Term
| What 2 subtypes is sensorineural hearing loss divided in to? |
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Definition
| cochlear and neural (retrocochlear) |
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Term
| Is defined as clearly detectable morphologic changes in the cochlea, most commonly regarding sensory cells (hair cells) |
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Definition
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Term
| Other pathologies can affect the function of the cochlea like a ___ of the cochlear windows (____ ___) and cochlear ___. |
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Definition
| fistulae; perilymphatic fistulae; otosclerosis |
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Term
| Cochlear hearing losses often have a ___ component |
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Definition
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Term
| Most disorders of the central auditory nervous system regard the ___ ___ |
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Definition
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Term
| Conductive HL is caused by a group of disorders characterized by impairment of ___ ___ to the ___, caused by morphologic changes in the middle ear including ___ processes and ___ of the ear canal. Unequal ___ ___ on the two sides of the tympanic membrane can also cause a conductive hearing loss |
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Definition
| sound transmission; cochlea; inflammatory; obstruction; air pressure |
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Term
| Changes in the function of the middle ear and cochlea can influence the function of the auditory nervous system because the ___ in signals from the ear to the nervous system activates ___ ___ |
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Definition
| decrease; plastic changes |
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Term
| Recording ___ ___ can help in assessing the nature of injuries to outer hair cells of the cochlea |
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Definition
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Term
| ___ tests, such as ABR, are valuable in assessing hearing loss caused by a ___ changes in the auditory nervous system, such as those caused by vestibular schwannoma |
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Definition
| Electrophysiologic; morphologic |
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Term
| A buildup of cerumen that blocks the ear canal (___ wax) causes the simples and easiest treatable form of hearing loss. The obstruction of sound conduction to the tympanic membrane caused by total blockage of the ear canal results in a nearly ___ hearing loss that varies between __-__ dB. Hearing is restored by removal of cerumen. |
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Definition
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Term
| With age, the outer portion of the ear canal in many persons changes from a nearly ___ cross section to an ___ shape |
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Definition
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Term
| Condition where one or both ear canals have not opened during prenatal life |
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Definition
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Term
| The mild form of ECA is characterized by what? |
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Definition
| A small ear canal and a nearly normal middle ear |
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Term
| In the more severe form of ECA, the ear canal is totally ___ and the ___ ___ is malformed |
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Definition
| occluded (or actually missing); ossicular chain |
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Term
| In the most severe from of ECA the ___ ___ is small or absent in addition to the ear canal being ___ |
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Definition
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Term
| ECA impairs transmission of ___ ___ to the tympanic membrane and the function of the ___ ___ may be impaired. HL of __-__ dB |
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Definition
| airborne sound; ME; 55-70 |
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Term
| ECA is best treated with what? |
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Definition
| bone-anchored hearing aids |
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Term
| The ___ ___ in the ME cavity, being different from the ambient pressure, is probably the most common cause of impairment of sound transmission to the cochlea |
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Definition
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Term
| Accumulation of ___ in the ME cavity is also a common disorder that can impair sound transmission to the cochlea |
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Definition
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Term
| Sound transmission to the cochlea is impaired when the air pressure in the ME cavity is different from that in the ___ ___ (the ambient pressure). The effect is a decrease in transmission that is greatest for ___ frequencies. |
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Definition
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Term
| ___ pressure in the middle ear cavity causes greater HL than the same value of positive pressure. Negative pressure in the ME cavity can be caused by malfunction of the ___ ___ and often occurs in connection with ME ___. The the ET doesn't open normally, ___ absorption by the mucosa in the ME causes the pressure to decrease. |
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Definition
| Negative; eustachian tube; infections; oxygen |
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Term
| Is an inflammation of the lining of the ME cavity, mastoid cell system, and eustachian tube |
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Definition
| Otitis Media with Effusion (OME) |
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Term
| __% of children within the first 3 years of life acquire OME |
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Definition
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Term
OME:
The inflammation of the ME mucosa prevents the eustachian tube from ___ normally, which creates ___ air pressure in the ME cavity because of absorption of oxygen by the mucosa. ___ ___ may effuse from the mucosa of the ME, and this fluid accumulates in the ME cavity. ___ fluid may accumulate as a result of this inflammatory process. |
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Definition
| opening; negative; Clear fluid; Viscous |
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Term
OME:
The HL from fluid in the ME depends on ___ ___ air remains in the ME and the ___ of the air |
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Definition
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Term
| The presence of clear fluid in the middle ear cavity affects sound conduction only when it covers the ___ ___ |
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Definition
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Term
| Given that HL depends on how large a portion of the TM is covered with fluid, the resulting HL depends on how the ___ is ___.. |
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Definition
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Term
| HL is independent of the head position in persons who middle ear is totally ___ filled or persons with highly ___ fluid. Clear (low-viscosity) fluid that covers the ossicles has ___ effect on their movement, and the fluid covering the round window of the cochlea doesn't affect the ___ of the cochlear fluid noticeably. |
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Definition
| fluid; viscous; minimal; motion |
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Term
| When fluid fills the ME cavity, sound is transferred through the __ and exerts approximately the same force on both the ___ and ___ ___, which is a situation similar to hearing without a ME. The average HL is approximately ___ dB with nearly normal bone-conduction thresholds. |
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Definition
| fluid; round; oval windows; 30 |
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Term
| Fluid in the ME can be diagnosed by ___. If the fluid covers the entire rear of the TM, the tympanogram will be ___ because of the acoustic impedance of the ear does not change with changing ___ ___ in the ear canal. |
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Definition
| tympanometry; flat; air pressure |
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Term
| The fluid in the ME cavity may contain toxic substances produced by bacteria, and these substances may enter the ___ by diffusion through the membranes of the ___ and ___ ___ |
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Definition
| cochlea; round; oval windows. |
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Term
| Are benign growths that may develop in the ME after long-term recurrent or chronic ME infection, or it may occur with no apparent cause. |
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Definition
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Term
| With a cholesteatoma, the extent of the HL it causes vary with the ___ of the growth, whether it is in contact with the ___ ___, to what extent it may cause ___ of the ossicular chain, and ___ of the ossicular chain. |
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Definition
| size; ossicular chain; erosion; interruption |
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Term
| A hole in the TM will allow some sound to reach the ___ of the TM, which reduces the difference between the ___ of the sound that is present on the 2 sides of the TM. The result is that the force that causes the TM to vibrate is ___. |
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Definition
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Term
| The reduction of the vibration of the TM caused by a perforation depends on the size of the ___ in the TM and the size of the ___ ___ ___. A small hole in the TM acts as a ___-___ filter that lets only ___ frequency sounds into the ME cavity. A larger hole will permit sounds within a ___ frequency range to reach the ME cavity, and, thus, impair hearing over a larger range of frequencies. |
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Definition
| holein ME cavity; low-pass; low; larger |
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Term
| When large parts of the TM are missing, the perforation also affects the way the ___ of the malleus vibrates because some of its suspension is lost. The effect on the hearing threshold depends not only on the size of the ___, but also on its ___ on the TM. |
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Definition
| manubrium; perforation; location |
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Term
| A large hole in the TM in commonly results in a __-__ dB, mostly flat, hearing loss. When the TM is totally missing, the HL can reach __ dB. |
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Definition
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Term
| ___ ___ can't be recorded and the tympanogram is ___ with a perforated TM |
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Definition
| Acoustic middle ear reflex; flat |
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Term
| Most forms of hearing impairment that are associated with a pathology of cochlear hair cells are associated with elevated hearing thresholds at ___ frequencies more than ___ frequencies. |
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Definition
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Term
| The HL that is associated with a cochlear pathology ___ at the highest frequencies and progresses toward lower frequencies as it becomes ___ |
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Definition
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Term
| What are some things that can cause pathologies of hair cells? |
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Definition
| ototoxic antibiotics and cytostatic drugs used to treat cancers; noise exposure |
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Term
| Hearing loss that follows from exposure to noise is an exception to the high frequency to low frequency rule because it normally affects the hearing threshold at ___ Hz more than other frequencies. HL from Meniere's disease affects mostly ___ frequencies. Certain forms of hereditary hearing loss affects mainly the ___-___ range (cookie-bite audiogram). |
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Definition
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Term
| The extent of injury or damage to cochlear hair cells from similar degrees of insult ___ among people, and that contributes to the individual variations in ___ ___ from seemingly identical conditions. Reduced input to the auditory nervous system from cochlear pathologies can activate ___ ___. |
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Definition
| varies; hearing impairment; neural plasticity |
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Term
| Speech discrimination is normally much more affected in people who have pathologies of the ___ ___ than what is the case for people with ___ types of hearing gloss. Injuries to the auditory nerve are often associated with very poor ___ ___ whereas the pure tone threshold is ___ affected. In persons with a cochlear type of HL speech discrimination usually only becomes affected when the threshold elevating at frequencies ___ ___ Hz become noticeable. |
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Definition
| nervous system; cochlear; speech discrimination; moderately; below 2000 |
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Term
| The reason that speech discrimination is affected only to a small degree when the hearing loss is moderate is that only ___ ___ ___ are affected. This impairs only the ___ ___, leaving sensory transduction unaffected. |
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Definition
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Term
| The cochlear amplifier is effective mainly at ___ sound levels where it increases the ear's sensitivity by about __ dB, and its effect is small at ___ sound levels. Given that speech tests are performed at ___ sound levels, impairment of the cochlear amplifier has little effect on speech discrimination. |
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Definition
| low; 50; physiologic; physiologic |
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Term
| Is the loss of hearing that occurs with increasing age |
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Definition
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Term
| Presbycusis is modifiable by ___ and by ___ factors |
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Definition
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Term
| Presbycusis affects ___ frequencies first and, to some extent, effects ___ ___ in quiet. More recent studies have revealed age-related changes, such as impaired ___ of speech in noise and in altered psychoacoustic features, such as ___ ___, gap detection, and ___-___ suppression. Such changes to a great extent, reflect changes in the function of the ___ ___ system. This means that there is now evidence that even presbycusis involves not only the ___, but also the ___ ___ system. |
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Definition
| high; speech discrimination; comprehension; frequency discrimination; two-tone; central nervous; cochlea; auditory nervous |
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Term
| Presbycusis is also associated with extensive changes in in the ___ brain |
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Definition
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Term
| In addition to operations for ___ ___, other operations in the ___ angle can cause injuries to the auditory nerve |
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Definition
| vestibular schwannema; cerebellopontine |
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Term
| These injuries from cerebellopontine angled surgeries have been reduced after introduction of ___ ___ monitoring. |
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Definition
| intraoperative neurophysiologic |
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Term
| Irritation or compression of the 8th cranial nerve from ___ ___ may also cause symptoms such as ___ and ___ ___ |
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Definition
| blood vessels; tinnitus; HL |
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Term
| Presbycusis appears as a ___ sloping hearing loss toward ___ frequencies |
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Definition
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Term
| Both ___ and ___l changes in the auditory nerve and central auditory nervous system happen in age related HL |
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Definition
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Term
| What is the main morphologic change of the cochlea in age related HL? |
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Definition
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Term
| What portion of the cochlea does it lose the most OHC? |
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Definition
| the basal end-affecting the higher frequencies |
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Term
| What is the main morphologic change in the auditory nerve in age related HL? |
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Definition
| the auditory nerve fibers widen with age |
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Term
| The risk of NIHL is related to the ___ of the noise, ___, and its ___ |
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Definition
| intensity; duration; character |
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Term
| NIHL has been thought of mainly as being caused by injury to ___ ___ ___ as well as also having components caused by changes in the function of the ___ ___ ___ |
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Definition
| cochlear hair cells; auditory nervous system |
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Term
| It has been shown that the organization of the ___ representation of the auditory cerebral cortex changes as a result of noise exposure. Changes in the function of the auditory nervous system may affect ___ ___ and ___ may accompany any of the different forms of cochlear hearing deficits. |
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Definition
| frequency; speech intelligibility; tinnitus |
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Term
| NIHL causes HL that ___ ___ after the end of the noise exposure. If the hearing threshold returns back to its normal value it is known as ___ ___ ___. Exposure to noise above a certain intensity and duration results in hearing loss that does not fully recover to its pre-exposure level. This remaining hearing loss is known as ___ ___ ___. |
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Definition
| decreases gradually; temporary threshold shift; permanent threshold shift (PTS) |
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Term
| Hearing impairment caused by noise exposure affects high frequencies more than low frequencies. If this is this case, how do you distinguish NIHL from presbycusis? |
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Definition
| The audiogram of a person with NIHL typically has a dip at 4000 Hz and the hearing threshold at 8000 Hz is better than it is at 4000 Hz. All of the high frequencies are affected in presbycusis. |
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Term
| What are some causes of variations in NIHL? |
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Definition
| Genetics, age and health status, different drugs that can increase susceptibility to NIHL, gender, pigmentation, differences in sound-conducting apparatus, blood supply, and innervation of the cochlea; whether or not you have a conductive hearing loss |
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Term
| It is mainly the ___ ___ ___ in the ___ portion of the cochlea that are injured or totally destroyed in NIHL and presbycusis |
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Definition
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Term
| Noise exposure causes a disarray of ___ on both inner and outer hair cells. Noise exposure also causes disconnection between the ___ of the OHC and the ___ membrane. |
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Definition
| stereocilia; stereocilia; tectorial |
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