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Audiology and Speech Perception > Audiology - Middle Ear > Flashcards

Audiology - Middle Ear Flashcards

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1
Q

What do Tympanograms measure?

A

Performance of the ear drum (Tympanic Membrane) and middle ear (Ossicles)

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2
Q

What is the stapedius reflex?

A

The acoustic reflex which protects the cochlea from intense sounds

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3
Q

What type of energy is transferred in the middle ear?

A

Mechanical energy

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4
Q

What type of energy is transferred in the inner ear?

A

Hydraulic energy

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5
Q

What type of energy is transferred in the central pathway and temporal lobe?

A

Bio-electrical energy

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6
Q

When does the tympanic membrane vibrate most efficiently?

A

When the pressure in the ear canal equals that in the middle ear

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7
Q

If the middle ear wasn’t functioning, what would happen to the acoustic energy?

A

It would be reflected off the oval window (not transferred to the cochlea)

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8
Q

What are the acoustic repercussions of a non-functioning middle ear?

A

The loudness of sounds will be attenuated

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9
Q

What are some of the middle ear disorders which result in conductive hearing loss?

A

OME,

Down Syndrome,

Otosclerosis

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10
Q

Can deaf adults/children also suffer from conductive hearing loss?

A

Yes (usually temporary)

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11
Q

What type of testing are Tympanometry and Acoustic Reflex Threshold?

A

Objective

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12
Q

What is meant by impedance of the middle ear system?

A

Stiffness of the system which stops the system from working efficiently

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13
Q

Does the system become more / less compliant as impedance increases?

A

Less compliant

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14
Q

What is meant by compliance of the middle ear system?

A

Flexibility of the system, allowing it to work efficiently

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15
Q

What are the acoustic consequences of impedance of the middle ear?

A

Sound waves will not be conducted efficiently and loudness will be attenuated

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16
Q

What does the Acoustic Reflex Threshold test measure?

A

The functionality of the middle ear, inner ear, auditory nerve and lower brain stem

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17
Q

Who is Tympanometry usually used with?

A

Children

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18
Q

How do Tympanograms measure the function of the middle ear?

A

By providing graphical illustrations of the change in movement of the ear drum as a result of variations in pressure

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19
Q

Which is a quicker and more reliable test - bone conduction or Tympanometry?

A

Tympanometry

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20
Q

What steps are involved in a Tympanogram test?

A
  1. Pressure in the outer canal is changed relative to the pressure in the middle ear
  2. Changes in compliance / impedance are measured using a probe tone
  3. Reduce pressure in ear canal in successive steps
  4. Measurements taken at each step
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21
Q

What pressure do Tympanograms usually start at?

A

200 daPa

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22
Q

What frequency is the starting probe tone usually?

A

220 or 226 Hz

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23
Q

What is known by maximum compliance in a Tympanogram?

A

The level at which the ear drum is operating at maximal capacity

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24
Q

What are the axis labels on a Tympanogram?

A

X is pressure (decaPascals - daPa)

Y is compliance / impedance (ml of water)

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25
What is it important to note regarding magnitude of greatest compliance on a Tympanogram?
The pressure at which this is achieved
26
What does a Jerger Type A Tympanogram represent?
Normal hearing
27
What is range of greatest compliance in normal hearing?
Minus 100 to Plus 50 daPa
28
What is the normal range of compliance?
0.3 to 1.5 ml of water
29
What does a Jerger Type As represent?
A stiffened middle ear system
30
What are the characteristics of a stiffened middle ear system (Jerger Type As)?
Normal middle ear pressure (middle ear pressure equal to ear canal) BUT low compliance
31
What are some of the causes of a stiffened middle ear system (Jerger Type As)?
Otosclerosis Transitional OME
32
What does a Jerger Type As Tympanogram look like?
A flatter line - within normal range for pressure (daPa) but a lower level of compliance (ml)
33
What does a Jerger Type Ad represent?
A hypermobile Tympanic Membrane
34
What are the characteristics of a hypermobile Tympanic Membrane (Jerger Type Ad)?
Normal middle ear pressure (middle ear pressure equal to ear canal) BUT high compliance
35
What are some of the causes of a stiffened middle ear system (Jerger Type Ad)?
- Ossicular separation - Scarred or thinned Tympanic Membrane (from several burst ear drums / recurring infections)
36
What does a Jerger Type Ad Tympanogram look like?
A pointier line - within normal range for pressure (daPa) but a high peak for level of compliance (ml)
37
What does a Jerger Type B represent?
Middle ear effusion
38
What are the characteristics of middle ear effusion (Jerger Type B)?
No point of greatest compliance!
39
What are some of the causes of middle ear effusion (Jerger Type B)?
Wax / liquid in middle ear
40
What does a Jerger Type B Tympanogram look like?
Low flat line - outside of normal pressure limits (daPa) and no point of greatest compliance (ml)
41
What type of Tympanogram is common in the elderly?
Tympanogram Type B
42
Why is the line relatively flat for middle ear effusion (Tympanogram Type B)?
Wax / liquid is stopping equalisation
43
What does a Jerger Type C Tympanogram represent?
Negative pressure in the middle ear / Eustachian Tube dysfunction
44
What are some of the causes of Eustachian Tube Dysfunction (Jerger Type C)?
Disease of the middle ear
45
What does a Jerger Type C Tympanogram look like?
Compliance (ml) peak within normal limits, but peak towards start of the X axis as pressure (daPa) is low
46
What is the most common middle ear pathology?
OME - Otitis Media with Effusion
47
What is meant by normal Eustachian Tube function?
The Eustachian Tube is closed 95% of the time - Equalises pressure between the middle and outer ear
48
Why is pressure equalisation between the middle and outer ear important?
For the efficient transfer of sound vibrations
49
When does the Eustachian Tube open when functioning normally?
Yawning or swallowing
50
What are the stages of OME?
1. Negative middle ear pressure 2. Ear drum retraction 3. Effusion of sterile fluid (as no refreshing of the middle ear) 4. Fluid is watery at first, then becomes thickened
51
What is serous OME?
When the fluid in the middle ear is watery
52
What is secretary OME?
When the fluid in the middle ear is thickened
53
What is the Acoustic Reflex?
Reflex contraction of the stapedial muscle in response to loud sounds
54
What happens to the Acoustic Reflex over time if exposed to loud sounds?
It weakens and decays quickly
55
Where is the neural network for the reflex arc located?
The lower brainstem
56
What is meant by an ipsilateral pathway?
When a sound is made in one ear and measured in the same ear (no cross over)
57
Why can the Acoustic Reflex not protect the cochlea from loud impulse sounds?
It is too slow
58
How is the Acoustic Reflex measured?
Indirectly - measuring slight changes in stiffness of the ear drum caused by the contraction of the middle ear muscles
59
What is meant by Reflex Decay?
If the stapedius muscle does not maintain contraction during an above reflex threshold stimulus
60
What can Reflex Decay be indicative of?
Retro-cochlear disorder
61
What is meant by Reflex Latency?
The time difference between stimulus and response
62
When does Reflex Latency decrease?
With increased intensity of stimulus
63
What is the Acoustic Reflex Threshold?
The quietest sound level at which an acoustic reflex can be obtained (dBHL)
64
What is the normal range for the Acoustic Reflex Threshold?
80 - 85 dBHL
65
What is the procedure for measuring ART?
1. Silence 2. Use impedance measuring equipment 3. Stimulus is a moderate to high intensity tone (must be audible to testee) 4. Look for a decrease in Tympanic Membrane compliance in same/opposite ear 5. Raise tone level until response seen
66
What will happen to the ART if there is a pathology at any point on the reflex pathway?
It will be raised or absent
67
What do ART results tell us?
The location of the pathology and an estimation of the patient's dynamic range
68
What will the ART results be for sensori-neural hearing loss that is greater than 80 dBHL?
The ART results will be absent
69
What will the ART results be for sensori-neural hearing loss less than 50 dBHL?
Normal (80 -85 dBHL)
70
When is loudness recruitment likely to be present?
When the threshold of hearing and the ART differ by less than 60dB
71
What is a common feature of sensori-neural hearing loss?
A reduced dynamic range
72
Why can ART often not be measured in conductive hearing loss?
Because of middle ear impedance (e.g. glue ear)

Audiology and Speech Perception (6 decks)

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