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AUDE 5410 > quiz 1 > Flashcards

quiz 1 Flashcards

1
Q

horizontal (axial)

A

divides the brain into superior and inferior parts

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2
Q

sagittal

A

divides the body into left and right parts

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3
Q

coronal (frontal)

A

divides the body into front and back

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4
Q

what are some reason that results may be outside of the normal range

A

race, diet, age, gender, menstrual cycle, degree of physical activity, human error with the specimen, use of prescription or non-prescription drugs, alcohol intake and illnesses

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5
Q

what are the 5 main types of lab tests

A

blood, genetic, urine, radiographic or biopsy

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6
Q

what are some uses of blood tests

A

-blood sugar, cholesterol, hemoglobin levels
-cardiac, renal and hepatic functions through the use of looking for enzymes
-finding infections
-electrolyte imbalances
-minerals
-markers for some diseases are present within the blood

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7
Q

what are some uses of genetic testing

A

-diagnose/rule out a genetic condition
-diagnose/rule out viral infection
-presymptomatic or predictive testing
-establish risk factors
-establish paternity
-prenatal diagnosis of genetic conditions

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8
Q

what is the purpose of a urine test or analysis

A

used to detect UTI, kidney or bladder diseases
-can show drug use/abuse

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9
Q

what are the types of radiographic or magnetic imaging

A

x-rays, CT and MRI

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10
Q

what is a biopsy

A

the examination of tissue, such as liver, bone or tumors, removed from the body to discover the presence, cause or extent of a disease

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11
Q

x-ray

A

a form of electromagnetic radiation with a higher energy and can pass through most objects including the body
-used to generate images of tissues or structures inside the body
-not great for soft tissues

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12
Q

CT scan

A

computerized tomography scan that combines a series of x-ray images taken from different angles around the body
-creates cross sectional images of the bones, blood vessels and soft tissues inside the body

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13
Q

explain the densities within a CT scan

A

-air is black
-fat is the most dark
-fluid/blood/muscle/soft tissue are shades of gray
-bone is white

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14
Q

magnetic resonance imagine (MRI)

A

powerful magnets combined with electromagnetic fields and coils which produce radio waves, to produce detailed images of organs and tissues in the body
-there are two different contrast images

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15
Q

T-1 weighted MRI

A

enhances fatty tissue and suppresses the signal of the water
-CSF is darker

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16
Q

two different contrast images

A

T-1 weighted MRI and T-2 weighted MRI

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17
Q

T-2 weighted MRI

A

enhances the signal of the water
-ideal for the use of edema
-CSF is brighter

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18
Q

_______ is good for soft tissue contrast, _______ is poor at soft tissue contrast

A

MRI ; CT scan

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19
Q

audiologic applications for CT and MRI

A

-acoustic neruoma
-nerve visualization
-congenital bony anomalies
-cholesteatoma and me tumors
-preoperative evaluation for CI
-trauma such as skull fractures

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20
Q

electrophysiologic test

A

a measure that can record and analyzes the auditory physiologic responses
-within audiology these are immittance tests, OAEs and AERs

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21
Q

auditory evoked responses (AERs)

A

an activity/response within the auditory system that is produced or stimulated by sounds
-neurons in the brain communicate with rapid electrical impulses that allow the brain to coordinate behavior, sensation, thoughts and emotions

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22
Q

what is used to record the activity of an AER

A

scalp electrodes

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23
Q

within an AER, where can the activity be

A

cochlea, auditory nerve or the central auditory nervous system

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24
Q

auditory brainstem response (ABR)

A

a sequential series of 5-7 peaks/responses following a stimulus
-usually occurs around 5-10 ms after the onset of the stimulus
-also called the BEAR test

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25
Q

what peaks do we typically focus on in an ABR

A

1-5 in general
-1, 3, and 5 in particular

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26
Q

what is the ABR threshold

A

the lowest intensity that wave 5 can be recognized

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27
Q

clinical applications of the ABR

A

-can provide a close estimate of hearing threshold for specific frequencies
-can predict a conductive, sensory or neural site of lesion
-is aa screening tool for retrocochlear pathologies
-measuring neural synchrony

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28
Q

ABR is a measure of _____________

A

neural synchrony
-ability to fire all the nerves in their set synchronous pattern

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29
Q

generation site of wave 1

A

distal CN 8 in the cochlea
-farther from the brain

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30
Q

generation site of wave 3

A

cochlear nucleus, trapezoid body, superior olivary complex

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31
Q

generation site of wave 5

A

lateral lemniscus

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32
Q

what is the blood supply related to an ABR

A

labyrinthe artery (in cochlear) and vertebrobasilar artery (in brainstem)

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33
Q

what are the normative peak latency values at 80 dB nHL

A

wave 1 : 1.5 ms
wave 2 : 2.6 ms
wave 3 : 3.7 ms
wave 4 : 4.7 ms
wave 5 : 5.5 ms

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34
Q

nHL

A

normal hearing level

35
Q

what are the normative interpeak latency values at 80 db nHL

A

waves 1-3 : 2.25 ms
waves 3-5 : 2.0 ms
waves 1-5 : 4.0 ms

36
Q

what are the stimulus parameters for an ABR

A

-inserts
-clicks, chirp, tone burst or speech stimuli
-polarity (how it goes in, either rarefaction, condensation or alternating)
-greater than 20/second for a typical ABR
-variable intensity in dB nHL

37
Q

describe the latency relationship with intensity

A

best ABR is the result of a high intensity click stimulus
-as intensity increases, latency gets shorter (increases)
-as intensity decreases, latency spreads out (decreases)
-as intensity decreases, the earlier waveforms will disappear
-morphology decreases with the increase in intensity

38
Q

describe the relationship between an ABR threshold and an actual threshold

A

the ABR threshold is typically within 10 dB of the actual threshold

39
Q

normal bone conducted ABR

A

it can help differentiate the type of loss in addition to an air ABR
-resembles an AC ABR but has poorer morphology and typically wave 5 will be the only one visible
-dynamic range is smaller as there are limits just like with BC thresholds

40
Q

ABR cautions

A

-affected by neuromaturation (how the brain matures/grows)
-does not rule out all auditory abnormalities
-sedation is generally required for children between ~6 months and 4 years

41
Q

how does changing the stimulus rate impact the ABR

A

higher rates can increase the latency of the ABR waveforms and decrease the amplitude
-increasing the latency above 90/second can be useful for diagnosing the neuropathology

42
Q

describe how an ABR relates to ANSD

A

the response will be revered because it is not a true ABR
-meaning we will receive a flat alternating polarity line due to both condensation and rarefaction being inverses
-response is referred to as cochlear microphonic and as we flip polarity, it flips itself

43
Q

what are some guidelines for ANSD ABR testing

A

-perform one run with rarefaction and one for condensation
-if the waveforms reverse, stop ANSD diagnoses
-if waveforms do not reverse, proceed to a threshold search by decreasing intensity and using any polarity
-do NOT use alternating polarity initially because this will give a sum resulting is the incorrect diagnosis of SNHL

44
Q

what occurs to the latency within a ANSD patient

A

-with the decrease in intensity, there is not change in wave 5
-poor morphology occurs

45
Q

otoacoustic emissions (OAEs)

A

produced spontaneously or in response to acoustic simulation based on the outer hair cell function
-absent or damaged OHCs are associated with the absence of OAEs

46
Q

limitations of OAEs

A

patient must sit still/be quiet for a couple of minutes for completion, only allows for prediction of a HL, and they cannot determine severity of the HL

47
Q

absent OAE

A

anything from a mild to severe SNHL or middle ear disorder

48
Q

present OAE

A

does not rule out a mild SNHL, auditory processing disorder or CN 8 disorder

49
Q

spontaneous OAEs (SOAEs)

A

elicited without external stimulation
-measured by placing a microphone in the ear canal

50
Q

transient evoked OAEs (TEOAEs)

A

occurs in response to a brief acoustic stimulus using a clock or tone burst
-appear age dependent (decreasing in amplitude with age)

51
Q

distortion product otoacoustic emissions (DPOAEs)

A

generated from the cochlea by simultaneously presenting pure tones at two frequencies at two levels
2F1-F2 is what we are graphing

52
Q

clinical applications of OAEs

A

-NBHS
-hereditary HL
-monitoring cochlear status (such as noise exposure or ototoxicity)
-difficult to test populations
-site of lesion testing
-diagnosing ANSD
-confirmation of behavioral testing

53
Q

microtia

A

underdevelopment of the outer ear
-there is a range from absence of the pinna to small ears with atresic canals
-rarely bilateral
-if bilateral, will be seen with treacher-collins syndrome

54
Q

constricted ear

A

tight helix seen in two different forms
-loop ear which is bending of the superior helix
-cup ear which is a flare of the superior ear

55
Q

auricular appendages

A

accessory auricular hillocks from which the auricular hillocks form which the auricle develops
-can be a problem or cannot cause any problems
-usually bilateral
-may contain skin alone or skin with cartilage
-may present with associated HL

56
Q

auricular sinuses/pits

A

pit like depression anterior to the auricle
-usually are harmless
-may result of failed closure of part of the first branchial groove
-may become blocked with debris or secondarily infection

57
Q

auricular trauma

A

can result from a thermal injury, penetrating injury or a blunt injury
-due to location, it is susceptible to trauma
-requires antibiotics and tenatus prophylaxis but also may require surgical reconstruction

58
Q

auricular hematoma

A

blood vessels in the perichondrium get separated from the underlying cartilage
-can result in devitalization of the avascular cartilage and can occur in scarring
-can result in cauliflower ear if left untreated

59
Q

penetrating injuries

A

seen with knife wounds, human and animal bites, and motor vehicle accidents
-complete or partial avulsion of the auricle
-reattachment can occur within 5 hours of injury

60
Q

perichondritis

A

inflammation of the perichondrium and cartilaginous layer that can be categorized as suppurative (infectious) or relapsing (noninfectious)
-caused by injury, burns, insect bites ear piercing, boils, etc.
-insidious onset

61
Q

infection of the auricle can be ________ or _________

A

bacterial ; viral

62
Q

herpes zoster oticus (shingles) or ramsay hunt syndrome

A

viral infections that involve CN 7 paralysis
-caused by reactivation of the chicken pox virus within the geniculate, spiral or vestibular ganglion and 8th nerve sheath
-earliest symptoms is pain and a painful rash in the ear canal, concha or below/behind the auricle
-treatment with antiviral drugs and steroids

63
Q

allergic contact dermatitis

A

caused by exposure to medicinal and cosmetic products
-auricle becomes red, inflamed and with pain
-treatment with topical antibiotics and steroids

64
Q

seborrheic dermatitis

A

believed to be due from an infection by a yeast like organism
-results in scaly superficial dermatitis
-not contagious
-causes otitis externa
-treatment with antimycotic drugs, topical steroid cream and drops

65
Q

neoplasm

A

new tissue, can be benign or malignant

66
Q

benign neoplasms of the auricle

A

cysts - fluid filled cysts that are generally seen following trauma (treat with antibiotics)
kleoids - outward overgrowth of scar tissue (treat with surgical excision or steroid injections)

67
Q

malignant neoplams of the auricle

A

are rare
-squamous cell carcinoma
-basal cell carcinoma
-cutaneous cell carcinoma
-rhabdomyosarcoma (cancer of connective tissue)

68
Q

ear canal stenosis

A

very narrow ear canal
-ear canal fails to completely develop during the 7th month in utero
-repaired by canalplasty which is to widen the canal

69
Q

congenital aural atresia

A

failure of canalization of the EAC
-sporadic or can occur with known syndromes
-associated with microtia and middle ear anomalies

70
Q

collapsing ear canals

A

can collapse when supra aural headphones are placed over the ears
-can result in normal tymp, CHL in higher frequencies with supras, thresholds will be better with inserts
-use inserts for best results

71
Q

who is at risk for collapsing canals

A

younger children and older adults due to soft and deteriorating cartilage

72
Q

inflammatory polyps

A

abnormal tissue growth that can present as masses in the EAC
-seen with chronic otitis media
-most are painful and respond to topical therapy

73
Q

otitis externa

A

inflammatory condition of the skin lining the EAC
-most common to affect the EAC
-can be acute diffuse, acute localized or chronic otitis

74
Q

acute diffuse otitis externa

A

typically a bacterial infection throughout the canal
-caused by local trauma, frequent swimming or spontaneously
-severe pain, conductive HL, otorrhea and/or acute swelling may be present
-treat with analgesics for pain, topical antibiotics and steroids and can have the removal of infected debris if needed

75
Q

acute localized otitis externa

A

two main forms, within one area of the canal typically
-furuncle (abscess) or bullous myringitis

76
Q

furuncle (abscess)

A

staphylococcus aureus infection of a hair follicle on the EaC
-tender and painful, but self remitting in a few days
-symtomatic treatment for pain if needed

77
Q

bullous myringitis

A

localized viral or bacterial infection of the TM or deep EAC
-more serious
-blood blisters of varying sizes
-painful but typically self remitting in a few days

78
Q

chronic otitis externa

A

generalized condition of the EAC
-seborrheic dermatitis is typically the cause (yeast like organism)
-underlying skin appears red and scaly with lack of cerumen
-treatment of topical steroids
-stenosis of EAC due to inflammation or formation of false membrane across the EAC that may block the TM and result in conductive HL

79
Q

otomycosis

A

fungal infection within the EAC
-spontaneous or result of frequent use of topical antibiotics
-extensive debris within the EAC
-patients complain of HL and/or a wet feeling inside the EAC
-treat with topical antifungal medication and removal of debris from the EAC

80
Q

necrotizing external otitis (NEO)

A

more aggressive otitis media infection in the immunocompromised patients
-skull based osteomyelitis can occur when the disease involved the temporal bone and skull based
-chronic infection with granulation and inflammatory tissue forming in the EAC replacing a significant portion of the bony EAC
-treat with topical antibiotics

81
Q

exostosis

A

bony growth and the most common tumor of the EAC
-caused by localized hyperplasia usually due to irritation
-single or multiple growths
-starts unilaterally
-can lead to a CHL

82
Q

osteomas

A

true benign bony tumor
-less common and more laterally based
-usually smooth and singular
-symptoms similar to exostosis
-treat with surgical excision

83
Q

malignant neoplasms

A

malignancies of the temporal bone are rare
-all patiens presenting with non-healing granulation tissue in the EAC should be biopsied

84
Q

osteoradionecrosis (ORN)

A

rare and most serious complication arising from radiation of the base of skull bones due to cancer, but idiopathic variants do occur
-localized or diffuse
-ear fullness, otalgia, foul odor, HL, discharge and tinnitus

AUDE 5410 (4 decks)

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