the auditory and vestibular function Flashcards

1
Q

what I hyperacusis

A

Hyperacusis is when everyday sounds seem much louder than they should

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2
Q

The middle ear conducts sound waves from the

A

the tympanic membrane to the oval window as vibrations along the malleus incus and stapes.

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3
Q

the endolymph is between the Scala vestibule and scale tympani

A

high in potassium - ecf

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4
Q

perilymph is found in the scala media

A

potassium

hair cells ( sterocilia on top) mallow potassium to move inside to out from endolymph to perilymph causing calcium channel to open which then causes AP in CN8

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5
Q

hair cell are between where

A

are between the basilar and tectorial membrane

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6
Q

where is your auditory cortex

A

temporal cortex

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7
Q

where does the primary auditory pathway cross over

A

superior olivary nucleus

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8
Q

high er pitch Is found at higher frequencies - where is this found on the cochlear

A

base of the cochlear

apex is lower frequencies

The width of the basilar membrane increases towards the apex

Therefore location on the membrane has a different resonant frequency

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9
Q

is the decibel threshold measured logarithmically

A

yes

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10
Q

what common antibiotic can cause ototoxicity

A

gentamicin

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11
Q

tinnitus - how long - start off and on constant leading to sudden blindness what could it be

A

posterior cerebellar stroke

when you’ve got vertigo need to figure out wether it is BBPV - things moving around you
lying down and turning head
or when you stand up like orthostatic hypertension

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12
Q

This involves holding a tuning fork in front of the ear (to elicit air conduction) and behind the ear on the mastoid process (to elicit bone conduction). As the table shows, if air conduction is better than bone conduction this could be NORMAL or it could be a SENSORINEURAL deficit.

A

rinnes test

You need to then conduct a Weber test to check. A Weber test is where you place the tuning fork in the middle of the forehead. If the patient hears the sound ‘in the middle’ then their hearing is normal. If they hear it louder in one ear than the other, they have a SENSORINEURAL deficit. The ear that hears the sound is the normal ear, the ear that doesn’t hear the sound has a sensorineural hearing loss. CONDUCTIVE hearing loss is a bit easier to work out. Basically, if bone conduction is better than air conduction (sound heard louder when tuning fork behind ear rather than in front of ear) then there is a conductive hearing loss. To work out which ear the hearing loss is in you then perform the Weber test. The patient will hear the sound LOUDER in the AFFECTED ear than the normal ear. Watch the video to see how one is performed.

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13
Q

Quantitative hearing testing is done with an

both bone conduction (triangles/brackets) and air conduction (O’s on right and X’s on left)

both lines overlapping sensioureuneral

A

audiogram
To do this, they basically play the patient lots of sounds at different decibels (volume) and frequency (pitch) and assess how loud the volume (how high the decibels) need to be for them to hear that sound. Normal is anything between 0 and 20dB! (so looking at the graph, any line that is above the line of 20dB on the graph - see blue arrow). Most audiograms will have a line for air and bone conduction plotted on the same chart. In a normal person, air conduction and bone conduction will have very similar plots (they will be along a similar line and overlap each other).

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14
Q

what crista ampullaris

A

The crista ampullaris is the sensory organ of rotation located in the semicircular canal of the inner ear.

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15
Q

difference between semicircular canals and otolith organs

A

There are two sets of end organs in the inner ear, or labyrinth: the semicircular canals, which respond to rotational movements (angular acceleration); and the utricle and saccule within the vestibule, which respond to changes in the position of the head with respect to gravity (linear acceleration).

Acceleration / gravity causes otoliths to move, creating a shearing effect in the gel matrix that activates the hair cells

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16
Q

Oculocephalic reflex

A

normally eyes turn opposite to head movement
abnormal if they have like a brain stem ( pontine ) ischaemia

both when the patient is unconscious s

17
Q

60yr old female who feels the room spin when she turns over in bed or hangs the washing on the line for the last week - each episode lasts - 60seocnds

dix hall pike test postive
what is diagnosis

causes by calcium debris within semicircular canal ( loose otoconai from utricle)

have debris causes inappropriate mvoemtn of endolymph with linear accelerations such as gravity and causes the erroneous sensation of spinning when the head shifts with respect to gravity

A

BPPV

benign - not due to serious disease

paroxysmal - occurs in short burst of 1 minute

positional - provoked specifically by movement to from certain positions

vertigo - dizziness defined as an illusion of movement

18
Q

pupillary reflex - reaction to bright light

A

2 - sensory

3 motor

19
Q

corneal reflex - cotton wool on cornea

A

5

7

20
Q

oculovestibular - saline to tympanic membrane

A

8

3,4,6

21
Q

pain Epson e- supra orbitala

A

5,7,

22
Q

agag reflex- instrument contact to pharynx

A

9,10

23
Q

coug reflex - suction catheter to carina

A

10 both

24
Q

35yr old female instead and dizzy like the room is spinning making her feel sick. it is often present when she wakes up and can start suddenly.

what is it

A

vestibular neuritis
due to inflammation of the vestibular nerve
may occur after a viral infection

no effect on hearing though

25
Q

45yr female unsteady and dizzy like room spinning and feeling sick. it often present when she wakes up and it starts suddenly. she has noticed some hearing loss and tinnitus
what is it

A

labyrinthitis

inflammation of the membranous labyrinth

symptoms of vestibular neuritis and labyrinthitis are very similar but labyrinthitis does after hearing

sensorineural deafness

26
Q

50yr old attacks of vertigo and vomtiign once a month. each episode lasts a couple hours. feeling of fullness in the ear and is beginning to lose hearing

A

menieres disease

progressive distension of the membranous labyrinth due to excessive endolymph
this may injure the vestibular system causing vertigo or the cochlea causing hearing loss