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Audiology
final
112
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12/06/2011

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Term
tympanogram measures
Definition
total immitance of the ears which includes the combined effects of the outer and middle ears
Term
immitance
Definition
the ear converting acoustic energy into mechanical energy
Term
types of mechanical immitance
Definition
impedance and admittance
Term
impedance (Z)
Definition
opposition offered by an object to the flow of energy (measured in ohms)
Term
admittance (Y)
Definition
the ease of flow of energy through an object (measured in mmhos)
Term
more convenient to characterize the immitance of the ear in terms of: ______
Definition
admittance
-how much is passing through (as opposed to how much isn't)
Term
immitance equation
Definition
Y = 1/Z
Term
measuring tympanometry doesn't give any information on ________ or ________
Definition
audibility
hearing sensitivity
Term
tympanometry measures
Definition
-ear canal volume
-middle ear pressure
-middle ear (TM) mobility
Term
how does tympanometry work?
Definition
-sound pressure is pumped into/ increased in the ear canal, making the TM stiff
-then the pressure is varied to measure the mobility
Term
true or flase: whether you pump in negative or positive pressure, the TM stiffens
Definition
true
Term
the TM will move nicely when:
Definition
the pressure pumped in is equal to the pressure behind the TM
Term
total admittance equation
Definition
total admittance = admittance of outer ear + admittance of middle ear
Term
air bone gap assumption with regards to tympanograms...
Definition
an abnormal tympanogram would signify a pathology in the outer or middle ear, meaning there would be an air bone gap
Term
directions for tympanogram:
Definition
1-inspect ear canal first
2-proper instructions to patient
3-choose proper probe size and make seal
4-run test
5-interpretevaluate the results
Term
directions for tympanogram:
Definition
1-inspect ear canal first
2-proper instructions to patient
3-choose proper probe size and make seal
4-run test
5-interpretevaluate the results
Term
tympanogram patient instructions:
Definition
-you will feel some pressure, and hear a tone or a hum
-sit still
-no talking
-no chewing/swallowing
Term
pathologies related to ear canal volume above normal limit
Definition
-TM perforation/hole
-mastoidosis
Term
pathology if ear canal volume is too small
Definition
-blockage
Term
pathologies related to flat line tympanogram
Definition
-no ear drum
-something (fluid) behind eardrum not allowing it to move
-the pressure is so abnormal is sucks the TM in
Term
when does the peak show up on the tympanogram?
Definition
when the pressure presented is similar/equal to the pressure in the middle ear
Term
when the pressure presented is equal to the _____ ____ _____, then the TM is __________ ___________
Definition
middle ear pressure
maximum mobility
Term
when the pressure presented is equal to the _____ ____ _____, then the TM is __________ ___________
Definition
middle ear pressure
maximum mobility
Term
normal peak pressure (children and adults)
Definition
children: -150 --> 50 Pa
adults:-100 --> 50 Pa
Term
norms for peak compensated static acoustic immitance (infant, child, adult)
Definition
infant: 0.25-->0.92 mmhos
child: 0.25-->1.55 mmhos
adult: 0.3-->1.7 mmhos
Term
what to look for on tympanogram
Definition
1-find ear canal volume
2-identify where peak is (positive or negative)
3-peak compensated static acoustic immitance
Term
reduced mobility
Definition
peak is below normal limits
-TM too stiff/not compliant
Term
types of tymps with reduced mobility
Definition
As
Term
hypermobility
Definition
peak greater than normal limits, system is too loose
Term
types of tymps for hypermoblity
Definition
Ad, Add
Term
type A tymp
Definition
-everything about normal
-peak within normal limit
-compliance is normal
Term
type As tympanogram
Definition
-shallow or stiff
-has a SMALL peak
-normal ear canal volume
-peak comp LOW
-low mobility
Term
pathologies associated with type As tymp
Definition
-otosclerosis
-tympanosclerosis
-middle ear fluid (glue ear)
-cholesteatoma
Term
otosclerosis
Definition
one or more ossicles not moving
Term
tympanosclerosis
Definition
scarring on the eardrum
Term
type Ad tympanogram
Definition
d=disarticulated or deep
-huge peak (too high)
-pressure is at normal limit
-too much mobility
Term
pathologies associated with Ad tymp:
Definition
-disarticulated (too loose) ossicular chain
-nomeric membrane
-healed TM post-rupture
Term
Add tymp:
Definition
-peak off the chart
Term
type b tymp:
Definition
-flat
-means the eardrum isn't moving at all
*have to look at ear canal volume
Term
most important info for type B tymp:
Definition
ear canal volume
Term
type B w/ normal ear canal volume:
Definition
something (fluid, cholesteatoma, fused ossicles) behind TM that's keeping it from moving
Term
type B w/ large ear canal volume
Definition
-TM perforation
-PE tubes
Term
type B w/ ear canal volume too small
Definition
-too much wax or skin blocking ear canal
Term
type C tymp
Definition
-normal ear canal volume
-there is a peak but the peak is really negative (outside normal limit)
Term
pathologies associated with type c tymp:
Definition
-ET dysfunction
-excessive middle ear pressure causing the TM to retract
Term
true or false: if the typmanogram is normal, you should see an air bone gap
Definition
false
Term
tympanogram results for conductive HL
Definition
B, As, Ad, C
Term
tanogram results for sensorineural HL:
Definition
A
Term
tymp results for mixed HL:
Definition
B, As, Ad, C
Term
calibration for speech audiometry
Definition
1000 Hz
Term
threshold tests
Definition
-SRT (speech recognition theshhold)
-SAT/SDT (speech awareness/detection threshold)
Term
SDT/SAT
Definition
speech detection/awareness threshold
-lowest level at which the patient acknowledges they hear something
Term
when is SAT/SDT most useful
Definition
-non native speakers
-people too young to identify speech
-too young to repeat speech
Term
truw or false: the SAT/SDT should compare to pure tona average PTA
Definition
true
Term
to find PTA:
Definition
take an average at 500, 1000, and 2000 Hz
Term
SRT
Definition
speech recognition (test or threshold?)
-lowest level at which the speech signal is recognized 50% of the time
-test each individually
-use spondee
Term
both SRT and SDT use down ___ up ___
Definition
10, 5
Term
SDT results should be _____ than SRT
Definition
7-9 dB lower (better)
Term
benefits or live voice and CD audio
Definition
live voice: more like real life
CD: truely doing same list/voice every time
Term
SRT should ______ audiometric testing
Definition
validate
Term
ABR
Definition
auditory brainstem response
Term
OAE
Definition
otoacoustic emission
Term
ABR and OAE give information about _______ ___________
Definition
hearing sensitivity
Term
OHCs are located in the _____ __ _____ and considered the ________ _________
Definition
organ of corti
cochlear amplifier
Term
OHCs receive acoustic signals...
Definition
up to 60 dB
Term
OHC info
Definition
-receive signals up to 60 dB
-amplify soft sounds
-amplify different signals different amounts
Term
healthy OHCs are good for _________ _______________
Definition
frequency differentiation
Term
steps for OAE
Definition
1-an acoustic signal is presented via air conduction
2-acoustic signal is reflected back by OHC through the middle and outer ear and recorded by a sensitive microphone in OE
Term
to record OAE:
Definition
-organ of corti must be intact
-healthy middle and outer ears
-healthy OHCs
Term
if you can't record OAE that may be because:
Definition
the patient's auditory system isn't sensitive enough
Term
what systems are (and aren't) being measured with OAE
Definition
are: OE, ME, -->OHCs
aren't: IHCs, auditory nerve
Term
two main types of OAEs
Definition
spontaneous (SOAE) and evoke (EOAE)
Term
spontaneous OAE
Definition
cochlear emission measured in the absence of stimulus
-50% of the population
Term
evoked OAE
Definition
emission is generated when an acoustic stimulus is presented
Term
types of evoked OAEs
Definition
transient evoked
distortion product
Term
transient evoked OAE
Definition
-present clicks or pips
-record the echo with has many components so is analyzed by frequency by the machine
-results displayed: SNR
Term
SNR
Definition
signal to noise ratio
-the higher the better
-necessary because sometimes the noise from environment contaminates the response
Term
acoustic stimulus TEOAEs
Definition
-clicks or pips
Term
benefits or presenting clicks:
Definition
-encompass large areas of the cochlea
-represents all frequencies
Term
in TEOAEs you don't look at the ___ frequency bands because ____ ___ ____________ __ _____
Definition
low
they are contaminated by noise
Term
presentation stimulus for DPEOAEs:
Definition
two stimulus tones in ear simultaneously
Term
DPOAEs
Definition
distortion product OAE
-present to tones in the ear
-record a 3rd tone produced by OHCs
Term
cubic difference equation (DPOAEs)
Definition
2f1-f2
Term
consider OAE present for TEOAEs if....
Definition
SNR >3 dB above noise
Term
DPOAE is considered present if:
Definition
SNR >6dB
Term
effect of conductive HL on OAEs
Definition
show an absence of OAE
-OAE might be there but you just can't record it because it can't pass through the pathology of the middle/outer ear
Term
effect of sensory HL on OAE
Definition
-may or may not get OAE
-depends on degree of HL
->30 dB TEOAE absent
->50-60 TEOAE and DPOAE absent
Term
at 30>HL<50...TEOAEs are _______ and DPOAEs are _______
Definition
absent
present
Term
at HL > 50 dB...TEOAE is _______ and DPOAE is _______
Definition
absent
absent
Term
effects or neural HL on OAEs
Definition
-present because site of lesion is beyond OHCs
Term
what test is important for discovering auditory neuropathies
Definition
OAEs
Term
ABR
Definition
auditory brainstem response
-looking at auditory function in brainstem
-information about auditory pathways
Term
auditory evoked potentials definition
Definition
reflects the electrophysiological function of a certain portion of the CNS in response to a stimulus sound
Term
when looking at ABR, you're only looking at ________milliseconds because ________
Definition
10ish
that's what's coming from the brainstem
Term
10-100 milliseconds on ABR
Definition
middle latency response
-coming from midbrain
Term
100+ milliseconds on ABR
Definition
late latency response coming from auditory cortex
Term
why is ABR used?
Definition
-can detect CNS dysfunction
-can predict hearing senstivity (threshold)
-newborn screenings
-monitor ANS during surgery
-assess 8th nerve problems
Term
ideal conditions for ABR
Definition
still, calm, quiet
-unaffected by sleep, sedation, anesthesia
-does not require subjective response
-proves reliable and objective repsonse
Term
ABR responses
Definition
-recorded via far field recording (electrodes on scalp or neck)
Term
threshold ABR
Definition
-seeing if you can identify peak or 5th wavee at different frequencies
-look at the threshold and latency or 5th wave
Term
acoustic reflex pathways (afferent)
Definition
outer ear
middle ear
inner ear
cochlea
8th nerve
ventral cochlear nucleus
superior olive complex

Term
acoustic reflex pathways (efferent)
Definition
superior olivary complex
ipsilateral pathway or contralateral
7th nerve
stapedius muscle
Term
afferent information goes up ___________ pathways and efferent information comes down ___________ ___ _____________ pathways
Definition
ipsilateral
ipsilateral and contralateral
Term
during acoustic reflex, the ear canal volume should increase by:
Definition
.3 ml or more
Term
true or false: the contraction of the stapedius muscle occurs in the ear it is presented in
Definition
false: it occurs in both ears becausethe information is sent back down
Term
stapedius muscle only contracts with _____ noises
Definition
loud
Term
measure ___________ to see if the stapedius muscle contracts
Definition
admittance
Term
acoustic reflex requires normal:
Definition
middle and outer ear function
Term
stimulus for acoustic reflex
Definition
-500 Hz
-1000 Hz
-2000 Hz
-broadband and narrowband noise
Term
if the patient has a conductive component then you ____________ (should/shouldn't) see a reflex
Definition
shouldn't
Term
normal acoustic reflex:
Definition
70-90 dB HL (85 is average)
60-100 for noise
Term
true or false: acoustic reflex can give you information about hearing loss and degree
Definition
true