Test 1

Cerumen

Earwax

Decibel Sound Pressure Level

Expresses the ratio of measured sound pressure to a reference sound pressure to indicate the intensity of a sound stimulus.

Pseudohypacusis/Malingering

False,exaggerated,orpsychogenically motivated hearing loss.

Endolymph

Fluid found in the scala media, which has a higher concentration of potassium than sodium ions. The difference in ionic concentration between endolymph and perilymph gives rise to an endocochlear electrical potential that helps conduct neutral transmission of sound.

Perilymph

Fluid found in the scalae vestibuli and tympani that has a higher concentration of sodium ions than potassium ions. The perilymph wave displaces the scala media, setting up a wave on the basilar membrane, which moves from the base to the apex.

Boyle's Law

For a fixed volume of vibrating air molecules, increased concentration (density) of air particles results in increased air pressure. Pressure and volume of a gas are inversely proportional if kept at a constant temperature.

Outer Hair Cells

Hair cells that form three rows. The base of the cells sits on top of the basilar membrane, and the stereocilia at the tops of the cells embed themselves in the tectorial membrane above; they connect with the cochlear branch of the 8th cranial nerve (vestibulocochlear). The vibration of the basilar membrane causes the cilia of the outer hair cells to bend, and the length of the outer hair cells increases to generate an electrical response created by the incoming stimulus. Outer hair cells are tuned to sound intensity to act as transducers by changing fluid energy into electrical energy.

Conductive Hearing Loss

Hearing loss caused by an abnormality in the external or middle ear characterized by the reduction in the conduction of sound into the ear. Individuals with (purely) conductive hearing loss have normal sensorineural hearing.

Sensorineural Hearing Loss

Hearing loss in the inner ear due to damage to the cochlea and/or retrocochlear pathway, resulting in alterations of perception of sound frequency and intensity. This hearing loss also results in a loss of speech clarity due to damage to the neural fibers located in the cochlea.

Displacement

In regards to sound waveforms, movement of air molecules away from the rest position.

Condensation/Compression

In regards to sound waveforms, the displacement passed from molecule to molecule that creates areas of increased pressure and density.

deaf

Note use of lowercase "d"; refers to an individual whose hearing loss is so severe that they cannot use their sense of audition as a primary means of daily communication.

Transducer

Object that changes one form of energy to another form. For example, the ear is a transducer because acoustic energy is changed to fluid/electrical energy via mechanical energy of the middle ear, which allows the ear to analyze various physical parameters to perceive in the brain what the ear has heard.

Saccule

One of the two organs of balance housed within the vestibule.

Utricle

One of the two organs of balance housed within the vestibule.

Round Window

One of the two tissue-covered openings found on the cochlea that is between the scala tympani and middle ear.

Oval Window

One of the two tissue-covered openings found on the cochlea, which is covered by the stapes footplate.

Scala Media

One of three chambers within the cochlea, in which endolymph circulates.

Scala Tympani

One of three chambers within the cochlea, in which perilymph circulates.

Scala Vestibuli

One of three chambers within the cochlea, in which perilymph circulates. When the stapes footplate rocks back and forth in the oval window, a wave is established within the scala vestibuli.

Eustachian Tube

Part of the middle ear anatomy that connects the middle ear space to the back of the throat. The Eustachian tube equalizes the pressure of the middle ear space with our environment (normal atmospheric pressure).

Eustachian Tube (ET)

Part of the middle ear anatomy that connects the middle ear space to the back of the throat. The Eustachian tube equalizes the pressure of the middle ear space with our environment (normal atmospheric pressure).

Retrocochlear Pathology

Pathological condition that is located beyond (retro) the level of the cochlea.

Sound

Physicalphenomenondescribedasthe movement or propagation of a disturbance (i.e., a vibration) through an elastic medium (e.g., air molecules) without permanent displacement of the particles. Three prerequisites are necessary for production of sound: a source of energy, a vibrating object, which generates an audible pressure wave, and a medium of transmission.

External Auditory Canal/Meatus

Portion of the ear that connects the pinna to the tympanic membrane and middle ear cavity.

External Auditory Meatus

Portion of the ear that connects the pinna to the tympanic membrane and middle ear cavity.

Hard of Hearing

Preferred terminology for a person presenting with a hearing loss who can derive benefit from hearing aids and uses aural/oral speech for communication.

Otoscopy

Process of examining the external auditory meatus, especially the eardrum, which allows the examiner to identify several common problems that preclude the sound from entering the ear.

Uniform Circular Motion

Projected movement of an air molecule if it were to move around the circumference of the circle, formed by the trough directly beneath the peak of a sine wave, at a constant rate.

Brownian Motion

Random movement at high speeds, which results from the impact of molecules, found within a gas or liquid. This was named after Robert Brown, a Scottish botanist, who described this motion.

Universal Precautions

Recommendations developed by the Centers for Disease Control and Prevention to control the spread of infectious diseases.

Semicircular Canals

Sensory end organs of balance within the vestibular labyrinth.

Membranous Labyrinth

Soft-tissue,fluid-filled channels within the osseous labyrinth containing the end- organ structures of the hearing and vestibular systems.

Pars Tensa

Stiffer, larger, section of the tympanic membrane located inferiorly to the pars flaccida.

Recruitment

Term used to describe an abnormal growth of loudness that comes from a sudden increase in the perceived loudness of a sound with only a slight increase in the volume intensity.

Wernicke's Area

That area of the brain within the lower temporal lobe, where speech perception is located.

Middle Ear

That portion of the ear that connects the outer ear anatomy to the inner ear anatomy and encompasses the ossicular chain, the Eustachian tube, middle ear cavity, and middle ear attic.

Acoustic Reflex Threshold

The acoustic threshold at which the muscles of the middle ear contract in response to a high-intensity sound.

Tympanometric Compliance

The amount of mobility (movement) the eardrum demonstrates

Tonotopic Organization

The auditory nerve fibers are arranged on the basilar membrane in this fashion, meaning nerve fibers at the apical end of the cochlea respond preferentially to low-frequency stimuli, and high-frequency sounds are encoded at the base. The auditory nerve is tonotopically arranged so that low- frequency sounds are found in the core of the auditory nerve and high-frequency sounds are arranged around the periphery.

Osseous Labyrinth

The bony structure of the inner ear, which lies within the temporal bone and houses both the auditory and vestibular labyrinth.

Impedance-Matching Transformer

The combined functions of the middle ear system that allow sound to overcome the difference in impedance between the air- filled cavity of the middle ear versus the fluid-filled cavity of the inner ear.

Traveling Wave Theory

The concept by which sound travels and is coded within the cochlea.

Interprofessional Collaboration

The concept of collaborating with other professionals to reach a common goal.

Endocochlear Electrical Potential

The difference in ionic concentration between endolymph and perilymph gives rise to this "cochlear battery."

Pinna

The visible part of the ear, also called the auricle, which is shaped like a funnel to collect and send sound waves through the ear canal. The pinna also assists in sound localization and helps to protect the entrance to the external auditory canal.

Ear Canal Volume (ECV)

The volume, measured in cubic centimeters or ML, of the external ear canal.

Rarefaction

Thinning of air molecules, which creates areas of decreased air pressure and density.

Vestibule

This connects the two end organs of hearing and balance (the cochlea and semicircular canals) and houses the saccule and utricle.

Decibel Hearing Level

This decibel reference level is used to audiometrically measure an individual's hearing level, and its reference varies with frequency according to minimum audibility curve.

Ossicular Chain

Three connected bones in the middle ear that form a chain. From lateral to medial, these bones are the malleus, the incus, and the stapes; they are collectively responsible for taking the acoustic energy at the tympanic membrane, converting it to mechanical energy, and delivering it to the oval window.

"Look, Play, Talk"

Variation of the informal observation in which the clinician should look at the child for nonverbal communication behaviors, observe play behavior, and listen to the child talk. This will allow the clinician to earn the trust of the child and determine developmental level and abilities.

Pressure Wave

Whenairmoleculesaresetinto vibration, they produce a pressure wave. When air molecules near a vibrating object are displaced, adjacent air molecules are also displaced and so on. This wave motion is propagated through the air to the human ear.

Mixed Hearing Loss

Ahearinglossthatisa combination of a conductive component plus a sensorineural component. Bone conduction thresholds are outside of normal (sensorineural component), and air conduction is even further abnormal (conductive component), showing an air-bone gap on the audiogram.

Look-alike Diseases

Also known as imitator diseases; conditions that present with many of the same or similar symptoms and characteristics as another disorder.

Auditory Labyrinth

Also known as the cochlea; the sensory end organ of hearing. The cochlea is a fluid-filled space within the temporal bone and is a snail-shaped spiral canal, with three chambers and inner and outer hair cells that help to analyze frequency and intensity of incoming sound signals.

Dementia

An age-associated syndrome with a negative impact on memory, cognition, attention, problem solving, and language.

Tympanometry

An evaluation of the physical working properties of the middle ear system based on the mathematical principles of pressure, compliance, and volume.

Otitis Media

An inflammation of the middle ear system, which may or may not include the collection of fluid in the middle ear cavity, primarily due to a dysfunctional Eustachian tube. When fluid is present, it typically becomes infected. This condition is also known commonly as an "ear infection."

Otoscope

An instrument that provides magnification and a light source to examine that portion of the ear from the external auditory canal to the eardrum.

Tympanic Membrane

Anatomic boundary between the outer and middle ear, which comprises multiple layers of tissue that are both concentric and radial. Also commonly known as the eardrum.

Evidence-Based Practice (EBP)

Conscientious, explicit, and judicious use of current best evidence in making decisions about the care of the individual patient.

Organ of Corti

Contains the sensory cells of hearing, which lie on the basilar membrane within the cochlear duct.

Comorbidity

A condition occurring simultaneously with another, which may or may not have similar characteristics.

Congenital

A condition that is present at birth. With reference to a congenital hearing loss, it may or may not be associated with a familial history.

Cochlea

A fluid-filled space within the temporal bones that is a snail-shaped spiral canal. Within each membranous duct there are three fluid-filled chambers. The organ of Corti is within the cochlear duct, which contains the sensory cells of hearing on the basilar membrane. The inner and outer hair cells analyze frequency and intensity of incoming sound signals at the basilar membrane.

Tectorial Membrane

A gel-like membrane that forms the roof of the basilar membrane. The outer hair cells are embedded into the tectorial membrane, with the inner hair cells in close proximity.

Wavelength

A graphic representation of the disturbance created by the sound wave in a medium, which is measured in units of length and represented by the Greek letter lambda (λ).

Genetic

A hearing loss linked to one's familial history through the generations.

Acquired Hearing Loss

A hearing loss that is the result of an illness, disease, or disorder that was not present at birth.

Pascal (Pa)

A linear unit of measurement that describes sound pressure.

Best Practice

A management philosophy that asserts that there is a technique, method, process, or activity that is more effective at delivering a particular outcome than any other technique, method, process, or activity.

Response to Intervention (RTI)

A portion of the federal education laws that requires school systems to put in place interventions that attempt to meet the needs of a child for academic success in the general education setting and emphasize prevention through special education services rather than failure. RTI must be school wide and provide high-quality instruction matched to individual student needs, include frequent monitoring of student progress to inform changes in instruction, and utilize child response data to make educational decisions.

Decibel

A ratio between the measured sound pressure and relative sound pressure, using logarithms. This is a useable unit of measurement for intensity of the range of human hearing.

Inner Hair Cells

Cellsthatformarowintheproximity of the tectorial membrane, near the modiolus of the cochlea. More than 90% of these hair cells are neurologically connected to the brain via nerve fibers, and they encode sound and send it further along the auditory nervous system up to the brain for interpretation.

Outer Ear

Comprising two structures, the pinna (or auricle) and the external auditory meatus (ear canal), that collect sound and direct sound to the middle ear.

Acoustic (Stapedial) Reflexes

Involuntary contractions of the middle ear muscles, the stapedius (primarily) and the tensor tympani, which occur in response to high- intensity sound.

Broca's Area

Located in the inferior frontal gyrus where motor production of language is located and processing of sentence structure, grammar, and syntax is located.

Acoustic Reflex Decay (ARD)

Measures how long and how well the acoustic reflex is capable of sustaining itself. In the normal system, the acoustic reflex should be able to maintain its contraction for a period of time before it drops off; however, the auditory system whose reflex falls off too quickly is abnormal.

Differential Diagnosis

Method used to clinically distinguish or differentiate one disorder from another that presents with many of the same or similar symptoms and characteristics. Key concerns include the correct diagnosis of hearing loss and the identification of possible additional comorbid conditions.

Pars Flaccida

Morecompliant,smallersectionof the tympanic membrane located superiorly to the pars tensa.

Propogation

Movement of a disturbance (vibration), which is generally represented as a wave.

Stapedius Muscle

Muscle of the middle ear that contracts bilaterally in response to high-intensity sounds to stiffen the ossicular chain, which protects the inner ear from intense sounds. This contraction results in attenuation of sound pressure reaching the inner ear.

Tensor Tympani Muscle

Muscle of the middle ear that runs parallel to the Eustachian tube and assists in its function. When the tensor tympani muscle contracts, it pulls the malleus to draw the tympanic membrane inward, which increases the pressure in the middle ear and Eustachian tube.

Decibel Sensation Level

The intensity level of stimulus presentation using the individual's threshold as reference. For example, a 30 dB SL sound for someone with a 20 dB HL threshold will result in a presentation level of 50 dB HL for that particular sound.

Tympanometric Pressure

The measure of pressure in the middle ear cavity referencing normal atmospheric pressure measured in daPa.

Vestibular Membrane

The membranous roof of the cochlear duct.

Incus

The middle bone of the ossicular chain that comprises two processes: the short crus, which fits into a recess wall of the tympanic membrane, and the long crus, which is attached to the head of the stapes.

Malleus

The most lateral of the three bones making up the ossicular chain, which is embedded slightly into the tympanic membrane at the manubrium. When the tympanic membrane vibrates from the sound energy impinging on it, the malleus also moves at the same vibratory speed.

Decruitment

The opposite of recruitment; where the individual response is generated at a higher intensity than expected based on the peripheral hearing threshold.

Helicotrema

The point where the scalae vestibuli and tympani communicate in the cochlea.

Vestibular Labyrinth

The portion of the ear that includes the semicircular canals and the vestibule, which houses the saccule and utricle. This sensory end organ of ear, in conjunction with the vision and proprioception, is responsible for maintaining our balance system.

Pure Tone

The resultant pressure wave formed by areas of alternating condensation/compression and rarefaction changing at a steady rate. Pure tones move in simple harmonic motion and are represented graphically by a sine wave.

Stapes

The stapes is the most medial bone in the ossicular chain and looks like a stirrup; it fits very neatly in the oval window of the cochlear wall to help push sound (as mechanical energy) into the inner ear.

Basilar Membrane

The structure on which the organ of Corti sits. The basilar membrane, along with other structures, form the "floor" of the cochlear duct.

Acoustics

The study of sound; a branch of physics.

Simple Harmonic Motion

The type of motion characteristic of pure tones, which is due to areas of alternating condensation and rarefaction occurring at a steady rate of change. When pure tones move in SHM, they take the same amount of time to complete each cycle of vibration, or are periodic.