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AUDE 5460 > midterm > Flashcards

midterm Flashcards

1
Q

otoacoustic emissions (OAEs)

A

emissions that are detected by placing a microphone within the ear canal that are being measured from the cochlear
-can be spontaneously or can be evoked by a sound stimuli

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2
Q

OAEs are related to the proper function of the ______

A

outer hair cells

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3
Q

what systems are involved with OAEs

A

outer, middle and inner ear, cochlea and the efferent system

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4
Q

list some factors that can influence OAE results

A

age, gender, ear difference, binaural effects, genetics, race, body temp and position, state of attention, poor probe placement or seal, things within the canal, uncooperative patient and noise

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5
Q

list some factors within the middle ear that can impact an OAE

A

tubes, perforations, fluid and negative ME pressure

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6
Q

outer hair cells

A

3 rows arranged that act as biochemical amplifier’s
-they have the ability to change their lengths in the response to stimuli
-motility allows us to be sensitive to soft sounds
-active process

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7
Q

inner hair cells

A

1 row arranges in a linear pattern that act as a sensory receptor
-transforms sound vibrations from the OHCs into an electrical signal that travels inward
-passive process

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8
Q

how does a traveling wave relate to the hair cells

A

the traveling wave causes the hair cells to shorten and elongate which causes the basilar membrane to move
-this causes those OHCs to move which is vital for basilar membrane movement

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9
Q

what is a overview of the process of an OAE

A

probe insertion, inward propagation, electromotility action, outward propagation, hits microphone and is recorded

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10
Q

inward propagation

A

the inward movement of the stimulus
-passes through the outer, middle and turns around in the inner ear

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11
Q

electromotility

A

the changing in length of the OHCs as they shorten and lengthen
-helps trigger an OAE to be recorded

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12
Q

outward propagation

A

the outward movement of the measurement
-what is reflected

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13
Q

explain the process in the inner ear during a OAE recording

A

-stimulus arrives and invokes movement of the basilar membrane
-this causes OHCs to move, their sterocilia will bend which changes the potential
-changes in voltage lead to length changes
-this action has a feedback effect on the membrane which causes it to vibrate and amplify the signal as it passes onto the IHCs
-from the IHCs it goes to the brain, but out signal that we are measuring gets reflected outward

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14
Q

explain ions in terms of the hair cell movement

A

ions rush in and out which results in changing the membrane potentials within the hair cells
-these changes cause electromotility

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15
Q

what is the relation between efferent connections and OAEs

A

the efferent system is a small part of OAEs
-the role is unsure however it should be included when discussing OAEs

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16
Q

what would occur is we put in too high of a stimulus

A

the stimulation of inner hair cells may occur
-plus we could no longer compare it to norms as it is playing outside of what the norms fall under

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17
Q

what are the three types of OAEs

A

transient evoked, distortion product and spontaneous

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18
Q

transient evoked OAEs (TEOAEs)

A

most used within NBHS but can be effective for validating testing
-done with the usage of clicks as a broad band stimuli
-within the probe, one sound playing and one microphone

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19
Q

what are the stimulus protocols for TEOAEs

A

present at 80-85 dB SPL
-rate at less then 60/second
-can play down to 74ish dB SPL

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20
Q

explain the measurement process for TEOAEs

A

completed by using time synchronous averaging
-alternating responses are stored in memory banks, A and B
-data that correlates between the two banks are considered a response
-data that does not correlate are considered noise

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21
Q

what is seen on a result screen for TEOAEs

A

stimulus, frequency response, stimulus intensity level in dB SPL, stability of the series, temporal waveform, spectrum of the TEOAE response and correlation in percentage

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22
Q

describe the difference of a good and bad/absent stimulus for a TEOAE

A

good : one distinct cycle present
bad/absent : no distinct cycle or can show many rapid signals, ringing occurs with too many cycles shown

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23
Q

what is our response for TEOAEs

A

emissions and noise floor showing the SNR

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24
Q

what is our response waveform for TEOAEs

A

SPL and time, looking at reproducibility

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25
Q

what values do we use to determine a pass/refer for a TEOAE

A

band reproducibility, sweeps completed and SNR

26
Q

what is the pass/refer criteria for a TEOAE

A

-band reproducibility : 50% at 1600 Hz, 70% at 2400-4000
-sweeps completed : 40-50
-SNR : 3-6 dB
-absolute amplitude : greater than or equal to 10 dB SPL

27
Q

pass TEOAE means…

A

normal or near normal peripheral hearing for the specified frequency region

28
Q

refer TEOAE means ….

A

further testing is needed

29
Q

distortion product OAEs (DPOAEs)

A

most common type, a frequency specific responses
-two pure tones are presented at the same time

30
Q

what are the stimulus protocols for DPOAEs

A

two tones are being presented at the same time
-L1 and L2 (aiming for 65 dB and 55 dB)
-f1 and f2, with a frequency ratio of at least 1.2
-the two signals are being presented to evoke a signal

31
Q

L1 and L2

A

the two intensity levels being presented in a DPOAE
-separated by around 10 dB
-65 dB for L1, 55 dB for L2

32
Q

f1 and f2

A

primary tones being played
-lower (f1) and higher (f2) frequencies

33
Q

what are the recording parameters of a DPOAE

A

the microphone/probe is placed in the outer ear and the averaging of the ear canal sound pressure occurs in response to two stimulating pure tones called f1 and f2

34
Q

explain the measurement process for DPOAEs

A

created as a by product of a nonlinear amplification of the basilar membrane motion due to movements of the OHCs
-amplitude of the signal ie being measured at the DP frequency
-presence is dependent on hearing sensitivity within the region of the primaries

35
Q

what is seen on a result screen for DPOAEs

A

DP - absolute amplitude by frequency
NF - noise floor (noise present in the room)
SNR (DP-NF) - the interference of the amplitude with noise

36
Q

distortion product (DP)

A

our absolute amplitude that we are recording
-DP = 2f1-f2
-being plotted with out f2

37
Q

what is our response for DPOAEs

A

our DP and the SNR
-absolute amplitude with the SNR is what we are interested in

38
Q

what values do we use to determine a pass/refer for a DPOAE

A

absolute DP value and the relative value (SNR)

39
Q

what is the pass/refer criteria for a DPOAE

A

-absolute DP value : greater than -10 dB SPL
-relative value (SNR) : greater than or equal to +6 dB

40
Q

pass DPOAE means ….

A

DPOAE is normal, replicated amplitudes are within normal range

41
Q

refer DPOAE means ….

A

no replicable DPOAEs are detected at any frequency

42
Q

what does a combination of a pass and refer of a DPOAE mean ….

A

some are normal and some are abnormal at different frequencies

43
Q

spontaneous OAEs (SOAEs)

A

the first type to be reported, does not required any type of evoking stimuli
-occurs in normal cochleas
-can be detected in 35-50% of the population

44
Q

in terms of stimulus stability, what is preferred?

A

higher stability

45
Q

measurement factors with recording OAEs

A

noise going into the microphone, ambient test setting, patient breathing, or the rubbing of the tube against clothing or skin

46
Q

DP-gram

A

a graphical representation of DPOAE amplitudes as a function of the f2 frequency

47
Q

gorgagram

A

a type of DP-gram that represented amplitude as a function of f2 frequency however, it assigns a normal or impaired region based on results
-can only be used with DPOAEs

48
Q

what is being plotted in a DPOAE

A

absolute amplitude
-dB SPL as a function of the f2 frequency

49
Q

how do gorgagram results correlate with potential dB audiogram levels

A

with normal and present OAEs, you can say hearing thresholds are around 15-20 dB HL
-normal : hearing better than or equal to 20 dB HL
-borderline : hearing is most likely better than or equal to 20 dB HL
-abnormal : hearing is worse than 20 dB HL

50
Q

if not using a gorgagram, what is the correlation to thresholds

A

with normal and present OAEs, you can say hearing thresholds are within the 25-30 dB HL range

51
Q

the presence of OAEs tells us ….

A

-canal is clear
-middle ear function is normal/near normal
-cochlear sensory function is normal by inference only

52
Q

the absence of OAEs tells us ….

A

-may be the blockage of the ear canal
-may be abnormal middle ear function

53
Q

are OAEs a test of hearing?

A

no, they are not a direct measure of hearing
-you are able to infer about hearing health of the individual but it cannot be directly inferred for a threshold

54
Q

some clinical uses of OAEs

A

assessment of functional HL, differentiation of cochlear vs. retrocochlear, monitoring ototoxicity, tinnitus and noise/music exposure

55
Q

cross check principle

A

being able to check the validity of two tests to ensure the results are matching up and can be a valid source of what is occurring
-using 1 electrophysiology test and 1 behavioral test

56
Q

what does it mean to have a robust recording

A

with anything robust, you are not able to quantify it

57
Q

standing waves

A

cancellations and reinforcements of some sound waves or interaction between stimulus sound wave moving towards the TM and moving out to be measured as an OAE

58
Q

standing waves are a problem with …

A

-higher frequencies are at higher risks
-are a problem with DPOAEs

59
Q

what is the only way to resolve standing waves

A

place the microphone at the tympanic membrane
-which is not clinically feasible

60
Q

in terms of TEOAEs, what does reproducibility mean

A

correlation
-two waves will overlap almost totally

61
Q

how does the middle ear act as a amplifier

A

through impedance matching
-pay attention to size difference between the tympanic membrane and the oval window
-results in an increase in sound pressure

AUDE 5460 (2 decks)

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