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29 True/False questions

  1. Reflex Decay: Interpretation

    Retrocochlear
    ≤ 3 secs

          

  2. Uni-box Jerger Patternnormal

          

  3. Anatomy of Acoustic Reflex-ME

    -Cochlea

    -Cochlear Nucleus (decussates)

    -Superior Olivary Complex

    -Motor Nucleus of the CN VII

    -Muscles in the ME

          

  4. Ipsilateral-Stimulus and probe on same side

    -We typically do not test 500 Hz b/c of standing waves

          

  5. Interpretation: Sensation Levels

    Elevated
    ≤ 60 dB SL

    -Cochlear

    -Suggests a sensory loss, specifically a problem related to the cochlea

          

  6. Normal Jerger Patternnormal

          

  7. Acoustic Reflex: Ispi Finding Threshold1. Place the probe tip in the test ear.

    2. Test 1000, 2000, and 4000 Hz

    3. Present stimulus at 80 dB HL and go up in 5 dB HL steps (100 dB HL = max limits of immittance bridge) until you see a deflection of 0.02 ml or greater.

    4. If there is a deflection of 0.02 or great the reflex is PRESENT

    5. If there is not a deflection of at least 0.02 ml the reflex is ABSENT

          

  8. Interpretation: Sensation Levels

    Reduced
    > 95 dB SL

    -Conductive loss

    -Retrocochlear loss

    -Suggests a neural loss, specifically a problem with the VIII CN or beyond

          

  9. Reflex Decay: Interpretation

    Normal
    7-9 secs

          

  10. Reflex Decay: Interpretation

    Soft Sign of Retrocochlear
    ≤ 3 secs

          

  11. Diagonal Jerger Pattern1. Disorder of the intra-axial brain stem pathways

          

  12. Vertical Jerger Pattern1. Mild middle ear disorder

    2. 8th nerve disorder

          

  13. Interpretation: Sensation Levels

    Normal
    -No response at the limits of the immittance bridge

    -Conductive loss

    -Sensorineural loss

    -Suggests loss is sensory, neural, or both

          

  14. Contralateral-Stimulus and probe on same side

    -We typically do not test 500 Hz b/c of standing waves

          

  15. Introduce Stimulus-Typically pure-tones, but can be noise

    -If the sound is loud enough, the sound bouncing back will tell us the room is smaller.

    -We are looking for 0.02 ml

          

  16. Jerger Patternpatterns suggest problem in the ear with the absent/elevated ipsilateral reflex

          

  17. Acoustic Reflex: Purpose-Measures the amount of time, in seconds, it takes for the acoustic reflex to decay by half.

    -Measures how the muscles in the middle ear respond to a constant and loud stimulus.

          

  18. Reflex Decay: Purpose1. Present stimulus at 1000 Hz at 10 dB SL above the contralateral threshold.

    2. Measure the number of seconds it takes for the reflex to decrease in amplitude by half.

    3. Record results on immittance form.

          

  19. Inverted-L Jerger Pattern1. Mild middle ear disorder

    2. 8th nerve disorder

          

  20. Reflex Decay: Interpretation

    Cochlear
    ≤ 3 secs

          

  21. Diagnostic Testing Pathways-Right Contralateral: stimulus in right ear; probe in left ear (Left Crossed)

    -Left Contralateral: stimulus in left ear; probe in right ear (Right Crossed)

    -Right Ipsilateral: stimulus and probe in right ear (Right Uncrossed)

    -Left Ipsilateral: stimulus and probe in left ear (Left Uncrossed)

          

  22. Peak PressureWe have to perform at peak pressure from the tympanogram

          

  23. Threshold of 0.02 ml-You can tax the system just like WRS, but instead of making it louder we make it LONGER

    -Figure out where their threshold was, then go in 10 dB above threshold at > .02 ml

          

  24. Reflex Decay-Measures the amount of time, in seconds, it takes for the acoustic reflex to decay by half.

    -Measures how the muscles in the middle ear respond to a constant and loud stimulus.

          

  25. Horizontal Jerger Pattern1. 8th nerve disorder

    2. Severe cochlear loss

          

  26. Interpretation: Sensation Levels

    Absent
    -65 - 95 dB SL

    -Normal hearing

    -Mild Conductive loss

          

  27. Reflex Decay: Procedure-Measures the amount of time, in seconds, it takes for the acoustic reflex to decay by half.

    -Measures how the muscles in the middle ear respond to a constant and loud stimulus.

          

  28. Acoustic Reflexes: Contralateral Procedure1. Place the probe in the test ear and the stimulus in the non-test ear.

    2. Test 500, 1000, and 2000 Hz

    3. Present stimulus at 80 dB HL (100 dB HL = max limits of immittance bridge)

    4. Use method similar to Hughson-Westlake
    -If reflex is present, decrease by 10 dB HL
    -If the reflex is absent, increase by 5 dB HL

    5. Once you determine the threshold record results on the immittance form.

    6. Plot thresholds onto the audiogram

          

  29. Acoustic Reflex: Ipsi Screening Procedure1. Place the probe in the test ear and the stimulus in the non-test ear.

    2. Test 500, 1000, and 2000 Hz

    3. Present stimulus at 80 dB HL (100 dB HL = max limits of immittance bridge)

    4. Use method similar to Hughson-Westlake
    -If reflex is present, decrease by 10 dB HL
    -If the reflex is absent, increase by 5 dB HL

    5. Once you determine the threshold record results on the immittance form.

    6. Plot thresholds onto the audiogram