Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
98 Cards in this Set
- Front
- Back
|
Comprehensive Audiologic Evaluations |
include pure tone thresholds speech thresholds word recognition testing any necessary examination of auditory and or vestibular function |
|
|
Physiologic tests are |
objective but still require cooperation from patient don't measure hearing; just give info about dif. functions of auditory system provide cross-check with other results help localize clients problems |
|
|
What is Immitance Testing-Tympanograms |
known as a middle ear analyzer provides info about how sound energy is transferred through the outer and middle ear |
|
|
Procedure for immitance testing |
3 hole probe placed in ear, speaker, pressure pump and microphone 226 Hz tone presented to canal while pressure varies microphone meaures intensity or volume of sound in ear canal |
|
|
Tympanometry |
static admittance/compliance cm or mL describes how much energy admitted by middle ear system measures how much the tympanic membrane moves |
|
|
peak pressure in tympanogram |
the pressure (daPa) where the peak occures-when the pressure is equal on both sides of the eardrum |
|
|
equivalent ear canal volume (cm^3) |
the space between the end of the probe and the eardrum |
|
|
Type A Tympanogram |
Normal compliance(cm^3) .30-1.7 adults or .25-1.05 kids Pressure(daPa) -100-50 Ear Canal Volume(cm^3) 0.6-2.0 children- 0.3-0.9 Look like a teepee |
|
|
Type B Tympanogram |
- No/ Low static admittance normal volume-middle ear fluid large volume-patent PE tube
fluid or infection behind ear drum sometimes perforated ear drum if higher ear canal volume |
|
|
Type C Tympanogram |
negative middle ear pressure eustachian tube dysfunction -sinus or allergy congestion look like teepee but pushed more to the left |
|
|
Type As Tympanogram & Type AD Tympanogram |
shallow, limited movement of TM -stiff system, middle ear bone problem type Ad- deep flaccid movement of TM-hypercompliant ossicular discontinuity |
|
|
Acoustic Reflexes |
measures the contraction of the stapedial muscle performed with the same equipment right after tympanogram bilateral response abnormal tympanogram=no acoustic reflexes |
|
|
Acoustic Reflex Thresholds |
ART- the lowest dB level that can elecit a reflex that can elicit a reflec can be measured ipsilaterally-response is measured from the same ear as the tone contralaterally-response is measured from opposite ear |
|
|
Acoustic Reflex decay |
possible 8th cranial nerve pathology-nerve can't sustain neural info in normal response-deflection maintained 10 sec not normal response =deflection increases by more than 50% within 5 sec |
|
|
OAEs |
record sounds coming out of the ear-emissions they are low intensity (-10-20dB) sounds that originate from cochlea and can be measured in ear canal Simpler test than ABR only requires headphones with a steady tone instead of clicks |
|
|
How are emissions created? |
outer hair cells amplify the vibrations on basilar membrane within the organ of corti the emissions then travel outward and can be measured in the ear canal with a tiny microphone |
|
|
In order to record emissions during an OAE you must... |
have a functioning middle ear |
|
|
Purpose of OAEs |
to determine OHC function within the cochlea |
|
|
Knowing the OHC function with an OAE can help |
estimate hearing thresholds in certain ares (1000-6000Hz) Screen for hearing loss- rules out all but very mild hearing loss use as a cross check for other tests differentiate between sensory and neural hearing loss Identify malingerers |
|
|
ABR -Auditory Brainstem Response records... |
auditory evoked response from the nueral pathways of the auditory system, beyond the cochlea -patient must be very still or asleep |
|
|
Purpose of ABR |
testing for those who are difficult to test with behavioral thresholds yields results about high frequency hearing evaluate suspicion of 8th cranial nerve disorders screening for newborns follow up with infants who may have failed OAE can still get a response even with middle ear disorders |
|
|
Auditory Steady-State Response(ASSR) |
newer test. not widely used clinically -shows promise for estimating thresholds-including more of the lower frequencies |
|
|
Outer ear disorders |
congenital or acquired visible with the eye or otoscope may or may not have associated hearing loss |
|
|
outer ear disorders may affect.. |
auricle. pinna external ear canal |
|
|
Microtia |
Congenital outer ear disorder under developed pinna/auricle -small ear |
|
|
Atresia |
Congenital outer ear disorder absence or closure of the external auditory canal |
|
|
Anotia |
Congenital outer ear disorder complete absence of both external ear and ear canal |
|
|
What kind of hearing loss would micortia/atresia/anotia cause? |
would be tested with bone conductor or headphones maximum conductive hearing loss up to 50dB |
|
|
Auricular Hematoma |
Acquired disorder of auricle/pinna outer ear disorder aka cauliflower ear -internal bleeding within auricle causing damage to cartilage usually bleeding underneath tissue of cartilage once healed bleeding goes away but not tissue damage |
|
|
Impetigo |
outer ear disorder-acquired disorder of auricle/pinna bacterial infection neoplasm,cysts, or benign tumor |
|
|
Basal Cell Carcinoma |
outer ear disorder, quired dis. of the pinna sun burn usually at the top of the pinna |
|
|
Hearing loss that would occur from acquired dis. of auricle/pinna |
microtia,atresia,anotia,auricular hematoma,impetigo,basal cell carcinoma usually no hearing loss unless trauma is done to the head |
|
|
Impacted cerumen/foreign objects |
ear canal disorder ear wax or weird stuff |
|
|
atresia |
congenital ear canal disorder absence of ear canal |
|
|
Hearing loss associated with cerumen impaction |
acquired ear canal disorder conductive hearing loss from wax impactionmost hearing loss would be around 30-40dB loss so mild conductive hearing loss |
|
|
Exostosis |
acquired ear canal disorder "surfers ear" usually bilateral almost looks like pearls of hard tissue-hard bone |
|
|
hearing loss associated with Exostosis |
conductive hearing loss is uncommon for bug exostosis = usually wax problems surgically addressed if it is closing off ear canal |
|
|
Osteoma |
acquired ear canal disorder usually unilateral benign tumors surgically addressed if causing ear canal closure |
|
|
Otitis Externa |
acquired ear canal disorder "swimmers ear" ear infection of ear canal usually bacteria that has been picked up in water treated w eardrops (alcohol or mineral oil) or antibiotic Hearing loss?- usually none or mild conductive if your ear is really swollen |
|
|
Middle Ear disorders |
congenital or acquired usually unilateral typically conductive hearing loss results in varying degrees affects either tympanic membrane or ossicles |
|
|
TM Perforation |
middle ear disorder rarely born with usually acquired usually happens bc of infection of middle ear-buildup of fluid, or pressure in middle ear or acoustic/physical trauma perforation=natural release SUPER PAINFUL |
|
|
Treatment for TM perforation? and what type of Hearing loss? |
antibiotics and treatment-usually repair on their own, big perforation may need surgical repair Tympanoplasti-eardrum created by other patch of skin normal-mild conductive hearing loss |
|
what disorder is this from? |
normal to mild conductive hearing loss caused by TM perforation |
|
|
Otitis Media |
middle ear disorder inflammation of middle ear space effusion=fluid in middle ear space can be accompanied by bacteria infection treatment involves antibiotics or PE(pressure equalization) tubes generally no tubes unless chronic or affecting speech |
|
|
Hearing loss caused by otitis media? |
all conductive hearing loss usually no much more than mild conductive hearing loss |
|
|
otitis media |
|
|
Cholesteatoma |
middle ear disorder usually starts w a retraction pocket, skin flap, and grows into middle ear space while becoming infected bulge that looks whiter than fluid MUST BE TREATED can begin to touch meningis and cause meningitis so must be treated can erode ossicles or rupture TM only dier when ignored |
|
|
what type of hearing loss can occur due to a cholesteaoma |
varying degree of conductive hearing loss |
|
|
Otoscelrosis |
middle ear disorder-usually genetic bony growth around stapes footplate more prevalent in females(during high hormone times) may begin unilaterally and progress bilaterally surgical treatment may restore hearing can rupture TM usually not diagnosed untill 3rd gen PRIMARY SYMTOM:hearing loss no infection or pain |
|
|
hearing loss that may occur due to otosclerosis |
conductive hearing loss maximum on low pitch sounds notch in bone at 2000Htz=classic sign flat tympanogram at later stages shallow tympanogram=early stages no acoustic reflexes not diagnosed by audiologist primary physician |
|
|
conductive hearing loss with bone conduction notch at 2k Hz |
|
what type of disorder might this person have? |
shallow and absent of acoustic reflexes otosclerosis |
|
|
Ossicular Disarticulation/Discontinuity |
middle ear disorder almost always happens because of trauma perforated ear drum gone bad the trauma that perforated the eardrum also broke the bones happens with car accidents or falls painful |
|
|
what type of hearing loss is attributed to ossicular disarticulation |
maximum conductive hearing loss no bone movement tympanogram -type AD =peak gone wild bc bones are moving but not how theyre supposed to opposite otosclerosis |
|
|
Hearing loss chart for Ossicular disarticulation |
|
|
disorder? |
Ossicular Discontinuity/Disarticulation |
|
|
Ossicular Reconstruction |
if bones are disarticulated they can be put back together is they are destroyed they can be replaced by prosthesis microscopic surgery idea is to close air bone gap |
|
|
Glomus Tumor |
Middle ear disorder benign highly vascular in middle ear space appears as red purplish mass otoscopically requires surgical removal symptoms aural fullness pulsating tinnitus conductive hearing loss |
|
|
Noise Induced Cochlear damage |
cochlear disorder most common cause of sensorineural hearing loss Damage to outer hair cells in the cochlea |
|
|
Audiogram of NICD |
|
|
|
Presbycuss |
Cochlear disfunction age related hearing loss most common adult acquired hearing loss |
|
|
what type of hearing loss is associated with presbycusis |
bilateral sloping high frequency sensorinueral hearing loss loss of OHC function then IHC function no treatment other than a hearing aid |
|
|
what type of tympanogram would show for presbycusis |
type a normal |
|
|
Endolymohatic Hydrops |
Cochlear Disfunction excess of endolymph in scala media of the cochlea and vestibular labyrinth severe episodic vertigo fluctuating low frequency sensorinueral hearing loss aural fullness low pitched roaring tinnitus usually unilateral |
|
|
audilogic findings of meniere's dosease |
|
|
Ototoxicity |
hearing loss from toxic drugs hearing loss may be temporary,some permanent, some progressive high frequency SNHL usually bilateral ay use high frequency headphones often accompanied w tinnitus |
|
|
Types of disorders |
outer ear middle ear cochlear neural central auditory |
|
|
Vestibular Scwannoma |
Neural disorder aka an acoustic neuroma benign tumor of 8th nerve |
|
|
audiologic findings of vestibular scwannoma |
usually unilateral affects high freq first poor word rec ability unilaterral high pitched tinnitus may have balance problems |
|
|
audilogic findings of vestibular scwannoma unilateral |
|
|
Central Auditory Processing Disorders CAPD |
Neural dis problem originates in CNS auditory pahways usually dont affect peripheral hearing normal pure tone audiogram nromal speech scores in quiet environments problems with more complicated tasks competing messages in two ears filtered speech time compressed speech trouble with localization easily distracted reading probs |
|
|
Corpus Callosum |
Neural dis large connective tract between hemispheres important for discrimination of patterns in pitch important for dichotic listening |
|
|
Balance system consists of |
visual system- oculomotor nuclei &eye muscles vestibular system-Otoliths,SCC,Vest.nerve,Vest nuclei proprioceptive system-spinal cord,muscles,joints & Brain-cerebellum &cerebral cortex |
|
|
3 main functions of balance system |
maintain balance provide accurate perceptions of body in space accurate direction and speed of movement control eye movements to maintain clear visual image |
|
|
Vestibular system includes |
3 semicircular canals sense angular and rotational motion through endolymph flow 2 otolith organs-sense linear acceleration and gravity changes |
|
|
vestibulo-ocular Reflex |
stabalizes the eyes during everyday activities such as walking/running by moving eye in equal and opposite direction to the ongoing head motion |
|
|
vestibulo-collic reflex |
stabalizes head in space through neck muscles originates in saccule involves projecting VN to motor neurons that control neck muscles including the sternocleidomastoid muscle |
|
|
vestibulospinal reflexes |
stabalize head and eyes and stance excited by standing and moving includes lateral vestibulospinal tract medial reticulospinal |
|
|
Vestibular system responsive to sound |
system is responsive to high level acoustic stimuli response of otolith is a reflexive movement likely due to movement of endolymph flow stimulating the vestibular system |
|
|
assessment of vestibular system |
includes administration and interpretation of behavrial and electrophysiological tests of equilibrium |
|
|
what would a patient present with if they need a vestibular eval.? |
complicated med. history comp. description of symptoms |
|
|
Nystagmus |
non-volitional rhythmic oscillation of one or both eyes can be recorded measured and quantifies-rapid eye movement |
|
|
videonystagmography (VNG) |
8 indiv. tests that fall into 2 sub groups goal is to determine the site of lesion measured w video goggles |
|
|
Central testing VNG |
oculomotor testing |
|
|
Peripheral testing VNG |
positional caloric |
|
|
caloric testing (VNG Component) |
tests VOR used to stimulate indiv. horiz. SCCs using warm and cool air or water as a stimulus stimulates vestibular system to verify function can determine if unilateral weakness is present |
|
|
VEMP |
cervical vemp tests integrety of the saccule and or posterior vestibular nerve Ocular VEMP tests integrity of utricle and or surperior nerve-uses wires and pods and transmits waves across screen |
|
|
Video Head Impulse Test(vHIT) |
new important development in vestibular testing. A test that expands testing of VOR measured via high speed vid. camera attached to goggles principles RALP/LAT/LARP measuring any compensatory eye movements that may occur when ther is a weakness you move clinets head in jerky movements |
|
|
Rotational chair testing |
best measure of VOR measures across frequency range 0.04-1.2 Hz slow to fast head movements measured by vid. goggles precise head and body movements |
|
|
computerized Dynamic Posturagraphy |
functional test of diff. systems that contribute to balance somatosensory vestibular visual Advantage:can isolate which of the three systems are affected |
|
|
NIHL |
hearing loss caused by exposure to very loud impulsive type sounds or from long term consistant exposure to high level industrial noise |
|
|
NIHL affects... |
hair cells in cochlea, causes them to become disorganized damaged or missing |
|
|
Can we fix NIHL |
no bih |
|
|
Damage risk criteria |
standards that set the acceptable limits for noise exposure with a 24 hour period in industry TWO ANGENCIES NIOSH-most conservative-maximum allowable exposure of 85dB for 8 hours/ 3 db increases cuts time in half & OSHA-90dB for 8 hours (5dbincrease cuts time in half) |
|
|
Common audiologic characteristics of Noise exposure |
sensorineural hearing loss and tinnitus bilateral with notch in 4000Hz range can vary in degree and will progress as increased exposure and presbycusis overlay can be permanent or temporary |
|
t |
NIHL bc notch at 4000Hz |
|
|
is there a cure for tinnitus |
no but there are treatments |
|
|
treatments for Tinnitus |
sound therapy tinnitus maskers with or without hearing aids stress management techs dietary changes counseling |
