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Hearing Disorders > Test 3 > Flashcards

Test 3 Flashcards

1
Q

Simple definition of mechanical impedance

A

how much force is needed to set a physical system in motion.

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2
Q

Simple definition of acoustic impedance

A

how much force is needed to transmit sound energy through the ear.

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3
Q

High Admittance

A

when theres too much flow because ossicles are broken

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4
Q

High Impedance

A

Too much fluid in Middle Ear which causes too much resistance

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5
Q

Acoustic Reflex Threshold:

A

Tests reflex of stapedius muscle

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6
Q

To test middle ear (tymp) what is a must?

A

The ear canal must be clear

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7
Q

When reading a tympanogram what are the 3 things we are looking for?

A

Compliance, pressure, and volume

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8
Q

Type A

A

Normal

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9
Q

Type As

A
  • tymp. membrane and ear drum is very STIFF
  • Compliance is abnormally LOW
  • see w/ otosclerosis b/c ossicles aren’t moving enough
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10
Q

Type Ad

A
  • compliance unusually HIGH
  • ear drum is very flexible, maybe stapes has broken off
  • looks like ossicular discontinuity
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11
Q

Type C

A
  • Compliance: NORMAL

- Pressure: ABNORMAL

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12
Q

Type B

A
  • completely flat
  • 0 compliance and pressure
  • ear drum did not move at all
  • otitis media, FLUID in ME that doesn’t allow for ear drum to move: normal ECV
  • or could have HOLE in ear drum: large ECV
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13
Q

If static admittance is high could have:

A

perpheration

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14
Q

If static admittance is too low:

A

problem w/ ME system

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15
Q

Tymp with abnormal ECV=

A

none. not looking at ECV. looking at pressure and compliance

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16
Q

Tymp with Abnormal pressure and Abnormal LOW Compliance

A

Type As and Type C

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17
Q

Tymp with Abnormal pressure and Abnormal HIGH Compliance

A

Type Ad and Type C

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18
Q

Normal compliance=

A

.3 to 1

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19
Q

Normal Pressure range=

A

-100daPa to +50daPa

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20
Q

Normal Volume Range=

A

0.9-2.0 cubic cm

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21
Q

Normal Static Admittance Range=

A

0.3-1.6cc

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22
Q

Normal OAE verifies what part of anatomy is functioning?

A

Outer Hair Cells

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23
Q

Will there be OAE results if there is a conductive HL?

A

No. Outer ear and Middle Ear must be normal to get OAE results.

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24
Q

What does ABR test?

A

CN VIII through LL

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25
Q

If there is an abnormal tymp, what type of HL?

A

Conductive

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26
Q

What is Acoustic Threshold?

A

what is the quietest to get it to reflex, to test AC

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27
Q

If normal tymp but abnormal OAE, what type of Audiogram would you expect?

A

Sensorineural

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28
Q

Abnormal tymp and abnormal OAE could be

A

Conductive or Mixed

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29
Q

Acoustic Reflex Arc Ipsilateral

A

outer ear, middle ear, inner ear, auditory nerve, cochlear nucleus, superior olivary complex, facial nerve, middle ear

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30
Q

Acoustic Reflex Arc Contralateral pathway

A

After SOC, to contra SOC to facial nerve to middle ear

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31
Q

Acoustic Reflex purpose:

A

What is the lowest dB level we can get stapedius muscle to contract

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32
Q

Normal Acoustic Reflex Result

A

normal sensation level (about 85dBSL)

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33
Q

Acoustic Reflex Outcomes

A
  • Reflex may be absent at limit of reflex activating system (usually 110 to 125dB)
  • reflex may be present, in case of hearing loss, but at low sensation level (less than 60dB above audiometric threshold
  • reflex may be present but at high sensation level (greater than 100dB above the audiometric threshold
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34
Q

Absent Acoustic Reflex

A

damage to CNVIII, facial nerve

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35
Q

Acoustic Reflex Cochlear HL results:

A

high freq decay

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36
Q

Acoustic Reflex CNVIII

A

decay in 3-5sec at all freq

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37
Q

Acoustic Reflex Facial Nerve Damage

A

: rapid acoustic reflex decay

38
Q

OAE Measurement

A
  • Probe in EAC, contains mini speaker to present evoking stimulus and also tiny mic to pick up emission and convert it from sound to electrical signal
  • Determines OHC function
  • If present in known SNHL, then disorder is retrocochlear
39
Q

Factors affecting OAE

A
  • Poor probe tip placement
  • Outer/middle ear dysfunction
  • Noisy, uncooperative patient
  • Ototoxicity, noise exposure, cochlear damage
40
Q

OAE:

A
  • ear makes sound back (ringing) twitch of muscle.

- outer hair cells produce sounds as they expand and contract.

41
Q

Types of OAE’s

A

-Transient Evoked:Does not guarantee normal hearing
Cannot determine if hearing loss is cochlear or OHCs
-Distortion Product: most common test

42
Q

Auditory Evoked Potentials:

A
  • measure ear’s response to diff. sounds
  • how long it takes for resonse to occur
  • amp= how strong response is
  • use ABR
43
Q

Process of AEP:

A
  • insert ephones.
  • click stimulates cochlea
  • EEG picks up response
  • use to make sure everything is ok after surgery or if patient has downs syndrome
44
Q

ECOG

A
  • best tested near field on promonotory btwn oval and round window
  • not easy to test
  • often done during surgical process
  • testing as soon as info. comes out of cochlea
45
Q

ABR

A
  • most common
  • electrodes on mastoid or ear lobe and on vertex (center line)
  • 7 waves, look for 1,3, and 5
46
Q

For ABR waves 1,3, and 5 look for:

A
  • time they occur
  • time distance btwn certain waves 1&3, 3&5, then 1&5
  • is info. taking longer than should?
  • waves not occurring-something blocking
47
Q

ABR Guidelines

A
  • click stimulates entire cochlea or freq. specific tone burst w/ children to find threshold (freq. specific)
  • must be in relaxed state , no clenching jaw, may sleep
  • may do it at 1 vol-tumor
  • change vol-threshold
48
Q

Stacked ABR

A
  • id very small vest. shwa.

- Measures whole nerve and whole cochlea by stacking amplitudes

49
Q

MLR

A
  • 15-60 msec
  • Considered myogenic for long time, now considered neurogenic
  • Patient must be awake but relaxed
  • Assesses neurologic function of higher CANS
50
Q

LLR

A
  • no sleeping but need to be relaxed
  • Use freq spec stimuli or short segments of speech
  • Difficult to use with children
  • Responses are called P1, P2, N1, N2 and P300
51
Q

ASSR

A

-becoming more common to newborn screening
-Useful in threshold determination in children (shorter than tone burst ABR)
500, 1000, 2000, 4000Hz
-Patient may be asleep

52
Q

Loudness Balancing

A

-Normal ears show logical progression of loudness as intensity increases
-Same is true of conductive hearing loss
ie 50dB tone above a threshold of 10dB (60dBHL), is equivalent as a 50dB tone above a threshold of 40dB (90dBHL) when conductive

53
Q

SISI

A
  • If can direct small changes in intensity
  • present at 20dB above threshold
  • Persons w. lesions of cochlea detect extremely small changes in intensity
  • Cochlear loss detect each increase
  • Retrocochlear, conductive and normal hearing will not detect all of them and may not detect any
54
Q

Tone Decay

A
  • able to hear a tone occurring
  • cochlear tone will go away even if still presented
  • 8th cranial=rapid decay
55
Q

If HL is conductive, why would DPOAE results be abnormal

A

-outer and middle ear must be normal to test DPOAE b/c can’t even get to cochlea b/c O and ME are abnormal

56
Q

Presbycusis

A

-age related HL

57
Q

Otosclerosis

A
  • will see decrease at 2000 Hz

- pregnancy, women, female relative, Type As

58
Q

Sensorineural would be what type of Tymp

A

Type A

59
Q

Pediatric MRL:

A
  • Minimal Response Levels
  • May be well above threshold
  • May be anything from slight movement, change in vocalization or may be unobservalble, except for a change in electrophysiological system
60
Q

Infant Hearing Screening

A

-mandatory

61
Q

Newborn Hearing Screening Equipment

A

-ABR: Diagnostic equipment developed simply for this purpose
-OAE: May have higher failure rate bc of conductive loss
Cheaper, easier
-ASSR: More expensive, but may be part of ABR diagnostic equipment

62
Q

BOA

A
  • Behavioral Observation Audiometry
  • Child sits on adults lap
  • May use noisemakers, or other non-calibrated sounds
  • Determine if child turns in response to sound
63
Q

VRA

A

-Visual Reinforcement Audiometry
-Noise made
-Child looks toward sound
-Reinforcement given (animated toy, light, picture)
-May be done in soundfield or w. headphones
6 months until 3 years

64
Q

Play Audiometry

A

-Can use stimuli through soundfield or earphones
-Can use screener/portable audiometer
Or can use 2 audiologists
-When sound is heard, toy is placed in bucket

65
Q

Pediatric Sound Field Testing

A
  • Narrowband, voice, warble tone
  • Will not id if loss is unilateral or bilateral
  • Look for child’s behavior in response to sound, Eye widening, Head turn, Eye turn, Stop crying, Startle
  • May respond to sound turning off, instead of sound turning on
66
Q

Pediatric Pure Tone

A
  • May not give correct responses
  • Two step directions
  • Can ask where sound is coming from
  • How many tones did they hear
67
Q

Pediatric Speech Audiometry

A 
Sometimes only responses you can obtain
SRT, Spondee
Touching body parts
Point to people
Ask questions
Appropriate vocab
68
Q

Pediatric Ling Sounds

A

/a/, /u/, /i/, /S/, /s/, /m/
Ling Six Sound Test
Use for SRT
Can use for CI verification

69
Q

Pediatric Referrals

A 
Concern about hearing loss due to:
Language delay/disorder
Other diagnosis
Fail school/pediatrician screening
Parental concern
70
Q

Hearing Aids Gain

A

difference between input signal and output signal

71
Q

Hearing Aids Frequency Response

A

Range of frequencies that can be amplified

72
Q

NOAH

A

only way to program hearing aid

73
Q

dmics

A

2 mics per hearing aid. one will pick up all sounds and other will pick up sound in direct direction (in front of you not noise behind you)

74
Q

BTE

A

behind the ear, the best

75
Q

ITE

A

in the ear (full)

76
Q

Half Shell

A

half ITE

77
Q

ITC

A

in the canal

78
Q

CIC

A

Completely in canal

79
Q

Mini BTE

A

receiver in ear/canal

80
Q

CROS Aids

A
  • normal in one, absolute 0 in other
  • has mic that picks up sound and transferred to good ear
  • good ear can hear on bad side
  • no localization though
81
Q

BICROS

A

-O in one ear, HL in better ear and signal is amplified

82
Q

Bone Conduction Hearing Aid

A
  • put screw behind mastoid and snap on box
  • if conductive HL, no ear canal, treacher collins, otosclerosis
  • functions as bone osscilator
  • for unilateral HL, works 100% of time
83
Q

Vibrotactile Hearing Aid

A
  • use vibrations to send info.

- use elastic band on head and BAHA sits on back of head until old enough to have screw in head

84
Q

Hearing Aids: Are 2 better than 1?

A

-yes, hear further and better, louder with both ears working

85
Q

Binaural Deprivation

A

-if only 1 hearing aid, other ear gets lazy and decrease faster. PTAS and WRS

86
Q

Data logging:

A

able to tell how often wear hearing aids, how often they turn it up

87
Q

FM tech:

A

-use w. children in school. allows teacher to wear mic

88
Q

Feedback (Hearing Aids)

A

when it whistles

89
Q

Cochlear Implant

A

-electrically stimulates auditory nerve of patients w. severe to profound HL to provide environmental sound and speech info, especially suprasegmental elements

90
Q

Implant Candidacy for Adults

A

-3-6 month trial period w. amp
-Show little benefit from hearing aids
-Score less than 40% on SRT
“Good attitude”- want to be part of hearing community
Overall good general health
Good emotional health and motivation to participate in intensive rehabilitation program
-if born deaf would really not be able to speak well

91
Q

Admittance

A

Ease at which energy will flow through am vibrating system

Hearing Disorders (1 decks)

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