, meningitis etc.) Higher chance of spontaneous recovery
acute tinnitus
59
Persists for 3-6 mos or longer Involves sustained neurobiological changes & may require ongoing management HL Less chance of spontaneous recovery
chronic tinnitus
60
chronic tinnitus
Persists for 3-6 mos or longer Involves sustained neurobiological changes & may require ongoing management HL Less chance of spontaneous recovery
61
recent onset tinnitus
Lasts weeks to a few months Vestib schwannoma, stress, noise exposure Often fear serious conditions - need + counseling
62
Lasts weeks to a few months Vestib schwannoma, stress, noise exposure Often fear serious conditions - need + counseling
recent onset
63
delayed onset tinnitus
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
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
delayed onset
65
what is the economic burden of tinnitus
substantial burden on society with health costs exceeding billions of dollars annually Tinnitus is the most common VA disability claim
66
how does tinnitus affect quality of life
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
what are common complaints of tinnitus
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
audiologist role with tinnitus
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
audiologist responsibility
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
barriers of tinnitis
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
why do we need tinnitus reserach
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

AUDE 6220 (TIN, MIS, & HYPER) (9 decks)

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