• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off

Card Range To Study



Play button


Play button




Click to flip

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;

66 Cards in this Set

  • Front
  • Back

What is the impedance mismatch between air and bone?

50 dB

What is the impedance mismatch between air and cochlear fluids?

30 dB

Air-conducted sound must exceed ________ threshold by at least ________ before __________ threshold reached

1. Air Conduction

2. 50 dB

3. Bone Conduction

A sound of 80 dB by air conduction will transmit how much by bone?

30 dB

Tonndorf distortional theory

*Mechanism of BC is distortional vibrations of cochlea

*Volume of SV > volume of ST

*Distortions cause displacements of BM

Skull vibration causes...

Ossicular vibration

What is the primary mechanism when testing by Bone Conduction: what are you testing?

You bypass the middle ear and test the cochlea directly

Where are the two places you might place the bone osilator?

Which is more common?

1. On the mastoid

2. On the front of the head

The mastoid placement is most common

Do the ossicles move side-to-side or front-to-back?


Outer ear component of BC

*source is cartilaginous portion of EAM

*EC wall vibration -------- sound in EC space

*Occlusion effect to be considered with ear canal of hearing aid/mold

*Occlusion effect, a LF phenomenon

**30 dB @ 250 Hz

**20 dB @ 500 Hz

**10 dB @ 1000 Hz

The occlusion effect, HF or LF phenomenon?


Besides through air, what causes the ossicular vibration?

Vibration of the skull, in other words bone conduction

When will the sound energy be greater, with the ears covered or uncovered?

When the ears are covered

Acoustic-Reflex contraction (attenuation levels by frequency)

Which muscle is responsible for these levels?

15-20 dB @ 250 Hz

10-15 dB @ 500 Hz

5-10 dB @ 1000 Hz

0-5 dB @ 2000 Hz

**The stapedial muscle is responsible because the tensor tympani contracts for much higher thresholds

What could be the primary reason the noise induced hearing loss is HF?

The acoustic reflex attenuation primarily attenuates the low frequencies but not the high frequencies; therefore, they protect the lower end of the frequency spectrum more over the high end.

What happens during the TT contraction?

** Manubrium is pulled inward

** TM displaced inward

What happens during stapedius contraction?

1. Contraction of this muscle pulls stapes perpendicular to piston-like motion so it rotates around its posterior ligament (does not cause movement of TM)

2. A "decoupling" between middle ear & cochlear fluid occurs


Plaques develop on the TM

*Calcium & phosphate crystals*

Usually confined to the pars tensa

Appears as white patches

Associated with TM perforation or ME disease


When confined to TM; not clinically significant

When tympanosclerosis appears in ME...

fixes ossicles &obliterates ME cleft, leading to CNHL

When is tympanosclerosis usually identified?

Usually not until exploratory surgery

Treatment for tympanosclerosis?

Surgical removal of disease

Serous otitis media

*Absorption ME nitrogen --- negative ME pressure

*Negative ME pressure pulls fluid from ME mucosa

*90% of cases resolve within 90 days

*air/bone gaps, can have CNHL up to 50 dB

Language re: Otitis media

Studies currently say no effect on language

Antibiotics and otitis media


Politzer maneuver

This is a procedure to relieve ME pressure where you inject air (using air bag) through nostrils and swallow BUT is uncontrolled

EarClear (Silman & Arick)

Same idea as Politzer maneuver but uses a controlled amount of pressure

Retraction pocket

*Retraction pocket is localized area of AT of the TM

*AT may be present prior to, concurrent with, or after OME

If persistent or progressive, can lead to CH (cholesteatoma) and ossicular chain discontinuity


Severe retraction


Protein in cells


*Cyst lined by epithelium and keratin

*Expanding, destructive bone lesion in ME

*Can be congenital, but uncommon

*can eat through the bone of ME

***ENT may have to remove ossicles to remove tumor

Primary acquired cholesteatoma

Progressive retraction of TM

Most commonly in pars flaccida

Secondary acquired cholesteatoma

*Consequence of TM perforation, trauma, and surgery

*Epithelium migrates inward, more commonly with marginal than central perforations

Early CH is ?

Asymptomatic - neither causing nor exhibiting symptoms of disease

Later, CH...

CNHL develops due to erosion of ossicular chain or mass effect of CH

*Perforation frequently occurs, leading to worsening of HL & purulent otorrhea

*treatment? -- surgical

purulent otorrhea

foul, smelling discharge

TM perforation causes...

*Blunt or penetrating head trauma

*chemical or thermal injury

*compression trauma from acoustic or *barometric injury

*acute otits media


*tympanostomy tubes


Acute otitis media define

Inflammatory process of ME with CNHL

Acute otitis media etiology, signs

Etiology is ETD



**ME pain



**recent onset of irritability, anorexia, vomiting, or diarrhea

**rapid onset of symptoms

Which type of otitis media needs treatment with antibiotics?

Acute otitis media needs this treatment

Glomus Tumors types

Glomus tympanicum tumors

Glomus Jugulare tumors

Glomus body...

is on the jugular bulb

is also a chemoreceptor

Where do Glomus Tympanicum tumors arise from?

The glomus body on promontory in ME

Where do Glomus Jugulare tumore arise from?

Arise from Glomus body on Jugular bulb

The etiology of Glomus tumors?

Is not well understood; obscure

Are Glomus fast or slow growing; expansive or localized?

Slow; expansive

What are the initial complaints when someone for those who have had a Glomus tumor?

**pulsatile tinnitus

**Aural fullness


For the Glomus Jugulare, what is another symptom that is not an auditory symptom?

Lower cranial nerve injury such as hoarseness or aspiration

These symptoms precede, come before the auditory symtoms

Treatment for Glomus tumors?

Surgery and/or radiation

Otosclerosis define

Stiffening of the three little bones; excess bone growth occurs at stapes footplate

Otosclerosis characteristics

Charhart notch -- reflects loss of ossicular resonance

*Genetically transmitted as auosomal-dominant trait with incomplete penetrance

*80-90% of cases bilateral

In 90% of the otosclerosis cases, the disease is _______ to the footplate


Disease progression: otosclerosis

Stapes footplate fixation & CNHL

Treatment for otosclerosis

BY surgery or amplifcation


*Anterior crurotomy + vertical fracture of footplate


Stapedotomy --

**Crura + head removed

**fenestration in footplate


Stapedotomy -- placement of prosthesis

The placement is within opening of oval window attached to inucs bone

Do AC & BC initiate same traveling waves in cochlea?


What did Bekesy show regarding AC & BC signals?

He showed that the signals cancel when phases & amplitude adjusted; IE: 180 degrees out of phase

What did Lowy show?

He showed that cancellation occurs in cochlea because CM cancelled

What is the CM

It is electrical potential that reflects BM activity

Why can AC and BC thresholds be compared?

Because of the phase relationship and the CM relationship

Regarding Bekesy and BC and skull vibration: state the frequency relationships

@ < 200 Hz, the skull vibrates as a unit

@ ~ 800 Hz, vibration of skull in 2 segments (F/B)

@ > 1000 Hz, vibration of skull in 4 segments (f/b and sides)


When RW compliance = OW compliance...

Cochlear fluids...

Cochlear fluids non-compressible; equal bulging at OW & RW


When RW compliance > OW compliance...

BM displaced downwards

BM displaced to greater degree than "B" indicates because area of ____________ and __________> area of___________ pressure release through cochlear aqueduct

1. Vestibule

2. SV

3. ST