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Diagnostics 2 > Final > Flashcards

Final Flashcards

1
Q

Stapedius Muscle location

A
  • originates bony canal within pyramidal eminence (posterior wall)
  • attaches to posterior neck of stapes
  • when contracted origination point will stay in place and pull attachment toward it
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2
Q

Tensor Tympani Muscle location

A
  • originates semicanal within anterior wall
  • slightly superior to eustachian tube
  • attaches superior aspect of manubrium
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3
Q

How are stapedius and tensor tympani muscles activated?

A
  • vocalizations
  • chewing
  • yawning
  • acoustical approximately 70 to 90 dB SL
  • air or water stimulation
  • tactile and similar stimulation of ears and parts of face
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4
Q

What activates tensor tympani muscles?

A
  • intense acoustic stimulus

- sound that produce startle response

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5
Q

Ipsilateral reflex pathways

A
  1. -Cochlea
    • Auditory nerve
    • ventral cochlear nucleus
    • medial nucleus of the facial nerve
    • facial nerve
    • stapedius nerve
  2. -Cochlea
    • Auditory nerve
    • ventral cochlear nucleus
    • superior olivary complex
    • medial nucleus of the facial nerve
    • facial nerve
    • stapedius nerve
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6
Q

Contralateral reflex pathways

A
  1. -cochlea
    • auditory nerve
    • ventral cochlear nucleus
    • superior olivary complex
    • (cross over)
    • medial nucleus of the facial nerve
    • facial nerve
    • stapedius nerve
  2. -cochlea
    • auditory nerve
    • ventral cochlear nerve
    • (cross over)
    • superior olivary complex
    • medial nucleus of the facial nerve
    • facial nerve
    • stapedius nerve
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7
Q

Acoustic Reflex Theories

A
  • protection theory
  • perceptual theory
  • multifunctional desensitization, interference, injury protection theory
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8
Q

What is the protection theory?

A

if sounds become too loud the muscles contract to protect the ear from damage

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9
Q

What is perceptual theory?

A

improves auditory perception- freq. response of conductive mechanism is smoothed, improves attention to acoustic environment, attenuates low freq. internal sounds

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10
Q

What is multifunctional desensitization, interference, injury protection theory?

A

reduces unimportant sounds to prevent interference during eating, talking, yelling, etc., to hearing acoustic message

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11
Q

Acoustic reflex testing involves:

A
  • use of immittance meter (220/226 Hz probe tone)
  • tonal or noise stimuli
  • elicitation of stapedial reflex
  • admittance change
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12
Q

Benefits of ipsilateral testing?

A
  • sensitive to middle ear pathology
  • ears independently evaluated, can measure individual pathways
  • effective with young children who are difficult to test
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13
Q

Benefits of contralateral testing?

A
  • sensitive to disorders involving crossed reflex pathways
  • less prone to artifact
  • greater available normative data
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14
Q

What would cause negative pressure and conductive pathologies?

A
  • absent acoustic reflexes occur most often

- could be elevated acoustic reflexes

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15
Q

Acoustic reflex test responses:

A
  • monophasic
  • biphasic at onset
  • biphasic at onset and offset
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16
Q

What is monophasic?

A

a decrease in admittance which results in an increase in impedance

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17
Q

What is biphasic at onset?

A

brief increase of admittance followed by decrease in admittance

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18
Q

What does biphasic at onset and offset mean?

A

an abnormal response

19
Q

What are Artifact Responses?

A

deflections caused by other activity as opposed to admittance measures

20
Q

Artifact Responses:

A
  • additive artifact
  • subtractive artifact
  • additive and subtractive artifacts
21
Q

What are additive artifacts?

A

stimulus and probe tones combine to increase level of probe tone and mimics decrease in admittance

22
Q

What are subtractive artifacts?

A

stimulus and probe tone combine to decrease level of probe tone and mimics increase in admittance

23
Q

Drugs that influence reflex results

A
  • barbiturates
  • alcohol
  • chloropromazine
  • curare
24
Q

What is the accoustic reflex threshold?

A

lowest level sound that elicits acoustic reflex response

25
Q

Acoustic reflex threshold norms?

A

85-110 dB SL (70-90 dB HL)

26
Q

What kind of acoustic reflex response do conductive disorders cause?

A
  • elevated

- absent

27
Q

Relationship between acoustic reflex thresholds and hearing thresholds?

A
  • acoustic reflex thresholds constant with hearing thresholds up to about 50 dB HL
  • acoustic reflex thresholds increase with hearing thresholds above 50 dB HL
  • 70 to 90 dB SL to the pure tone thresholds
28
Q

What is Acoustic Decay?

A

reduction in acoustic reflex magnitude during presentation of sustained stimulus

29
Q

Procedure of acoustic decay testing?

A
  • ipsi and contra stimulation
  • record 10 sec response
  • 10 dB SL to the acoustic reflex threshold
  • test at 500 and 1000 Hz
30
Q

What is the criteria for positive acoustic decay?

A

response falls equal to or less than 50% of initial response magnitude during 10 sec stimulus

31
Q

What are otoacoustic emissions?

A

noninvasive objective measures of (nonlinear biological mechanism within the cochlea) outer hair cell function

32
Q

What do OAEs differentiate between?

A

sensory or neural loss

33
Q

Problems with OAEs?

A

Sensitive to agents that influence cochlear function such as noise, ototoxicity, presbycusis

34
Q

What are the generators of OAEs?

A
  • external canal
  • middle ear
  • cochlea
  • efferent system
35
Q

Types of OAEs?

A
  • spontaneous
  • evoked
  • transient evoked
  • distortion products
36
Q

What are spontaneous OAEs?

A

occur without external acoustic stimulation, no clinical value

37
Q

What are evoked OAEs?

A

constant pure tone frequency is introduced at low level, no clinical value

38
Q

What are transient evoked OAEs?

A

broad band stimulus produces time locked simultaneous response from basal to apex

39
Q

What are distortion product OAEs?

A

present 2 stimuli simultaneously to produce a distortion at a different location in the cochlea, produce distortion frequency at a lower frequency

40
Q

What kind of audiogram would you expect with a flat tymp?

A

could see up to a max conductive component of 60 dB HL depends on the amount and consistency of the fluid in the ME

41
Q

What kind of audiogram would you expect with a negative pressure tymp?

A
  • conductive component at low frequencies

- possibly 250= 20 dB HL, 500= 15 dB HL, 1000= 10 dB HL

42
Q

What kind of audiogram would you expect with a flat with negative pressure tymp?

A

conductive component across all frequencies, lows will be worse,20 to 40 dB HL loss

43
Q

What kind of audiogram would you expect with a negative pressure (-180), eustachian tube dysfunction, tymp?

A

conductive component at low frequencies

44
Q

What kind of audiogram would you expect with a flat peak, wide width, tymp?

A

conductive worse low frequencies than high frequencies

Diagnostics 2 (3 decks)

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