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9510 Term 2 > week 4 > Flashcards

week 4 Flashcards

1
Q

low frequencies encounter high impedance due to

A

stiffness

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2
Q

high frequencies encounter high impedance due to

A

mass

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3
Q

why is use of single probe tympanometry not beneficial

A

it may not be as sensitive to middle ear pathologies

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4
Q

Patient has a build up of fluid in ME causing increasing mass and stiffness. What hearing loss and tymp configuration might we expect

A

FLAT CONDUCTIVE HEARING LOSS
type b

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5
Q

patient has increase in stiffness in ME due to otosclerosis. What hearing loss and tymp configuration might we expect

A

low frequency conductive loss
type A, AS or B (in late stages)

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6
Q

what is different in children’s ears to adults that make 226Hz not as sensitive

A
  • bony portion not fully formed, more soft tissue (increasing compliance)
    -smaller canals
  • change in TM orientation (more horizontal when first born)
  • tightening of ossicular joints
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7
Q

An infant has a more compliant ear canal. What frequencies are impeded? What hearing loss and tymp configuration might we expect?

A
  • all frequencies (maybe more likely high freq. BC mass dominated)
  • flat conductive
    Possible A (for adults we expect B but bc less bony can see type A even if fluid)
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8
Q

issues of 226 tympanometry

A

its hard to tell the difference between 2 very different pathologies causing conductive HL
ex., infant with ME effusion (type A) or Normal hearing vs early otosclerosis (type A)

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9
Q

Multi-frequency tympanometry

A

used to assess ME disorders by looking at resonant frequencies of middle ear

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10
Q

What is 1B1G

A

its a tympanogram that is peaked like a normal Type A we expect to see

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11
Q

What is B in a type 1B1G

A

B refers to suceptance

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12
Q

What is a G in a type 1B1G

A

G refers to conductance

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13
Q

How do we interpret multi-peak tymps in children

A

challenging
higher proportion of infants with multiple peaks using 226HZ

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14
Q

why is 1000Hz used

A

tight variation among children which is helpful when you are trying to indicate deviations, easier to interpret when someone falls outside of the norm

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15
Q

how does area of ear canal change

A

the relative area increases over time
- length increases (increased bony tissue and becomes more stiff over time)

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16
Q

immitance

A

impedance+admittance

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17
Q

Admittance

A

Conductance (Ba) + Susceptance (Ga)

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18
Q

Conductance

A

frictional commonents in ME
- how much friction is present at these points
- driven by how things are connected ex., ossicles

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19
Q

susceptance

A

mass and compliance components

20
Q

impedance

A

inverse of admittance (1/admittance)
- vector sum of mass compliance and friction elements
- ease at which it can move

21
Q

multicomponent tympanometry

A
  • simultaneously measure admittance components of susceptance and conductance
  • change frequency beyond 226Hz
    -look at #of peaks when we tease apart (1B1G)
  • frequency and pressure specific
22
Q

resonant frequency

A

where mass and stiffness are equal
this is where succeptance =0

23
Q

at 45 degrees what do we see on a BA GA graph

A

1B1G

24
Q

what is the name of the model for multicomponent tympanometry

A

Vanhuyse model

25
Q

what are we looking for when we use multiple frequencies to assess tymps

A

changes in the patterns

26
Q

things to consider with Vanhuyse model

A
  1. # of peaks for B should not exceed 5 and G should not exceed 3
  2. Distance b/w outermost G must not exceed distance between the 8 maxima- G peak should be within b peak in terms of height
  3. distance b/w outermost maxima must not exceed 75daPA for tymps with 3 peaks and 100dapa for tymps with 5 peaks
27
Q

what is a system that is more mass dominated

A

5B3G
-cholesteatoma forming

28
Q

resonant frequency increases when

A

stiffness increases

29
Q

resonant frequency decreases when

A

mass increases

30
Q

whats a system thats more stifness dominated

A

3B1G
otosclerosis

31
Q

what is an abnormal Vanhuyse

A

anything bigger than 5B3G

32
Q

resonant frequency averages for adults vs infants

A

adults 1000Hz
infants 250Hz
72-84 days 385Hz

33
Q

objective of MFT or WT

A

obtain resonance frequencies of middle ear

34
Q

Multifrequency Tympanometry steps

A

4 Steps
1. set to +200daPa sweep through frequencies
2. measure tymp at 226HZ obtain TPP
3. Keep pressure at Tympanic peak pressure sweep frequencies
4. conduct several tympanograms around RF (where suceptance crosses 0)

35
Q

Wideband Tympanometry

A

1 step
simultaneously records tympanometry across pressure and frequency using broad band stimulus click

36
Q

wideband energy reflectance

A

measures ratio of energy reflected back by middle ear system.

37
Q

advantages of wideband energy reflectance over MFT

A
  • location of probe not crucial
  • can test up to 10KHz (compared to 2KHz in MFT)
  • greater sensitivity to various pathologies
38
Q

3D typanometry

A

absorbance across pressures and frequencies
-as we increase frequencies, peak in middle of graph corresponding to resonant, more accoustical energy around ambient or peak pressure

39
Q

Benefits of 3D Tymp

A

faster
higher resolution
wider bandwith
more sensitive to ME pathologies

40
Q

how does an ear with otosclerosis differ form normal ear with absorbance

A

stiffness dominated system so more energy in low frequencies reflected back
- less energy absorbed

41
Q

how does a conductive hearing loss in a child (presence of airbone gap) change their absorbance

A
  • shifts lower (particularly in mid-high frequencies and becomes flat) as most of energy reflected back
  • as gap shrinks it trends towards normative
42
Q

GSI tympstar V2.0

A

Multicomponent/Multifrequency tymp

43
Q

titan

A

wideband tymp, OAE

44
Q

mimosa

A

wideband energy reflectance, OAE

45
Q

GSI tympstar pro

A

MFT and wideband Tymp

9510 Term 2 (4 decks)

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