SM_28b: Ear Function and Testing Flashcards

(43 cards)

1
Q

Lateral portion of external auditory canal is composed of ____, while medial portion of external auditory canal is composed of ____

A

Lateral portion of external auditory canal is composed of cartilage, while medial portion of external auditory canal is composed of bone

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2
Q

Describe innervation of external auditory canal

A

Innervation of external auditory canal

  • Lesser occipital nerve (C2)
  • Auriculotemporal nerve (V3)
  • Facial nerve sensory branch
  • Greater auricular nerve (C2, C3)
  • Auricular branch of vagus nerve
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3
Q

Outer ear functions include ____, ____, and ____

A

Outer ear functions include amplification / filtering, protection, and localization

  • Amplification / filtering: filters sound to external auditory canal, 20 dB amplification, strongest at 4000 Hz
  • Localization: interaural time difference, interaural intensity difference (Head Shadow effect)
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4
Q

Tympanic membrane parts include ____ and ____

A

Tympanic membrane parts include pars tensa and pars flaccida

  • Para tensa: how eardrum grows, vibrates ossicles
  • Pars flaccida: prevents eardrum from collapsing on itself
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5
Q

Describe the middle ear

A

Middle ear

  • Mucous membrane lining
  • Tympanic membrane separates it from external auditory canal
  • Eustachian tube connects it to nasopharynx
  • Also connected to mastoid air cells
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6
Q

Label the middle ear structures

A

Middle ear structures

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7
Q

Middle ear muscles include the ____ and ____

A

Middle ear muscles include the stapedius and tensor tympani

  • Stapedius: attaches to stapes, makes ossicles less likely to move, contracts in response to loud sounds / chewing / speaking, facial (CN VII)
  • Tensor tympani: helps open Eustachian tube
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8
Q

____ matchmaking occurs in the middle ear

A

Impedance matchmaking occurs in the middle ear

  • Fluid in cochlea has high impedence compared to air in external / middle ear
  • Ossicles overcome this with impedance matching and increasing sound pressure
  • Multiple mechanisms: area ratio of tympanic membrane to oval window is 20:1, lever action of ossicles
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9
Q

Inner ear is composed of ____ and ____ halves, both of which use ____

A

Inner ear is composed of vestibular and cochlear halves, both of which use hair cells

  • Vestibular: transduces motion and pull of gravity
  • Cochlear: transduces sound energy
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10
Q

Scala vestibuli and scala tympani have high ___ and low ___, while the scala media has low ___ and high ___

A

Scala vestibuli and scala tympani have high Na and low K, while the scala media has low Na and high K

(ionic gradient acts as a battery)

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11
Q

Stapes movement sets up vibration in the ____

A

Stapes movement sets up vibration in the scala media

  • Fluid wave starts at the oval window and scala vestibuli
  • Travels from the base to apex of cochlea
  • Continues back down through scala tympani to the round window
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12
Q

____ is in the scala media

A

Organ of Corti is in the scala media

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13
Q

Describe the process of a traveling sound wave

A

Traveling sound wave

  1. Fluid wave displaces basilar membrane
  2. Resonates in specific areas based on frequency
  3. Appropriate hair cells stimulated: inner hair cells created signal, outer hair cells amplify
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14
Q

Describe cochlear tuning

A

Cochlear tuning

  • Tuning exists through auditory system
  • Basilar membrane has varying width and stiffness
  • Base of cochlea has stiff basilar membrane so high frequency
  • Apex of cochlea has flaccid basilar membrane so low frequency
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15
Q

Base of cochlea has ___ basilar membrane so frequency is ___

A

Base of cochlea has stiff basilar membrane so frequency is high

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16
Q

Apex of cochlea has ___ basilar membrane so frequency is ___

A

Apex of cochlea has flaccid basilar membrane so frequency is low

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17
Q

____ are found on inner and outer hair cells

A

Stereocilia are found on inner and outer hair cells

  • Outer hair cells: V or W shaped ranks
  • Inner hair cells: straight line ranks
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18
Q

Inner hair cell activation alters ____

A

Inner hair cell activation alters firing rate

19
Q

Inner hair cells stimulate ____

A

Inner hair cells stimulate spiral ganglion cells

  • Housed in Rosental’s Canal
  • Afferent projections make cochlear nerve
20
Q

Cochlear nerve stimulates ____

A

Cochlear nerve stimulates spiral ganglion cells

(normally stimulated by inner hair cells)

21
Q

Describe the central auditory nervous system pathway

A

Central auditory nervous system pathway

  1. Brainstem
  2. Midbrain
  3. Thalamus
  4. Temporal lobe
22
Q

Cortical auditory processing functions in ____, ____, ____, and ____

A

Cortical auditory processing functions in pattern recognition, duration discrimination, localization of sounds, and selective attention

23
Q

Semicircular canals are for ____ movements, while the saccule / utricle are for ____ accelerations

A

Semicircular canals are for rotational movements, while the saccule / utricle are for linear accelerations

24
Q

Head rotation causes a fluid shift in the ____, pushing against the ____, causing the hair cells to ____

A

Head rotation causes a fluid shift in the semicircular canal, pushing against the cupula, causing the hair cells to depolarize

25
Describe ear testing
Ear testing
26
Conductive hearing loss is \_\_\_
Conductive hearing loss is when sound is blocked on its way to the cochlea
27
Sensorineural hearing loss is \_\_\_\_
Sensorineural hearing loss is when the cochlea and/or auditory nerve are not working
28
Air conduction is \_\_\_\_
Air conduction is the normal auditory pathway
29
Bone conduction is \_\_\_\_
Bone conduction is when vibrations on bone directly transmit to cochlea
30
Describe the Weber test
Weber test * Vibrating tuning fork is placed on middle of the forehead or vertex * Normal hearing: Equal sound in both ears * Sensorineural hearing loss: sound lateralizes towards the good ear (away from bad ear) * Conductive hearing loss: sound lateralizes towards bad ear
31
Sensorineural hearing loss on the Weber test is when \_\_\_\_
Sensorineural hearing loss on the Weber test is when sound lateralizes towards the good ear (away from bad)
32
Conductive hearing loss on the Weber test is when \_\_\_\_
Conductive hearing loss on the Weber test is when sound lateralizes toward the bad ear
33
Describe the Rhinne test
Rhinne test * Vibrating tuning fork placed on mastoid bone (bone conduction) and moved to outside of ear (air conduction) when patient can no longer hear sound * Normal hearing: air conduction is louder than bone (+ Rhinne) * Sensorineural hearing loss: air conduction is louder than bone (unless "dead ear") * Conductive hearing loss: bone conduction is louder than air (- Rhinne)
34
Sensorineural hearing loss on Rhinne test is when \_\_\_\_
Sensorineural hearing loss on Rhinne test is when air conduction is louder than bone (unless "dead ear")
35
Conductive hearing loss on Rhinne test is when \_\_\_\_
Conductive hearing loss on Rhinne test is when bone conduction is louder than air (- Rhinne)
36
Describe conventional audiometry (audiogram)
Conventional audiometry (audiogram) * Pure tones at different frequencies, using air and bone conduction * Increasing sound levels (dB) with worsening hearing loss * Higher on chart is better: lower on chart (higher dB) is worse hearing
37
Describe profound hearing loss
Profound hearing loss * Poor word understanding * Distortion * No role for hearing aids * Cochlear implants
38
Tympanometry is used to ___ and \_\_\_
Tympanometry is used to check pressure in ear and help establish Eustachian tube function (pressures should be the same on either side of eardrum)
39
Describe speech testing
Speech testing * Speech reception thresholds: when sound is recognized as speech * Word recognition scores: ability to understand what is being spoken: closed set (4 options), open set (all words)
40
Describe acoustic reflex testing
Acoustic reflex testing * Response of stapedius muscle to loud sound * Reflex arc through auditory (VIII), brainstem, and facial (VII) bilaterally * Tone presented to each ear and response measured in both * Absent in severe hearing loss / stapes fixation
41
Otoacoustic emissions are \_\_\_\_
Otoacoustic emissions are sounds given off by the inner ear when the cochlea is stimulated by sound * Vibration produces a nearly inaudible sound that echoes back into the middle ear * Sound can be measured with a small probe inserted into ear canal * When click sound is applied to ear, it clicks back * Absence of otoacoustic emissions: block in air conduction or within cochlea * May be present with deficits of auditory nerve (VIII)
42
Describe audiograms in children by age
Audiograms in children by age * Age 0-5 months: behavioral observation audiometry - eye widening, startle, quieting * Age 6 months - 2 years: visual reinforcement audiometry - toy lights up if they turn towards sound * Age 2-5 years: conditioned play audiometry - listening game (putting toys in a bucket)
43
Auditory brainstem response is \_\_\_
Auditory brainstem response is evoked potential generated by brief click * Amplitude is averaged and charted against time * Done in young or developmentally delayed children or those with severe / profound hearing loss during cochlear implant workup