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CMSD5260 Hearing Disorders > Intro: Review of anatomy, Physical exam and General Terminology > Flashcards

Intro: Review of anatomy, Physical exam and General Terminology Flashcards

1
Q

How many percent of the population have speech and/or hearing disorders?

A

10-15% of the population have speech and/or hearing disorders

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2
Q

Why do we have to know these Universal medical terms? (2)

A
  • Conveys specific ideas, facts and concepts about a patient/client or condition
  • Important in precise communication with other healthcare professionals
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3
Q

Give the anatomical terms in the list below:

Medial
Lateral
Proximal
Distal
Ipsilateral
Contralateral
Superior (cephalic)
Inferior (caudal)
Anterior (ventral)
Posterior (dorsal)
Unilateral
Bilateral

A

Medial
Lateral
Proximal
Distal
Ipsilateral
Contralateral
Superior (cephalic)
Inferior (caudal)
Anterior (ventral)
Posterior (dorsal)
Unilateral
Bilateral

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4
Q

What is the difference between the epidemiological terms of incidence and prevalence? (2)

A

Incidence
Number of new cases per certain time period

Prevalence
Number of cases present at a certain time

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5
Q

Which terms are used to evaluate a clinical test? (2)

A

Sensitivity and specificity

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6
Q

Complete this table in relation to True/False positive/negative

A
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7
Q

What does Sensitivy test? (2)

A

Test’s ability to identify positive results
Sn = TP / (TP + FN)

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8
Q

What does specificity test?

A

Test’s ability to identify negative results
Sp = TN / (TN + FP)

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9
Q

What does this table tell us?

A

Sn = 95 / (95 + 5) = 95% chance that positive means you have the disorder
Sp = 810 / (810 + 90) = 90%

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10
Q

Oto- =

A

ear

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11
Q

-itis =

A

infection/inflammation

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12
Q

-algia =

A

pain

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13
Q

-rrhea =

A

fluid

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14
Q

-ectomy =

A

remove/excise

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15
Q

-otomy =

A

cut into/incise

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16
Q

-plasty =

A

alter or change

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17
Q

Hypo- =
Hyper- =

A

Hypo- = too little
Hyper- = too much

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18
Q

Tumor =
Lesion =

A

Tumor = any growth or mass
Lesion = skin changes, masses,…

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19
Q

Why must we know about anatomy?

A

You must know normal anatomy in order to recognize abnormalities

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20
Q

What are the three parts of the ear?

A

EE ME and IE

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21
Q

What constitutes the EE? (2)

A

Auricle (pinna, outer ear)
External auditory canal (EAC)

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22
Q

What constitutes the ME?

A

Tympanic membrane
Ossicles

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23
Q

What constitutes the IE? (2)

A

Cochlea
Balance organs (SSCs and vestibular organ)

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24
Q

Fill in the blanks

A
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25
Q

What is so special about the ME?

A

It is an air filled cavity

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26
Q

The inner ear is a synonym of a

A

Labyrinth

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27
Q

What fluids are in the IE?

A

Perilympgh and Endolymph

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28
Q

What are some important parts of the Organ of Corti? Give 5

A
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28
Q

What are some important parts of the Organ of Corti? Give 5

A
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29
Q

What are the important locations of the CAP? (7)

A

.

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30
Q

What are the 12 cranial nerves?

A
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31
Q

Which cranial nerve is affected?

A

VI Abducens – turns eye laterally

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32
Q

Which cranial nerve is affected?

A

XII Hypoglossal – tongue movement

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33
Q

What are the steps in patient evaluation? (6)

A

History
Physical examination
Investigations/tests
Diagnosis
Treatment and referral
Follow-up

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34
Q

What are the steps in History taking? (2)

A
  1. General structure
    (ex: History of present illness (otologic or speech history)
    Past medical/surgical history
    Medications/allergies
    Family history
    Birth/labour history -especially for kids)
  2. Otologic History
    Ex: Otalgia
    Hearing loss
    Aural fullness
    Tinnitus
    Vertigo
    Otorrhea
    (Ear tugging)
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35
Q

What are the steps of the Ear Exam? (2)

A
  1. Inspection
    Masses
    Skin changes
    Symmetry
    Abnormal shape
    Abnormal position
    Discharge
  2. Otoscopy
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36
Q

What is otoscopy? (4)

A

Examine both the EAC, TM and middle ear space
Difficult skill to learn
Many ways to hold the otoscope
Steady yourself against the patient

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37
Q

What are tips for Otoscopy? (3)

A

Use the LARGEST size speculum that fits

Bigger aperture -> more light, wider view

Most 12 months old can accommodate 4 or 5 mm speculum

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38
Q

What are otoscopy tips for older children? (2)

A

Ideally patient is sitting
Your eye level should be at or below child’s ear

39
Q

What are otoscopy tips for Younger children? (2)

A

Sitting on parent’s lap with hands being held

If uncooperative, parent hold forehead with one hand and arms with the other

40
Q

What are Otoscopy tips related to the EAC (External Auditory canal)? (2)

A

Not a straight structure-make sure to gently pull the ear backwards
EAC usually lies in a slightly superior and anterior direction-point the otoscope in the same direction

41
Q

What is the difference between Pneumatic otoscopy and Otomicroscopy?

A

Improved diagnosis with
Pneumatic otoscopy (which uses air)
Otomicroscopy (microscope)

42
Q

How does a pneumatic otoscope work? (2)

A

Form a tight seal in the EAC
Insufflate the bulb to see TM movement

43
Q

What do we typically see during otoscopy? (6)

A

EAC
Pars tensa (all 4 quadrants)
Pars flaccida (attic)
Color/thickness of TM
Translucency
Anatomic structures

44
Q

What part is not always visible during Otoscopy?

A

Incus

45
Q

What can we see in a normal LEFT TM for example? (4)

A

Malleus (umbo, lateral process, handle)
Pars tensa, pars flaccida (upper 1/5)
Long process of incus
Stapes

45
Q

What can we see in a normal LEFT TM for example? (4)

A

Malleus (umbo, lateral process, handle)
Pars tensa, pars flaccida (upper 1/5)
Long process of incus
Stapes

46
Q

What are important aspects in Mouth and throat exams? (3)

A

1- Bright light is very important
2- Use a tongue depressor to view throat, tongue and all mucosal surfaces (Remove dentures)
3- Press on only anterior ½ of tongue to minimize gag reflex (“ahhh” will raise the palate)

47
Q

Which type of exam is this?

A

Endoscopic Exam

48
Q

What are the two types of tuning fork tests and are done with how many Hz tuning forks?

A

Weber
Rinne
Usually done with a 512 Hz tuning fork

49
Q

Describe the Weber test: (3)

A

Uses the occlusion effect
Normal = no lateralization
Sound lateralizes to side with
- CHL
- Contralateral ear with SNHL

50
Q

Describe the Rinne Test: (3)

A

Normal
AC > BC (Rinne +ve)

CHL
AC < BC (Rinne –ve)
SNHL
AC > BC (Rinne +ve)

51
Q

What are the differences between the Weber and Rinne tests?

A

In the Weber test, lateralization to one side can mean that the ear has better hearing or conductive loss

The Rinne test is mostly a Comparison of AC and BC

52
Q

What is a deciBel? (3)

A

Sound pressure unit (intensity) based on a logarithmic ratio
It is nonlinear and is a relative measure
2 dB ≠ doubling of intensity

53
Q

What is HL (hearing level)?

A
  1. Threshold dB based on normative hearing data as a reference
  2. 0 dB is the minimal intensity for average ear to perceive a specific frequency
  3. Reference used in most audiometers
54
Q

What is SL?

A

Sensation level
Sensation level (SL)
Level in dB above an individual’s threshold
Eg, if someone’s threshold is 20 dB HL then 50 dB SL = 70 dB HL

55
Q

What are the 3 parts of an Audiogram Testing?

A

Pure tone testing (frequency response)
Speech testing
Acoustic impedance

56
Q

Describe the three parts of an Audiogram:

A
  1. Pure tone testing (frequency response)
    Ability to detect sound
  2. Speech testing
    Ability to decode sound
  3. Acoustic impedance
    Helps define where problem is
57
Q

What information could we see on an Audiological Evaluation?

A
58
Q

Describe the Pure tone testing: (3)

A
  1. Pure tones (single-frequency) at 250, 500, 1000, 2000, 4000, and 8000 Hz
  2. Air conduction (AC)
  3. Bone conduction (BC)
58
Q

Describe the Pure tone testing: (3)

A
  1. Pure tones (single-frequency) at 250, 500, 1000, 2000, 4000, and 8000 Hz
  2. Air conduction (AC)
  3. Bone conduction (BC)
58
Q

Describe the Pure tone testing: (3)

A
  1. Pure tones (single-frequency) at 250, 500, 1000, 2000, 4000, and 8000 Hz
  2. Air conduction (AC)
  3. Bone conduction (BC)
59
Q

Is this a recording BC or AC threshold?

A

BC

60
Q

Is this a recording BC or AC threshold?

A

AC

61
Q

Describe AC pure tones test: (2)

A

Lowest level dB HL at which the subject perceives 50% of pure tones introduced via ear/head phones or speakers (sound field)

Conduction from auricle to cochlea

62
Q

Describe BC pure tones test: (3)

A

Lowest level dB HL at which the subject perceives 50% of pure tones introduced via bone oscillator

Conduction from skull bones to cochlea (bypassing the EAC and middle ear)

BC not tested at 8000 Hz

63
Q

Describe PTA (pure tone average): (2)

A

Average threshold at 500, 1000, and 2000 Hz

Should be within 10 dB of speech reception threshold

64
Q

What is speech audiometry?

A

Spoken voice serves as the sound stimulus

65
Q

What is Air-bone gap (ABG)?

A

Decibel difference between BC and AC

65
Q

What is Air-bone gap (ABG)?

A

Decibel difference between BC and AC

66
Q

What is Mixed hearing loss?

A

CHL + SNHL

67
Q

What is recruitment?

A

Increasing signal intensity leads to out-of-proportion perception of loudness

Suggests cochlear hearing loss (eg Meniere’s)

68
Q

What a are the 4 types of curves in the diagram?

A

Flat
Rising
Sloping
Cookie bite

69
Q

What is Rollover? (2)

A

Paradoxical decrease in discrimination ability with increasing stimulus intensity

Suggests retrocochlear disorder (eg acoustic neuroma)

70
Q

What is tone decay and fatigue? (2)

A

Decrease in auditory perception with a sustained stimulus
Suggests retrocochlear disorder

71
Q

What are the degrees of severity in hearing loss? (5)

A
72
Q

What is Masking?

A

Noise introduced with AC into non-test ear to prevent crossover

73
Q

What is crossover?

A

Perceived sound from an acoustic signal introduced to opposite ear

74
Q

What is crossover?

A

Perceived sound from an acoustic signal introduced to opposite ear

75
Q

What is AC crossover?

A

When test ear intensity is 40 dB or greater than BC of non-test ear

76
Q

When does BC crossover occurs?

A

Occurs at 0 dB

77
Q

What is Masking dilemma?

A

Bilateral ABG (Air-Bone Gap) of 50 dB cannot be masked
A masking dilemma occurs when energy from a non-test ear crosses over the head to a test ear. In cases of bilateral atresia, obtaining thresholds on the poorer ear is problematic.

78
Q

What are the two ways to measure Acoustic impedance?

A

Tympanometry
Acoustic reflex testing

79
Q

What is Tympanometry? (2)

A
  • Indirect test of middle ear function by transmission/reflection of sound energy
  • Tympanogram plots compliance changes of TM vs air pressure in the EAC
80
Q

Which Tympanometry result Type is this?

A

A: normal (peak between -150 & +50 daPa)

81
Q

Which Tympanometry result Type is this?

A

AS: “shallow” (reduced compliance)

82
Q

Which Tympanometry result Type is this?

A

AD: “deep” (hypercompliant)

83
Q

Which Tympanometry result Type is this?

A

B: flat (fluid, perforation, tube)

84
Q

Which Tympanometry result Type is this?

A

C: -ve pressure (retracted TM, ETD)

85
Q

What is an acoustic reflex? (2)

A

Reflexive contraction of stapedius muscle in response to high-intensity sound

Acoustic signal in one ear and TM mobility detected in both ears (ipsilateral and contralateral responses)

86
Q

What are 3 conclusion we can see from Acoustic Reflex Testing?

A
  1. Test response: ipsilateral > contralateral
  2. Bilateral
  3. Occurs at the brainstem level
87
Q

What could cause absent acoustic reflexes? (5)

A

minimal CHL, SNHL (> 60 dB), brainstem lesion, CN VIII impairment, CN VII dysfunction

88
Q

What are otoacoustic emissions (OAE)?

A

Objective sound in the EAC emitted from outer hair cells
Presence of OAE -> normal cochlea (organ of Corti)
Normal with retrocochlear and central auditory disorders

89
Q

What are Auditory brainstem response (ABR) tests?

A

Recording of the activity of 8th nerve and CNS response to auditory stimulus

Electrodes placed on head, mastoid, and ear to detect electrical signals with sound stimulus

90
Q

What are the 5 ABR peaks? (HINT: E COLI)

A

I-II: Eight nerve
III: Cochlear nuclei
IV: Olive (superior)
V: Lateral lemniscus
VI-VII: Inferior colliculus

CMSD5260 Hearing Disorders (12 decks)

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