Audiology Final Exam

What are the major structures of the inner ear

1 Cochlea

2 semicicular canal

3 Vestibular

what are 3 other words for the vestibular nerve

8th cranial nerve

CN VIII

audiotory nerve

how does the vestibulocochlear nerve transmit neural pulses to the brain

• hair cells, nerve cavity, nerve fibers, and brain

• Hair cells detect sound vibrations.

• Signals enter the nerve cavity.

• Signals travel through nerve fibers.

• Signals reach the brain and are processed as hearing.

what is the cross section of the CN 8

facial nerver fibers I Vestibular nerve fiber

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auditory nerve fibers I Vestibular nerve fibers

cross section of the CN 8 in terms of high and low frequency

if cut In half the outside is high frequency and the middle is low frequency

the 8 CN develops from what term and is completed by what week

ectoderm and week 7

what other 3 is the ectoderm responsible for?

Cochlea

Brain

spinal cord

what type of hearing loss will result in 8th cranial nerve disorders

sensorineural

what 3 ways can you access disorders effecting the 8th cranial nerve

Auditory brainstem response

MRI or CT scan

Autoacostic omissions

what is a vestibular schwannoma where is it at?

it is a benign tumor on the vestibular branch above the cochlea

in terms of a Vestibular Schwannoma what is neurofibromatosis

condition someone has were a person grows tumors everywhere

what are symptoms (4) of the vestibular schwannoma

unilateral- loss in one ear

tinitus

dizziness

speech recognition difficulties - trouble understanding speech

in terms of a vestibular schwannoma why would an OAE be normal and a ABR (auditory brain stem response) abnormal

because in OAE haircells are not damaged

the tumor would be disrupting the test

what’s management of vestibular schwannoma

Surgery or radiation

hearing aids or tinitius managment can be annoying

What is Auditory neuropathy spectrum disorder (ANSD)

When the auditory nerve does not send signals to the brain properly

in terms of Auditory neuropathy spectrum disorder what is dys-synchorous

what is the cause/reason

children who have problem with the nerve not sending pulses to the brain from cochlea consistently

unknown cause

Treatments of Auditory neuropathy spectrum disorder

hearing devices bilateral and cochlear implants earliest at 12m

where is the auditory cortex located at ?

in the temporal lobe

superior gyrus

what are the 2 major functions of the auditory cortex

interpret speech , hearing sounds , localization

operates speech from noise

what are the three Central auditory nervous system disorders

auditory processing disorder

age related deterioration

other lesions: Strokes ,MS ,truama

what is Auditory processing disorder

defects in processing of auditory signal

what are the 3 difficulties in Auditory processing disorder

1. abilitiy to hear different sounds ex Pat and Bat

2. processing sound into both ears ex: in a noisy area its better to hear a convo with both ears than 2

3. follow the timing in different singals long or short ex: beep beeep

signs of Auditory processing disorders

poor listening skills

unable to follow multiple steps

unable to localize sound poor academic performance

problems with reading verbal and language comprehension

Management of APD

SLP and environmental modifications

SLP- intensity timing and phonemes discrimination

pattern recognition

localization and speech in noise task

Environmental modifications - fit amplification and fm devices

seating in classroom

visual aids

speak slower and pause often

what is Vestibular disorder/ also known as vertigo or imbalance

rooms spinning around you can’t drive or walk

what is nystagmus?

eyes beating

treatment of vestibular disorders

medication

epley maneuver

physical therapy - balance retraining

what is tinitus and the different types

cronic and acute

ringing in one or both ears described as ringing hissing or roaring

what are the different causes of tinitus and which one is the most common

the most common is noise

age (presypercusis)

disease

head injury

unknown

medication

given the visual of (haircells ,nerve acvity and never fiber and the brain) how is Tinnitus caused

increase in nerve activity / action potential

what are reactions/ emotions to tinnitus

1. thoughts and emotions ( depression anxiety )

2. hearing difficulties (hearing the ringing so its hard to hear over it ear)

3. sleep (insomnia) difficulties sleeping

4. concentration (hard to work)

how do they diagnosis tinntius if they can’t do any testing

using a questionnaire and rating the loudness annoyance and pitch

how should one manage tinitus

counseling

sound therapy -

hearing aids don’t sit in a quiet room ex: fan white noise music ac

what are some devices for sound therapy

sound pillow

sound generator

smart phone apps

radio

What is hyperacusis?

when sounds are moderately loud like a slam on a desk , babies crying , checkout beep people with hypnosis think these sounds are to loud

what are some more sounds that are bothersome form those with hyperacusis

babies crying

fishes clanging

lawn mowers

chewing gum

what are some causes of hypercusis

genetic disorders like autism and williamson

bells palsy

head injury

migraine

noise

Menderes disease

hypercusis related sympoms include what

depression and anxiety

how do you diagnose hyperacusis

questionnaires and a soundbotth to determine discomfort level (DL )

how do you manage hyperacusis

counseling

earplugs

sound therapy

relaxtion

medication for anxiety depression and insomia

what are HA considerations and which one of them is a strong factor

strong factor: motivation

age

severity of hearing loss

education

finances

duration of hearing loss

Which hearing aid is easy to put in and out and which hearing aid is used by kids and why

ITE- in the ear easy to remove and put in

BTE- high in kids easy and a mold

what are the 3 recommendations for successful hearing aid use

1. be motivated

2. wear for at least 8 hours a day

3. fit both ears when possible

how do you care for hearing aids

don’t wear to sleep

daily cleaning and maintenance

don’t wear in shower

what topics are reviewed with the patient

price

what should be avoided when wearing hearing aids ?s

shower and sleeping

what steps are needed to maintain the hearing aids

clean , battery charged , wear for at least 8 hours

how early should you fit babies for hearing aids

and what else should be considered

fit as soon as 6months of age

parent report

verify hearing properly recommend behind the ear aids - mold tube hearing aid because they grow

given this label the 3 parts of the BAHA

screw titanium implant

abutment (adapter)

haha sound processor

what is the BAHA

how long does it take to integrate '

How does the pathway send signals to the cochlea

hearing aid that is surgically placed in the temporal bone

it takes 3 months to integrate

by bone conduction

how is the middle ear implants surgically implanted

implant is surgically implanted under the skin while the processor clips on the outside

then the hearing aid has the middle ear bones vibrates

when are cochlear implants used

when hearing aids that are not surgically implanted don’t benfit you anymore

how is the cochlear implanted

goes under the skin in the cochlear

what is the HAT hearing assistive technology used by

OHH population

Personal HAT systems examples

Examples are Frequency/Directed modulated (Fm/Dm) which uses FM radio waves or digital signal code to transmit wirelessly and applications are through classrooms, churches or theaters. Also infrared (IR) which uses light waves to transmit signals wirelessly and application is through tv systems and theaters

Benefits of HAT systems

reduce background noise and can improve SNR by 15-20 db

reduce effects of reverberation

reduce distance from sound source to listener improves audibility

what is induction loop IL personal systems

uses electromagnetic energy to transmit via on induction

requires telecoil

Benefits of the induction loop IL and problem

low cost

reliable and portable

requires telecoil or compact

General use of HAT hearing assertive technology

texting and email

alerting devices

general communication

Advocate is what and used for what

: to support or argue for 

-Used to educate, inform, and persuade 

what is Lobbying and grassroots lobbying

-lobbying: attempt to influence new or existing legislation via communication w/legislators

-grassroots lobbying: asking general publics to contact legislators

Types of advocacy

• self

-individual/group

-systems 

Advocacy in audiology:

-policy advocacy

-OTC hearing aids

-provider referral processes

-factors and barriers affecting access to care

-billing reimbursement

-hearing loss prevention

-occupational and rural/agricultural medicine

-EHDI and newborn hearing screening

-screening, identification, and intervention of hearing and balance

Multiculturalism and DEI

-Diversity:

-Equity:

-Inclusion:

-Diversity: variety of experiences, skills, knowledge, that shape us

-Equity: fairness, promoting justice and impartiality

-Inclusion: employing systems policies and practices that support value for all individuals

Cultural competence:

-Cultural humility:

-Person-centered care:

-Culturally responsiveness:

Cultural competence: lifelong evolution of knowledge and skills needed to address language and culture 

-Cultural humility: commitment to lifelong learning, self eval, and desire to develop mutually beneficial partnerships w/individuals from all backgrounds

-Person-centered care: collaborative approach to planning, delivery, and eval of clinical services

-Culturally responsiveness: understanding and appropriately including and responding to the combination of cultural variables and full range of dimensions of diversity that an individual brings to interactions 

Ethics:

-Ethics definition and help you what -professional code of ethics

critical reflection of morality and what people believe to be right or wrong 

-help us to formulate decisions based on our values as professionals 

what are the Ethical principles:

autonomy, beneficence, and justice