Hearing Disorders Exam 1

Front 1

incidence

Back 1

frequency of occurance

Front 2

prevalence

Back 2

number of existing cases

Front 3

Why is there variability in estimates on the number of people who have hearing loss?

Back 3

- differences in how info was obtained
- differences in definitions and criteria for hearing loss
-differences in terms that are associated with hearing loss

Front 4

HL associated terms: pathology

Back 4

pathology=disorder

Front 5

HL associated terms: impairment

Back 5

abnormal or reduced function

Front 6

HL associated terms: disability

Back 6

limitation of abilities

Front 7

HL associated terms: handicap

Back 7

adverse impact due to disability

Front 8

audiology

Back 8

as a scientific discipline, the study of hearing and balance and hearing and balance disorders

Front 9

purpose of outer ear

Back 9

-capture, funnel and direct sounds towards eardrum
-amplify mid-frequencies

Front 10

purpose of middle ear

Back 10

-protection
-impedence matching

Front 11

purpose of inner ear

Back 11

-frequency and intensity analysis
-transduction

Front 12

purpose of the auditory nerve

Back 12

- transmission of neural impulses to central auditory system

Front 13

what is the change in the type of energy transduction that occurs as you move from the outer ear inward?

Back 13

1. acoustic
2. mechanical
3. hydraulic
4. electrochemical

Front 14

outer ear: auricle/pinna

Back 14

- most visible part of the ear
- made of cartilage and skin
- the deep bowl is called the concha: shape helps to amplify the sound

Front 15

Ear canal

Back 15

- the long, narrow canal leading to the eardrum
- filled with hair and often times wax called cerumen
-it protects the eardrum from any foreign bodies entering the ear

Front 16

tympanic membrane

Back 16

- aka eardrum
- healthy eardrum is opaque in color
- acts like a drum and transmits sounds into the middle ear

Front 17

middle ear

Back 17

-air filled space behind tympanic membrane
- contains eustachian tube which equalizes pressure in the middle ear
-houses the ossicles

Front 18

the ossicles

Back 18

- three smallest bones in the body
-malleus, incus and stapes
-help transmit sounds to the inner ear via the oval window

Front 19

inner ear: auditory portion

Back 19

cochlea
cochlear duct:
-organ of corti

Front 20

organ of corti

Back 20

- sits on the upper surface of the basilar membrane
- bathes in endolymph
- contains supporting cells
-contains sensory cells for hearing: inner/outer hair cells

Front 21

outer hair cells

Back 21

-3 or 4 rows
-12,000- 20,000
stereocilia in W or V pattern

Front 22

inner hair cells

Back 22

one row
- 3,500
- stereocilia in U or straight line pattern

Front 23

how are hair cells stimulated

Back 23

- stapes moves membranes on oval window
- fluid (perilymph) is pushed, scala vestibuli displaced
-reissners membrane displaced by fluid movement
- agitates endolymph inside cochlear duct
-tectorial membrane also displaced
-cilia of hair cells bent/displaced

Front 24

central auditory system

Back 24

-ascending/afferent pathways
-auditory cortex: temporal lobe
- descending/efferent pathways

Front 25

vestibular system

Back 25

-helps regulate the orientation of body space
-helps the motor system control posture, balance, equilibrium
- works with input from other sensory systems to produce the sensation of motion: visual and somatosensory systems
- provides info on gravity, rotation, acceleration
- inputs down to the spinal cord influence muscle tone and reflex activity
- all these data are processed by the CNS to provide BALANCE

Front 26

Embryo

Back 26

baby during the first 8 weeks of gestation

Front 27

what are the three germ cell layers in embryonic development?

Back 27

ectoderm, mesoderm, endoderm

Front 28

neural tube

Back 28

- approx 3 weeks after conception
-embryonic development occurs along 3 germ cell layers
- top of tube becomes brain
- the swellings near the side, on top, will become the branchail arches

Front 29

what do the branchial arches become?

Back 29

structures of the face, throat, and inner ear

Front 30

germinal layers: ectoderm: what will it become (ear)?

Back 30

outer ear, lateral layer of the tympanic membrane, membraneous labyrinth, organ of corti

Front 31

germinal layer: mesoderm- what will it become (ear)?

Back 31

ossicles, temporal bone, fibrous layer of the tympanic membrane

Front 32

germinal layer: endoderm- what will it become (ear)?

Back 32

middle ear cavity, eustachian tube, medial layer of the tympanic membrane

Front 33

maturation of the inner ear, inner ear adult size

Back 33

complete by 20th fetal week

Front 34

development of auricle

Back 34

begins at 3-4 weeks by thickening, swelling of branchial arch 1 and 2. by week 20 is adult shaped but will continue to grow in size until about age 9

Front 35

development of the external auditory canal

Back 35

begins at week 5, at week 21 meatal plug disintegrates, exposes tympanic membrane, continues to grow/mature til age 7

Front 36

development of the middle ear

Back 36

week 3: middle ear and tube arise from endoderm tissue, develops into week 37

Front 37

development of ossicles

Back 37

week 5-6: ossicles begin to develop from cells in branchial arch 1 and 2
week 32- malleus and incus complete ossification, stapes will continue to develop until adulthood

Front 38

development of TM

Back 38

-primordial germ cells which eventually become the 3 layers of the eardrum present at 3 weeks
- week 21 actual TM is formed after meatal plug disintigrates

Front 39

TM position at newborn stage will change to adult position during the first ____ of life

Back 39

2 years

Front 40

the _______ is the only sense organ to reach adult size by mid-fetal life

Back 40

inner ear

Front 41

What matures later- the cochlear portion of the inner ear or the vestibular portion?

Back 41

the cochlear portion matures later, so is subject to greater chances of developmental deviations and malformations

Front 42

What are the steps in a basic audiological evaluation?

Back 42

1. case history
2. visual and otoscopic examination
3. pure tone audiometry- AC, BC
4. speech audiometry: threshold, suprathreshold
5. Immittance audiometry: tympanometry, acoustic reflex threshold

Front 43

case history

Back 43

info necessary for est an audiological and otologic diagnosis- chief complaint and associated symptoms: who, when, why, where, how, how long, etc.

Front 44

visual exam and otoscopy

Back 44

-sizez, shape, position of each auricle assessed
- 2 auricles compared for symmetry
- check for other visible signs of abnormality
- info on current status, previous conditions, current function

Front 45

What are the 5 tests in a basic audiological test battery?

Back 45

- pure tone tests
- speech recognition threshold
- word recognition score
- tympanometry
- acoustic reflex test

Front 46

Pure tone test

Back 46

tone threshold tests ID the weakest level that can be heard for each test frequency (pitch)

Front 47

what range of pitch is usually tested in a pure tone test

Back 47

250-8,000 hertz

Front 48

Pure tone test are done by __________________ and by _______________

Back 48

air conduction, bone conduction. air conduction tests use earphones, bone conduction a vibrator on the mastoid bone

Front 49

speech recognition threshold test- how does it work?

Back 49

test to determine the patients threshold for two syllable words like baseball and cowboy.

Front 50

what is the threshold level for speech recognition test?

Back 50

faintest intensity that the words can correctly be repeated at least 50% of the time

Front 51

word recognition score

Back 51

determines the patients ability to correctly repeat a single syllable word presented at a comfortable intensity. reflects how clearly/distinctly words are understood

Front 52

Tympanometry and acoustic reflex tests are what type of tests?

Back 52

tympanometry= impedence/admittance
acoustic reflex=Immitance tests

Front 53

tympanometry

Back 53

shows how efficiently middle ear is working. uses a small pump to vary pressure in middle ear.

Front 54

acoustic reflex test

Back 54

loud sounds cause contraction of tiny ear muscles. gives info about function of inner ear, the auditory nerve up to the brainstem level, and the function of the facial nerve

Front 55

otoacoustic emissions

Back 55

an advance audiological evaluation. Test cochlear outer hair cell functioning/integrity

Front 56

auditory evoked potentials

Back 56

advance audiologic evaluation. test function and integrity of the auditory system from the outer ear through the cortical areas.

Front 57

balance assessment

Back 57

advanced audiologic evaluation
-differentiate between an inner ear problem or other problem sites
- use patterns of nystagmus

Front 58

nystagmus

Back 58

involuntary jerky or rapid eye movements

Front 59

electronystagmography and videonystagmography

Back 59

recording/video recording of eye movements

Front 60

other audiologic assessment procedures

Back 60

- tinnitus eval
- hearing conservation
- hearing aid eval/fitting
-cochlear implant assessment/mapping

Front 61

aural rehabilitaiton: keys to success

Back 61

- knowledge about hearing/hearing help
-support of family/friends/coworkers
- speech reading, auditory training, communication and self help strategies
- appropriate use of technologies

Front 62

aural agenesis

Back 62

total failure of the outer ear to develop

Front 63

aural dysgenesis

Back 63

partial failure of outer ear to develop

Front 64

anotia

Back 64

absent pinna/auricle

Front 65

microtia

Back 65

abnormally small pinna/auricle
- usually unilateral
- occurs more on the right side
- occurs more frequently in males

Front 66

macrotia

Back 66

ear too large

Front 67

preauricular pits/fistulae

Back 67

pit like depression or holes near the auricle- abnormal development of auricular hillock

Front 68

preauricular rudiments/tags

Back 68

appendages found at or near the area of the auricle
- accessory auricular hillock

Front 69

stenosis

Back 69

narrowing of the external ear canal
- can be acquired as a consequence of an acquired outer ear disorder or congenital

Front 70

aural/ear canal atresia

Back 70

complete closure of the external auditory meatus and/or absense of the external ear canal
- usually occurs with severe microtia
- can also occur with normal pinna
- usually unilateral, more on the right, more in males
-often associated with middle ear abnomalities
- canal often marked by a shallow pit with soft tissue or a bony place in the site of where the meatus/opening should be

Front 71

branchial arch syndromes

Back 71

congenital outer ear and other cranofacial abnormalities- example- treacher collins

Front 72

treacher collins

Back 72

- autosomal dominant
- flattened nasofrontal angle
- microtia in 85%- typically bilateral
- EAC Atresia in 30-40%- typically bilateral
- middle ear abnormalities- conductive hearing loss typical
-sensorineural hearing loss occassional

Front 73

medical/surgical intervention: cosmesis

Back 73

prosthesis- fastened with bone anchored mounts
pinnaplasty- utilizing local soft tissue, cartilage or synthetic implants

Front 74

hearing restoration: otologic surgical procedures

Back 74

- attempted esp in cases of bilateral atresia
-best if inner ear/cochlea function is normal

Front 75

meatoplasty/tympanoplasty/ossiculoplasty

Back 75

repair/reconstruction of the ear canal/eardrum/ossicular chain

Front 76

what are the five sensory organs of the peripheral vestibular system?

Back 76

- superior semicircular canal
- posterior semicircular canal
- lateral semicircular canal
- utricle
- saccule

Front 77

Where are the 5 sensory organs of the vestibular system housed?

Back 77

within the membraneous labyrinth, which is filled with endolymph. The membraneous laybrinth is suspended in the bony labyrinth which is filled with perilymph.

Front 78

what are the two major divisions encased within the otic capsule of the temporal bone?

Back 78

- the semicircular canals
- the utricle and saccule

Front 79

Because they are situated at ____________ angles to each other in the three planes of the body, the semicircular canals can perceive __________ acceleration and deceleration or movements of the head in space

Back 79

right, angular

Front 80

each semicircular canal has an ____________ or widening of the canal where the ___________ is located

Back 80

ampula, crista ampullaris

Front 81

what does the crista ampularis contain?

Back 81

specialized hair cells, imbedded in a gelatinous material to form the cupula

Front 82

What happens when the head undergoes angular acceleration or deceleration?

Back 82

the endolymph within the SCC lags behind the head movement and initially moves in the opposite direction. Cupula is moved from original position, cilia of haircells which insert into the gelatinous cupula undergo shearing action and sensory hair cells translate mechanical info into neural impulses

Front 83

the saccule and utricle position of the vestibular apparatus detect the position of the head relative to _______, related to ______ acceleration and deceleration or movements of the head in space

Back 83

gravity, linear

Front 84

remember: saccule and utricle= _____________ acceleration/deceleration, semicircular canals= _______________ acceleration/deceleration

Back 84

linear, angular

Front 85

both the utricle and saccule have __________ which contain hair cells embedded in a gelatinous material covered with ________________ or calcium carbonate crystals

Back 85

maculae, otoconia

Front 86

how do the maculae respond to effects of gravity?

Back 86

they aid in mechanical movements or shearing of the sensory hair cell cilia. sensory receptor/hair cells translate mechanical info into neural impulses by way of shearing action

Front 87

How are the sensory organs within the SCC, utricle and saccule innervated?

Back 87

by the vestibular portion of the 8th cranial nerve

Front 88

central vestibular system- where is it located?

Back 88

- beings at the brainstem and bifurcates, extends are far rostal as the cerebral cortex, extends as far caudal as the spinal cord

Front 89

acceleration, decceleration, or rotational movement of the head leads to _____________ of one system (ear) and ________ of the other system (ear)

Back 89

excitation, inhibition

Front 90

when does the inner ear start to develop?

Back 90

early 3rd through the 4th week, from the thickened superficial ectoderm on either side of neural tube

Front 91

hearing impaired

Back 91

a generic term for all types of degrees of hearing loss

Front 92

hard of hearing

Back 92

- hearing impairment within the range of slight (>15 dB HL) through severe (90 dB HL). Have useful hearing to various degrees and are able to acquire oral language and use it for communication with variable proficiency

Front 93

deaf

Back 93

a person who has greater than severe loss (over 90 dB) and who cannot hear or understand conversational speech under normal circumstances

Front 94

exogenous

Back 94

originating outside the organism- outside of the genes
- various etiologies: noise, ototoxicity, infections, trauma

Front 95

endogenous

Back 95

originating within the organism- inside the genes, recessive, dominant, X-linked

Front 96

prelingual hearing loss

Back 96

before development of language and speech- congenital or HL before age 3 to 5

Front 97

postlingual hearing loss

Back 97

after development of speech/langage, became HI after age 5-10. Had enough hearing prior to loss to est. fairly well develop speech patterns

Front 98

deaf v Deaf v deafened

Back 98

deaf= audiologically deaf
Deaf= culturally deaf
deafened= hearing loss occurs after completion of education- late teens or upwards

Front 99

degree of HL- minimal

Back 99

16-25 dB

Front 100

degree of HL- mild

Back 100

26-40 dB

Front 101

degree of HL- moderate

Back 101

41-55 dB

Front 102

degree of HL- moderately-severe

Back 102

56-70 dB

Front 103

degree of HL- severe

Back 103

71-91 dB

Front 104

degree of HL- profound

Back 104

91 dB or more

Front 105

conductive hearing loss

Back 105

- problem with outer and/or middle ear
- majority are temporary
- many times treatable with medication and/or surgery
-audiological monitoring or aural (Re)habilitation

Front 106

sensorineural hearing loss, what is it and does the loss usually occur more in high or low freq?

Back 106

- problem with inner ear/auditory nerve
- usually more loss in high freq than low freq
- characterized by reduction in loudness/clarity
- usually permanent
-audiological monitoring/aural (re)habilitation

Front 107

central hearing loss

Back 107

aka auditory processing disorder
-problem with brainstem/cortical levels
-clarity/understanding issues
- problem with background noise
-hearing sensitivity within normal limits
- advanced audiological testing required

Front 108

pseudohypacusis

Back 108

functional or nonorganic hearing loss
- may be feigning or exaggerating HL- children for attention, adults for monitory gain

Front 109

where are the hair and glands located in the ear canal?

Back 109

in the inner cartilagenous, not the bony portion of the ear canal

Front 110

hematoma auris

Back 110

classic boxers injury, usually result of blunt trauma to the head. Blood clot between pinna cartilage and overlying perichondrium. if untreated=califlour ear, thickening, loss of blood supply to cartilage

Front 111

ear canal trauma: how does it occur?

Back 111

lacerations and abrasions are common. self trauma and ear cleaning by professionals, as well as hearing aid related procedures

Front 112

ear canal trauma:what results?

Back 112

- usually minor injury but presence of blood, blood clots, wax can obscure visualization of precise location/extent of trama. typically no hearing loss, but can result in temporary, mild conductive hearing loss

Front 113

otitis externa

Back 113

-most common condition affecting the ear canal
-inflammatory condition of the skin lining
-caused by a bacterial infection or dermatitis, allergic reaction
-typically no hearing loss but can result in temporary, mild to moderate conductive hearing loss

Front 114

pruritus

Back 114

itchy sensation

Front 115

otorrhea

Back 115

discharge

Front 116

otalgia

Back 116

ear pain

Front 117

outer cartilaginous third of the external canal formed

Back 117

8th week

Front 118

auricles begin to move dorsolaterally

Back 118

week 7

Front 119

two and a half cochlear coils present- 8th cranial nerve attaches to cochlear duct

Back 119

week 11

Front 120

development of auditory placode, auditory pit

Back 120

week 3

Front 121

development of auditory vessicle- otocyst- vestibular cochlear division

Back 121

week 4

Front 122

utricle and saccule present, semicircular canals begin

Back 122

week 6

Front 123

one cochlear coil present, sensory cells in utricle and saccule

Back 123

week 7

Front 124

sensory cells in cochlea, mambraneous labyrynth complete, otic capsule begins to ossify

Back 124

week 12

Front 125

meatal plug disintegrates, exposing typmanic membrane. Pneumatization of tympanum

Back 125

21st week

Front 126

three tissue layers at tympanic membrane are present

Back 126

week 9

Front 127

primary auditory meatus begins

Back 127

week 5

Front 128

six hillocks evident, cartilage begins to form

Back 128

week 6

Front 129

ampula, crista ampullaris, and cupula are related to what?

Back 129

the semicircular canals

Front 130

maculae and otoconia are related to what?

Back 130

the saccule and utricle

Front 131

ampula

Back 131

widening of the semicircular canal where crista ampularis is located

Front 132

the crista ampullaris is located where?

Back 132

at the ampula, or widening, of the semicircular canals

Front 133

the specialized hair cells imbedded in the crista ampullaris are called what?

Back 133

cupula

Front 134

what contains the hair cells within the utricle and saccule?

Back 134

maculae

Front 135

what are the calcium carbonate crystals that cover the gelatinous material in the maculae called?

Back 135

otoconia

Front 136

Pseudomonas acruginosa bacterial infection and an allergic reaction to the material used to make hearing aids would be an example of what?

Back 136

acute diffuse otitus externa

Front 137

Staphylococcus aureus bacterial infection would be an example of what?

Back 137

acute localized otitis externa

Front 138

seborrheic dermititis would be an example of what?

Back 138

chronic otitis externa

Front 139

what portion of the ear canal is cartilaginous vs bony

Back 139

the outer 2/3

Front 140

what does the ectoderm become (general)?

Back 140

outer skin, nervous system, sense organs

Front 141

what does the mesoderm become (general)?

Back 141

circulation structures, reproductive organ, skeletal structures

Front 142

what does the endoderm become (general)?

Back 142

digestive and respiratory system