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AUDE 5460 OAEs > Exam 1 Study Guide > Flashcards

Exam 1 Study Guide Flashcards

(110 cards)

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1
Q

what is the current and excepted definition of OAEs

A

low level sounds emitted by the cochlea, either spontaneously as an echo or other sound evoked by an auditory stimulus, related to the fxn of the OHC of the cochlea

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2
Q

two types of noise

A

body & environmental

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3
Q

why is energy lost during backward transmission

A

impedance mismatch
backward transmission is less efficient; the oval window is a smaller surface area sending signal to a larger surface (TM) via the ossicular chain that results in a loss of intensity during the transmission
spiked heel effect

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4
Q

what is the spiked heel effect

A

Sound goes from a big area (TM) to a tiny one at the oval window which creates more pressure or the spiked heel effect (pretty sure it relates to the area size difference we learned in anatomy)

Stepping on your foot with more surface area doesn’t hurt as much as stepping on it with less surface area like a stiletto heal
So the stiletto has more pressure on it because it’s a smaller area than if you were to step on it with the ball of your foo

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5
Q

describe inward propagation of OAEs

A

stimulus is presented in teh EAM with a probe & delivered to the TM then the ME

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6
Q

role of the ME in OAEa

A

both stimuli sent in and OAEs coming back out travel to and from the cochlea via this space therefore the health of ME influences OAE recordings TWICE

in: has mechanical advantages like the area ratio bw tm and oval window, lever action of ossicles, and the geometry and placement of the eardrum

out: not efficient coming out, systems that act as an impedance matcher hinders the reversal transmission

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7
Q

describe the outward propagation

A

it is an impedance mismatch; distortion picked up is so small because of the force it takes to push back out because it doesn’t have the ME impedance matching to assist it

backward transmission is less efficient becaues the oval window is a smaller surface area sending the signal to a larger surface (TM) through the ossicles, resulting in a loss of intensity during transmission

spiked heel effect

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8
Q

Impedance mismatch on outward propagation can decrease up to

A

15 dB.

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9
Q

what is a travelling wave

A

Displacement wave traveling along the BM from base to apex

cancellations and reinforcements of some sound waves or interaction bw stimulus sound wave moving toward the TM and OAE sound wave moving outward from the TM

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10
Q

Describe the importance of basilar membrane to OAEs

A

OAEs are generated by the movement of the BM

BM is displaced to its max displacement with different stimuli frequencies

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11
Q

describe the role of OHC in OAEs

A

lower intensity levels activate ohcs (65/55 DPs & 79-83 for TEs)

bm moves from stim causing OHCs to be deflected and stereocilia bending in one direction

ions rush in and out changing the membrane potentials in the hair cells

voltage change across plasma membrane causes electromotility (lengtheneing & shortening of OHCs)

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12
Q

how do OHCs become absent

A

when electromotility is blocked

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13
Q

what is electromotility

A

the shortening and elongating of OHCs

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14
Q

generators of OAEs

A

OHCs

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15
Q

what is the fxn of the OHCs

A

improve sensitivity to sound (100 fold increase, 40dB)
make thresholds lower
AMPLIFY
damage results in mild to mod-severe SHNL

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16
Q

3 rows in a v pattern

A

OHCs

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17
Q

what happens to IHC after activation from OHCs

A

traveling wave in cochlea that moves the BM from stapes pushing into oval window finding the best movement, (vibrates best at apex for this 500 Hz example), IHC gets its stereocilia sheared shortest to tallest (tip links fanning open) potassium rushes in (high in endolymph), depolarizes causing the triggering of calcium to rush in from opening of calcium ion channel ,calcium rushing in causes which causes the neurotransmitter (ligand/chemical) vesicle to rush to the edge of the cell and dumps out onto the synaptic cleft (glutamate). NT binds to receptor sites on CN VIII causing ligand gated ion channels to open and depolarize the cell (excitatory post-synaptic potential).

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18
Q

describe what happens after NT is dumped onto the CN viii

A

stimulated enough starts ap, ap - voltage gated channel opens to allow for sodium to rush in and depolarize spot on cn 8, spot resets itself after absolute and refractory period and is maintained by sodium potassium pump, action potentials move forward to next node etc., process repeats. propagates down cn 8, cn 8 enters cns at cerebellopontine angle synapsing on cn (AVCN, PVCN, DCN)

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19
Q

the actual sensory receptors of hearing

A

IHC

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20
Q

damage causes severe to profound SNHL

A

ihc

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21
Q

1 row in linear pattern

A

ihc

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22
Q

this allows the cell to signal the VIIIth Nerve

A

Hair cells in the cochlea turn mechanical energy of sound waves into a change in membrane potential

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23
Q

what is the role of the efferent system

A

Don’t need them to get outer hair cell motility/ cochlear amplifier
May modify motility or cochlear amplifier.
Reduction in masking
Selective attention
Protection from intense sound
Adjust input to two ears to maintain balance

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24
Q

Not clear why efferent innervation of OHCs affects cochlear responses

A

true

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25
active processing
OHCs
26
passive processing
IHC
27
when is passive processing activated
activated with stimulus of 70dBSPL (75 dB) or higher Likely vibration of the basilar membrane Not measuring the actual motility (lengthening and shortening) of OHCs
28
Negative middle ear pressure can affect OAE measurements by
reducing amplitudes or entire responses
29
how does ME pressure affect TEOAEs
as little as -35 to -65 daPa can affect
30
how does ME pressure affecct DPOAEs
DPOAEs >-100 daPa or less can affect
31
worse in ____ frequencies with less effect, if any at _____ frequencies
low frequencies (<1000-2000 Hz) high frequencies
32
what is not often done clinically with ME pressure
Consider adding pressurization to OAE recordings to overcome suboptimal middle ear transfer mechanism
33
do we still test OAEs with neg me pressure
yes may result in reduction of OAE amplitude or be absent
34
should you do OAEs with perfs
yes they can be recorded if ME is otherwise normal
35
Will the stimulus be strong enough without the vibration of the ™ to get to the inner ear to record an oae?
sometimes varies by individuals
36
Which frequencies are most affected by a perf or tube?
LF
37
can you still do OAEs with Tympanostomy / Ventilation tubes
OAEs may be recorded if there is a patent tube and no active middle ear pathology but the likelihood of OAE presence <50%.
38
If OAEs are reliably present and, in particular, within the normal region, it can be concluded also that:
the tubes are patent, there can be little or nor middle ear dysfunction, and Significant cochlear dysfunction is effectively ruled out.
39
otosclerosis and OAEs
OAEs typically not detected at any frequency for any degree of hearing loss though much like immittance presentation may vary slightly based upon stage of disease
40
Why wouldn’t you have OAEs with otosclerosis
with the stiffness, it cannot get through the ME efficiently to stimulate the cochlea and get an OAE
41
neonatal fluid and OAEs
persists in ME space around a day 48hrs after birth, ME usually aerated and ™ mobile
42
what is mesenchyme? how does it affect OAEs
form of connective tissue located between epithelium and bone fetal ME contains this and it is usually reabsorbed at the end of pregnancy or soon after birth but can persist up to a year after birth
43
if you see fluid line in ME on otoscopy
can run OAE and see
44
bulging tm that is yellow
do not perform OAE
45
2 clinical advantages of oaes
site-specificity of OAEs to auditory dysfunction high degree of sensitivity specifically to cochlear impairment
46
what is high degree of sensitivity specifically to cochlear impairment
Considerable evidence shows that noise or music induced cochlear damage is detectable with OAEs before it becomes apparent in the audiogram
47
what is site-specificity of OAEs to auditory dysfunction
is loss purely sensory (cochlear), purely neural (retro) or does it involve sensory and neural structures? can be answered with OAEs and ABRs
48
why does she hate robust
you cannot quantify it
49
what are the differences between diagnostic and screening OAEs
you use fewer frequencies with the screening, you get an automatic result, and you went to screen from highs to Lows
50
What are 3 ways OAEs are affected by the efferent system
protects cochlea from trauma improved ability to detect stimuli in background noise attention
51
how does age affect OAE
decrease in OAE amp abnormal findings in adults should consider aging as a factor
52
why does age change OAEs
intensity level and ear canal anatomy ear canal resonances changes ME status changes maturation of efferent function
53
what are non pathological subject factors
age, gender, ear differences, noise noisy rooms, right ears are better, women are better, declines over age
54
how does gender affect OAEs
males are less sensitive, lower, and slower responses to signals than females DPOAE latencies are longer in males TEOAE amps and reproducibility values are higher in females than males
55
what are 4 factors that may explain the gender differences
differences in cochlear length differences in hearing sensitivity tinnitus more SOAEs in females
56
how do ear differences affect OAEs
right ear hears better especially for higher frequencies
57
how does noise affect OAEs
the success of an OAE measurement and the accuracy of OAE interpretation is highly dependent on noise
58
describe TEOAEs
has a probe with 2 ports - one delivers click & other records emission look for >75% reproducibility stim between 78 to 83, not exceeding 83-85 min 40-50 sweeps SNR of >/= 6dB spl non linear, 800-5000 Hz
59
what does a pass TEOAE mean
normal or near normal peripheral hearing for the specified frequency region which pass occurred hearing is
60
if there are present TEOAEs what does the information look like
SNR >/= 6dB 75% or > reproducibility
61
what is the stimulus for teoae
80 microsecond , brief click
62
what is the fast fourier transform analysis
.8-5 kHz takes the broadband signal that comes back out and puts it into frequency specifics to analyze
63
what is the presentation level of TEOAE
80-85dB or 74-83 dB
64
what is reproducibility in TEOAE
correlattion a and b waveforms should approximate 100% two waves should overlap
65
what relates to lower correlation
too much noise or probe fit is incorrect
66
what does the response look like in TEOAE
alternating responses are stored in alternating computer memory banks, a and b want them to overlap
67
describe DPOAEs
3 ports in the probe - f1 f1 and recording 2 pure tone stimuli measures 2f1-f2 (abs amp, dp) 500-8000 Hz L1 - 55, L2 - 65, L1-L2 = 10 dNB F2/F1 ratio = 1.22
68
what criteria is a pass DPOAE
absolute emission/absolute amp/DP - >/= neg 10 SNR >/= 6dB can be plotted on dp gram or gorgagram
69
if criteria is met for DPOAE and polotted on gorgagram at normal
hearing is better or equal to approximately 15-20 dB HL
70
if criteria is met and did not use a gorgagram
hearing is expected to be better than or equal to approximately 25-35 dB HL
71
what does 2f1 - f2 represent
DP value
72
if f1 is 2000, what is f2, dp, and where is it plotted at?
2000 x 1.22 = 2440 (f2) 2(2000) - 2440 = 1560 DP = 1560 Plotted at 2440 (f2)
73
when plotted on the graph, where is it plotted? why?
F2 because it is the main contributor to basilar membrane movement that creates the distortion product from research
74
what is the stimulus of DPOAE
2 pure tones F2 is the higher frequency, F1 is the lower frequency
75
what is the stim intensity of DPOAE
L1 = 65 L2 = 55
76
what is the largest dp evoked by tones in humans
defiend by 2f1-f2
77
what is the difference between screening and diagnostic OAEs
screenings are fast, portable, not as expensive, get an automatic result, screen from highs to lows, fewer frequencies used diagnostic provide valuable info in assessment and diagnosis
78
diagnostic OAEs provide valuable info in assessment and diagnosis of
PT that cannot complete behavioral testing non organic HL noise induced HL ANSD cochlear vs retro ototoxic medictation
79
are OAEs a direct measure of hearing
no only tells us the fxn of cochlea's oHC from which we determine cochlear function ALMOST direct measure of OHC integrity but not because of ME fxn as a factor in OAEs
80
OAE amp within normal range
0-15dB hl
81
OAE amp below normal limits but >6dB above the noise floor
15-30dB HL
82
OAEs probably not observed
35-50dB HL
83
OAEs are not observed
>50 dB HL
84
OAE outcomes fall in 1 of 3 categories. what are they
amp is normal (relative to an appropriate normative region) amp is abnormal (OAE is present but below normal limits) no evidence of reliable OAE activity above an acceptable low noise floor (abs)
85
Objective in most applications is to
describe cochlear function
86
what are 2 clinical advantages to OAEs
site specificity: determine retro vs cochlear or both cochlear impairment sensitivity: noise/music induced cochlear damage is apparent on OAEs before in an audio
87
abnormal thresholds but normal OAEs could have 3 possibilities
pseudohypacousis retro pathology pt may superimpose fxnal HL on pre existing sensory impairment
88
what are the clinical applications of OAEs in adults
assessment in suspected fxnal hl tinnitus noise/music induced differentiate cochlear vs retro monitoring ototoxicity meneire's disease
89
_____% of retro path had normal OAEs associated with higher chance of hearing preservation post op
20-25
90
how does tinnitus affect OAEs
originates in cochlea and cas cannot conclude that absent OAEs give objective evidence of tinnitus see present OAEs, but not entirely normal
91
measurable SOAEs are not linked to tinnitus but some PTs tinnitus frequencies coincides with
frequencies of the SOAEs
92
how can OAEs help with noise/music induced
can provide an early and reliable warning sign of cochlear dysfunction before it shows on the audio can provide objective confirmation of even mild cochlear dysfunction in PTs with normal audios
93
what are the two patterns of OAEs seen in Meniere's
majority with snesory hL secondary to meniere's - OAEs are abnormal with HL >/= 25-35 dB - do not expect OAE activity some have TEOAEs or DPOAEs w/ normal or even greater than expected amplitude values with thresholds exceeding 30 dB HL or up to 60 dB HL
94
what is the crosscheck principle and examples for OAEs
a single test may not be accepted or used in a diagnosis of hearing loss until it is confirmed by one or more other measures behavioral audiometry, immittance, abr
95
why does cunningham hate robust
cannot quantify the term
96
what is a gorgagram
type of dp gram goes into hearing levels - normal, borderline, abnormal plots dp amp as a fxn of f2
97
what is a dp gram
plots SNR at F2 nothing about HL graphs dp as a fxn of stimulus frequency, usually f2
98
can we estimate hearing when we only use a dp gram
NO can only state that HL if passing the criteria is expected to be better than or equal to approx. 25-35 dB HL
99
what is cunningham's occupation
pediatric audiologist currently clinical and educational audiologist
100
where does cunningham live
indiana
101
has been friends with buck for
over 30 yrs
102
how long has cunningham taught OAEs
20 yrs
103
what is her favorite team
colts peyton manning
104
what animals does cunningham have
cats and dogs
105
what is significant about Cunningham's dog
barks at 6:25 when her husband comes home her and the dog are a certified therapy team and go to libraries and the Peyton Manning Hospital
106
does she have children
yes 1 girl and 3 boys
107
where did she get her phd in audiology
cincinnati 2000
108
where is cunningham a pediatric audiologist at
Deaf and Hard of Hearing Education/Indiana State Department of Health
109
where was her ba from
speech and hearing sciences 1991 indiana university
110
where was her masters of audiology from
Purdue universityn1993

AUDE 5460 OAEs (3 decks)

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