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107 Cards in this Set
- Front
- Back
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What are the major nuclei in the Central Auditory Nervous System?
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~ Central Nuclei (Dorsal, Ventral)
~ Superior Olivary Complex ~ Nuclei of Lateral Lemniscus ~ Inferior Colliculus ~ Medial Geniculate Body ~ Auditory Cortex |
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What are the functions of the Nuclei?
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Relay
Mediate reflexes Integrate |
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What are the major nerve tracts in the Central Auditory Nervous System?
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~ VIIIth Cranial Nerve (Peripheral Proc -> Spiral Ganglia -> central Proc)
~ Acoustic Strai (Dorsal, intermediate, ventral) ~ Lateral Lemniscus ~ Brachium of the Inferior Colluculus ~ Auditory Radiations |
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Why do we say that the auditory system is a "primary crossed" system?
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A majority of the information processed was/is originated from the opposite side of the cochlea.
Right cochlea -> left auditory cortex Left Cochlea -> right auditory cortex |
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Why is the central Auditory System so complex?
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It has to support 2 Systems
~ Localization of sound (brain stem) ~ Path that goes to the brain for a higher level of processing. |
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What part of the Central Auditory System seems to be responsible for localization
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Brain Stem (superior Olivary complex and Inferior Colliculus)
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What are the 4 general categories of "causes" of hearing loss?
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Disease, Degeneration (aging), Difference, Damage
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What is the influence of aging on hearing loss?
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Born with Normal hearing structures then:
~ Affected by disease, growths or aging. ~ Damage by environmental influences ~ Born with abnormal structures, that gets worse. |
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What is meant by "type" of hearing loss?
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~ Conductive: Outer and/or middle ear, hearing loss
~ Sensorineural: Problem in the cochlea or auditory nerve ~ Mixed: Combination of both conductive and sensorineural |
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What is the relationship between type of hearing loss and location of “lesion” in the auditory system?
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depending on where the hearing loss is, will determine what treatment is needed.
Sensory Neural -> Hearing Aide Conductive -> cleaning in outer ear ect. |
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Why does sensorineural hearing loss generally have a poorer prognosis as compared to conductive hearing loss?
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Conductive hearing loss is purely Reduced Sensitivity
Sensorineural is reduced sensitivity and a processing or encoding deficit. |
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What is the distinction between “sensori” versus “neural” in sensorineural hearing loss?
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Sensory not lethal
Nerve processed can be lethal |
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Why is the distinction in #126 significant?
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Because it can KILL YOU!
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How is hearing measured?
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Measuring some response to acoustic stimuli.
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What other tests are used to estimate hearing/assess the auditory system?
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~ Behavioral Testing
~ Electro physiological testing ~ Psychological testing (Depending on what you want to test) |
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What is the difference between “behavioral” as compared to “electrophysiological” tests?
What are some examples of each type of test? Which type is “better”? |
B: Measure a behavior
Influenced by cooperation and participation on the task E: Measure a physical response doesn't measuring hearing, but measures the parts required for testing No type is better, it just depends on what you are looking to measure. |
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What is an acoustic neuroma? What are other/better names for this same entity?
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Described as a growth, along the acoustic nerve
AKA: |
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What are the test findings and symptoms in acoustic neuroma?
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~ Unilateral in presentation
~ Asymmetrical ~ Tinnitus ~ High frequency hearing loss ~ Reduced speech understanding |
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What is the treatment for acoustic neuroma?
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Surgical removal or reduction
But there are risks of hearing loss, sensory loss ect. |
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What are the consequences of untreated acoustic neuroma?
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Could be lethal if brain stem is compressed
Progressive hearing loss |
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What other physical lesions present with similar test findings as acoustic neuroma?
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Meningioma, A-V malformations (antiral ventral)
Other skull based lesions pressing on the auditory nerve may elicit similar findings |
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What specifically is responsible for bilateral acoustic neuromas?
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Genetic or Inherited, Autosomal Dominance.
Neurofibromatosis Type II (NF2) |
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Regarding bilateral acoustic neuromas, what are treatment options, consequences and prognosis?
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could have some treatment removal (ect), but the prognosis is usually poor.
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Other than mass occupying lesions of the skull base or brainstem, what other general neurological dysfunction can cause hearing loss?
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~ Any neurological disorder that affects Myelinisation (or Demyelinisation)
~ Affects auditory nerve function, HL, and auditory symptoms |
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What test can be used to assess neural hearing loss, regardless of etiology?
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Auditory Brain Stem Response
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What are the four general things that can cause dysfunction of (any part of) the auditory system?
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~ Disease
~ Disintegration ~ Difference ~ Damage |
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What is an important and usual protocol for medical-based professionals in consideration of auditory dysfunction?
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Often there is no medically based treatment for many or most causes of hearing loss
more value is based on preventing progression |
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What is a gene
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In a DNA molecule, chemical building blocks.
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What is DNA
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~ Nuclei Acid Molecule that is in the form of a twisted double helix
~ Deoxyribonucleic acid |
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How are genes and DNA related?
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Genes make up DNA molecules
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What is the relationship between Gene, DNA and proteins
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Product of a gene is a protein,
Genes make up DNA |
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What is the genetic code?
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A string of DNA
Key to life |
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Hot many human genes are there
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35,000
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Hot many chemical based pairs are there
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Over 3 Billion
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What is Junk DNA
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DNA that isn't utilized (or DNA that we don't know what the utilization is)
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What percentage is Junk DNA
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95%
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What is ELSI
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Ethical Legal Social Issues (talks about the implications of using genetics so it is not misused.)
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What branch of the US government funded the Human Genome Project
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Department of Energy
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What is a persons genotype
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Persons genetic Code
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What is their phenotype
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Traits that are observed in the genetic codes
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What is the total number of Human chromosomes
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46
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How many autosomes
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22 Pairs
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How many Sex chromosomes?
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2
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Is it possible to have more or less in the number then the numbers above?
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Yes, for instance Down Syndrome had a third chromosome (trisomy on the 21 chromosome).
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What is "locus"
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the location of the gene on the chromosome
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Approximately what % of congenital deafness is genetic in etiology?
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50%
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Hoe many genetic types of deafness have been documented?
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400 +/-
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Addition to genes which directly cause deafness, what other kinds of genes are involved in deafness?
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Mitochondrial DNA ????
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What is Autosomal Dominant Inheritance?
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Need for only one mutant gene trait to be expressed (usually expressed as a dominant trait)
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What is the probability of transmission?
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50% chance of hearing loss
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What is Autosomal Recessive Inheritance?
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Need two copies of a mutant gene (one from each parent)
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What is the probability of transmission?
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25% chance of mutant gene hearing loss,
50% chance of being a recessive mutant gene holder 25% change of NO mutant gene hearing loss |
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What are some differences between dominant and recessive transmission?
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% of hearing loss obtained.
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What is another type of genetically transmitted inheritance patterns
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~ Sex linked
~ Matrilnear |
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How is a condition like Down Syndrome different from a single gene defect?
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The Error on the chromosomes affects the entire body
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What are sex general classes of problems that can affect the outer ear?
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1. Physical congenital differences
2. Dermatologic inflammations 3. Inflammatory disease 4. Blockage 5. Trauma 6. Neoplasms |
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What type of hearing loss is associated with outer ear disorders?
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Conductive
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What general statements can you make regarding congenital malformation of the outer ear?
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No pinna
Small opening into ear canal |
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What is microtia (anotia)
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~ Microtia is a malformed Auricle (pinna)
~ Anotia is no Auricle (pinna) |
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What is Atresia
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No External Auditory Canal
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What is otitis externa? What are symptoms? What causes it? Treatment
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~ Caused by bacteria, fungus or a virus
~ Includes swelling and discharge ~ |
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What are other inflammatory conditions affecting the auricle and EAC?
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Cysts and keloids
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What are different causes of blockage in EAC?
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~ Extrinsic: Foreign body
~ Intrinsic: Cerumen, Exostosis |
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When is hearing loss associated with disorders of the outer ear?
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Where there is a blockage that doesn't allow sound waves into the EAC
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What are some typical traumatic events that can affect the outer ear?
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~ Lacerations (bites from a dog, human)
~ Burns (electrical, chemical) ~ Frostbite |
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What are malignancies that affect the outer ear?
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~ Squamous Cell Carcinoma
~ Basal Cell Carcinoma ~ Malignant Melanoma |
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Does a disorder in OE or ME always have associated hearing loss?
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not always, but it usually has some sort of associative hearing loss.
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What are typical audiometric findings with a disorder of the middle ear?
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finding are associated with the side of the perforation.
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What is a problem that affects the tympanic membrane?
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~ Perforations
~ Tympanoscleosis |
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What are some causes of TM perforation?
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Trauma (self inflicted, Q-tips)
Secondary to ear disease |
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What is tympanosclerosis?
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White plaque material on the TM
Suggestive of previous ear disease |
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What are risks/complications associated with TM perforation?
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Infection and debris getting into the middle ear.
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What are four example disorder that affect the middle ear
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~ Congenital Generic Conditions
~ Otosclerosis ~ Consequences of Trauma ~ Eustachian tube dysfunction ~ Otitis media ~ Cholesteatoma |
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What generally causes hearing loss when there is hearing loss in a middle ear disorder?
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When the Ossicular chain is compromised
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What are some genetic differences that affect the middle ear?
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~ Malformed of Absent ossicles
(Treacher collins syndrome) |
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What is one example genetic syndrome that affects both outer and middle ears?
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Apent Syndrome
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What is otosclerosis?
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bone growth over grows the size in which it needs to fit, fusing the footplate of the stapes
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what happens to cause Stapes fixation?
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Anomalous new bone formation
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What are the remedies?
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~ Surgery
~ Amplification of sound |
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What traumatic events can affect the middle ear and cause hearing loss?
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~ Ossicular Disarticulation
~ Auto accidents, head trauma, probe in ears |
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What is Eustachian Tube dysfunction?
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ET isn't able to open in the velopharynx
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What are the two classes of EDT?
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Extrinsic (Swollen glands)
Intrinsic (inflammation of the ET) |
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What changes in the ME does ETD lead to?
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Breaks down cells in the lining.
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In general, what is otitis media?
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~ Fluid present in ear.
~ Fluid may, or may not be infected |
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What are characteristics of acute otitis media?
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~ Most common in young children
~ Isolated incidents ~ Usually after or a part of a Upper respiratory Infection |
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What are characteristics of otitis media with effusion?
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~ Presence of Fluid
~ Secondary to ETD ~ Hearing loss as liquid thickens |
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What is cholesteatoma? What causes it?
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~ Mass in ME of dead, shed skin
~ Can be erosive to surrounding tissue |
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What are consequences if cholesteatoma is not removed, or even if it is removed successfully?
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Surgical removal - some hearing loss
no removal - erode into chain of ossicles and erode into brain |
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What typically causes congenital differences in inner ear structure?
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~ Genetics
~ Environmental factors |
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In considering congenital hearing loss, what percentage is inherited/genetic?
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50% is inherited/genetic
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What percentage of inherited hearing loss is syndromic? Nonsyndromic?
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30% Syndromic
70% Non-syndromic |
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What is an example of a syndrome with hearing loss?
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Usher Syndrome
Pendren Syndrome Alport Syndrome |
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What else besides hearing loss is involved?
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Blindness
Goiters Kidney problems |
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In considering nonsyndromic genetic hearing loss, what is the most common genetic mutation?
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GJB2
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What percentage of nonsyndromic hearing loss does this account for?
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70% of the 70% of the non-syndromic is accounted for.
(49% overall hearing) |
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What are two routes of transmission that infectious disease can reach an inner ear?
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Maternal/Trans-placental (prenatal) transmission
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What is the group of infectious diseases which may cause prenatal hearing loss?
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Torches (Rubella, Herpes simplex virus, Syphilis)
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What else can cause cochlear hearing loss in an infant?
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Viral issues
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Which Infectious disease is a common cause of postnatal/acquired hearing loss?
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Menningitus
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What inflammatory 'disease' is commonly diagnosed inner ear problem?
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Maniere's Disease
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What are symptoms of above?
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Episodes of Vertigo, Unilateral senseorineural hearing loss, and unilateral tinnitus
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Four Classes of Ototoxic Drugs
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~ Antineoplastic Drugs
~ Aminoglucoside Antibiotics ~ Loop Diuretics ~ Analgesics and Antimalarials |
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For which type is there a genetically transmitted susceptibility?
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Aminoglucoside Antibiotics
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What are two different and distinct ways an inner ear can be damaged?
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~ Duration of exposure
~ Intensity of acoustic stimulation |
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What is the name given to hearing changes due to the aging process?
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Presbycusis
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What are some of the audiologic findings in presbycusis?
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~ Mild to moderate, higher frequency Sensorineural hearing loss
~ Typically with reduced word understanding. |
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What do current and projected US population statistics tell about presbycusis?
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~ 21% incidence rate over 5 years in initally normal hearing older adults
~ There are going to be a lot of old people who have some sort of hearing loss. |
