AUDIOLOGY TEST 3

Primarily responsible for gathering sound waves and localization. (made entirely of cartilage)

Outer rim of the auricle that folds over outwardly

Small triangular protrusion, which points slightly backward and forms anterior portion of the auricle.

Middle-most- portion just before the opening into the head

Aids in localizing the sound sources that come from the front, below and above the head.

The auricle is more efficent at delivering ________ frequency sounds than ________ frequency.

The auricle helps in___________ of sounds delivered to the head.

It begins at the concha and extending inward at a slight upward angle for approximately 1 inch in adults.

The ________ portion of the EAC passes through cartilage.

The EAC contains ___________ _________ which secrete ________.

The product of the secretions of sebum is____________.

Cerumen is

Cerumen exits the ear naturally during _________ or ___________.

The outer 1/3 of the EAC contains __________ _________.

The ___________ and the ____________ ________ keep foreign objects from passing into the inner 2/3 of the ear canal.

The inner ____ of the EAC do not contain ___________ _________.

Where do the two portions of the EAC meet together at the _________ _____________.

The ____________ lies just below this junstion and when the mandible overrides its normal position, the __________ will press into the junction causing pain.

When the condyle presses into the osseocartilaginous junction and causes pain, this is called _____________ ______________ ___________.

When TMJ syndrome produces a referred pain in the ear it is called ________________.

The angle of an infants EAC angles ______________ rather than ___________ and is at a more ________ angle.

An adult's pinna is pulled ______ and _______ for inspection.

An child's pinna is pulled ______ and _______ for inspection.

The EAC provides protection for the ___________.

The EAC filters sounds by reducing ________ frequencies and enhances between __________ and ________ Hz.

The TM marks the border between the ___________ and ________ ear.

The TM has how many layers?

The 3 layers of the TM are?

The outer layer of the TM is _________ from the EAC.

The layer of the TM that is a tough, fibrous, connective tissue that contributes the ability of the TM to vibrate sounds is the ________ __________.

This layer of the TM is lined with mucous membrane which is consistent with the middle ear.

T or F
The TM is very rich in blood supply?
True False

The malleus is embedded in the _________ portion of the TM.

The tip of the ________ ends in the center of the TM and angles ____________ and __________.

The point of greatest retraction in the TM is the ________.

What are the 4 quadrants of the TM?

A ring of tissue at the end of the EAC that holds the TM in position.

Greatest surface area of the TM essentially the lower 2/3 of the TM?

Above the malleus, the tissue is looser because they contain only the epidermal and mucous membrane layers?

28 days after conception, the tissue bulges into what will develop into the head and neck. known as the?

___ to ____ weeks of gestation hearing is fully developed?

What are the first 3 arches in the Outer ear ?

The _________ develops from the first 2 arches, begins before the 2nd fetal month.

The _____ develops from the 1st pharyngeal groove.

Solid core canalizes around the _____ gestational week.

___________ forms the connective tissue as well as blood and lymphatic vessels.

TM is formed by the ____ embryonic month.

A _________ hearing loss results when the normal sound path through the EAC is blocked?

One or both ears may be very small size?

Complete absence of the pinna

a __________ or __________ may be performed when the pinna protrudes markedly from the head or when it is pressed tightly against the skull.

Lack of canalization fo the EAC

Tiny folds of skin just in front of the pinna area, representing incomplete embryological development.

A marked narrowing of the canal?

T or F
Valuable information from OAE's and ABR's cannot be obtained with atresia?
True False

Collapsing the EAC:
Inspection of the ear prior to testing can prevent the finding of a __________ conductive loss?
True False

Outer portion of canal in kids is less rigid before the age of ___.

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 ___________.

An infection that occurs in the skin of the EAC?

An external otitis is also known as

External Otitis is usually thought of as a _________ infection, although ____________ infections are more common.

__________ infection is rare and may be caused by overuse of eardrops.

External Otitis may also occur because of allergic reactions to _______ _______, ______ and other __________.

________ is common along with extreme ________, when you have an external otitis infection.

Bony tumors, both benign and malignant are called?

Outward projections for the surfaces of bone, often seen in people who have done a great deal of swimming in cold water.

T or F
If the EAC is blocked by ear wax, hearing will not be normal even if there is a tiny opening?
True False

Natural cleansing of the EAC can be disrupted if you excessively __________ your ears.

What is the leading cause of wax being pushed into the EAC?

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.

Which of the following are used for cerumen removal?
A. Water Irrigation
B. Suction
C. Curettes
D. All of the above

Ear candling dates back nearly _______ years.

T or F
Ear Candling is suppose to create a partial vacuum to remove earwax?
True False

T or F
There is scientific evidence to prove that candling works.
True False

TM perforations are caused by excessive pressure __________, __________, ________ of the TM and the most common of trauma due to perforation.

TM perforations can be caused by this kind of activites?

____________ perforations spontaneoulsy close better than do perforations resulting from disease.

Perforations in the ___________ portion of the TM heal more rapidly than those in the ___________ portion.

Surgical repair of a perforated TM?

When calcium plaques appear, adding to the mass of the TM and interfering with its vibration.

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.

The middle ear is an ___ filled space roughly 2cm³.

The _______ of the middle ear is a thin layer of ________ separating the middle-ear cavity from the brain.

The floor of the middle ear contains the _______ _______.

Behind the anterior wall in the middle ear is the ______ ________.

Behind the medial wall in the middle ear is the _____________.

Behind the posterior wall in the middle ear is the ___________ ___________.

The middle ear is connected to the _______________.

The nasopharynx communicates via the

The _______, _________, and _______ are all lined with mucous membranes, the same lining found in the nose and paranasal sinuses.

Hair-like cells are called

Mucous membranes contain _______ that use a sweeping motion to clear out debris.

The Eustachian Tube in normally _________, but is opened by __________ in the nasopharynx.

Opening of the Eastachian Tube is caused by

In infants, the ET is ________, ________ and more __________ when compared to adults.

The ET remains open in the nasopharynx orifice in infants until the age of _____.

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.

The Eustachian tube will lock shut at ________ _________ making pressure equalization impossible.

The _________ is honeycombed with hundreds of air cells and the cells are lined with __________ membrane similar to the middle ear.

The bony protuberance behind the auricle is the

What are the two windows in the middle ear?

________ is filled by a membrane that supports the base of the stapes

The tiniest bone in the human body is the

__________ Allows for transmission of sound to be carried out in the middle ear air space

The bones in the ear are termed?

The ossicles are comprised of the

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).

What is the primary responsibility of the bones of the middle ear?

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.

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 ________ ________.

The increase in pressure in the middle ear is needed due to a transfer of sound from ______ to ________ in the inner ear.

T or F
The TM is a 100% efficient as an impedance matcher?
True False

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?

A ____ dB loss would result due to the air to fluid impedance mismatch without the ossicles.

Contains a portion of the facial nerve(VIIth cranial nerve) and passes through the middle ear via a medial wall.

A branch of the facial nerve.

Carries information about the sensation of taset from the anterior 2/3 of one side of the tongue.

May serve as a minor protection to loud sounds and contraction may also serve to decrease internal sounds such as chewing or speaking.

Tendon attaches to the neck of the stapes, may aid in word recognition in noise by attenuating ___ frequency components of the noise.

Inserts in the manubrium of the malleus and contraction may cause the TM to become tense.

Innervation of the Tensor Tympani is via the ______ _______.

Abnormalities of the middle ear produce a __________ hearing loss.

CHL may show alteration of the ______ conduction thresholds even without sensory/neural involvement.

The sensory/neural component in ______ hearing losses may be exaggerated by artifacts of bone conduction.

Negative Middle Ear Pressure:
Many middle ear disorders arise from ________ function of the Eustachian Tube (ET)

Common causes of ET dysfunction include:

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.

The _________ pressure in the EAC causes the TM to be retracted.

Resolution of a closed ET may sometimes be resolved by 2 methods:

The patient may auto inflate the ET by increased pressure on forced expiration with the nostrils held shut.

Accomplishes ET opening when the patient closes the jaw, holds the nostrils shut and swallows.

Any infection of the mucous membrane lining of the middle ear cleft is known as?

Suppurative Otitis Media:
_______ Is highly resistant to antibiotics possibly due to overuse of antibiotics.

Suppurative Otitis Media:
Organisms gain access to the middle ear through the ______ from the nasopharynx.

Suppurative Otitis Media:
Often the infection is literally blown through the _______ by a stifled _______ or by blowing the ______ too hard.

Initial Suppurative Otitis Media:

Progression of Suppurative Otitis Media:
Middle ear mucosa becomes_________.

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.

Progression of Suppurative Otitis Media:
Causes -symptoms

Progression of Suppurative Otitis Media:
If the condition progressess the TM will ___________.

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.

What are the 2 types of Chronic Suppurative OM?

A condition of long standing duration of OM?

Develops rapidly and includes swelling, redness and bleeding.

Suppurative OM reveal a ________ tymp, __________ loss and ________ reflexes.

The amount of hearing loss is directly related to the accumulation of _____ in the middle ear. Usually ______ in configuration and ____ results are normal.

Treatment of OM:

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.
True False

When the antibiotics are not completed, OM may lay _______ and __________ stronger.

T or F:
Sometimes when dealing with OM, in the initial stages, a wait and watch treatment may be employed?
True False

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
Usually ____________ to a poorly functioning ET. Reveals a _______ tymp.

Serous Effusion:
Initially shows a greater loss for ______ than for _________ frequencies.

Surgical treatment of OM:
Primary purpose of surgery is to eliminate ___________.

incision in the TM) is used to relieve the fluid pressure and the remaining fluid is suctioned out.

__________ _________ tubes may be inserted to keep the TM patent.

What is the primary function of P.E. tubes?

When thick mucoid secretions, ofter forced through the ET by sneezing or excessive pressure when blowing the nose, accumulate in the middle ear.

When the TM has ruptured and imperfect healing results in calcium deposits.

Whenever skin is introduced to the middle ear, the results may be a ___________.

Cholesteatoma:

A foul smelling discharge that drains from the ears is called __________.

Results when the mastoid is chronically infected.

May result in a large "bowl" that results from removal of a portion of the mastoid bone.

Requires frequent cleaning and is more susceptible to infection.

Surgical reconstruction of the middle ear auditory apparatus.

The simplest form of repair of the TM is called ____________?

During some chronic OM, the bony covering of the fallopian canal becomes eroded, exposing the facial nerve to the disease process called

______________ may result causing a unilateral facial paralysis, possibly due to decreased blood supply to the nerve or a viral infection.

When the ET is chronically patent (open) this is called?

Having a Patulous Eustachian tube can result in ______________.

The "head in a barrel" feeling resulting in a persons own voice being percieved as loud is?

Autophony often occurs in

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.

Otosclerosis:

When patients with a CHL feel that speech is easier to understand in the presence of background noise this is called?

The fact that we speak louder naturally in the presence of noise is called the ____________.

First appears as a low frequency air bone gap due to the stiffness component.

May involve an incision in the TM, then the stapes is rocked back and forth until it is loosened?

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)

On Average, the BC thresholds appear poorer than the true sensory/neural sensitivity in what?

Otosclerosis Audiometric Findings:
BC thresholds appear the worst at 2000Hz, this is referred to as __________ _______.

__________ __________ 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.

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.

The cochlea is the transducer that converts sound waves into an energy form useful to the auditory nerve, this is termed _____ ______.

The primary ending place for balance/spatial orientation is the cerebellum, is known as the ______ _____.

The Vestibular Mechanism receives information from the _______, ________, and ________ systems.

This system depends on the visual input and depends on the ability of the eyes to see in the presence of sufficient light.

This system involves the sense of touch (somatosensory).

This system relies on the forces of gravity and inertia.

The vestibule is the immediate entryway after the oval window and contains ______.

The Vestibule houses the _____ and _____ which are the end organs for balance.

The ______ is the beginning of the semicircular canals (SCC).

The Semicircular Canals (SCC) are:

The SCC contain _______ and are surrounded by a bony cavern of perilymph.

The _____ are at the beginning of the SCCs and contain an end organ (crista) that provides a sense of equilibrium.

The SCCs are arranged _______ to one another to cover all dimensions in space.

The ________ mechanism responds to linear acceleration (elevator, car accelerating).

The SCCs respond to ______ acceleration (increase/decrease of the body’s revolutions).

Review Slide 8 of the Inner Ear: SCC

Damage to the vestibular system may result in ______ and _______.

The sensation of whirling or spinning and they experience true turning is known as?

A rapid rocking movement of the eyes (always comes with vertigo) is known as?

T or F:
Vertigo is the same as dizziness, light-headedness or falling tendencies.
True False

Stimulation of the labyrinth is accomplished by “washing” cold or warm water or air against the TM, known as the ____ Test.

__________ measures the changes in potential produced by nystagmus and measures the rate and direction of nystagmus.

The vestibule, just past the oval window, also communicates with the _______.

The cochlea has several compartments filled with _____ and ______.

_____ ______ is connected to the oval window and contains perilymph.

_____ ______ begins at the round window and contains perilymph.

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?

_____ ______ is filled with endolymph that is shared with the saccule, utricle, and SCCs.

_____ ______ separates scala vestibuli from the scala media.

______ ______ separates scala tympani from the scala media.

How many curls does the cochlea turn?
A. 1
B. 2 1/2
C. 2
D. 3

This fluid of the cochlea has a high concentration of potassium ions and low in sodium.

This fluid of the cochlea is high in sodium ions and low in potassium ions.

The end organ of hearing is known as the _____ of ______.

_____ ______ produces the endolymph and supplies oxygen and other nutrients to the cochlea.

_____ _______ is the central core of the cochlea around which it is wound.

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.

The auditory nerve endings are located on the ______ _______.

_____ is located at the top of each hair cell.

Oval window is pushed in by the _______.
A. Incus
B. Stapes
C. Malleus

The perilymph is displaced in the ______ _______(basal end) creating a wave towards the apex (center or end) of the cochlea.

The fluids in the cochlea are __________, so the round window is pushed “into” the middle ear.

Sounds introduced to the inner ear cause a wave that moves from the _____ to the _____ of the cochlea.

Due to longer wavelengths, they cause max displacement near the apical of the cochlea.

Due to shorter wavelengths, these show max displacement at the basal end of the cochlea.

In response to fluid displacement and frequency specific information, the hair cells are _____ (twisted) in a complex manner.

How many rows of outer hair cells help “sharpen” the sound waves, enhancing frequency discrimination.

The cochlea contains about 30,000 _________ neurons and 1800 _______ neurons.

A specialized cell designed as a conductor of nerve impulses is known as a ______.

This part of the neuron receives nerve impulses from the other nerve cells.

This part of the neuron transmits impulses along the neurons.

This type of neurons carry impulses from the cochlea to the central auditory nervous system (to brain).

T or F
The exact means by which we hear are still unknown.
True False

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

The lowest frequencies to which the ear responds (about 20 Hz) is at the ____.

Frequencies between 2,000 and 20,000 Hz lie from the ______ of the basilar membrane to the ___ ___ of the cochlea near the oval window.

Fibers for frequencies below _____ Hz are contained on the other half of the basilar membrane.

Differentiation of the inner ear begins during the ___ week of gestation.

The Inner ear reaches adult size by ____ months.

The cochlea, utricle and semicircular canals all form from here.

_______ portions of the inner ear develop earlier than the auditory portions.

Cochlear turns begin the ____ week and are complete by the ___ week.

By ______ weeks of gestation the inner ear has fully formed.

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
B. Postnatally
C. Perinatally

An inner ear disorder that the infant contracts during the birth process, possibly from the cervix is known as.

An inner ear disorder that is transmitted in the infected mother’s milk is known as.

different forms of genes is known as _______.

an allele inherited from both parents is known as _______.

alleles are different (mixed)means _____.

only 1 gene from a parent required, is known as _____.

When allele from both parents is required, this is known as ____.

When each child has a 50% chance of inheriting the disorder, this is called _____ _____.

This trait accounts for about 80% of profound genetic hearing impairments.

What is a group of symptoms considered together for the diagnosis of a particular disorder called?

when an extra (third) chromosome is present on a pair, this is called a ______.

Women over (what age?) show an increased risk for having kids with trisomic chromosomal disorders, such as Down syndrome.

An infection in the _____ trimester is most dangerous due to the cells of the inner ear and central nervous system are differentiating most rapidly.

when a baby’s blood contains the protein molecule called the Rh factor, this is called the _____.

Rh Factor

A disorder which causes damage to the brain, that affects the motor and the sensory systems of the body.

One of the few viruses that crosses the placental barrier.

Rubella has re-surged recently due to lack of ______.

Rubella Results in brain damage, blindness, heart defects, mental retardation and what type of hearing loss?

T or F:
As the maternal body temp. rises in response to infections, the oxygen requirement of the fetus decreases dramatically.
True False

oxygen deprivation is known as _____.

Cytomegalovirus (CMV)

_____ 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.

T or F:
Prematurity is determined by the weight of the child NOT necessarily the length of the pregnancy.
True False

Another cause of damage to the cochlea and central nervous system is _______.

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.

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.

Tuberculosis, syphilis, cholesteatomas or viral infection also cause hearing loss and may be misdiagnosed with __________.

Cochleotoxic meds include:

Vestibulotoxic meds include:

__________ may also cause hearing loss.

Initial loss from ototoxic drugs occurs in the ___ frequencies.

Any hearing loss related to noise exposure is known as a _____.

This type of NIHL is perceived when hearing thresholds from initial noise trauma improve over time.

This type of NIHL causes an irreversible loss due to noise trauma.

Prevalence of NIHL in children 6-19 years is greater than ___% for boys, and lower than ___% for girls.

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!

Noise-induced hearing loss from impulsive sounds such as explosions and gunfire is known as _____ ______.

Acoustic Trauma Notch:

Occupational Safety and Health Admin: OSHA

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.

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.

T or F:
Sudden Idiopathic SNHL is not a medical emergency.
True False

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

Hearing loss directly related to head injury may result from _____ ______.

Hearing thresholds caused by head trauma are similar to that of acoustic trauma, with a “notch” at __________ Hz range.

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?

With Presbycusis, one may experience significant difficulty with speech recognition, known as _____ ______.

Will hearing loss due to aging effects, such as Presbycusis, make other conditions better or worse?

A person with Presbycusis may have a sense of isolation from inability to hear, which may cause a _______ in social interaction.