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AUDIOLOGY > The Inner Ear > Flashcards

The Inner Ear Flashcards

1
Q

The inner ear house structures for….

A

Hearing and Balance

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2
Q

What structures of the inner ear are important for hearing?

A

Cochlea & Auditory Nerve

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3
Q

What structures are important for balance?

A

Semicircular & Vestibular Portion of the 8th Nerve

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4
Q

To maintain balance, we rely on input from how many body systems?

A

Three

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5
Q

What are the body systems we rely input from to maintain balance?

A
  1. Visual
  2. Proprioceptive
  3. Vestibular
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6
Q

Define “visual” for the vestibular system

A

It provides vision, light, and help us adjust to our surroundings accordinly

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7
Q

Define “proprioceptive” for the vestibular system

A

It provides info from supporting structures such as our muscle/tendons

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8
Q

Define “vestibular” of for the vestibular system

A

It helps us maintain our balance by using gravity and inertia for info

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9
Q

The semi-circular canals provide…

A

Angular Acceleration

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10
Q

How does our semi-circular canals tell us when we’re turning?

A

From our otolith

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11
Q

How does the otolith work?

A

Since it’s organized in different planes, when it moves around the semi-circular canals, it gives stimulation to our brain to know when we’re turning

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12
Q

The utricle/saccule provides ….

A

Linear acceleration

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13
Q

How does the utricle/saccule work?

A

It does not involve turning but up/down and fwd/back

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14
Q

Where is the utricle/saccule located?

A

Between the portion of the semi-circular and cochlea

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15
Q

What are some things we should note about the Auditory Mechanism?

A
  1. As we transition from an air-filled space, we enter a fluid-filled cochlea
  2. Organ of corti is where the action occurs
  3. THREE rows of outer hair cell
  4. ONE row of inner hair cells
  5. Tectorial membrane is where the shearing movement of the stereocilia occurs
  6. Tonotopically Organized
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16
Q

For the Auditory system, where is the stereocilia located?

A

On the top of the 3 rows of outer hair cells and 1 row of inner hair cells

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17
Q

For the Auditory system, the tectorial membrane undergoes the shearing action when…

A

It touches the stereocilia which helps stimulate the shearing action

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18
Q

For the Auditory system, its tonotopically organized …

A

According to frequency

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19
Q

What does tonotopically organized mean?

A

Depending on the frequency, one part of the cochlea would respond

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20
Q

For our cochlea being tonotopically organized, how does it relate to the turns on the cochlea?

A

When we get to the first turn(base), the higher frequencies would respond and then it gets lower in frequencies and spirals down into the apex

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21
Q

What are the structures of the neurons?

A

Cell body, Axon, Dendrites

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22
Q

What’s the purpose of the neurons?

A

To carry information in one direction or the other

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23
Q

Afferent carries

A

Info from the brain to cochlea

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24
Q

Efferent carries

A

Info from the brain to the cochlea

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25
Q

The cochlea has _____ afferent neurons and ____ efferent neurons

A

30,000 and 1,800

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26
Q

For the vestibular portion of the inner ear, what are the disorders?

A
  1. Vestibular Dysfunction

2. Hearing Loss

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27
Q

What disorders falls under the vestibular dysfunction?

A
  1. Vertigo

2. Dizziness

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28
Q

Define vertigo

A

It’s true spinning. Where either you’re spinning, or the room is

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29
Q

Define Dizziness

A

Has a less concrete definition. It pertains to being off-balanced or light-headed

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30
Q

What type of hearing loss is associated w/Inner Ear Hearing loss?

A

SNHL

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31
Q

What SNHL mean?

A

That BC and AC are =

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32
Q

With a SNHL, what does the patient experience?

A

A loss of sensitivity and increase in distortion

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33
Q

Why would a patient w/a SNHL state “I can hear, I can’t understand?

A

They lose volume and clarity due to the broaden of the cochlea. When we a cochlear damage exist and send a 100Hz tone, we’re impacting the frequency response of the cochlea making it less specific and this adds more sounds is perceived as noise

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34
Q

What are prenatal causes of SNHL?

A
  1. Genetics
  2. Syndromes
  3. Rh factor incompatibility
  4. Hyperbilirubinemia
  5. Viruses
  6. Anoxia
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35
Q

Explain genetics being a factor for SNHL

A

Baby could be born with HL or can develop progressively due to the child getting the recessive gene

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36
Q

Explain Rh factor incompatibility

A

Is when there’s protein in the blood! The baby has a Rh factor but the mom doesn’t. So the mom’s immune system was to produce antibodies to protect against Rh factor and the baby’s RBC are damaged

37
Q

What’s the function of RBC and how does it affect the baby?

A

RBC job is to transport oxygen to our body. Since the mom’s immune system produces antibodies to fight against Rh factor and RBC, this causes a decrease in oxygen being carried to our cochlea

38
Q

What is hyperbilirubinemia?

A

When there’s too much production of bilirubin

39
Q

How can hyperbilirubinemia become a problem for our ears?

A

Bilirubin can get deposited into the ears and if the child receives too much of it, they can receive gentamycin which can damage the inner ear

40
Q

What is bilirubin a byproduct of?

A

Broken-down RBC

41
Q

What are the types of virus that can occur prenatally?

A
  1. Rubelle

2. Cytomegalovirus (CMV)

42
Q

How can rubella become a problem?

A

If it contacted during the first trimester, it could interrupt development of the cochlea by making it malformed and not have an organ of corti

43
Q

What is anoxia?

A

It is oxygen deprivation that causes damage to the cochlea. If no oxygen gets to the cochlea, the hair cells can die off

44
Q

What are some perinatal causes of SNHL?

A
  1. Anoxia
  2. Toxicity
  3. Prematurity
  4. Trauma
45
Q

What are postnatal causes of SNHL?

A
  1. Meningitis
  2. Viral Infections (measles, mumps, chickenpox etc)
  3. Syphilis
  4. High Fever
46
Q

What can meningitis cause and what does it impact?

A

Ossification of the cochlea after infection which impacts intervention for the pt getting a Cochlea Implant

47
Q

For a pt w/meningitis, if treated early what intervention could they receive?

A

A cochlear implant since a cochlea implant puts electrodes into our cochlea to allow our ossicles to move

48
Q

Which toxins could cause SNHL?

A
  1. Antibiotics
  2. Quinine
  3. Chemotherapy Agents
  4. Erectile Dysfunction Meds
  5. Hydrocodone
  6. Diuretics
49
Q

What kind of antibiotics are considered systemic?

A

‘Mycins’ (gentamycin, neomycin etc)

50
Q

What are the type categories of antibiotics?

A
  1. ‘Mycins’

2. Ototoxic/Vestibulotoxic

51
Q

What is Ototoxic/Vestibulotoxic?

A

An antibiotic that could damage hair cells, utricle & saccule and other parts of the vestibular system

52
Q

What is quinine and where else could it be found?

A

An anti-malaria drug and could be found in tonic water

53
Q

How does chemotherapy cause SNHL?

A

Chemotherapy kills healthy cells which could damage hair cells

54
Q

What does diuretics cause?

A

A temporary hearing loss due to the diuretics stopping the pumping of the hair cell because we’re upsetting the sodium potassium balance channels in the cochlea that makes this pumping possible

55
Q

Which ototoxic meds cause High Frequency & Permanent HL?

A
  1. Antibiotics
  2. Quinine
  3. Chemotherapy Agents
  4. Erectile Dysfunction Meds
  5. Hydrocodone
56
Q

Can Noise Induced Hearing Loss (NIHL) cause a significant HL

A

Yes

57
Q

What are they two types of Noise Induced HL?

A
  1. Temporary Threshold Shift (TTS)

2. Permanent Threshold Shift (PTS)

58
Q

What does noise interact with when it comes to factors and causing an increase in HL?

A
  1. Age
  2. Genetics
  3. Medication
59
Q

Can NIHL be seen in more men than women and why?

A

Yes due to societal norms

60
Q

What are some reasons why men experience a NIHL more than women?

A
  1. Occupation
  2. Recreation
  3. Men being less likely to wear ear protections
61
Q

For NIHL, what would you find on the audiogram and what does it mean?

A

The “classic” 4kHz notch and that hearing is worse at 4kHz than any other frequency but we’ll see HL from 2-7kHz

62
Q

Why would we see the 4kHz being the notch for those with NIHL?

A

For our ear canal, the resonance frequency is from 2-7kHz. 4kHz is the peak frequency and it’s the frequency that’s often over amplified. This portion of our cochlea is overworked so there’s more energy being pushed into the cochlea at 4kHz

63
Q

Can NIHL be unilateral or bilateral?

A

Either or. It depends on how the exposure took place

64
Q

What is OSHA

A

Occupational Safety and Health Adminsitration

65
Q

What purpose does OSHA when it pertains to Audiology?

A

Federally mandates acceptable noise exposure levels in the workplace

66
Q

What’s the # that’s acceptable for an 8-hr workday?

A

Eighty-five dBA

67
Q

What does dBA mean?

A

It’s the weighting from the sound-level meter which mimics the human ear (gives a boost in the 2-7kHz)

68
Q

For every increase in noise, what should occur?

A

For every increase in 5 dB, the time should be cut in half

69
Q

What devices measures noise intensity?

A

Sound level meter/dosimeters

70
Q

What is presbycusis?

A

It’s the aging of the auditory system

71
Q

What is the typical compliant for those w/Presbycusis?

A

“Everyone mumbles

72
Q

Which frequency does those w/Presbycusis have issues with hearing?

A

High frequencies, lower is better

73
Q

Why are those w/Presbycusis state “Everyone mumbles?”

A

Because they have a HL in higher frequencies and constants in English language are made up of high frequencies. Consonants gives us clarity of speech. Since they still have residual hearing in the lower frequencies, they can easily hear the vowels since vowels are spoken in lower frequencies and only give us power of speech

74
Q

What are OTHER causes of SNHL?

A
  1. Meniere’s Disease
  2. Sudden idiopathic SNHL
  3. Surgical complications
  4. Autoimmune Diseases
  5. Head trauma
75
Q

What characteristics falls under Meniere’s disease?

A
  1. Fluctuates (comes, gets better, but never gets back to the first baseline)
  2. Typically, unilateral
  3. Low frequency SNHL
  4. Vertigo
  5. Roaring Tinnitus
76
Q

What is Meniere’s disease?

A

It’s where the endolymphatic space in the cochlea gets bigger and it impacts the functioning of the inner ear

77
Q

What are two of the most common complaints for SNHL?

A
  1. Tinnitus

2. Peripheral HL

78
Q

What is tinnitus?

A

Perception of sound in the head without an external cause

79
Q

Is tinnitus associated w/HL?

A

Yes. 70-80% of people with tinnitus have HL

80
Q

Are there various descriptions of sounds?

A

Yes (hissing, buzzing, ringing etc)

81
Q

What is the etiology of tinnitus?

A

Unknown hence why it’s hard to cure it

82
Q

Even though the etiology is unknown, what are some probable causes?

A
  1. Noise-Induced
  2. Head/neck trauma
  3. Head/Neck illness
83
Q

What the range of severity for tinnitus?

A

Ranges from tolerable - debilitating

84
Q

For treatment for tinnitus, it’s a combination of

A

Physical and Psychological approaches

85
Q

What are the physical and psychological approaches?

A
  1. Sound therapy
  2. Tinnitus retraining therapy
  3. Medications
  4. Psychotherapy
86
Q

What is sound therapy for those w/tinnitus?

A

Making sure that they’re not in quite (ex: sound machines, white noises)

87
Q

What is tinnitus retraining therapy those w/tinnitus?

A

Retraining patient’s reaction to tinnitus/teaching patients not to concentrate on sound

88
Q

What purpose does medication holds for those w/tinnitus?

A

It doesn’t treat tinnitus but the reaction and condition that it might have brought on with it (sleep aid, anti-anxiety, or depression)

AUDIOLOGY (17 decks)

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