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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
For the Tympanometry test, when getting the results for Physical Volume, what should you do and why?
Compare right and left with each other because if the number matches in both ears, then there's nothing to worry about
26
For the Tympanometry test, the middle ear pressure is determined by?
Varying pressure in the EAC until point of maximum vibration was found
27
For the Tympanometry test, what are the two steps when finding the middle ear pressure?
1. Find the point where eardrum moves the best | 2. Note that that answer would be the same for the ME space
28
For the Tympanometry test, what should the daPa # be for the ME pressure to be considered normal?
~0daPa
29
For the Tympanometry test, what should the daPa # be for the ME pressure to be considered abnormal?
Less than or = to -200 dPa
30
For the Tympanometry test, what type of number is extremely rare for the middle ear pressure?
Extreme positive pressure
31
From the Tympanometry test what does the machine create? And what is it called?
A graphic representation of results called a tympanogram
32
For the Tympanometry test, how are the graph, compliance, physical volume, and ME pressure identified?
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)
33
For the Tympanometry test, what are the tympanogram classifications?
- Type A - Type A(S) - Type A(D) - Type B - Type C
34
For the Tympanometry test, what is the normal tympanogram?
Type A
35
For the Tympanometry test, what does a Type A tympanogram mean?
1. Normal middle ear function | 2. Normal compliance, physical volume, ME pressure
36
For the Tympanometry test, what does Type A(s) tympanogram mean?
- Reduced compliance (stiffness) - Normal physical volume - Normal middle ear pressure
37
For the Tympanometry test, what does Type A(d) tympanogram mean?
- Increased Compliance (extra floppy) - Normal physical volume - Normal ME pressure
38
For the Tympanometry test, what does Type B tympanogram mean?
- No TM mobility - No ME pressures - Could have normal, small, or large physical volume
39
For the Tympanometry test, what does Type C tympanogram mean?
- Compliance depends on height of peak - Normal physical volume - Negative middle ear pressure
40
For the Tympanometry test, why should we learn about tympanogram graphs?
1. To assess ME issues 2. To assess TM perforation 3. To identify prolonged negative middle ear
41
For the Tympanometry test, what does a flatter tymps for ME issue mean?
It's a result from obstruction to sound
42
For the Tympanometry test, what does a deeper tymps for ME issue mean?
Result from hypermobility
43
What equipment does the Acoustic Reflex Testing use?
Acoustic Immittance Equipment
44
What does an acoustic reflex mean?
When a bilateral muscle contracts in response to loud sound
45
When an acoustic reflex occurs, what happens?
It causes the ME system to stiffen
46
For Acoustic Reflex Testing, what is the equipment measuring?
When a loud sound is played in the ear, we will know when the eardrum stiffens
47
For Acoustic Reflex Testing, for normal hearing individuals, what will the reflex to pure tones elicit?
85-100 dB SPL
48
For Acoustic Reflex Testing, what kind of response is it?
Bilateral
49
For Acoustic Reflex Testing, how do measure Acoustic Reflex?
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
For Acoustic Reflex Testing, what are you looking for to find out the client's acoustic reflex threshold?
The softest level at which reflex (the eardrum stiffens) occurs
51
For Acoustic Reflex Testing, what are the two ways you can measure the acoustic reflex?
1. Ipsilateral | 2. Contralateral
52
For Acoustic Reflex Testing, what does ipsilateral mean for measuring acoustic reflex?
You will stimulate and measure reflex in the same ear
53
For Acoustic Reflex Testing, what does contralateral mean?
You will stimulate one ear and measure reflex in opposite ear
54
For Acoustic Reflex Testing, what are the possible outcomes from the test?
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
What is Otoacoustic Emission (OAE)
An acoustic signal that comes out of your ear, which is a weak or soft generated by the outer hair cells
56
For Otoacoustic Emission, where does the signal come from?
The outer hair cells
57
For Otoacoustic Emission, if there's damage to the outer hair cells, what does that mean for OAE?
1. There will be a reduced (quitter) OEAs | 2. Or there will be eliminates (no signal at all) OAEs
58
For Otoacoustic Emission, what are types of testing?
1. Spontaneous Otoacoustic Emission (SOAE) | 2. Evoked Otoacoustic Emissions (EOAE)
59
For Otoacoustic Emission, what is spontaneous otoacoustic emissions?
Without giving an external stimulus, you're able to measure the otoacoustic emission
60
For Otoacoustic Emission, why isn't using spontaneous otoacoustic emission used for clinical purposes?
SOAE is present in over 50% of the normal hearing population, which is not enough for us to use for clinical purposes
61
For Otoacoustic Emission, what is evoked otoacoustic emissions (EOAE)?
Are hair cells responses brought about by a signal
62
For Otoacoustic Emission, for EOAE, what's the procedure?
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
For Otoacoustic Emission, what kind of probe is used?
It's like the tymp probe (soft flexible mushroom probe & need a seal but not too tight)
64
For Otoacoustic Emission, are we pressuring?
No, but a good seal is still needed
65
For Otoacoustic Emission, what are the two types of EOAE that we may use?
1. Transient-Evoked Otoacoustic Emissions (TEOAE) | 2. Distortion-Product Otoacoustic Emissions (DPOAE)
66
What is a transient-evoked otoacoustic emission?
It's sound from the outer hair cells dancing brought out by a transient signal
67
For Transient-evoked Otoacoustic Emission, what stimulus is used?
A click
68
For Transient-evoked Otoacoustic Emission, is the stimulus used frequency specific?
No
69
For Transient-evoked Otoacoustic Emission, why isn't using a click ideal for clinical purposes?
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
What is Distortion-product Otoacoustic emission?
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
What does DPOAE allows us to do?
To isolate different areas of the cochlea
72
When using DPOAE as a diagnostic tool, what does it provide?
1. Information specifically on outer hair cell cochlear function 2. Amplitude of response
73
For DPOAE, what does 'amplitude of response typically matches with hearing loss' mean?
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
For DPOAE as a diagnostic tool, what's the issue we come across?
If the SNHL is >40 dB HL, OAEs will not be present past a mild hearing loss
75
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?
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
For DPOAE as a diagnostic tool, what is it good for?
It does not require a behavioral response from client
77
For DPOAE as a diagnostic tool, even though it measures cochlear function, where must sound pass?
Through the ME space to reach the cochlea
78
For DPOAE as a diagnostic tool, what hearing loss would exist for OAEs to be present?
CHL since sound must pass through ME space to the cochlea
79
For DPOAE as a diagnostic tool, who is often used for?
1. Individuals who can't or won't provide behavioral response 2. Newborn screenings
80
For DPOAE as a diagnostic tool, what other function can it serve?
1. As a screening tool in some medical offices | 2. Used to monitor individuals at risk for OHC damage
81
What is Auditory Evoked Potentials (AEP)?
A very small electrical response to sound from the cochlea, brainstem, and cortex
82
What is needed to record an AEP?
1. Electrode being placed on the scalp 2. Transducer 3. Stimulus
83
Where does Auditory Brainstem Response (ABR) comes from?
It's a type of Auditory Evoked Potentials
84
What is ABR?
A series of seven 'wavelets' that appear within 10 ms after the stimulus
85
Which AEP is often used?
ABR
86
For ABR, where does the response originate?
From the VIIIth nerve and brainstem
87
For the wavelets, what are you looking at?
Analyzing latency and amplitude of waves as compared to norms
88
For AEPs, what the relationship between an electrical amplitude and the AEP system?
The greater the electrical amplitude response to sound is, the better the AEP system
89
For ABRs, what stimuli is preferred?
Tone burst
90
What equipment can we use for threshold search?
ABR
91
What is the ABR, not affected by?
Attention or Sleep
92
AEPs in general...
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
What else can AEPs do?
1. Evaluate other portions of SN mechanism | 3. Evaluate auditory processing

AUDIOLOGY (18 decks)

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