1. Primarily responsible for gathering sound waves and localization. (made entirely of cartilage)
    Auricle (aka.Pinna)
  2. Outer rim of the auricle that folds over outwardly
  3. Small triangular protrusion, which points slightly backward and forms anterior portion of the auricle.
  4. Middle-most- portion just before the opening into the head
  5. Aids in localizing the sound sources that come from the front, below and above the head.
    Concha (of the Auricle)
  6. The auricle is more efficent at delivering ________ frequency sounds than ________ frequency.
    high, low
  7. The auricle helps in___________ of sounds delivered to the head.
  8. It begins at the concha and extending inward at a slight upward angle for approximately 1 inch in adults.
    EAC (External Auditory Canal)
  9. The ________ portion of the EAC passes through cartilage.
  10. The EAC contains ___________ _________ which secrete ________.
    sebaceous glands, sebum
  11. The product of the secretions of sebum is____________.
  12. Cerumen is
  13. Cerumen exits the ear naturally during _________ or ___________.
    chewing or speaking
  14. The outer 1/3 of the EAC contains __________ _________.
    hair follicles
  15. The ___________ and the ____________ ________ keep foreign objects from passing into the inner 2/3 of the ear canal.
    cerumen and hair follicles
  16. The inner ____ of the EAC do not contain ___________ _________.
    2/3, hair follicles
  17. Where do the two portions of the EAC meet together at the _________ _____________.
    osseocartilaginous junction
  18. The ____________ lies just below this junstion and when the mandible overrides its normal position, the __________ will press into the junction causing pain.
    condyle, condyle
  19. When the condyle presses into the osseocartilaginous junction and causes pain, this is called _____________ ______________ ___________.
    temporomandibular joint syndrome (TMJ)
  20. When TMJ syndrome produces a referred pain in the ear it is called ________________.
    otalgia (ear pain)
  21. The angle of an infants EAC angles ______________ rather than ___________ and is at a more ________ angle.
    downward, upward, acute
  22. An adult's pinna is pulled ______ and _______ for inspection.
    up, back
  23. An child's pinna is pulled ______ and _______ for inspection.
    down, back
  24. The EAC provides protection for the ___________.
    (TM) tempanic membrane
  25. The EAC filters sounds by reducing ________ frequencies and enhances between __________ and ________ Hz.
    low, 2000, 7000
  26. The TM marks the border between the ___________ and ________ ear.
    outer, middle
  27. The TM has how many layers?
  28. The 3 layers of the TM are?
    • Outer
    • Middle
    • Inner
  29. The outer layer of the TM is _________ from the EAC.
  30. The layer of the TM that is a tough, fibrous, connective tissue that contributes the ability of the TM to vibrate sounds is the ________ __________.
    middle layer
  31. This layer of the TM is lined with mucous membrane which is consistent with the middle ear.
    the inner layer
  32. T or F
    The TM is very rich in blood supply?
  33. The malleus is embedded in the _________ portion of the TM.
  34. The tip of the ________ ends in the center of the TM and angles ____________ and __________.
    malleus, downward, backward
  35. The point of greatest retraction in the TM is the ________.
  36. What are the 4 quadrants of the TM?
    • 1. Anterior- superior
    • 2. Posterior - superior
    • 3. Anterior - inferior
    • 4. Posterior - inferior
  37. A ring of tissue at the end of the EAC that holds the TM in position.
  38. Greatest surface area of the TM essentially the lower 2/3 of the TM?
    Pars Tensa (most dense)
  39. Above the malleus, the tissue is looser because they contain only the epidermal and mucous membrane layers?
    Pars Flaccida (thinest layer)
  40. 28 days after conception, the tissue bulges into what will develop into the head and neck. known as the?
    Pharyngeal Arches
  41. ___ to ____ weeks of gestation hearing is fully developed?
    27, 28
  42. What are the first 3 arches in the Outer ear ?
    Mandibular arch, the hyoid arch and glossopharyngeal arch.
  43. The _________ develops from the first 2 arches, begins before the 2nd fetal month.
  44. The _____ develops from the 1st pharyngeal groove.
  45. Solid core canalizes around the _____ gestational week.
  46. ___________ forms the connective tissue as well as blood and lymphatic vessels.
  47. TM is formed by the ____ embryonic month.
  48. A _________ hearing loss results when the normal sound path through the EAC is blocked?
    • conductive
    • * (loss of hearing is rarely severe and never exceeds a 60 dB air bone gap)
  49. One or both ears may be very small size?
    Microtia (cauliflower ear)
  50. Complete absence of the pinna
  51. a __________ or __________ may be performed when the pinna protrudes markedly from the head or when it is pressed tightly against the skull.
    Otoplasty or pinnaplasty
  52. Lack of canalization fo the EAC
    Atresia (occurs in isolation or in combination with other anomalies)
  53. Tiny folds of skin just in front of the pinna area, representing incomplete embryological development.
    Preauricular Tags (moles)
  54. A marked narrowing of the canal?
    Stenosis (do not produce hearing loss like canals with atresia)
  55. T or F
    Valuable information from OAE's and ABR's cannot be obtained with atresia?
  56. Collapsing the EAC:
    Inspection of the ear prior to testing can prevent the finding of a __________ conductive loss?
    • false
    • (may occur in as many as 4% of a typical audilogy caseload.)
  57. Outer portion of canal in kids is less rigid before the age of ___.
  58. Foreign bodies in the EAC usually do not cause a hearing loss unless the EAC is completley ____________ or there is a significant closure due to ___________.
    occluded, irritation/swelling
  59. An infection that occurs in the skin of the EAC?
    External Otitis
  60. An external otitis is also known as
    "swimmers ear"
  61. External Otitis is usually thought of as a _________ infection, although ____________ infections are more common.
    fungal, bacterial
  62. __________ infection is rare and may be caused by overuse of eardrops.
    Otomycosis (fungal)
  63. External Otitis may also occur because of allergic reactions to _______ _______, ______ and other __________.
    hearing protection, soaps, allergens
  64. ________ is common along with extreme ________, when you have an external otitis infection.
    itching, pain
  65. Bony tumors, both benign and malignant are called?
    Osteomas (does not present hearing loss unless its a complete occlusion)
  66. Outward projections for the surfaces of bone, often seen in people who have done a great deal of swimming in cold water.
  67. T or F
    If the EAC is blocked by ear wax, hearing will not be normal even if there is a tiny opening?
    False, it will still be normal so long as there is a tiny opening.
  68. Natural cleansing of the EAC can be disrupted if you excessively __________ your ears.
    • clean
    • (this can push earwax (cerumen) into the inner 2/3 of the EAC)
  69. What is the leading cause of wax being pushed into the EAC?
  70. Wax deposited in the _______ _______ becomes itchy and dry, causing itching and encourages the indv. to push the wax fruther down while trying to remove it with cotton swabs.
    bony canal
  71. Which of the following are used for cerumen removal?

    D. All of the above
  72. Ear candling dates back nearly _______ years.
  73. T or F
    Ear Candling is suppose to create a partial vacuum to remove earwax?
  74. T or F
    There is scientific evidence to prove that candling works.
    False (also can cause risk of mild and severe burns)
  75. TM perforations are caused by excessive pressure __________, __________, ________ of the TM and the most common of trauma due to perforation.
    build-up, infections, necrosis
  76. TM perforations can be caused by this kind of activites?
    • 1. Q-tip
    • 2. Sudden pressure (hands claped over ear)
    • 3. Explosion
  77. ____________ perforations spontaneoulsy close better than do perforations resulting from disease.
  78. Perforations in the ___________ portion of the TM heal more rapidly than those in the ___________ portion.
    inferior, superior
  79. Surgical repair of a perforated TM?
  80. When calcium plaques appear, adding to the mass of the TM and interfering with its vibration.
  81. When you have a TM perforation, measurements on acoustic immittance are sometimes________ because an airtight seal cannot be formed as a consequence of pressure leakage from the air pump of the meter through the perforation into the middle ear.
  82. The middle ear is an ___ filled space roughly 2cm3.
  83. The _______ of the middle ear is a thin layer of ________ separating the middle-ear cavity from the brain.
    roof, bone
  84. The floor of the middle ear contains the _______ _______.
    jugular bulb
  85. Behind the anterior wall in the middle ear is the ______ ________.
    carotid artery
  86. Behind the medial wall in the middle ear is the _____________.
  87. Behind the posterior wall in the middle ear is the ___________ ___________.
    mastoid process
  88. The middle ear is connected to the _______________.
    nasopharynx (back of the throat and nose communicate)
  89. The nasopharynx communicates via the
    Eustachian Tube (ET)
  90. The _______, _________, and _______ are all lined with mucous membranes, the same lining found in the nose and paranasal sinuses.
    ET, middle ear, TM
  91. Hair-like cells are called
  92. Mucous membranes contain _______ that use a sweeping motion to clear out debris.
  93. The Eustachian Tube in normally _________, but is opened by __________ in the nasopharynx.
    closed, muscles
  94. Opening of the Eastachian Tube is caused by
    yawning, sneezing, swallowing, or excessive air pressure applied to the nose.
  95. In infants, the ET is ________, ________ and more __________ when compared to adults.
    shorter, wider and horizontal
  96. The ET remains open in the nasopharynx orifice in infants until the age of _____.
    6 months
  97. The air pressure in the middle ear must ________ that of the EAC to keep pressure ________ on both sides of the TM to maximize mobility for optimal sound transmission.
    match, equal
  98. The Eustachian tube will lock shut at ________ _________ making pressure equalization impossible.
    extreme pressure
  99. The _________ is honeycombed with hundreds of air cells and the cells are lined with __________ membrane similar to the middle ear.
    mastoid, mucous membrane
  100. The bony protuberance behind the auricle is the
    mastoid process - used for placement of the bone oscillator
  101. What are the two windows in the middle ear?
    oval and round windows
  102. ________ is filled by a membrane that supports the base of the stapes
    Oval Window.
  103. The tiniest bone in the human body is the
  104. __________ Allows for transmission of sound to be carried out in the middle ear air space
    Bones in the middle ear
  105. The bones in the ear are termed?
  106. The ossicles are comprised of the
    stapes, malleus, incus
  107. The __________ of the malleus is embedded in the middle (fibrous) layer of the TM and extends to the ________ of the TM of the area of greatest retraction (Umbo).
    manubrium (handle), center
  108. What is the primary responsibility of the bones of the middle ear?
    sound transmission to the inner ear
  109. Sound hits the TM and transfers to the ______ and _______ as they move in an inward outward motion causing them to rotate. The sound is then transferred to the __________ and causes it to move in and out of the oval window.
    malleus, incus. stapes
  110. The area of the TM is _____ times that of the oval window. This allows for a sound pressure increase in the middle ear to transfer the presure to the inner ear via the ________ ________.
    17, oval window
  111. The increase in pressure in the middle ear is needed due to a transfer of sound from ______ to ________ in the inner ear.
    air, fluid
  112. T or F
    The TM is a 100% efficient as an impedance matcher?
    False it is NOT
  113. Increased pressure and the lever action of the __________ result in a pressure increase of _____ times that of an airborne tranmission alone. Approximatley a ____ dB increase?
    malleus, 23 times. 30 dB
  114. A ____ dB loss would result due to the air to fluid impedance mismatch without the ossicles.
    28 dB
  115. Contains a portion of the facial nerve(VIIth cranial nerve) and passes through the middle ear via a medial wall.
    Fallopian Canal
  116. A branch of the facial nerve.
    Chorda Tympani Nerve- get hit in surgery a lot, causes a loss of sensation(metallic taste)
  117. Carries information about the sensation of taset from the anterior 2/3 of one side of the tongue.
    Chorda Tympani Nerve
  118. May serve as a minor protection to loud sounds and contraction may also serve to decrease internal sounds such as chewing or speaking.
    Middle Ear Muscles
  119. Tendon attaches to the neck of the stapes, may aid in word recognition in noise by attenuating ___ frequency components of the noise.
    Stapedius Muscle, low
  120. Inserts in the manubrium of the malleus and contraction may cause the TM to become tense.
    Tensor Tympani Muscle
  121. Innervation of the Tensor Tympani is via the ______ _______.
    trigeminal nerve (Vth cranial nerve)
  122. Abnormalities of the middle ear produce a __________ hearing loss.
  123. CHL may show alteration of the ______ conduction thresholds even without sensory/neural involvement.
    bone (BC)
  124. The sensory/neural component in ______ hearing losses may be exaggerated by artifacts of bone conduction.
  125. Negative Middle Ear Pressure:
    Many middle ear disorders arise from ________ function of the Eustachian Tube (ET)
  126. Common causes of ET dysfunction include:
    - swelling of the ET due to infection or blockage of the orifice by overgrown adenoids.
  127. A _______ in pressure in the middle ear occurs due to the air trapped being absorbed by the tissues that line the middle ear without normal air replenishment through the ET.
  128. The _________ pressure in the EAC causes the TM to be retracted.
  129. Resolution of a closed ET may sometimes be resolved by 2 methods:
    Valsalva and Toynbee maneuver
  130. The patient may auto inflate the ET by increased pressure on forced expiration with the nostrils held shut.
  131. Accomplishes ET opening when the patient closes the jaw, holds the nostrils shut and swallows.
    Toynbee maneuver
  132. Any infection of the mucous membrane lining of the middle ear cleft is known as?
    Otitis Media
  133. Suppurative Otitis Media:
    _______ Is highly resistant to antibiotics possibly due to overuse of antibiotics.
    • Methicilin-resistant staphylococcus aureus
    • (MRSA)
  134. Suppurative Otitis Media:
    Organisms gain access to the middle ear through the ______ from the nasopharynx.
  135. Suppurative Otitis Media:
    Often the infection is literally blown through the _______ by a stifled _______ or by blowing the ______ too hard.
    ET, sneeze, nose
  136. Initial Suppurative Otitis Media:
    • * - initially the ET swells, causing occlusion
    • * - negative middle ear pressure builds up
    • * - TM may appear retracted (sucked in)
    • * - Normal hearing with a Type C tymp
  137. Progression of Suppurative Otitis Media:
    Middle ear mucosa becomes_________.
  138. Progression of Suppurative Otitis Media:
    As condition worsens, suppurative (pus) like fluid may may accumulate.
    Enzymes from the bacteria infection can have a __________ effect on the
    middle ear structures.
  139. Progression of Suppurative Otitis Media:
    Causes -symptoms
    pain and fever
  140. Progression of Suppurative Otitis Media:
    If the condition progressess the TM will ___________.
  141. Pus, due to infection, that cannot escape may invade the mastoid causing ___________. Breaks down the wall separtating the air cells and can cause ___________ and sometimes death.
    Mastoiditis, menigitis
  142. What are the 2 types of Chronic Suppurative OM?
    • * Chronic
    • * Acute
  143. A condition of long standing duration of OM?
  144. Develops rapidly and includes swelling, redness and bleeding.
  145. Suppurative OM reveal a ________ tymp, __________ loss and ________ reflexes.
    Type B, conductive, absent
  146. The amount of hearing loss is directly related to the accumulation of _____ in the middle ear. Usually ______ in configuration and ____ results are normal.
    Fluid, flat, BC
  147. Treatment of OM:
    - majority treated with antibiotics
  148. T or F:
    Due to patient compliance, resistant bacteria, excessive build up of
    bacteria or the wrong precp. of antibiotics, OM may not be treatable
    with antibiotics alone and the condition may worsen.
  149. When the antibiotics are not completed, OM may lay _______ and __________ stronger.
    dormant, re-emerge
  150. T or F:
    Sometimes when dealing with OM, in the initial stages, a wait and watch treatment may be employed?
  151. When fluids normally secreted by the mucous-membrane lining of the middle ear may literally be sucked into the midde ear space resulting in ___________ _______.
    Serous Effusion
  152. Serous Effusion
    Usually ____________ to a poorly functioning ET. Reveals a _______ tymp.
    secondary, Type B
  153. Serous Effusion:
    Initially shows a greater loss for ______ than for _________ frequencies.
    higher, lower
  154. Surgical treatment of OM:
    Primary purpose of surgery is to eliminate ___________.
  155. incision in the TM) is used to relieve the fluid pressure and the remaining fluid is suctioned out.
    Myringotomy or Myringostomy
  156. __________ _________ tubes may be inserted to keep the TM patent.
    • pressure-equalizing (P.E.)
    • (used for chronic OM)
  157. What is the primary function of P.E. tubes?
    to allow for direct ventilation of the middle ear and secondary fluid drainage.
  158. When thick mucoid secretions, ofter forced through the ET by sneezing or excessive pressure when blowing the nose, accumulate in the middle ear.
    Mucous Otitis Media (aka glue ear)
  159. When the TM has ruptured and imperfect healing results in calcium deposits.
  160. Whenever skin is introduced to the middle ear, the results may be a ___________.
  161. Cholesteatoma:
    • * - forms as a sac with onion like rings made up of keratin mixed with squamous(scaly) epithelium and with fats such as cholesterol.
    • * - May occur when the par flaccida of the TM is sucked into the middle ear cavity and opens
    • * - May occupy the entire middle ear
    • * - Highly erosive and may cause destruction of bone
    • * - produces a foul smelling discharge that drains from the ears
  162. A foul smelling discharge that drains from the ears is called __________.
  163. Results when the mastoid is chronically infected.
  164. May result in a large "bowl" that results from removal of a portion of the mastoid bone.
    Mastoidectomy (removal of bone is avoided as much as possible, because of the negative effects)
  165. Requires frequent cleaning and is more susceptible to infection.
  166. Surgical reconstruction of the middle ear auditory apparatus.
  167. The simplest form of repair of the TM is called ____________?
  168. During some chronic OM, the bony covering of the fallopian canal becomes eroded, exposing the facial nerve to the disease process called
    Facial Palsy
  169. ______________ may result causing a unilateral facial paralysis, possibly due to decreased blood supply to the nerve or a viral infection.
    Bell's Palsy
  170. When the ET is chronically patent (open) this is called?
    Patulous Eustachian Tube (PET)
  171. Having a Patulous Eustachian tube can result in ______________.
  172. The "head in a barrel" feeling resulting in a persons own voice being percieved as loud is?
    • autophony
    • * -causes an echoing effect that interferes with their speech production
  173. Autophony often occurs in
    pregnancy, loss of weight, TMJ syndrome, decongestant medications and stress.
  174. Originates in the bony labyrinth and appears as the formation of a new growth of spongy bone, usually over the stapedial footplate of one or both ears.
  175. Otosclerosis:
    • * - causes the footplate to become partially fixed, limiting the transmission of sound to the inner ear
    • * - progressive
    • * - hereditary in 70% of cases
    • * -may show up during pregnancy or menopause
    • * -presence of tinnitus
  176. When patients with a CHL feel that speech is easier to understand in the presence of background noise this is called?
    Paracusis Willsii
  177. The fact that we speak louder naturally in the presence of noise is called the ____________.
    Lombard Voice Reflex
  178. First appears as a low frequency air bone gap due to the stiffness component.
    Otosclerosis Audiometric Findings
  179. May involve an incision in the TM, then the stapes is rocked back and forth until it is loosened?
    • Otosclerosis Treatment
    • (effectiveness is dependent on regrowth of the spongy bone)
  180. The actual removal of the stapes and a prosthesis is connected to the incus to replace the crura of the stapes (horseshoe portion of the stapes)
  181. On Average, the BC thresholds appear poorer than the true sensory/neural sensitivity in what?
    Otosclerosis Audiometric Findings
  182. Otosclerosis Audiometric Findings:
    BC thresholds appear the worst at 2000Hz, this is referred to as __________ _______.
    Carhart's Notch
  183. __________ __________ probably occurs as a mechanical aritfact because the loss of inertial mode of BC and a shift of the normal resonant frequency of the middle ear.
    • Carhart's Notch:
    • All produced by the immobility of the oval window.
    • Tymp results are Type As due to stiffness (impedance high and compliance low)
  184. The _____ ______ functions as a receiver of the signal from the middle ear and is responsible for creating/transferring the energy into a signal that is readable by the auditory nerve.
    • Inner Ear
    • It is also responsible for reporting information regarding the body’s position and movement
  185. The cochlea is the transducer that converts sound waves into an energy form useful to the auditory nerve, this is termed _____ ______.
    • Cochlear Microphonic (CM)
    • Resembles the action of a microphone
    • Converts pressure waves issuing from a speaker’s mouth into an alternating electrical current
  186. The primary ending place for balance/spatial orientation is the cerebellum, is known as the ______ _____.
    Vestibular Mechanism
  187. The Vestibular Mechanism receives information from the _______, ________, and ________ systems.
    visual, proprioceptive, vestibular
  188. This system depends on the visual input and depends on the ability of the eyes to see in the presence of sufficient light.
  189. This system involves the sense of touch (somatosensory).
  190. This system relies on the forces of gravity and inertia.
  191. The vestibule is the immediate entryway after the oval window and contains ______.
  192. The Vestibule houses the _____ and _____ which are the end organs for balance.
    utricle and saccule
  193. The ______ is the beginning of the semicircular canals (SCC).
  194. The Semicircular Canals (SCC) are:
    • Superior (anterior)
    • Inferior (posterior)
    • Horizontal (lateral)
  195. The SCC contain _______ and are surrounded by a bony cavern of perilymph.
  196. The _____ are at the beginning of the SCCs and contain an end organ (crista) that provides a sense of equilibrium.
  197. The SCCs are arranged _______ to one another to cover all dimensions in space.
  198. The ________ mechanism responds to linear acceleration (elevator, car accelerating).
  199. The SCCs respond to ______ acceleration (increase/decrease of the body’s revolutions).
  200. Review Slide 8 of the Inner Ear: SCC
  201. Damage to the vestibular system may result in ______ and _______.
    vertigo and nystagmus
  202. The sensation of whirling or spinning and they experience true turning is known as?
  203. A rapid rocking movement of the eyes (always comes with vertigo) is known as?
  204. T or F:
    Vertigo is the same as dizziness, light-headedness or falling tendencies.
    False, they are NOT the same.
  205. Stimulation of the labyrinth is accomplished by “washing” cold or warm water or air against the TM, known as the ____ Test.
  206. __________ measures the changes in potential produced by nystagmus and measures the rate and direction of nystagmus.
    Electronystamograph (ENG)
  207. The vestibule, just past the oval window, also communicates with the _______.
    • cochlea
    • The cochlea is a twisting bony shell
  208. The cochlea has several compartments filled with _____ and ______.
    perilymph and endolymph.
  209. _____ ______ is connected to the oval window and contains perilymph.
    Scala Vestibuli
  210. _____ ______ begins at the round window and contains perilymph.
    Scala Tympani
  211. A passage located at the apex of the cochlea that allows perilymph to transfer from the scala Vestibuli to the Scala Tympani is known as what?
  212. _____ ______ is filled with endolymph that is shared with the saccule, utricle, and SCCs.
    • Scala Media
    • lies in between the scala vestibuli and scala tympani
  213. _____ ______ separates scala vestibuli from the scala media.
    Reissner’s membrane
  214. ______ ______ separates scala tympani from the scala media.
    Basilar Membrane
  215. How many curls does the cochlea turn?

    B. 2 1/2
  216. This fluid of the cochlea has a high concentration of potassium ions and low in sodium.
    • Endolymph
    • Exhibits a strong positive potential due to the high potassium levels
    • Contained in utricle, saccule, semicircular canals and scala media
  217. This fluid of the cochlea is high in sodium ions and low in potassium ions.
    • Perilymph
    • Contained in scala tympani/vestibuli
    • Exhibits a small positive potential
    • Rest of cochlea exhibits a negative potential
  218. The end organ of hearing is known as the _____ of ______.
    • Organ of Corti
    • Contains the inner/outer hair cells
    • Resides in the basilar membrane
  219. _____ ______ produces the endolymph and supplies oxygen and other nutrients to the cochlea.
    Stria Vascularis
  220. _____ _______ is the central core of the cochlea around which it is wound.
    • Modiolus
    • the entryway to the organ of corti for the blood supply and nerve supply
  221. In the fibrous layer of the Basilar membrane there are three to five parallel rows of ____ to ____ outer hair cells and one row of ____ inner hair cells.
  222. The auditory nerve endings are located on the ______ _______.
    basilar membrane
  223. _____ is located at the top of each hair cell.
    • Stereocilia
    • The direction in which they are bent during stimulation determines nerve stimulation or inhibition.
    • Figure 10.6 in your book
  224. Oval window is pushed in by the _______.

    B. Stapes
  225. The perilymph is displaced in the ______ _______(basal end) creating a wave towards the apex (center or end) of the cochlea.
    scala vestibuli
  226. The fluids in the cochlea are __________, so the round window is pushed “into” the middle ear.
  227. Sounds introduced to the inner ear cause a wave that moves from the _____ to the _____ of the cochlea.
    from the Base to the Apex
  228. Due to longer wavelengths, they cause max displacement near the apical of the cochlea.
    Low frequencies
  229. Due to shorter wavelengths, these show max displacement at the basal end of the cochlea.
    High frequencies
  230. In response to fluid displacement and frequency specific information, the hair cells are _____ (twisted) in a complex manner.
  231. How many rows of outer hair cells help “sharpen” the sound waves, enhancing frequency discrimination.
    • 3
    • Therefore, outer hair cell damage decreases speech-recognition abilities
  232. The cochlea contains about 30,000 _________ neurons and 1800 _______ neurons.
    afferent (sensory), efferent
  233. A specialized cell designed as a conductor of nerve impulses is known as a ______.
  234. This part of the neuron receives nerve impulses from the other nerve cells.
  235. This part of the neuron transmits impulses along the neurons.
  236. This type of neurons carry impulses from the cochlea to the central auditory nervous system (to brain).

    • This type of neurons project from the superior olivary complex and contact the hair cells directly and indirectly (receive from the brain).
    • Efferent
  237. T or F
    The exact means by which we hear are still unknown.
  238. This theory coined by (Bekesy, 1960)states that the movement of the stapes causes an up and down movement of the basilar membrane, produced by the disturbance of endolymph.
    Traveling Wave Theory
  239. Traveling Wave Theory
    • Wave moves in cochlear duct from base to apex
    • High frequencies at base and lows at apex
    • Lows are unique because they excite fibers all along the basilar membrane
  240. The lowest frequencies to which the ear responds (about 20 Hz) is at the ____.
  241. Frequencies between 2,000 and 20,000 Hz lie from the ______ of the basilar membrane to the ___ ___ of the cochlea near the oval window.
    midpoint, basal end
  242. Fibers for frequencies below _____ Hz are contained on the other half of the basilar membrane.
  243. Differentiation of the inner ear begins during the ___ week of gestation.
  244. The Inner ear reaches adult size by ____ months.
  245. The cochlea, utricle and semicircular canals all form from here.
    Auditory Placode
  246. _______ portions of the inner ear develop earlier than the auditory portions.
  247. Cochlear turns begin the ____ week and are complete by the ___ week.
    6th, 10th
  248. By ______ weeks of gestation the inner ear has fully formed.
    By 25 weeks
  249. An inner ear disorder that is contracted while the baby is still in the womb through the placenta is known as which of the following?

    A. Prenatal
  250. An inner ear disorder that the infant contracts during the birth process, possibly from the cervix is known as.
  251. An inner ear disorder that is transmitted in the infected mother’s milk is known as.
  252. different forms of genes is known as _______.
  253. an allele inherited from both parents is known as _______.
  254. alleles are different (mixed)means _____.
  255. only 1 gene from a parent required, is known as _____.
  256. When allele from both parents is required, this is known as ____.
  257. When each child has a 50% chance of inheriting the disorder, this is called _____ _____.
    Autosomal Dominant
  258. This trait accounts for about 80% of profound genetic hearing impairments.
    • Autosomal Recessive
    • 25% chance that the gene is passed on during pregnancy
  259. What is a group of symptoms considered together for the diagnosis of a particular disorder called?
    A Syndrome
  260. when an extra (third) chromosome is present on a pair, this is called a ______.
  261. Women over (what age?) show an increased risk for having kids with trisomic chromosomal disorders, such as Down syndrome.
  262. An infection in the _____ trimester is most dangerous due to the cells of the inner ear and central nervous system are differentiating most rapidly.
  263. when a baby’s blood contains the protein molecule called the Rh factor, this is called the _____.
    Rh (rhesus) factor
  264. Rh Factor
    • the mother produces antibodies for protection against the Rh factor
    • The antibodies prevent oxygen flow to the child and can harm the cochlea
    • Rh incompatibility can also cause cerebral palsy
  265. A disorder which causes damage to the brain, that affects the motor and the sensory systems of the body.
    Cerebral Palsy
  266. One of the few viruses that crosses the placental barrier.
  267. Rubella has re-surged recently due to lack of ______.
  268. Rubella Results in brain damage, blindness, heart defects, mental retardation and what type of hearing loss?
  269. T or F:
    As the maternal body temp. rises in response to infections, the oxygen requirement of the fetus decreases dramatically.
    False, the oxygen requirement of the fetus INCREASES.
  270. oxygen deprivation is known as _____.
  271. Cytomegalovirus (CMV)
    • Caused by an infection called cytomegalic inclusion disease (CID)
    • Member of the herpes group
    • Major cause of prenatal SNHL
    • Does not warn an expectant mother with a rash or other symptoms
    • Easily screened due to the presence in an infected infant’s urine
  272. _____ is one of the most common causes of damage to the cochlea and central nervous system, which may occur during the process of birth, perinatally.
    • Anoxia
    • Over-administration of oxygen is damaging also because it produces retinal defects
  273. T or F:
    Prematurity is determined by the weight of the child NOT necessarily the length of the pregnancy.
    • True
    • Under 1500 grams (3.5 pounds)is considered premature.
  274. Another cause of damage to the cochlea and central nervous system is _______.
  275. This is a postnatal cause of inner ear disorders which causes inflammation of the meninges; may cause total deafness by the healing process of the labyrinth that causes scarring and ossification.
    • Bacterial Meningitis
    • Other causes of cochlear hearing loss include measles, mumps, chickenpox, influenza and viral pneumonia
  276. This is a postnatal cause of inner ear disorders which causes infections of the labyrinth that may affect both hearing and balance, causing hearing loss and vertigo.
  277. Tuberculosis, syphilis, cholesteatomas or viral infection also cause hearing loss and may be misdiagnosed with __________.
    • labyrinthitis
    • Excessively high fevers are also at risk for hearing loss
  278. Cochleotoxic meds include:
    dihydrostreptomycin, viomycin, neomycin and kanamycin
  279. Vestibulotoxic meds include:
    streptomycin and gentamycin
  280. __________ may also cause hearing loss.
    • Tuberculosis
    • As well as, Quinine, aspirin, certain diuretics, nicotine and alcohol, or recreational drug exposure.
  281. Initial loss from ototoxic drugs occurs in the ___ frequencies.
  282. Any hearing loss related to noise exposure is known as a _____.
  283. This type of NIHL is perceived when hearing thresholds from initial noise trauma improve over time.
    Temporary Threshold Shift (TTS):
  284. This type of NIHL causes an irreversible loss due to noise trauma.
    • Permanent Threshold Shift (PTS):
    • Aspirin in combination with NIHL may cause a GREATER shift in temporary hearing sensitivity.
  285. Prevalence of NIHL in children 6-19 years is greater than ___% for boys, and lower than ___% for girls.
    14, 10
  286. NIHL in children is possibly due to toy phones, musical instruments, fire crackers, stereo systems and toy guns that produce noise levels up to ___ dBA!
  287. Noise-induced hearing loss from impulsive sounds such as explosions and gunfire is known as _____ ______.
    Acoustic Trauma
  288. Acoustic Trauma Notch:
    • hearing is poorest between 3000 and 6000 Hz with recovery at 8000 Hz.
    • Damage is at those specific frequency regions of the basal end of the cochlea
    • Millions of dollars each year are spent on military vets due to compensation for NIHL.
  289. Occupational Safety and Health Admin: OSHA
    • Recommend safety limitations for workers in noisy environments
    • They state: 85 dBA in an 8 hour work day is acceptable.
    • For every 5 dB increase, you cut the time in 1/2
  290. The National Institute of Occupational Safety and Health (NIOSH) recommends guidelines that are more stringent than OSHA’s 5 dB step, by using a __ dB exchange rate.
  291. This hearing loss is Defined as a decrease of at least 30 dB over at least 3 octaves within a period no greater than 3 days.
    • Sudden Idiopathic SNHL
    • Usually unilateral, that may develop over the course of a few days or occur seemingly instantaneously
  292. T or F:
    Sudden Idiopathic SNHL is not a medical emergency.
    • False It Should ALWAYS be treated as a medical emergency.
    • The quicker the therapy, the more likely the recovery
  293. This disease is caused by an interruption in endolymph volume causing an interruption in the concentration of sodium, chloride, potassium and other electrolytes needed for the system to function normally.
    Meniere’s Disease
  294. Meniere’s Disease
    • Shows sudden attacks of vertigo, tinnitus, vomiting and fluctuating unilateral hearing loss.
    • Sensation of fullness in one ear, low frequency roaring tinnitus, violent turning or whirling sensation and hearing loss with speech recognition difficulty.
  295. Hearing loss directly related to head injury may result from _____ ______.
    • Head trauma
    • Structures of the inner may be torn, stretched or deteriorated from the loss of oxygen following hemorrhage
  296. Hearing thresholds caused by head trauma are similar to that of acoustic trauma, with a “notch” at __________ Hz range.
    3000 to 6000
  297. The aging process produces alterations in the auditory system, including the TM, ossicular chain, cochlear windows and central auditory nervous system, this results in what type of hearing loss?
  298. With Presbycusis, one may experience significant difficulty with speech recognition, known as _____ ______.
    • Phonemic Regression
    • May report they often understand speech better when people speak slowly rather than when they speak loudly.
  299. Will hearing loss due to aging effects, such as Presbycusis, make other conditions better or worse?
    • Worse
    • May effect Social, emotional, vocational and psychological areas.
  300. A person with Presbycusis may have a sense of isolation from inability to hear, which may cause a _______ in social interaction.
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