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73 Cards in this Set
- Front
- Back
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Where does acoustic transduction take place?
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In the Scala media
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Where is the stria vascularis lacated, and what does it do?
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-It is located in the scala media
-It secretes endolymph which coats the scala media |
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What is the organ of corti?
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Organ in the ear between scala tympani and scala vestibuli that has pilar cells and inner and outer hair cells
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What is found within the bony labrynth? (i.e. lymph?)
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-Perilymph
-Similiar to plasma -High Na and Low K |
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What is found within the membranous labrynth?
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-Endolymph
-Similiar to cytoplasm -High in K and Low in Na |
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Where is the endolymph produced?
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Stria Vascularis
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A person with what kind of abnormalities will often have developmental problems with stria vascularis?
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Pigment anomalies
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Patients with stria vascularis developmental problems have what syndrome?
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Wardenberg Syndrome
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What are the principle transducer cells of acoustic stimuli?
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Inner hair cells
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-What synapses with the IHC?
-What kind of axons do they have? -Where do they synapse? |
-Most afferent axons (for that area)
-Bipolar axons (type 1) -Cochlear nuclei |
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DO outer hair cells have sparse or prevalent afferent innervation?
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SPARSE
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What type of efferent innervation do IHC have?
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Axo-axonic synapses on type I afferent axons.
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What type of efferent innervation do OHC have?
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Direct synapses with highly vesiculated butons.
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What do the efferent synapses modulate for the OHC?
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Their motility. Their lengthening and shortening.
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In the central auditory pathway, what is the center for sound localization in space?
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The superior olivary complex
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What are the three levels of crossing in the central auditory pathway in the medulla?
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-Dorsal Acoustic Stria
-Intermediate Acoustic Stria -Superior Olivary Complex |
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What does the Superior coliculus "handle"?
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Vision
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What does the inferior coliculus "handle"?
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Auditory
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What is the only type of sense that the lateral lemniscus carries?
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Auditory
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What is the only type of sense that the medial geniculate body carries?
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Auditory
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What is the terminal location of the central auditory pathway?
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Transverse temporal gyrus
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In the cochlea, where are the high pitch frequencies absorbed?
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At the BASE (skinny end)
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In the cochlea, where are the low pitch frequencies absorbed?
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At the APEX (Thick center)
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What are the scala vestibula and the scala tympani divided by?
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The scala media / Basilar membrane
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The Basilar membrane is essentially what?
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A mechanical tuning device that adjusts the maximum amount of disturbance depending on the frequency of the input!!
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What is the membrane that makes contact with the hair of the hair cells of the inner ear?
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The Tectorial membrane
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What are the two fulcrums used to create a differential movement between surface hair cells?
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Scala media and the scala vestibula
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What do these differential movements do?
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This generated frequency will tune the cochlea
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What do the OHC act as?
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Amplifiers of cochlear mechanics due to their ability to change shape. THey sharpen frequency tuning in the cochlea
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If the cochlea is out of phase, will that increase or decrease shearing?
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Out of phase = INCREASE SHEARING
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What is the function of the middle ear?
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To translate pressure difference into a mechanical displacement
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What are the two methods of stimulating the cochlea?
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-Air conduction
-Bone conduction |
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What does air conduction require?
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-Natural Stimulation
-Intact Ear -Intact Cochlea -Intact Central Pathways |
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What does bone conduction require/entail?
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-Direct Vibration to the Petrus Bone
-Bypass middle ear -Requires intact Cochlea -Requires intact central pathways |
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If you vibrate the temporal bone, what does the sound go directly to?
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The basilar membrane
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For the middle ear, what do the ossicles provide?
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A mechanical advantage (think about it)
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What would be an example of a crude hearing test?
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Finger rubbing test
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How do you compare the sensitivity of the two ears?
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With the Webber test
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How do you preform a webber test?
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Place a 512 or 256 Hz tuning fork midline on the skull. The nasal bone is the most accurate spot
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What is the dogma of the Webber test?
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If the patient lateralizes (hears the sound) to one ear, then hearing is not equally sensitive
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If there is a left ear, middle ear obstruction, which side will the sound lateralize to?
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The LEFT ear!!!! This is due to masking!
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If the right ear has cochlear damage, which side will the sound lateralize to?
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The LEFT ear!!!
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What is the Rinne's test?
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It compares air conduction to bone conduction one ear at a time.
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What is the normal finding in a Rinne's test?
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Air conduction is more sensitive than bone conduction. This means that there is no middle ear obstruction.
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What is the finding in a Rinne's test when there is middle ear obstruction?
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Bone conduction is more sensitive than ear conduction.
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Hear loss charts are based on what?
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Standared hearing loss threshold measurements.
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What is a decibel a measure of?
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It is a logarithmic measure of acustic intensity.
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On the hearing threshold curve, what has the steeper vs shallow slope?
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High frequency has the steep slope. Low frequency has the shallow slope
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On a hearing loss chart, what would perfect normal hearing look like?
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It would be a straight line across the ZERO axis
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What are the three main types of hearing loss?
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-Conductive (middle ear pathology)
-Sensory-neural (cochlear or acustic nerve pathology, VIII) -Central (retrocochlear) CNS lesion and cerebral cortex |
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What are three common causes of conductive hearing loss?
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-Wax in e.a.m.
-Fluid in middle ear -Otosclerosis |
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For conductive hearing loss, what are the two forms of fluid problems in the middle ear? And describe each?
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-Infection (treatable and PAINFUL)
-Serous Otitis Media (clear fluid buildup in middle ear) -Treatable, but NOT associated with pain |
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What is otosclerosis from, what does it cause, how do you diagnose, how do you treat?
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-From an autosomal dominant gene
-Most common cause of adult hearing loss -Test with Webber Renee and Audio gram -Treat with surgery |
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Where is Serous Otitis Media usually found? What is it? is it infected? What does it result in?
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-Common in Children
-Fluid buildup in middle ear, NOT infected -Significant conductive hearing loss, poor language acquisition |
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How do you diagnose Serous Otitis Media? How do you fix it?
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-Diagnose with tympanometry (measure stiffness of tympanic membrane)
-Treat with ear tubes to drain fluid |
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On a tympanogram, what is a normal finding?
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The peak will be located in the box!!!!!
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What are the two types of pathology associated with sensory neural hearing?
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-Cochlear pathology
-Acoustic nerve pathology (acoustic neuroma) |
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What are the three types of cochlear pathology?
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-Presbyacusis
-Ototoxic agents -Noise induced hearing loss |
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What is presbyacusis? What do you loose? Why? Where is it limited to?
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-Old Hearing
-Loss of high frequency sensitivity due to: -Mechanical damage and thus loss of hair cells -Limited to basilar turn of the basilar membrane |
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What are 4 major ototoxic agents?
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-Aminoglycoside antibiotics
-Diuretics -Quinine -Aspirin |
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What happens with Aminoglycoside antibiotics in the ear?
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-They are toxic to hair cells and will concentrate in the endolymph
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What are some contraindicators for patients when prescribing aminoglycoside antibiotics?
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-RENAL FAILURE!!!!!!
-Normally the kidney can excrete the antibiotic, but when it is in failure it will be unable to clear it out, and thus the toxic buildup |
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Describe the causes of noise induced hearing loss?
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-Mechanical damage to cochlea
-Glutamate damage to type I axon |
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What is guaranteeded danger zone for loud sounds?
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Around 130
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what happens chemically when you hear a loud sound and why is it damaging?
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-Depolarize IHC -> Release Glutamate -> Glutamate allows Ca into bouton -> excessive Ca causes damage!!!!!
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What is Tinitis always associated with?
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Cochlear damage!! (and sometimes presbyacusis)
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What is Tinitis, and what causes it?
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-The ringing in the ears
-Essentially a phantom limb scenario (loss of neurons cause reorganization) |
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What is the classic acoustic neuroma?
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-A schwannoma of the VIII nerve (cancer of the schwan cells)
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Where does a acoustic neuroma usually begin? And what are the first signs?
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-Begins in the vestibular nerve
-First signs are hearing loss But patients do not notice right away bcs the brain continues to acclimate to the slow change |
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What secondary structures will become involved if left untreated?
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-Facila nerve
-Trigeminal nerve -Lateral pons! |
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What are the symptoms of central (CNS) hearing loss?
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-NOT full hearing loss!!!
-Increased thresholds -Deficits in sound localization -Pitch Perception Speech recognition |
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What is BAER?
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-Brainstem Auditory Evoked Response
-Stimulate the ear with clicks, look for brainstem response (it will cancel out the noise |
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What is the advantage of the BAER test?
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-Preform on noncompliant patient
-Infants -Unconscious |
