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Anatomy and Physiology > Pathology of Hearing > Flashcards

Pathology of Hearing Flashcards

Noise-induced and Age-related hearing loss

1
Q

_____is the strongest predictor of hearing loss among adults aged 20-69

A

age

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2
Q

common complaints (5)

A

1) tinnitus
2) HL
3) otalgia
4) otorrhea
5) vertigo

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3
Q

sound that appears to be coming from one or both ears, internally generated

A

tinnitus

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4
Q

T/F Most american habituate to tinnitus and say they do not suffer from the condition

A

True

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5
Q

______ % of tinnitus patients hear the sound constantly, without intermission

A

83%

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6
Q

what is the primary cause of tinnitus?
- what other known causes are there?

A

primary: exposure to loud noise
secondary: stress, BP, meds, infections, head trauma

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7
Q

______ tinnitus is usually related to blood vessel or muscle spasm
- the sound can also be heard by an observer

A

pulsatile

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8
Q

tinnitus is more prevalent in adults but can be the first sign of _____ in children

A

HL

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9
Q

the source of tinnitus is difficult to determine but is likely associated with damage to __________

A

nerve endings at hair cells

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10
Q

what are some tinnitus treatments? (3)

A

masking devices, biofeedback, and relaxation exercises (wellness approach)

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11
Q

common complain: HL may arise due to ___________ (5)

A

noise exposure, meds, genetic predisposition, ototoxicity, or aging

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12
Q

two ototoxic exposure may interact to provide a _________ HL, which compounds risk of certain professions

A

syngergistic HL

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13
Q

common complaints: otalgia is what?

A

ear pain

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14
Q

T/F most otalgia is related to structures of the ear

A

false; most otalgia is not related to structures of the
ear, but more structures of larynx, pharynx, tonsils, muscles of mastication, TMJ, orthodonture

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15
Q

T/F Many of the most common and important otologic diseases are associated with any level of pain

A

False; they are NOT associated with pain

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16
Q

T/F Most otogenic pain is caused by infection or cerumen impaction

A

True

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17
Q

common complaints: what is otorrhea

A

fluid drainage from the ear

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18
Q

what is otorrhea most always due to?

A

infection, with the rare exception of a CSF leak

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19
Q

_________ drainage likely due to chronic otitis media or cholesteatoma

A

painless

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20
Q

__________ drainage likely due to acute otitis media and TM rupture

A

Painful

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21
Q

present with the principle component of “illusion of motion”

A

vertigo

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22
Q

vertigo is a condition of the _________ system, or peripheral or central

A

Vestibular

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23
Q

displaced otoconia from saccule entering and stimulating the lateral semicircular canal can cause ___________

A

BPPV (benign paroxysmal positional vertigo)

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24
Q

what is another cause of otoconial displacement

A

head trauma

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25
Q

how do ME disorder interfere with ME’s ability to act as impedance matching device

A

interfering with the mobility of ME structures

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26
Q

Otitis media

A
  • common feature: eustachian tube malfunction
    (allowing for bacteria secretion from nasopharynx to enter ME space)
  • kiddos more prone bc of shorter, wider, and more horizontal ETs
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27
Q

how can the blockage of the eustachian tube perpetuate otitis media

A

not allow effusions (fluid collections) to drain

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28
Q

OM blockage can be perpetuated at the nasal end by ___________

A

inflammation
- allergies, cigs, pool water chlorine

29
Q

pus infection exhibiting swelling, increased blood flow, bleeding, and fever

A

acute otitis media

30
Q

what is the idea of AOM

A

pus collects in the middle ear space until the TM ruptures, resulting in a sudden relief of symptoms
- can hear instantly
- effusion clears within month but can persist indefinitely & may be asymptomatic
- tubes are recommended for kiddos with 15dB loss / unresponsive to antibiotics

31
Q

low grade or recurrent infections
- may be only intermittently response to antibiotics

A

chronic otitis media

32
Q

collection of dead cells accumulates, incites growth on medial side of TM

A

cholesteatoma

33
Q

what do the dead skin components provide at the center of the cholesteatoma

A

provide an excellent medium for bacterial growth and chronic infections are a consistent feature of cholesteatomas

34
Q

T/F The growing mass induces bone erosion of any contacted bony structures

A

true

35
Q

What some structures that can be affected by cholesteatoma (3)

A

ossicles, labyrinth, temporal bone

36
Q

what can cholesteatoma present as

A

significant hL and vertigo

37
Q

when encountered in _________, cholesteatomas are aggressive (fast growing)

A

kiddos

38
Q

what is the intervention for cholesteatoma

A

surgical eradication
- will under many surgeries
antibiotic is ineffective

39
Q

disease where normal head labyrinthine bone is replaced by vascular spongy bone

A

otosclerosis

40
Q

what does otosclerosis most frequently affect?

A

the oval window, extending to the footplate of the stapes by freezing (immobile chain of ossicles)
- can sometimes primarly affect cochlea

41
Q

genetic condition that can develop in both ears
ossicular chain becomes poor conduction apparatus &. sign. conductive HL results

A

otoscleorisis

42
Q

otosclerosis intervention includes the _________ to be surgically replaced in part or in whole by
graft tissues or manufactured substitutes such as small pistons which
reconnect remnant structures with the oval window

A

ossicular chain

43
Q

bacterial biofilms are colonies/bacteria that exist in what two forms

A

sessile form (hibernating)
planktonic form (active)

44
Q

where are biofilms commonly found

A

on living/non living areas (slime, ponds, etc.)

45
Q

why are biofilms clinically relevant

A
  • bacteria changes phenotype (making it easier to reject antibiotics)
  • biofilm helps protect bacteria
46
Q

what are some otolaryngologic diseases presumed to be mediated by biofilms

A
  • chronic sinusitis
  • chronic otitis media
  • cholesteatoma
  • tonsilitis
    (chronicity is the common denominator)
47
Q

biofilms can grow on implanted substrates (including CIs) and these are often the initial sites of _________

A

colonization

48
Q

any drug/chemical that can damage OE, ME, IE

A

ototoxic

49
Q

what are some common ototoxic drugs

A

cisplatin (cancer drugs)
antibiotics
aspirin
antidepressants
etc.

50
Q

what are some ototoxic chemicals

A

1) organic solvents
2) heavy metals
3) in the home

51
Q

how does an ototoxin like aspirin affect the neuron tuning curve (3)

A

1) elevated threshold
2) widened bandwidth
3) shifts CF toward lower frequency

52
Q

diagram of the neuron tuning curve

A
53
Q

any age related hearing loss

A

presbycusis

54
Q

what is presbycusis characterized by (4)

A

1) reduced hearing sensitivity
2) reduced speech discrimination in noise
3) slowed central processing
4) impaired localization of sound sources

55
Q

what should presbycusis be considered as

A

an accumulation of acquired auditory stresses, traumas, otologic diseases and drug/chemical exposures all superimposed on an intrinsic, genetically regulated ageing process

56
Q

loss of hair cells, outer (mostly) or inner
- aging alone does not cause the loss of OHCs

A

sensory presbycusis

57
Q

also called metabolic
degeneration of stria vascularis leading to disruption or reduction in EP

A

strial presbycusis

58
Q

loss of SGN or changes in synaptic density further up the pathway prior to loss of hair cells
- may require huge losses before HL is noticed
- reduced OAEs may suggest weaknesses in MOC feedback before HL is noticed

A

neural presbycusis

59
Q

changes in stiffness of BM
- may indicate damage to: spiral ligament, limbus, BM, or supporting cells

A

conductive presbycusis

60
Q

any combination of other presbycusis’

A

mixed presbycusis

61
Q

obvious due to the wide variety of potentiating exposures & genetic variances

A

intermediate presbycusis

62
Q

NIHL can cause _____ or __________ hearing loss depending on the level of sound exposure

A

temporary (reversible) or permanent (irreversible)

63
Q

results from moderately intense sounds such as a rock concert

A

TTs

64
Q

results from 2 types of exposure
a) acoustic trauma (such as gun shot) that is sudden and usually painful [greater than 140 dB]
b) classical NIHL results from chronic exposure
[workday durations of greater than 85 dB]

A

PTS

65
Q

how can a permanent SNHL be determined

A

detected clinically by finding that bone conduction is NOT better than air conduction.

66
Q

what are some other symptoms/findings that could determine NIHL

A
  • hx of long term exposure to dangerous noise levels
  • HL involving high freq
  • SRT consistent with audiometric loss
  • HL stabilizes one noise exposure is terminated
67
Q
  • trauma noise that is usually short exposures greater than 140 dB
  • stretch inner ear tissues / organ of corti may detach from BM / tectorial membrane becomes detached from sterociliary buncles
A

direct mechanical stress (trauma noise)

68
Q
  • metabolic exhaustion of activated (stimulated) cells
  • activity induced vascular narrowing that leads to ischemia
  • ionic poisioning, oxygen/nitrogen free radical, enzymes
A

induced metabolic activity (sub-traumatic noise)

69
Q

what are the mechanisms of protection from NIHL

A

1) middle ear muscles
2) pillar cell buckling
- removing stereocilia from embedment which reduces likelihood of physical trauma to these hair cells
3) antioxidants
- Vitamincs A,C,E, etc.

Anatomy and Physiology (17 decks)

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