Hearing Disorders: Part 3
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Questions and Answers

What does the sensation level primarily depend on?

  • Duration of exposure to sound
  • Environmental noise levels
  • Individual's hearing threshold (correct)
  • Type of hearing aid used

Which of the following is NOT one of the three parts of an audiogram?

  • Pure tone testing
  • Emittance testing
  • Tinnitus evaluation (correct)
  • Speech audiometry

In pure tone testing, what does air conduction testing assess?

  • Vocal cord function
  • The entire auditory pathway (correct)
  • The outer ear only
  • Only the inner ear

What is typically used for air conduction testing in pure tone audiometry?

<p>Headphones or insert earphones (C)</p> Signup and view all the answers

What do different symbols on an audiogram represent?

<p>Results from different ears and conduction types (B)</p> Signup and view all the answers

How are frequencies typically presented in pure tone audiometry?

<p>Single frequencies at octave intervals (C)</p> Signup and view all the answers

What might indicate a discrepancy in audiogram results?

<p>One test shows normal results while another shows severe hearing loss (B)</p> Signup and view all the answers

What is the purpose of emittance testing in an audiogram?

<p>To assess the movements of the eardrum (B)</p> Signup and view all the answers

What is the primary advantage of MRI over CT scans in imaging?

<p>MRI involves no radiation at all. (C)</p> Signup and view all the answers

What is MRI particularly best at imaging in relation to the inner ear?

<p>Nerve structures related to hearing. (C)</p> Signup and view all the answers

Which cranial nerve is primarily associated with acoustic neuromas?

<p>Cranial nerve 8. (D)</p> Signup and view all the answers

What type of imaging modality is noted for showing brain lesions such as acoustic neuromas?

<p>MRI. (C)</p> Signup and view all the answers

What type of tumor is described as a benign growth arising from the 8th cranial nerve?

<p>Acoustic neuroma. (B)</p> Signup and view all the answers

What is the effect of a stroke in the brain stem on hearing?

<p>It may affect hearing. (B)</p> Signup and view all the answers

What is a common tool used in hearing assessments?

<p>Audiogram. (A)</p> Signup and view all the answers

How does an MRI visualize the details of the brain compared to a CT scan?

<p>It reveals intricate details such as gyri and cerebellum. (B)</p> Signup and view all the answers

What does a type B tympanogram indicate about the eardrum's movement?

<p>The eardrum is stationary despite applied pressure. (A)</p> Signup and view all the answers

What is the primary purpose of the acoustic reflex?

<p>To protect the ear from loud sounds. (A)</p> Signup and view all the answers

Which factor could lead to a type C tympanogram as mentioned in the context?

<p>Eustachian tube dysfunction. (A)</p> Signup and view all the answers

What does the x-axis represent in terms of eardrum movement measurements?

<p>Pressure levels in decopascals. (D)</p> Signup and view all the answers

What happens to the ossicles when the stapedius muscle contracts?

<p>They become stiff, reducing sound transmission. (D)</p> Signup and view all the answers

What could be a result if the eardrum experiences energy but does not move?

<p>A type B tympanogram. (A)</p> Signup and view all the answers

How does the stapedius muscle respond to loud sounds?

<p>It contracts to protect the inner ear. (B)</p> Signup and view all the answers

In what condition would you likely observe eardrum movement but find it under negative pressure?

<p>Acute otitis media. (D)</p> Signup and view all the answers

What does decibel measure in relation to sound?

<p>Sound pressure level (A)</p> Signup and view all the answers

How is the decibel scale characterized?

<p>Logarithmic scale (B)</p> Signup and view all the answers

What does a 0 decibel hearing level signify?

<p>Minimal detectable sound for an average ear (A)</p> Signup and view all the answers

What does the decibel hearing level (DVHL) provide?

<p>Relative measure based on normal hearing individuals (B)</p> Signup and view all the answers

Why is it important to understand the logarithmic nature of the decibel scale?

<p>It affects the interpretation of hearing loss severity (A)</p> Signup and view all the answers

What does the sensation level refer to?

<p>Individual's own hearing level (C)</p> Signup and view all the answers

When experiencing a few decibel worsening in hearing loss, what might be misleading?

<p>It may not significantly affect hearing at all (A)</p> Signup and view all the answers

What is the relationship between decibel levels and the perception of sound?

<p>Changes in decibel levels affect the perception logarithmically (C)</p> Signup and view all the answers

What does the presence of otoacoustic emissions (OAEs) indicate about the cochlea?

<p>The cochlea is functioning normally. (D)</p> Signup and view all the answers

What is primarily measured during an auditory brainstem response (ABR) test?

<p>Electrical activity in the auditory brainstem pathway. (D)</p> Signup and view all the answers

Which statement is true regarding the process of OAE testing?

<p>It only gives a result indicating presence or absence. (D)</p> Signup and view all the answers

Which of the following techniques requires electrodes to be placed on the patient?

<p>Auditory brainstem response. (D)</p> Signup and view all the answers

What does the acronym 'e coli' help to remember in auditory testing?

<p>Components of the auditory brainstem pathway. (D)</p> Signup and view all the answers

How is otoacoustic emission testing beneficial during newborn hearing screenings?

<p>It provides quick results indicating cochlear function. (A)</p> Signup and view all the answers

Which type of auditory measurement is considered complex and time-consuming?

<p>Auditory brainstem response. (A)</p> Signup and view all the answers

What can a clinician infer if OAEs are not present during testing?

<p>There may be a malfunction in the cochlea. (D)</p> Signup and view all the answers

What does a 'cookie bite' audiogram configuration indicate?

<p>A hereditary or genetic hearing loss (D)</p> Signup and view all the answers

In a pure tone audiogram, which axis represents the frequencies?

<p>Horizontal axis (A)</p> Signup and view all the answers

Which of the following represents the worst category of hearing loss?

<p>Profound hearing loss (D)</p> Signup and view all the answers

What is the purpose of masking in hearing tests?

<p>To mask noise and prevent crossover to the non-test ear (C)</p> Signup and view all the answers

How is the severity of hearing loss categorized in an audiogram?

<p>According to the intensity of sound stimulus levels (D)</p> Signup and view all the answers

Which statement is true regarding pediatric and adult hearing loss cutoffs?

<p>Children typically have higher hearing ability than adults (B)</p> Signup and view all the answers

What does a flat audiogram shape typically represent?

<p>A consistent level of hearing across frequencies (C)</p> Signup and view all the answers

At what point is cochlear implantation usually considered?

<p>Profound hearing loss (A)</p> Signup and view all the answers

Flashcards

Decibel (dB)

A logarithmic scale that measures sound pressure, indicating how loud a sound is. It is not linear, meaning doubling the decibel level does not mean doubling the sound.

Decibel Hearing Level (dBHL)

A measure of hearing level that is based on the average hearing thresholds of people with normal hearing. 0 dBHL does not mean there's no sound but represents the minimum intensity for an average person to perceive a sound.

Sensation Level (SL)

A measure of sound intensity relative to an individual's own hearing threshold. It helps determine how loud a sound needs to be for a particular person to hear it.

Hearing Threshold

The lowest intensity of a sound that a person can hear 50% of the time.

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Audiogram

A visual representation of a person's hearing ability at different frequencies.

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Pure Tone Audiometry

Testing that uses pure tones (single frequencies) to assess hearing.

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Speech Audiometry

Testing that uses speech sounds to assess hearing.

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Emittance Testing (Acoustic Impedance Testing)

Testing that looks at the function of the middle ear (eardrum and ossicles).

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Air Conduction

Sound is transmitted through the air.

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Bone Conduction

Sound is transmitted through the bones of the skull.

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Cookie Bite Hearing Loss

A type of hearing loss pattern that affects the middle frequencies, leaving the high and low frequencies relatively intact. It resembles a bite taken out of the middle of the audiogram graph.

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Flat Audiogram

A type of audiogram where the hearing loss is similar across different frequencies.

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Sloping Audiogram

A type of audiogram showing a gradual decrease in hearing ability as the frequency increases.

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Rising Audiogram

A type of audiogram where the hearing loss increases as the frequency increases.

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Masking in Audiograms

The process of introducing a noise into one ear to prevent sound from crossing over to the other ear during hearing testing.

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Severity of Hearing Loss

The severity of hearing loss, ranging from mild to profound, indicating how much sound intensity is needed for someone to hear.

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Normal Hearing

The ability to hear sounds at a normal level without needing amplification.

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Profound Hearing Loss

A type of hearing loss so severe that the individual needs assistive devices like cochlear implants to hear.

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What is an MRI?

MRI stands for Magnetic Resonance Imaging. This imaging technique utilizes magnetic fields and radio waves to produce detailed images of soft tissues, including the brain, brain stem, and cranial nerves. MRIs are considered a safer imaging modality compared to CT scans as they do not involve radiation.

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What are the advantages of using an MRI compared to a CT scan?

Compared to CT scans, MRI offers superior visualization of the brain and cranial nerves, as well as the inner ear structures such as the semicircular canals and cochlea. The MRI provides a more detailed view of anatomical structures compared to CT scans.

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What are acoustic neuromas?

Acoustic neuromas, also known as vestibular schwannomas, are benign tumors that originate from the eighth cranial nerve, the vestibulocochlear nerve. These tumors are often identified on MRI as small, bright lesions in the brain stem area.

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What is an audiogram?

An audiogram is a test used to assess an individual's hearing ability. It measures the ability to hear different frequencies and intensities of sound. Audiograms provide valuable information for diagnosis of hearing disorders and determining the severity of hearing loss.

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How can a stroke in the brainstem affect hearing?

A bleed or stroke in the brain stem can affect hearing, as the brain stem plays a vital role in auditory processing and transmission. An MRI would be crucial in identifying such a bleed.

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Why are hearing assessments important?

Hearing assessments are a vital part of diagnosis and management of hearing disorders. They help identify the nature and extent of hearing loss, guide treatment options, and monitor progress.

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Tympanogram

A graphical representation of the eardrum's movement in response to changes in air pressure.

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Type B Tympanogram

A type of tympanogram where the eardrum does not move at all, indicating a possible middle ear fluid buildup or blockage.

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Type C Tympanogram

A type of tympanogram where the eardrum moves, but only in a very negative pressure range, suggesting a possible eustachian tube dysfunction.

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Stapedius Muscle

The smallest muscle in the human body, located in the middle ear, responsible for the acoustic reflex.

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Acoustic Reflex

An involuntary contraction of the stapedius muscle that occurs in response to loud sounds, protecting the inner ear from damage.

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Ossicle Stiffening

The stiffening of the ossicles (tiny bones in the middle ear) caused by the contraction of the stapedius muscle during the acoustic reflex.

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Tympanometry

A test that measures the eardrum's compliance and movement in response to changes in air pressure.

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Acoustic Reflex Testing

A test that measures the acoustic reflex, assessing the stapedius muscle's response to loud sounds.

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What are Otoacoustic Emissions (OAEs)?

Otoacoustic emissions (OAEs) are sounds generated by the outer hair cells of the cochlea.

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How are OAEs used?

OAEs are a simple "present or absent" test, like an acoustic reflex. If present, it indicates normal cochlear function.

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What is an Auditory Brainstem Response (ABR)?

Auditory Brainstem Response (ABR) is a test that measures the electrical activity along the auditory nerve pathway in the brainstem.

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How can I remember the auditory brainstem pathway?

The auditory brainstem pathway can be remembered with the acronym "ECOLI":

  • E = Eighth nerve
  • C = Cochlear nucleus
  • O = Superior olivary complex
  • LI = Lateral lemniscus
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How is an ABR performed?

An ABR test requires electrodes on the scalp and involves reading multiple brainwave patterns.

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Why are OAEs used for newborn hearing screenings?

OAEs are used in newborn hearing screenings because they are a quick and easy way to assess cochlear function.

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Why are ABR tests used in some cases?

ABR tests are more complex, requiring the patient to be asleep or still. They provide more detailed information about the auditory pathway.

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What is the significance of the ABR wave patterns?

The patterns of waves seen in ABR tests help to identify specific issues within the auditory brainstem pathway.

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Study Notes

Hearing Disorders: Part 3

  • MRI scans are complementary to CT scans, good for soft tissue anatomy, and involve no radiation
  • CT scanners have minimal radiation
  • MRI is safer than CT for looking at the brain, brain stem, and cranial nerves
  • CT scans of the brain are gray
  • MRI scans show gyri, white matter, and the inner details of the ear
  • MRI scans show the semicircular canals, the inside of the membranous part, and different perspectives of the same anatomy
  • MRI can show the cochlea and nerves (7 and 8)
  • MRI scans can reveal small brainstem lesions, acoustic pneumomas or vestibular schwannomas, which are benign tumors on the 8th cranial nerve
  • Diagnosis requires confirmation through MRI

Decibel Hearing Levels

  • Decibel hearing level (dBHL) is a logarithmic scale, not linear
  • Doubling the dBHL doesn't double the sound level
  • 0 dBHL does not mean no sound; it is a relative measure, based on data from normal hearing individuals
  • Sensation level describes a sound in relation to an individual's hearing threshold.

Audiograms

  • Audiograms have 3 parts: pure tone testing, speech testing, and emittance testing
  • Pure tone testing uses a headphone or earphones, measuring intensities
  • Bone conduction testing uses a bone oscillator on the mastoid bone
  • The pure tone average (PTA) is calculated by averaging the decibel hearing levels at 500, 1000, and 2000 Hz
  • Speech reception threshold (SRT) is the lowest hearing level at which a person can repeat a spondee (two-syllable word) 50% of the time
  • Audiograms can show different shapes
  • Cookie-bite audiogram indicates a hereditary or familial hearing loss
  • Hearing levels on an audiogram worsen as the numbers get lower
  • Different cutoffs and ranges for different age demographics, like children versus adults

Masking and Audiometry

  • Masking is the introduction of noise to prevent sound crossover
  • Air conduction crossover occurs when hearing levels differ by at least 40 dB
  • Bone conduction is vibratory energy, transmitted through the skull, and does not rely on the outer ear
  • Masking dilemma happens with significant conductive hearing loss, requiring louder stimulus levels
  • Tympanometry uses a probe to measure eardrum movement, and there are normal (type A), abnormal (type B), and reduced compliance (type C) responses

Acoustic Reflex Testing

  • The stapedius muscle, connected to the stapes bone, dampens sound
  • Acoustic reflexes are bilateral and protect the ear from excessively loud noises
  • Absence of acoustic reflexes can indicate problems anywhere along the auditory pathway

Other Important Concepts

  • Recruitment happens when increasing sound intensity leads to a disproportionately large increase in perceived loudness
  • Paradoxical decrease in discrimination ability with increasing stimulus may indicate neurological problems
  • Different types of audiograms and testing methods show different things and have multiple uses

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Lec #1 Hearing Disorders: Part 3 PDF

Description

Explore the nuances of hearing disorders, focusing on the role of MRI and CT scans in diagnosis. Learn about the decibel hearing levels and their logarithmic nature, along with critical insights into structures such as the cochlea and brainstem. This quiz is perfect for anyone wanting to deepen their understanding of audiology and imaging techniques.

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