Term
| What does acoustic immittance testing general refer to? |
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Definition
| tympanometry, ART, and reflex decay |
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Term
| evaluation of the admittance of the outer and middle ear system (generally interpreted as compliance of the TM) as a function of ear canal pressure |
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Definition
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Term
| evaluation of changes to the admittance of the outer and middle ear system resulting from contraction of the stapedius muscle when a loud sound is introduced to either or both ears |
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Definition
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Term
| evaluation of the ability of the auditory system to maintain the acoustic reflex during a prolonged stimulating signal. Tells you if its a retrocochlear pathology or not. |
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Definition
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Term
| Early 19th century: William Hyde ___ and Sir Charles ___ publish papers describing the effects of air pressure changes on hearing |
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Definition
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Term
| Late 19th century: Oliver ___ describes electric impedance |
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Definition
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Term
| Early 20th century: telephone engineers AG ___ and W ___ apply impedance concepts to acoustic signals |
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Definition
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Term
-___: Hensen first describes the response of the tensor tympani and stapedius muscles to loud sounds in dogs
-___: Kato notes that only the stapedius muscle seems to have this response in primates (monkeys)
-___: Lüscher first describes direct observation of the acoustic stapedius reflex in humans |
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Definition
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Term
| 1934: ____, a German engineer studying acoustic impedance as a parameter in telephone design, modifies a mechanical bridge developed by Schuster for the measurement of sound absorption in construction materials |
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Definition
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Term
| Mid ___ century: Georg von ___ conducts experiments to measure acoustic impedance of the air with varying air pressure |
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Definition
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Term
-1946: Danish physician Otto Metz publishes a paper which
describes an early (non-electrical) device for measurement of
___ ___
-1952: ___ publishes the first paper describing the acoustic
reflex in patients with otologic disease |
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Definition
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Term
| 1955: A student named ________ at the University of Aarhus in Denmark writes a doctoral thesis titled Studies on the acoustic stapedius reflex in man. Measurements of the acoustic ___ of the tympanic membrane in normal individuals and in patients with peripheral facial palsy. |
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Definition
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Term
1959: Danish scientist Knud ___ and colleagues
develop the first prototype electroacoustic immittance
bridge and publish the first description of (and use of the
term) tympanometry |
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Definition
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Term
-____-____: Terkildsen and colleagues work with a Danish inventor named Paul Madsen to convert their lab device into a commercial impedance audiometer, the Madsen ZO61
-___: American audiologist James Jerger attends the
International Congress of Audiology in Copenhagen and
is shown the ZO61 |
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Definition
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Term
| ____: Jozef Zwislocki, working for Grason- Stadler, designs a commercially-available mechanical acoustic bridge |
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Definition
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Term
___: Jerger publishes the first paper describing
clinical use of immittance audiometry. Includes a description of Type _____________ tympanograms. Modified terminology introduced by Gunnar ___ |
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Definition
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Term
-1975: Physicists at the University of Antwerp describe the relations between tympanometric response and ___ ___ status
-___ ___: described the effects of probe frequency,
middle ear development, middle ear pathology on tympanometric patterns |
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Definition
| middle ear; Vanhuyse model |
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Term
| When was the first description of acoustic reflectance? |
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Definition
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Term
Has been the routine diagnostic measure of middle ear status
since ~___ |
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Definition
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Term
| Tympanogram shows measurement of acoustic ___ of a probe tone across the TM at various ___ |
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Definition
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Term
-Prior to 1987, immittance instrumentation and procedure ___ substantially
-ANSI S3.39 published in 1987 to encourage ____ in instrumentation, unit measures, and terminology for reporting immittance data
–Definition: “the dynamic measure of acoustic immittance
in the external ear canal as a function of changes in ___ ___ in the ear canal” |
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Definition
| varied; uniformity; air pressure |
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Term
-The admittance of any system is a complex ratio of a ___ quantity to a ___ quantity and is the reciprocal of impedance
-Acoustic admittance is measured by applying a known ___ ___ ___ to the middle ear system, then measuring the resulting velocity (admittance = velocity/sound pressure)
-Affected by the ___, ___, and ___ of the middle ear system, especially the TM |
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Definition
velocity (or velocity analogue); force (or force analogue); sound
pressure level; compliance, mass, and friction |
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Term
| A plot of middle ear admittance as a function of ear canal pressure |
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Definition
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Term
-Ear canal air pressure typically is swept from ___ to ___ or ___ daPa
– Peak admittance occurs at the point where middle ear and ambient air pressures are ___ |
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Definition
| +200 to -200; -400; equal |
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Term
Tympanometry:
-Well-suited to identifying ___ ___ in middle ear status associated with pathology
-Primarily used to provide information about middle ear ___ of energy |
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Definition
| physical changes; transmission |
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Term
| What are the 4 components of a tympanogram? |
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Definition
| peak height, peak compensated static acoustic admittance, ear canal volume, and tympanogram width/gradient |
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Term
| Jerger tympanogram types are applicable only for Y-___ tympanograms |
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Definition
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Term
| What is the main reason why we use a 220 Hz probe tone? |
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Definition
| Standards for immittance devices apply to those that employ a 226 Hz probe tone frequency |
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Term
-Prototype papers for 220-Hz tympanometry were published by ___ and colleagues in 1959 and 1960
-220-Hz probe tone was chosen “partly at ___” |
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Definition
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Term
Limitations:
-No ___ ___ for each separate middle ear disorder
-In the case of multiple ME pathologies, the most ___ pathology (TM) will dominate immittance measured, whether it has the greatest effect on hearing status or not
-Tympanometric measures are highly ___ within middle ear diseases and between normal and pathological ears |
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Definition
| unique pattern; lateral; variable |
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Term
-Measurement of ___ change in outer/middle ear system in response to loud sound – presumably a result of --reflexive bilateral contraction of ___ ___ muscles
-In humans, the acoustic reflex is a ___ reflex only. It is possible for the tensor tympani to contract if the stimulus sound is very ___ or if it induces a ___ reaction
-Induced by presentation of ____ stimulus to one ear |
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Definition
| admittance; middle ear; stapedius; intense; startle; noise/tone |
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Term
Acoustic Reflex:
-Resulting changes in middle ear admittance are monitored using the same techniques and instrumentation as ____
-Usually a ___- or ___-Hz probe tone, except in neonates (higher- frequency probe tone – usually ___ Hz – due to compliant EAM) |
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Definition
| tympanometry; 220; 226; 1000 |
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Term
Acoustic Reflex:
-Typically, thresholds estimated ___ and ___ in conditions of constant ear canal pressure
-Usually absent if tymp is ___
-Should we test 4000 Hz? |
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Definition
| ipsi- and contralaterally; flat; Not really necessary because they could be absent even in people with normal hearing. |
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Term
Acoustic Reflex Decay (adaptation):
-Reduction in the magnitude of the acoustic reflex response
during presentation of a ___ stimulus
-Usually tested ___
-Abnormal reflex decay is associated with ___ pathology |
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Definition
| prolonged; contralaterally; retrocochlear |
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Term
Instrumentation-Tympanometry:
-Production of a ___ tone
–Control and measurement of ___ ___ in the outer ear
–____ |
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Definition
| probe; air pressure; Microphone |
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Term
Instrumentation-Acoustic Reflexes and Decay
-Production of a ___ tone
– Production of ___ signals
– Control and measurement of ___ ___ in the outer ear
–___ |
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Definition
| probe; stimulus; air pressure; Microphone |
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Term
Elecroacoustic Immittance Meter (tympanometer, immittance bridge, impedance meter):
-Primary function is to quantify ___ (resistance to transmission of sound) of the TM and middle ear
-Produces a ___ tone which reflects from the TM
-Measures the proportion of ___ sound |
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Definition
| impedance; probe; reflected |
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Term
Immittance Output:
-Tympanometry: Graphs the admittance of middle ear as a function of change in ___ ___ ___
-Acoustic reflexes: Graphs the admittance of the middle ear as a function of change in ___ ___ status
-Acoustic reflex decay test: Graphs the admittance of the middle ear over time as a function of ___ change in stapedius muscle status |
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Definition
| outer ear pressure; stapedius muscle; sustained |
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Term
| Do a acoustic reflex decay test if there is an asymmetry of __ dB or more at ___ frequencies and/or suspected ___ cases. |
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Definition
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Term
-All modern immittance instruments provide measures in terms of ___ ___.
-Some instruments are capable of producing _____
and ____ measures as well. Thees are real and ___ components of complex acoustic admittance |
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Definition
| acoustic admittance (Ya); conductance (Ga); imaginary |
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Term
-The unit measure of Ya is the acoustic ___ which is the unit of admittance/impedance.
-Acoustic immittance is not a measure of ___
-Acoustic immittance is not a measure of ___
-Ya is typically expressed as peak compensated static acoustic
admittance, reflecting ___ ___ within tympanometric
sweep (height of the peak)
-Ear canal volume: ____
-Peak pressure: ___. The ear canal pressure that produces peak compensated static acoustic admittance |
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Definition
| millimho (mmho); compliance; mobility; peak pressure; cubic cm; daPa |
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Term
Basic components of an immittance meter:
-Signal Drivers: ____ ____ driver produces the probe tone. ___ ___ driver produces signals to evoke acoustic reflexes.
-___-measures canal SPL of the probe tone
-___ ___-changes air pressure in the ear canal
-Processor-digital or analog
-Display-digital or analog |
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Definition
| Probe signal; AR stimulus ; Microphone; Air pump |
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Term
| What are the 3 components (tubes) of the immittance probe? |
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Definition
| output (probe tone, reflex stimulus signals), air pressure (from air pump), and mic |
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Term
Microphone:
-Measured SPL is directly proportional to the ___ at the microphone output
-Ya is inversely proportional to the measured _______
-When SPL is too low or too high (outside of the test time envelope), ___ is increased or decreased to maintain a constant probe level |
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Definition
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Term
| Contralateral probe is ___ only |
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Definition
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Term
| What is the American National Standard Specifications or Instruments to Measure Aural Acoustic Impedance and Admittance (Aural Acoustic Immittance)? |
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Definition
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Term
ANSI S3.39-1987 (R2007) describes the classifications for 4 types of instruments:
-Type 1 or 2 typically used for ___ testing
-Type 3 for ___
-Type 4 instruments only have one capability– either ___ or ___ ___ |
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Definition
| diagnostic; screening; tympanometry; acoustic reflexes |
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Term
| There are no minimum requirements for Type __ devices |
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Definition
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Term
Type 1 requirements:
-Automatic and manual control of ___ ___
–___ plane tympanometry
–___ tympanometry
–___ and ___ reflex signals
–___ and ___ reflex signals |
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Definition
| air pressure; Measurement; Compensated; Noise; tone; Ipsilateral; contralateral |
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Term
Type 2 requirements:
-Automatic ___ manual control of air pressure
–___ tympanometry
–___ reflex signals
–___ or ___ reflex signals |
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Definition
| or; Compensated; Tone; Ipsilateral or contralateral |
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Term
Key Requirements for Types 1-3:
-___-Hz probe signal
-Manual or automatic ___ pump
-Ability to measure ___ ___ immittance
-Ability to measure ___
-Ability to measure ___ ___ |
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Definition
| 226; pneumatic; static acoustic; tympanometry; acoustic reflexes |
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Term
What are the immittance calibration domains of these parts?
1. Probe tone
2. Pump
3. Stimulus signals
4. System |
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Definition
1. Intensity, frequency
2. static pressure, volume
3. Intensity, frequency, time
4. Static acoustic admittance |
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Term
| What calibration equipment do you need? |
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Definition
| Sound level meter with octave band filter, HA-1 coupler, Spectrum analyzer or electronic counter, Manometer, and Test cavities |
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Term
Hard-walled test cavities:
-ANSI S3.39 mandates that the manufacturer must ___ cavities with all new equipment
-At minimum, type 1-3 immittance bridges must include cavities with volume ___, ___, and ___ cc
[image] |
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Definition
| provide; 0.5, 2.0, and 5.0 |
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Term
Probe Tone Calibration: Frequency
-All immittance devices, regardless of type, must be able to produce a ___ Hz probe tone with accuracy within +/- ___% and with no more than ___% total distortion
-Many devices produce other probe tones as well, but a 226 Hz
tone is the ___ requirement for all devices
-3% tolerance for a 226 Hz tone is ___ Hz
-3% tolerance for a 220 Hz tone is ___ Hz
-Measured using similar instrumentation to frequency domain checks for insert headphones (HA1 / HA2 coupler, SLM with octave band filter, spectrum analyzer, frequency counter, etc) |
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Definition
| 226; 3; 5; minimum; 6.8; 6.6 |
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Term
Probe Tone Calibration: Intensity
-Probe tone SPL should be below the level that elicits the ___ ___, but high enough to obtain a favorable SNR
-Probe inserted and sealed into a ____ coupler connected to an __________
-Octave band filter set to ___ Hz
-Measured SPL should be within +/- ___dB of the level stated by the manufacturer |
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Definition
| acoustic reflexHA-1; SLM; 250; 3 |
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Term
Pressure calibration:
-Type 1, 2, and 3 immittance devices must be able to change the air pressure in the ear canal and ___ these pressure changes accurately
-Maximum permissible pressure range for any immittance device: ____ to ___ daPa
-Type 1 and 2 immittance bridges typically operate in the range from ___ to ___ daPa
-Type 3 bridges typically range from ___ to ___ daPa |
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Definition
| measure; -800 to +600; -600 to +200; -300 to +100 |
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Term
What kind of device is this?
[image] |
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Definition
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Term
Pressure Calibration:
-Connect ___ to a manometer
– Measure water ___ as immittance device pressure dial is rotated
-Type 1 or 2: Air pressure should not differ from stated values by more than +/- ___ daPa or +/- ___% of the reading, whichever is greater
-Type 3 or 4: Air pressure should not differ from stated values by more than +/- ___ daPa or +/- ___% of the reading, whichever is greater |
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Definition
| probe; displacement; 10; 10; 10; 15 |
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Term
Static Acoustic Immittance Calibration:
-Impedance values should be accurate to within ___% of displayed values or +/- ____ mmho, whichever is greater
-Measured by connecting probe to test cavities and checking accuracy of output at specified ___ and ___ pressure levels |
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Definition
| 5; 1 .1 ; temperatures; barometric |
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Term
Volume Calibration:
-Signals and pressure calibrated using an ___ volume of air in a test cavity
-ANSI S3.39 specifies that Type 1-3 instruments must have
calibration cavities with volumes of ___, ___, and ___ cc
-Volume tolerance: +/- ___% or ___ cc, whichever is greater
-Many diagnostic instruments perform calibration procedures ___ when the probe is sealed in the cavity |
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Definition
| enclosed; 0.5, 2.0, and 5.0; 2; .05; automatically |
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Definition
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