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AUDE 5460 - Otoacoustic Emissions > Exam 1 Study Guide > Flashcards

Exam 1 Study Guide Flashcards

1
Q

What is the presentation levels for TEOAEs?

A

74-83 dB SPL

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2
Q

What is the presentation levels for DPOAEs?

A

65 (L1) and 55 (L2) dB SPL

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3
Q

Are there national standards for a passing OAE?

A

No

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4
Q

What is generally accepted for passing rates for OAEs?

A

6 dB SNR (TEOAE and DPOAE)
Must also look at reproducibility and DP amp

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5
Q

What is the stimulus stability for TEOAEs?

A

Consistency of a stimulus intensity throughout the period of data collection
Percentage
Higher stability preferred

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6
Q

What is TEOAE reproducibility?

A

Correlation
A and B waveforms should approx 100%
Two waveforms will overlap almost totally

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7
Q

What are the accepted guidelines for a passing DPOAE?

A

SNR of at least 6 dB and a DP of -10 or better

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8
Q

What is the stimulus frequency for DPOAEs?

A

Activated by 2 tones (primary tones)
f2 (higher frequency) and f1 (lower frequency)

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9
Q

What is the stimulus intensity for DPOAEs?

A

L1=65 dB
L2=55 dB
Needed to elicit the best DPOAEs in humans

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10
Q

What are the largest DP evoked tones in the human ear defined by?

A

2f1-f2

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11
Q

Are DPOAE equipment algorithms designed to detect energy at DP frequency ad distinguish it from noise in the ear canal at the same frequency?

A

Yes

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12
Q

What is plotted on a gorgagram?

A

DP amp as a function of stimulus frequency (f2)

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13
Q

Why is energy lost with backward transmission of the OAE?

A

Impedance mismatch
Less efficient due to smaller surface of oval window
Spiked heel effect

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14
Q

What is passive processing of the cochlea?

A

Activated with stimulus of 70 dB SPL or higher
Likely vibration of the basilar membrane
Not measuring the actual motility (lengthening and shortening) of the OHCs

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15
Q

With lower intensity levels, what are we triggering?

A

Only the OHCs
Stimulus invokes movement of the BM, causing OHCs to move or be deflected
Causes stereocilia of OHCs to bend

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16
Q

What happens after stereocilia bend in the OHCs?

A

Ions rush in and out changing membrane potentials within the hair cells
Voltage changes across plasma membrane cause electromotility
OHCs are absent when electromotility is blocked

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17
Q

What are standing waves?

A

Cancellations and reinforcements of some sound waves or interaction between stimulus sound wave moving toward TM and OAE sound wave moving outward from TM

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18
Q

Are standing waves a problem with both TEOAEs and DPOAEs?

A

No, just DPOAEs
Because they are usually at frequencies at and above 6k

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19
Q

What is one way to resolve standing waves?

A

Place mic at TM, but its not clinically feasible

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20
Q

Can you do OAEs on someone with negative ME pressure?

A

It is not prohibited
Recorded except in extreme negative pressure when ABR exceeds 15
Low frequencies affected first

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21
Q

Can you do OAEs on someone with PE tubes?

A

You can, but you might not get anything

22
Q

Can you do OAEs on someone with a perf?

A

You can, but you might not get anything

23
Q

Can you do OAEs on someone with ME effusion?

A

It depends on the viscosity of the fluid
If it is yellowish, they probably won’t have any
A lot of people won’t even try

24
Q

Can you do OAEs on someone with ossicular fixation?

A

No

25
Q

Can negative middle ear pressure affect OAE measurements?

A

Yes
Can reduce amplitude or entire response

26
Q

What is the cross check principle?

A

The use of subjective and objective tests
You might consider a functional hearing loss if the cross check principle doesn’t add up

27
Q

What is an example of the cross check principle?

A
28
Q

Do some people think that OAEs are related to tinnitus?

A

Yes, some people think that OAEs are effected in the frequency region of the tinnitus

29
Q

Where is tinnitus theorized to originate?

A

Both the cochlea and the central auditory system

30
Q

Do studies show consistent TEOAE results between tinnitus patients with hearing loss and those without?

A

No
Cannot conclude that OAEs give objective evidence of tinnitus
More research is needed

31
Q

Are OAEs often present in tinnitus patients?

A

Yes, but entirely normal findings are rare

32
Q

Is tinnitus often related to cochlear dysfunction associated with either aging and/or noise exposure?

A

Yes

33
Q

Are OAEs useful in predicting cochlear function?

A

Yes

34
Q

Can OAEs be useful for site of lesion and for separating out sensory from neural in SNHL?

A

Yes

35
Q

Can OAEs also be abnormal in conductive/mixed losses due to the inability to record?

A

Yes

36
Q

How are OAEs used in NBHS?

A

Used in isolation with the goal of distinguishing infants with normal hearing from those who need further intervention

37
Q

How are OAEs used in adult cases?

A

Best applied as part of a comprehensive test battery approach
Cross-check

38
Q

Are OAEs a test of hearing?

A

No
Peripheral hearing sensitivity is inferred from them

39
Q

What do OAEs tell us?

A

Function of the cochlea OHCs

40
Q

What do OAEs not tell us?

A

Neural or cortical information

41
Q

Are OAEs sensitive to damage before it shows up on an audiogram?

A

Yes

42
Q

What are some of the clinical uses of OAEs in adults?

A

Suspected functional hearing loss
Tinnitus
Ototoxicity
Noise exposure
Cochlear vs retro

43
Q

What are some conditions that might result in an abnormal OAE with normal pure tones?

A

Tinnitus
Noise exposure
Ototoxicity
Vestibular pathology

44
Q

What are some conditions that might result in normal OAEs with abnormal pure tones?

A

Functional hearing loss
Central auditory nervous system dysfunction
8th nerve auditory dysfunction
Those with inner hair cell damage (exclusively)

45
Q

What type of hearing loss are OAEs not expected?

A

35-45 dB HL to profound loss

46
Q

Can OAE findings be correlated with pure-tone audiometric threshold levels?

A

No because there is inter-subject variability

47
Q

Can OAEs be used to accurately estimate degree of hearing loss?

A

No

48
Q

What are the three categories of OAE outcomes?

A

Amp is normal (relative to an appropriate normative region)
Amp is abnormal (present but below normal)
No evidence of reliable OAE activity above an acceptably low noise floor (absent)

49
Q

What do DP-grams and gorgagrams plot?

A

Measure amp at a frequency

50
Q

What is a gorgagram?

A

A type of DP-gram

51
Q

What are the thresholds for TEOAEs?

A

SNR: greater than 6 dB
Repro of 70% or greater

52
Q

What does it mean if SNR and repro meet the requirements for TEOAEs?

A

It means you have present OAEs at all the tested frequencies

AUDE 5460 - Otoacoustic Emissions (3 decks)

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