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Audiology 4
Final Exam
| Question | Answer |
|---|---|
| What does the middle ear do? | it carries vibrations from the outer ear to the inner ear by transferring the sound energy from the air into the outer ear to the fluids of the inner ear |
| What must the middle ear over comee to transfer sound to the inner ear? | a loss of energy when sound passes from one medium to another |
| What is the space of the middle ear like? | almost oval, air-filled, about 2cm, no fluid but sometimes when sick (bad) |
| What separates the middle ear from the external ear canal? | the tympanic membrane |
| What lines the middle ear? | mucous membrane and cilia |
| Where does the middle ear connect to through the eustachian tube? | the nasopharynx |
| What is the eustachian tube lined with? | ciliated epithelium |
| What is ciliated epithelium? | small hairlike projections that help to cleanse the middle ear |
| What is the eustachian tube's state of rest? | close, due to a spring mechanism of cartilage |
| How is the eustachian tube opened? | by four sets of muscles |
| What is the upper one third of the eustachian tube like? | bony canal, near the middle ear |
| What is the lower 2/3 of the eustachian tube like> | cartilaginous, near nasopharynx |
| What is the orientation of the eustachian tube in children? | more horizontal |
| What is the orientation of the eustachian tube in adults? | more angled |
| Why do children tendon to get more ear infections? | because their eustachian tube is more horizontal |
| What is the main purpose of the eustachian tube? | to match pressure of the middle ear to the pressure of the outer ear |
| Why is it important to have equal pressure in the middle and outer ear? | it allows the tympanic membrane to move the most and hear sound most efficiently |
| When does the eustachian tube open? | during yawning, swallowing, sneezing, and when excessive air pressure is applied to the nose |
| What is the mastoid? | the honeycombed bones of the skull that surround the middle ear, can be felt behind the ear |
| What is the aditus ad antrum? | the area where the middle ear opens up, not a fully open connection, connects middle ear to mastoid |
| What is the mastoid process? | the bony protuberance behind the pinna |
| When can the mastoid become infected? | when the middle ear is infected, the spreads to mastoid air cells after being left untreated for long periods of time |
| How can mastoiditis be treated | through antibiotics, but may require mastoidectomy if severe enough |
| What happens during a mastoidectomy | mastoid air cells are scraped away |
| When is a mastoidectomy performed? | to clean mastoiditis or for cochlear implant patients |
| What is the promontory of the inner ear? | a "bump" that protrudes into the middle ear space and separates the two connections between the middle ear and inner ear |
| What are the qualities of the oval window? | above the promontory, supports the stapes footplate, leads to the scala vestibuli |
| What are the qualities of the round window? | below the promontory, leads the the scala tympani |
| What are the three bones are the middle ear called? | the ossicular chain |
| What is the order of the ossicular chain from largest/most lateral to smallest/most medial? | malleus, incus, stapes |
| Where is the stapes located? | at the oval window |
| Where is the manubrium of the malleus embedded? | in the fibrous layer of the tympanic membrane |
| What is the head of the malleus connected to? | the body of the incus |
| What is the long process of the incus connected to? | the head of the stapes |
| What happens to the malleus and incus because of their rigid connection? | they rotate when the tympanic membrane vibrates |
| What is a transducer? | a device that changes energy from one form to another |
| How is the middle ear a transducer? | it changes acoustic sound waves to mechanical vibrations to deliver energy to the inner ear |
| When does energy flow best? | when it goes from one system to another of the same quality (liquid to liquid) |
| What would happen if there was no tympanic membrane or ossicles? | sound vibration would hit the oval window and fluid filled cochlea, causing an impedance mismatch that could result in a hearing loss |
| How does the middle ear act as an impedance transformer to regain lost energy? | Using the area ratio transformer, ossicular lever, and catenary lever action of TM, it works to overcome the loss of energy |
| What is the area ratio transformer mechanisms? | sound pressure collected over the large area of the tympanic membrane is concentrated to the smaller area of the oval window, causing an increase in sound pressure which helps overcome energy lost due to impedance mismatch |
| What is the ossicular lever mechanism? | the malleus is longer than the incus, which forms an anatomical lever that increases the force at the stapes, in turn increasing the energy transmitted to the inner ear |
| What is the Catenary Lever Action of the tympanic membrane? | Areas of the TM move greater than others, meaning an anatomic lever is created with greater force at the umbo of the TM |
| What are the muscles of the middle ear? | the stapedius and tensor tympanic |
| What are the qualities of the stapedius muscle? | next to the facial canal, causes the stapes to move, stiffens the membrane in the oval window, reacts to intense sounds reflexively |
| What do abnormalities of the middle ear create? | a conductive hearing loss |
| What can provide information on existence of middle ear dysfunction and the type of hearing disorder? | audiometric assessments such as an otoscopy or tympanometry |
| What are a number of middle ear disorders a result of? | abnormal eustachian tube function |
| What are the two common causes of eustachian tube malfunctions? | edema (swelling) of the ET or a blockage of ET opening by growing adenoids |
| What happens if there is negative middle ear pressure? | tissues absorb air, causing the tympanic membrane to appear retracted into the middle ear space, may result in a mild conductive hearing loss |
| What is otitis media? | infection of the mucous membrane lining of the middle ear (with and without fluid) |
| What is the prevalence of otitis media? | one of the most common disorders of the middle ear, seen in 0% of children born in the US before two year |
| What is Serous Effusion of the middle ear? | tissues extrude fluid because of negative pressure in the middle ear, consistent with conductive hearing loss, can be seen through otoscopy |
| What are the qualities of suppurative otitis media? | mucosa is filled with excessive amounts of blood and/or pus, eardrum becomes red and swollen, painful, can be accompanied by fever, can lead to TM rupture, can lead to mastoiditis |
| What are the qualities of a cholesteatoma? | result of introduction of skin into middle ear space, forms as a sac |
| What can cause a cholesteatoma? | skin entering the middle ear space in a variety of ways include a tympanic membrane perofration |
| What can happen because of a cholesteatoma? | can erode structures of the middle ear, can travel to nasopharynx or even brain, requires surgery to remove |
| What are the qualities of Ossicular Disarticulation? | typically, incus and stapes have an interrupted connection usually caused by head injury, can require surgery, creates conductive hearing loss |
| What is Otosclerosis? | a spongy growth over the stapedial footplate on one or both ears, partially fixates the stapes into the oval window, progressive disorder with varying age of onset |
| What are the treatment options for a middle ear disorder? | referral to physician (ENT) is required, they determine best treatment, audiologists cannot recommend certain treatments |
| What is the audiologists role in a middle ear disorder? | work with ENT to decide site of lesion, provide pre-/post- operative assessment, provide rehabilitation |
| What are the treatment options for otitis media? | wait and see, medication (antibiotics, decongestants), or Pressure equalization tubes |
| What is a Myringotomy? | Fluid gets suctioned out of the middle ear space through an incision made in the tympanic membrane, then pressure equalization tubes are placed |
| What do pressure equalization (PE) tubes allow for? | direct ventilation of the middle ear, functions as an artificial eustachian tube to maintain normal ear pressure |
| What is a tympanoplasty? | surgical repair of a tympanic membrane preformation, small piece of fascia tissue is woven around opening, when healed, the tissue creates a patch of epithelial tissue |
| What is ossicular chain reconstruction? | prosthetic is used to reconstruct all or some of the ossicles in the middle ear |
| What is a Stapendectomy? | treatment for otosclerosis, happens in the later stages when stapes is completely fixated. Stapes is removed, inserts footplate, and hangs a prosthetic to act as stapes |
Created by:
hrshook0104
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