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A. MLA Map ENT > Physiology of Hearing > Flashcards

Physiology of Hearing Flashcards

1
Q

What are mechanoreceptors?

A
  • a somatosensory receptors
  • relay extracellular stimulus to intracellular signal transduction through mechanically gated ion channels
  • external stimuli are usually in the form of touch, pressure, stretching, sound waves, and motion
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2
Q

What is the normal range of sound that humans can hear?

1 - 5-6 decibels
2 - 15-20 decibels
3 - 50-60 decibels
4 - 115-130 decibels

A

3 - 50-60 decibels

Repeated high DB can damage hearing

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3
Q

Is the inner ear more sensitive to air or bone conduction?

A
  • Air conduction
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4
Q

Label the 2 parts of the inner ear in the image below, numbered 1-2?

vestibule (with semi-circle canals)
cochlea

A

1 - cochlea
2 - vestibular apparatus (vestibular and semi-circle canals)

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5
Q

The ossicles in the middle ear are important for transmitting the vibrations from sound waves from the outer ear to the inner ear. What is the stapes connected to?

1 - oval window
2 - temporal bone
3 - tympanic membrane
4 - pinna

A

1 - oval window

Also stapedius muscle

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6
Q

The ossicles in the middle ear are important for transmitting the vibrations from sound waves from the outer ear to the inner ear. What is the malleus connected to?

1 - oval window
2 - temporal bone
3 - tympanic membrane
4 - pinna

A

3 - tympanic membrane

Also tympanic muscle

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7
Q

There are 2 labyrinths in the inner ear, and both contain fluid. What are the names of the labyrinths and what fluid is contained within each?

A
  • bony labyrinth = perilymph
  • membranous labyrinth = endolymph
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8
Q

There are 2 labyrinths in the inner ear, the bony and membranous labyrinth, which contain perilymph and endolymph, respectively. Match the following with the fluids:

  • perilymph
  • endolymph

= high Na+ and low K+ similar to extracellular fluid
= high K+ and low Na+ similar to extracellular fluid

A

perilymph = high Na+ and low K+ similar to extracellular fluid

endolymph = high K+ and low Na+ similar to extracellular fluid

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9
Q

Which nerve is in direct contact with the cochlea, and which cranial nerve (CN) is this a branch of?

1 - cochlea branch of vestibulocochlear nerve
2 - vestibular branch of vestibulocochlear nerve
3 - chorda tympani branch of vestibulocochlear nerve
4 - all of the above

A

1 - cochlea branch of vestibulocochlear nerve
CN 8

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10
Q

Which spongy bone does the cochlea nerve and the spiral ganglion sit inside?

1 - modiolus bone
2 - temporal bone
3 - zygomatic bone
4 - mandiubular bone

A

1 - modiolus bone

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11
Q

The tubes of the cochlea are actually composed of 3 separate tubes. Label the tubes and the membrane using the labels below and what they contain (fluid wise).

  • Scala vestibuli (perilymph)
  • Scala media/cochlear duct (endolymph and the organ of Corti)
  • Scala tympani (perilymph)
  • basilar membrane
A 
1 = scala vestibuli (perilymph)
2 = scala media/cochlear duct (endolymph and organ of Corti)
3 = scala tympani (perilymph)
4 = basilar membrane
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12
Q

What is the spiral ganglion?

A
  • group of cell bodies
  • neurons axons supply the hairs of the organ of corti
  • synapses with the cochlea nerve
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13
Q

Of the 3 parts of the cochlea below, which 2 are are directly connected to the middle ear?

  • scala vestibuli (perilymph)
  • scala media/cochlear duct (endolymph and organ of Corti)
  • scala tympani (perilymph)
A
  • scala tympani connects with round window
  • scala vestibuli connects with oval window
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14
Q

When we look at the middle tube of the cochlea, the scala media/cochlear duct, there are 2 membranes, one above and one below. What are these called?

A

1 - top membrane = vestibular membrane (close to scala vestibuli)
2 - bottom membrane = basilar membrane

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15
Q

The organ of corti contains mechanoreceptor hair cells, which include an inner and outer layer. Which of there layers is important for the following:

  • sensory nerve fibres in charge of auditory transduction
  • motor nerve fibre from the brain to contract or loosen the basilar membrane
A
  • inner = sensory nerve fibres in charge of auditory transduction
  • outer = motor nerve fibre from the brain to contract or loosen the basilar membrane (if its a loud noise then this is loosened so we don’t hear as much, but if its a whisper it tightens to accentuate the sound)
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16
Q

What is the tectorial membrane?

1 - gel like membrane attached to the modiolus at one end and free on the other end
2 - gel like membrane between basilar membrane and the hair cells
3 - gel like membrane surrounding the organ of corti

A

1 - gel like membrane attached to the modiolus at one end and free on the other end

  • runs parallel to the basilar membrane throughout the cochlea with hair cells between the 2
  • in direct contact with the stereocilia (cilia) of hair cells contained within the organ of corti
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17
Q

When vibrations move through the perilymph contained within the scala vestibuli and scale tympani they create movement to the basilar membrane, which causes what to happen?

1 - basilar membrane moves and pushes hair cells into the tectorial membrane
2 - vestibular membrane pushes tectorial membrane down into hair cells
3 - basilar membrane tightens and tectorial membrane will move down into the hair cells
4 - basilar membrane loosens and tectorial membrane will move down into the hair cells

A

1 - basilar membrane moves and pushes hair cells into the tectorial membrane
- stereocilia at top of hair cells and the organ of corti are pressed into the tectorial membrane

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18
Q

When vibrations move through the perilymph contained within the scala vestibuli and scale tympani they create movement in the basilar membrane, causing the stereocilia of the hair cells and the organ of corti to press against the tectorial membrane. What does this do to the stereocilia of the hair cells?

1 - as soon as hair cells touch tectorial membrane, Na+ channels open
2 - hair cells trigger and intracellular pathway that will lead to an electrical signal
3 - tip link between adjacent stereocilia lean against one another opening mechanical gated K+ channels to open

A

3 - tip link between adjacent stereocilia lean against one another opening mechanical gated K+ channels to open

19
Q

When vibrations move through the perilymph contained within the scala vestibuli and scale tympani they create movement in the basilar membrane, causing the stereocilia of the hair cells and the organ of corti to press against the tectorial membrane. This causes the tip link between 2 adjacent stereocilia to lean against one another and open the mechanically gated K+ channels to open. What then happens to the stereocilia of the hair cells?

1 - endolymph, high in K+ runs down concentration gradient into hair cells causing depolarisation
2 - endolymph, high in Na+ runs down concentration gradient into hair cells causing depolarisation
3 - endolymph, high in K+ means K+ will leave the hair cell causing depolarisation
4 - endolymph, high in Na+ runs down concentration gradient into hair cells causing depolarisation

A

1 - endolymph, high in K+ runs down concentration gradient into hair cells causing depolarisation

  • K+ concentration is higher in endolymph than in the cells
  • K+ rushes inside the cells and depolarises
  • Ca2+ channels open increasing Ca2+
  • neurotransmitter glutamate is then released into synaptic space
20
Q

Once a hair cell has depolarised in the organ of corti due to the influx of K+, what must then happen at the basilar end, which is where the pre-synaptic membrane is located in order for this to create a neuronal signal along the cochlea branch of the vestibulocochlear nerve (CN VIII)?

1 - depolarisation of hair cells release Ca2+ signalling the release of dopamine
2 - depolarisation of hair cells release Ca2+ signalling the release of glutamate
3 - depolarisation of hair cells release Ca2+ signalling the release of serotonin
4 - depolarisation of hair cells release Ca2+ signalling the release of acetylcholine

A

2 - depolarisation of hair cells release Ca2+ signalling the release of glutamate
- neurotransmitter glutamate is then released into synaptic space

21
Q

When we look at the stereocilia, they are able to move laterally, which signals K+ influx and depolarisation. What does medial movement of the stereocilia of the hair cells cause?

1 - hyperpolarisation and must stronger action potential and glutamate release
2 - hyperpolarisation, K+ efflux from the cell, no Ca2+ channels open and no glutamate released
3 - hyperdepolarisation and must stronger action potential and glutamate release

A

2 - hyperpolarisation, K+ efflux from the cell, no Ca2+ channels open and no glutamate released

22
Q

In addition to causing the binding of vesicles containing glutamate with the pre-synaptic membrane for the release of glutamate, what else does the release of Ca2+ do to the hair cell?

1 - maintains depolarisation ensuring signal is constant
2 - can lead to excitotoxicity of the organ of corti
3 - induce hyperpolarisation of the hair cell due to an efflux of K+

A

3 - induce hyperpolarisation of the hair cell due to an efflux of K+

23
Q

On the hair cells there are 2 types of hair. What are these called?

A

1 - steriocilia
2 - kinocilia

24
Q

In the organ of corti there are inner and outer hair cells. Do they both transmit afferent and efferent nerve impulses?

A
  • no
  • inner = afferent neurons (sensory information) which signal auditory transduction
  • outer = afferent and efferent which change the stiffness of basilar membrane as required
25
Q

How is the organ of corti connected to the vestibulocochlear nerve (cranial nerve 8 (VIII))?

A
  • hair cells send action potential to spiral ganglion
  • spiral ganglion (bipolar) synapses with the cochlear nerve
  • cochlear nerve merges into the vestibulocochlear nerve (cranial nerve VIII (8)).
26
Q

Once the vestibulocochlear nerve (cranial nerve VIII (8)) has received an action potential the afferent signals synapse at the ventral and dorsal cochlea nucleus in the brain stem. From here the afferent signals will go to 3 different places, what are they?

A

1 - nerve decussates to opposite side with inferior colliculus
2 - nerve decussates to opposite side with superior olivary complex
3 - superior olivary complex on the same side

27
Q

Which bone is the auditory cortex located within in the brain?

1 - zygomatic bone
2 - temporal bone
3 - parietal bone
4 - occipital bone

A

2 - temporal bone

28
Q

The the auditory cortex is located below the temporal bone. What are the broadman areas responsible for the auditory cortex?

1 - 41 and 41
2 - 4
3 - 1, 2 and 3
4 - 17

A

1 - 41 and 41

29
Q

Although Wernicke’s area and Broca’s area are secondary auditory areas, they are involved in speech. Why are these 2 areas important for the auditory system?

A
  • Wernicke’s area (BA 22) = important for our interpretation
  • Broca’s area (BA 44) = important for speech development

BA = Broadmann Area

30
Q

Hearing loss can be subdivided into different categories. What is conductive hearing loss?

1 - disease/impairment of inner ear
2 - disease/impairment of outer ear canal or in the middle ear
3 - disease/impairment of middle ear
4 - disease/impairment of cochlear duct

A

2 - disease/impairment of outer ear canal or in the middle ear

Some form of impairment transmitted air to sound wave to stapes

31
Q

Hearing loss can be subdivided into different categories. What is sensorineural hearing loss?

  • sensor= sensory
  • neural = neurons

1 - disease/impairment of inner ear
2 - disease/impairment of outer ear canal or in the middle ear
3 - disease/impairment of middle ear
4 - disease/impairment of cochlear duct or neural pathway

A

4 - disease/impairment of cochlear duct or neural pathway
- neural pathway from the cochlea to the brain is impaired or the cochlea is damaged

32
Q

Can there be a mixture of conductive and sensorineural hearing loss?

A
  • Yes

This is called mixed hearing loss

33
Q

In the image of an audiogram below, what type of hearing loss is this?

1 - conductive
2 - normal
3 - sensorineural
4 - mixed

A

2 - normal

34
Q

Hearing loss can be subdivided into different categories. What is occupational hearing loss?

A
  • noisy work environment can cause deterioration of the organ of corti
  • organ of corti becomes less sensitive to vibrations
35
Q

Hearing loss can be subdivided into different categories. What is Ototoxic hearing loss?

A
  • oto = ear
  • toxic = dangerous causing toxicity to tissue
  • drug induced damage to hearing
36
Q

Hearing loss can be subdivided into different categories. What is infectious hearing loss?

A
  • destruction of the cochlea (mumps or rubella virus), cytomegalovirus
37
Q

Hearing loss can be subdivided into different categories. What is Tinnitus?

A
  • hearing of a sound that has no external source
38
Q

Hearing loss can be subdivided into different categories. Conductive hearing loss, which is a disease affecting the outer ear canal or in the middle ear. What are some of the most common causes of this?

A
  • earwax
  • outer ear infection
  • middle ear inflammation – Otitis media
  • perforated eardrum (due to high pressure sounds)
  • tumour in the ear canal or middle ear
39
Q

Hearing loss can be subdivided into different categories. Conductive hearing loss, which is a disease affecting the outer ear canal or in the middle ear. One such disease is Otosclerosis, what is this?

A
  • oto = ear
  • sclerosis = hard
  • hard and abnormal bone growth in the ear (Pagets disease)
  • can be genetic or external factors, such as viral infection
  • temporal bone sclerosis affects the stapes that becomes fixed to the oval window and impair vibrations
40
Q

Hearing loss can be subdivided into different categories. Conductive hearing loss, which is a disease affecting the outer ear canal or in the middle ear. One such disease is Otosclerosis, which is abnormal bone growth in the ear and can cause the temporal bone sclerosis affects the stapes, which becomes fixed to the oval window. How can this be treated?

A
  • external hearing aids (amplify sounds)
  • bypasses the need to be dependent on the stapes
  • surgery: stapedectomy that involves the use of an implant
41
Q

Cochlear implants can be used to treat people with hearing loss. What are cochlear implants?

A
  • an electronic device that provides a sense of sound to someone with severe hearing loss
  • needs to be surgically implanted
  • contains a microphone, speech processor, transmitter, receiver
    an array of electrodes
42
Q

Cochlear implants can be used to treat people with hearing loss. How do cochlear implants improve hearing?

A
  • the microphone detects sounds arranged by the processor as the external ear would
  • electrodes transform the sounds to nerve stimulations bypassing external, middle and inner ear
  • they do not completely restore hearing
43
Q

What is the most common genetic defect that causes non-syndromic hearing loss?

A
  • gene GJB2 encodes for protein connexin 26
  • this is involved in the inner ear K+ homeostasis
  • there is now a genetic test that can be done on babies
44
Q

Otosclerosis is abnormal bone growth in the temporal bone, which can cause the stapes to fuse with the oval window and impair vibrations and therefore sound. Patients can have surgery called a stapedectomy, which is removal of the stapes. This can damage one specific nerve that runs through the nerve. Which nerve is this and what can happen to the patients sensory information?

A
  • chorda tympani, part of the mastoid nerve of cranial nerve VII (7) the facial nerve runs through the middle ear
  • if damaged this can affect the patients sense of taste on anterior 2/3rds of the tongue

A. MLA Map ENT (27 decks)

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