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Physiologic Testing Flashcards

1
Q

What doesn’t a physiologic test require?

A

A behavioral response from patients

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2
Q

What test falls under a physiologic test?

A
  1. Tympanometry
  2. Acoustic Reflexes
  3. Otoacoustic Emissions
  4. Auditory Evoked Potentials
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3
Q

What is Acoustic Immittance?

A

Measurements made by Acoustic Impedance Meters

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4
Q

An acoustic immittance makes up?

A

The tympanometry and acoustic reflex text

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5
Q

What does tympanometry test?

A

Middle Ear function

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6
Q

To test the middle ear function, what’s being measured?

A
  1. Tympanic Membrane Compliance
  2. Physical Volume
  3. Middle Ear Pressure
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7
Q

An acoustic immittance equipment has how many tubes?

A

3

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8
Q

What are three tubes that makes up the Acoustic Immittance test?

A
  1. Speaker
  2. Microphone
  3. Air pressure pump
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9
Q

For the Tympanometry test, what’s the purpose of the speaker?

A

Sends sound into the ear

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10
Q

For the Tympanometry test, what’s the purpose of the microphone?

A

It measures the sound that comes back after a sound was sent down the ear canal

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11
Q

For the Tympanometry test, what’s the purpose of air pressure pump?

A

It changes the pressure in the ear canal

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12
Q

For the Tympanometry test, when is an additional speaker used?

A

Contralateral acoustic reflexes

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13
Q

For the Tympanometry test, what needs to happen?

A
  1. A tight seal of ear canal with probe

2. EAC must be clear of cerumen/foreign objects

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14
Q

For the Tympanometry test, why must the EAC be free of cerumen/foreign objects?

A

If it’s not free of cerumen/foreign objects we won’t get an accurate result of the movement

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15
Q

For the Tympanometry test, define compliance

A

Compliance is how the eardrum moves as you change pressure in the ear canal

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16
Q

For the Tympanometry test, as we increase pressure to a specific level, what’s being introduced?

A

Sound is being introduced into to EAC

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17
Q

For the Tympanometry test, how does TM mobility affect sound being reflected?

A

If a lot of sound gets bounced back, the TM is not moving

If a lot of sound is not bouncing back, then the TM is moving, and sound is going where it needs to.

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18
Q

For the Tympanometry test, what does the physical volume portion measures?

A

The volume of the ear canal

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19
Q

For the Tympanometry test, how can physical volume be helpful?

A

It can help identify perforations and cerumen impaction

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20
Q

For the Tympanometry test, what is the breakdown of volume with regards to perforation

A

Large volume = Perforation

Average Volume = No perforation

Small volume = Cerumen Impaction

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21
Q

For the Tympanometry test, what is the Compliance/Physical Volume normative data for adults?

A

Compliance: 0.30-1.70

Volume = 0.9 - 2.0

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22
Q

For the Tympanometry test, what is the Compliance and Physical Volume normative date for children?

A

Compliance: 0.25-1.05

Volume: 0.3-0.9

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23
Q

For the Tympanometry test, what does smaller and larger numbers means for compliance?

A

The smaller #’s means the ear canal is more stiff

The larger the #’s means the eardrum is more floppy

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24
Q

For the Tympanometry test, when the eardrum is too floppy what could be the causes?

A
  1. Perforation that heals and the layers of the TM membrane doesn’t grow back
  2. Ossicular Disarticulation
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25
Q

For the Tympanometry test, when getting the results for Physical Volume, what should you do and why?

A

Compare right and left with each other because if the number matches in both ears, then there’s nothing to worry about

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26
Q

For the Tympanometry test, the middle ear pressure is determined by?

A

Varying pressure in the EAC until point of maximum vibration was found

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27
Q

For the Tympanometry test, what are the two steps when finding the middle ear pressure?

A
  1. Find the point where eardrum moves the best

2. Note that that answer would be the same for the ME space

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28
Q

For the Tympanometry test, what should the daPa # be for the ME pressure to be considered normal?

A

~0daPa

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29
Q

For the Tympanometry test, what should the daPa # be for the ME pressure to be considered abnormal?

A

Less than or = to -200 dPa

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30
Q

For the Tympanometry test, what type of number is extremely rare for the middle ear pressure?

A

Extreme positive pressure

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31
Q

From the Tympanometry test what does the machine create? And what is it called?

A

A graphic representation of results called a tympanogram

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32
Q

For the Tympanometry test, how are the graph, compliance, physical volume, and ME pressure identified?

A
  1. Graph
    Upside down ‘V’
  2. Compliance
    Height of peak
  3. Physical volume
    Height of line
  4. ME pressure
    Location of peak (where the peak falls on horizontal axis)
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33
Q

For the Tympanometry test, what are the tympanogram classifications?

A
  • Type A
  • Type A(S)
  • Type A(D)
  • Type B
  • Type C
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34
Q

For the Tympanometry test, what is the normal tympanogram?

A

Type A

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35
Q

For the Tympanometry test, what does a Type A tympanogram mean?

A
  1. Normal middle ear function

2. Normal compliance, physical volume, ME pressure

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36
Q

For the Tympanometry test, what does Type A(s) tympanogram mean?

A
  • Reduced compliance (stiffness)
  • Normal physical volume
  • Normal middle ear pressure
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37
Q

For the Tympanometry test, what does Type A(d) tympanogram mean?

A
  • Increased Compliance (extra floppy)
  • Normal physical volume
  • Normal ME pressure
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38
Q

For the Tympanometry test, what does Type B tympanogram mean?

A
  • No TM mobility
  • No ME pressures
  • Could have normal, small, or large physical volume
39
Q

For the Tympanometry test, what does Type C tympanogram mean?

A
  • Compliance depends on height of peak
  • Normal physical volume
  • Negative middle ear pressure
40
Q

For the Tympanometry test, why should we learn about tympanogram graphs?

A
  1. To assess ME issues
  2. To assess TM perforation
  3. To identify prolonged negative middle ear
41
Q

For the Tympanometry test, what does a flatter tymps for ME issue mean?

A

It’s a result from obstruction to sound

42
Q

For the Tympanometry test, what does a deeper tymps for ME issue mean?

A

Result from hypermobility

43
Q

What equipment does the Acoustic Reflex Testing use?

A

Acoustic Immittance Equipment

44
Q

What does an acoustic reflex mean?

A

When a bilateral muscle contracts in response to loud sound

45
Q

When an acoustic reflex occurs, what happens?

A

It causes the ME system to stiffen

46
Q

For Acoustic Reflex Testing, what is the equipment measuring?

A

When a loud sound is played in the ear, we will know when the eardrum stiffens

47
Q

For Acoustic Reflex Testing, for normal hearing individuals, what will the reflex to pure tones elicit?

A

85-100 dB SPL

48
Q

For Acoustic Reflex Testing, what kind of response is it?

49
Q

For Acoustic Reflex Testing, how do measure Acoustic Reflex?

A
  1. Present a pure tone signa at 500, 1k, 2k Hz to ear

2. Look for a decrease in TM compliance (when it stiffens)

50
Q

For Acoustic Reflex Testing, what are you looking for to find out the client’s acoustic reflex threshold?

A

The softest level at which reflex (the eardrum stiffens) occurs

51
Q

For Acoustic Reflex Testing, what are the two ways you can measure the acoustic reflex?

A
  1. Ipsilateral

2. Contralateral

52
Q

For Acoustic Reflex Testing, what does ipsilateral mean for measuring acoustic reflex?

A

You will stimulate and measure reflex in the same ear

53
Q

For Acoustic Reflex Testing, what does contralateral mean?

A

You will stimulate one ear and measure reflex in opposite ear

54
Q

For Acoustic Reflex Testing, what are the possible outcomes from the test?

A
  1. Expect normal sensation levels ~85 dB SL
  2. Absent to the limit of the equipment/machine
  3. AR occurring at reduced sensation levels (<60 dB SL)
  4. AR present at elevated sensation levels
55
Q

What is Otoacoustic Emission (OAE)

A

An acoustic signal that comes out of your ear, which is a weak or soft generated by the outer hair cells

56
Q

For Otoacoustic Emission, where does the signal come from?

A

The outer hair cells

57
Q

For Otoacoustic Emission, if there’s damage to the outer hair cells, what does that mean for OAE?

A
  1. There will be a reduced (quitter) OEAs

2. Or there will be eliminates (no signal at all) OAEs

58
Q

For Otoacoustic Emission, what are types of testing?

A
  1. Spontaneous Otoacoustic Emission (SOAE)

2. Evoked Otoacoustic Emissions (EOAE)

59
Q

For Otoacoustic Emission, what is spontaneous otoacoustic emissions?

A

Without giving an external stimulus, you’re able to measure the otoacoustic emission

60
Q

For Otoacoustic Emission, why isn’t using spontaneous otoacoustic emission used for clinical purposes?

A

SOAE is present in over 50% of the normal hearing population, which is not enough for us to use for clinical purposes

61
Q

For Otoacoustic Emission, what is evoked otoacoustic emissions (EOAE)?

A

Are hair cells responses brought about by a signal

62
Q

For Otoacoustic Emission, for EOAE, what’s the procedure?

A
  1. A signal would be presented for 5-20ms

2. After presentation to the EC, then we measure the signal that came back from the hair cells

63
Q

For Otoacoustic Emission, what kind of probe is used?

A

It’s like the tymp probe (soft flexible mushroom probe & need a seal but not too tight)

64
Q

For Otoacoustic Emission, are we pressuring?

A

No, but a good seal is still needed

65
Q

For Otoacoustic Emission, what are the two types of EOAE that we may use?

A
  1. Transient-Evoked Otoacoustic Emissions (TEOAE)

2. Distortion-Product Otoacoustic Emissions (DPOAE)

66
Q

What is a transient-evoked otoacoustic emission?

A

It’s sound from the outer hair cells dancing brought out by a transient signal

67
Q

For Transient-evoked Otoacoustic Emission, what stimulus is used?

68
Q

For Transient-evoked Otoacoustic Emission, is the stimulus used frequency specific?

69
Q

For Transient-evoked Otoacoustic Emission, why isn’t using a click ideal for clinical purposes?

A

Since the click isn’t frequency specific, we’ll get a lot of different areas from the hair cells dancing and this will give us a broad response and not isolate the different areas of the cochlea

70
Q

What is Distortion-product Otoacoustic emission?

A

Two tones at different frequencies are being presented to the ear and it creates a distortion product and stimulate a particular region of the cochlea

71
Q

What does DPOAE allows us to do?

A

To isolate different areas of the cochlea

72
Q

When using DPOAE as a diagnostic tool, what does it provide?

A
  1. Information specifically on outer hair cell cochlear function
  2. Amplitude of response
73
Q

For DPOAE, what does ‘amplitude of response typically matches with hearing loss’ mean?

A

Greater the amplitude, the better the functioning of hair cells but if it’s a significant HL, the less dancing of the hair cells and if the hair cells aren’t dancing then the less sound the hair cells generate for us to record

74
Q

For DPOAE as a diagnostic tool, what’s the issue we come across?

A

If the SNHL is >40 dB HL, OAEs will not be present past a mild hearing loss

75
Q

For DPOAE as a diagnostic tool, since OAEs won’t be present past 40 dB HL or greater, what does that mean for threshold searching?

A

We can’t use OAEs to determine a threshold search since they’re absent, we’re not exactly sure at what hearing severity OAEs are absent (mild, severe etc?)

76
Q

For DPOAE as a diagnostic tool, what is it good for?

A

It does not require a behavioral response from client

77
Q

For DPOAE as a diagnostic tool, even though it measures cochlear function, where must sound pass?

A

Through the ME space to reach the cochlea

78
Q

For DPOAE as a diagnostic tool, what hearing loss would exist for OAEs to be present?

A

CHL since sound must pass through ME space to the cochlea

79
Q

For DPOAE as a diagnostic tool, who is often used for?

A
  1. Individuals who can’t or won’t provide behavioral response
  2. Newborn screenings
80
Q

For DPOAE as a diagnostic tool, what other function can it serve?

A
  1. As a screening tool in some medical offices

2. Used to monitor individuals at risk for OHC damage

81
Q

What is Auditory Evoked Potentials (AEP)?

A

A very small electrical response to sound from the cochlea, brainstem, and cortex

82
Q

What is needed to record an AEP?

A
  1. Electrode being placed on the scalp
  2. Transducer
  3. Stimulus
83
Q

Where does Auditory Brainstem Response (ABR) comes from?

A

It’s a type of Auditory Evoked Potentials

84
Q

What is ABR?

A

A series of seven ‘wavelets’ that appear within 10 ms after the stimulus

85
Q

Which AEP is often used?

86
Q

For ABR, where does the response originate?

A

From the VIIIth nerve and brainstem

87
Q

For the wavelets, what are you looking at?

A

Analyzing latency and amplitude of waves as compared to norms

88
Q

For AEPs, what the relationship between an electrical amplitude and the AEP system?

A

The greater the electrical amplitude response to sound is, the better the AEP system

89
Q

For ABRs, what stimuli is preferred?

A

Tone burst

90
Q

What equipment can we use for threshold search?

91
Q

What is the ABR, not affected by?

A

Attention or Sleep

92
Q

AEPs in general…

A
  1. Use to identify retro-cochlear pathology
  2. Identify behavioral thresholds
  3. Used in newborn hearing screenings
  4. Some medical office (but less common)
  5. Used for intraoperative monitoring
93
Q

What else can AEPs do?

A
  1. Evaluate other portions of SN mechanism

3. Evaluate auditory processing

AUDIOLOGY (18 decks)

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