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Diagnostics 2 > Mid Term > Flashcards

Mid Term Flashcards

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1
Q

Impedance (Za) = resistance (Ra) + reactance

A

Impedance (Za) = resistance (Ra) + reactance

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2
Q

Admittance (Ya) = Conductance (Ga) + Susceptance (j or -jBa)

A

Admittance (Ya) = Conductance (Ga) + Susceptance (j or -jBa)

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3
Q

Impedance

A

resistance of flow of sound energy

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4
Q

what affects impedance?

A

acoustic resistance, compliant acoustic reactance, mass acoustic reactance

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5
Q

Compliance susceptance

A

ease of flow through a system

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6
Q

what freq. is compliant susceptance greatest?

A

low freq.

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7
Q

Mass Susceptance

A

ease of sound flow through a mass or inertial elements

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8
Q

what freq. is mass susceptance greatest

A

high freq.

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9
Q

Stiffness contributions to ME function

A

TM, round window, ossicular ligaments, ME muscles, air within EAC & ME

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10
Q

Mass contributions to ME function

A

ossicles, air movement in ME, frictional properties inherent to air movement within the system

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11
Q

Resonance

A

compliant acoustic susceptance and mass acoustic susceptance are equal and cancel each other out

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12
Q

Components of tympanometer

A

probe, pneumatic system (changes air pressure), acoustic immittance measurement system (converting difference between driver and mic), acoustic reflex activator system (ipsi & contra)

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13
Q

Type 1 Tympanometer

A

manual & auto, ipsi & contra, noise & pure-tone

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14
Q

Type 2 tympanometer

A

manual & auto, ipsi & contra, pure-tone, what we use

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15
Q

Type 3 tympanometer

A

static immittance & tymps, acoustic reflex at specified levels, used for screenings

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16
Q

Type 4 tympanometer

A

can separately do static immittance, tymps, or reflexes

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17
Q

What systems need calibration?

A

probe signal, acoustic immittance measurement system, pneumatic system, acoustic reflex activating system

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18
Q

What do we look at when calibrating probe signal?

A

output level, freq. accuracy, harmonic distortion

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19
Q

What do we look at when calibrating acoustic immittance measurement system?

A

calibration cavities equals admittance magnitude–> 0.5 cc=0.5 mmhos, 2.0cc=2.0 mmhos, 5.0cc=5.0mmhos

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20
Q

What do we look at when calibrating pneumatic system?

A

pressure changes: type 1 & 2= +200 and -600 daPa, Type 3= +100 and -300 daPa

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21
Q

What do we look at when calibrating acoustic reflex activating system?

A

freq. accuracy, output levels, attenuator linearity, harmonic distortion, temporal characteristics of instrument (initial latency, rise time, terminal latency, fall time, drift)

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22
Q

What due admittance measures tell us?

A

about ME function, Eustachian tube function, and indicates ME effusion, patency of PE tubes, and TM perforations

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23
Q

What do reflex measures tell us?

A

function of ME pathway (stapedius muscle), sensory pathway, neural pathway, and motor pathway

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24
Q

Parts of tymp tubes

A

manometer, mic, speaker

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25
What do LF (226/220 Hz) tymps tell us?
assess stiffness of ME (effusion affects stiffness)
26
Importance of ECV
provides insight to etiology of flat tymp.
27
Norms for Tymps ECV--> Birth to 4 months
0.3 cc
28
Abnormal Tymps ECV--> Birth to 4 months
greater than 1.0 cc
29
Norms for Tymps ECV--> 2.8 to 5.8 years
0.4 to 0.9 cc
30
Abnormal tymp ECV--> 2.8 to 5.8 years
greater than 1.0 cc
31
Norms for tymp ECV--> 6 weeks to 6.7 years
0.3 to 0.9 cc
32
Abnormal tymp ECV--> 6 weeks to 6.7 years
1.0 to 5.5 cc with PE tubes
33
Norms for tymp ECV--> Adult
0.63 to 1.46 cc
34
Abnormal tymp ECV--> Adults
greater than 1.5 cc
35
Normal tymp ECV--> 5th decade
1.41 cc
36
Norms for tymp ECV--> 8th decade
1.28 cc
37
Norms for tymp ECV--> Female
1.28 cc
38
Norms for tymp ECV--> Male
1.50 cc
39
Tympanic Peak Pressure (TPP)
measure at peak of tymp, point where pressure of EAC is equal to ME pressure (0= EAC pressure is equal to atmospheric pressure), most admittance at this point
40
Factors that influence tympanic peak pressure (TPP)
positive change with negative EAC pressure, direction of pressure change (+ to - = lower admittance, - to + = higher admittance), rate of pressure change, sneezing, coughing
41
What does tympanic peak pressure tell us?
about Eustachian tube function, monitors otitis media (negative pressure associated with fluid= reduced tymp height)
42
Peak Compensated Static Acoustic Admittance
ear canal admittance contributions removed, combo of acoustic admittance of TM and ME system
43
Admittance Norms--> Adult
0.72 mmhos
44
Abnormal Admittance--> Adults
less than 0.3 mmhos
45
Admittance norms--> 4 month old
0.45 mmhos
46
Abnormal Admittance--> 4 month old
less than 0.02 mmhos
47
Admittance Norms--> 2.8 to 5.8 years
0.5 mmhos
48
Abnormal Admittance--> 2.8 to 5.8 years
less than 0.2 mmhos
49
What could a reduced admittance peak mean?
ME effusion, effects of chronic otitis media (cholesteatoma, polyps, granuloma tissue), otosclerosis, impacted cerumen, TM perf
50
What could an increased admittance peak mean?
ossicular chain discontinuity, mononumeric TM (one layer TM), atrophic scars
51
What should not be used to diagnose otitis media?
peak admittance: only correct 56% of the time
52
Sensitivity
test truly identifies those that have the problem
53
Specificity
truly identifies those that do not have the problem
54
Tympanometric Gradient
describes the steepness of the slope near the peak, height and width of the tymp, draw line where width is 100 daPa--> hp/ht
55
Abnormal Gradient
0.2 or less
56
What could a lower gradient mean?
ME fluid
57
Tympanometric Width
flatness of tymp, 1/2 of admittance, connect the legs and draw lines down to x-axis, distance between legs
58
Abnormal width for infants less than 12 months
235 daPa or greater
59
Abnormal width for children 1-18
equal to or greater than 200 daPa
60
Abnormal width for adults
greater than or equal to 155 daPa
61
What could an abnormal width mean?
ME fluid
62
Type A tymp admittance, pressure, and meaning
``` admittance= 0.3 to 1.4 mmhos pressure= -100 to +100 daPa Meaning= normal ME function ```
63
Type As tymp admittance, pressure, and meaning
``` admittance= less than 0.3 mmhos pressure= -100 to +100 daPa meaning= shallow or stiff, could be minimal ME effusion or ossicular chain fixation ```
64
Type Ad tymp admittance, pressure, and meaning
``` admittance= greater than 1.4 mmhos pressure= -100 to +100 daPa meaning= flaccid TM pathology (mononumeric TM), ossicular chain disarticulation ```
65
Type C tymp admittance, pressure, and meaning
``` admittance= 0.3 to 1.4 mmhos pressure= less than -100 daPa meaning= Eustachian tube dysfunction, minimal ME effusion ```
66
Type B tymp admittance, pressure, and meaning
``` admittance= no peak pressure= no peak meaning= ME effusion, canal/probe occlusion, perforation, PE tubes, cholesteatoma ```
67
Type D tymp admittance, pressure, and meaning
``` admittance= 0.3 to 1.4 mmhos with 2 peaks pressure= -100 to +100 daPa with 2 pressures meaning= flaccid TM, ossicular chain disarticulation ```
68
Explain process of simple Eustachian tube test
run tymp perform valsalva repeat tymp TPP should be more positive
69
Explain process of Pressure Swallow Test for Intact Tympanic membrane
run tymp add +400 daPa pressure (pushes TM back, pressure inc.) have pt. swallow (ET opens & closes, pressure becomes more neg) repeat tymp add -400 daPa pressure have pt. swallow (pressure enters ME) repeat tymp (should be more positive)
70
Norms for pressure swallow test
+400 daPa: want 15 to 20 daPa negative shift -400 daPa: want 15 to 20 daPa positive shift ET dysfunction: shift will be less than 15 to 20 daPa
71
Eustachian tube testing for perforated tympanic membrane
introduce +400 daPa or -400 daPa | have pt. swallow
72
Norms for eustacian tube testing for perf
healthy ET open at +150 daPa | ET dysfunction requires +350 daPa
73
What will Eustachian tube testing tell us?
pressure change will tell us if there is normal ET function, but will give us no info concerning physiology of ET
74
Interpreting B/G tymps
``` look at shape & configuration named according to peaks meet width criteria 226 Hz normally has single peak 668 Hz normally has multiple peaks ```
75
What does it mean if susceptance notch is above the tail value?
total susceptance is positive ME is stiffness dominated admittance vector is in upper quadrant
76
What does it mean if susceptance notch is equal to tail value?
admittance vector is 0 degrees | ME is in resonance
77
What does it mean if susceptance notch is below the tail value?
total susceptance is negative ME is mass controlled admittance vector now is in the lower quadrant
78
Abnormal criteria for B/G tymps
have too many peaks being too wide (75 daPa greater than or equal for 3B tymps, 100 daPa greater than or equal for 5B tymps, peak to tail magnitude B is greater than G in 1B1G- considered abnormally stiff)
79
Clinical significance of B/G tymps
helps distinguish between ossicular discontinuities and other disorders gives more info than 226 Hz tymp
80
Screening tympanometry protocol
``` for 7 months to 18 year old visual inspections of outer ear & TM 226 Hz tymp measures look at ECV, admittance, and TW abnormal initial screening repeat in 6-8 weeks abnormal second screening medical referral ```
81
Abnormal results for B\G tymps for infants
admittance < 0.2 mmhos | width > 235 daPa
82
Abnormal results for B\G tymps for 1-8 year olds
admittance < 0.3 mmhos | width > 200 daPa

Diagnostics 2 (3 decks)

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