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Acoustic Reflex

Audiology Exam 3

QuestionAnswer
Acoustic Reflex Activation of the Middle Ear Muscles (Stapedius & Tensor Tympani) in response to a loud sound
Stapedius Muscle attached to the Stapes and wall of the middle ear cavity
Tensor Tympani Attached to Malleus and wall of middle ear cavity
What happens when the Tensor Tympani is activated? These muscles pull on the ossicular chain, making it more tense (increase impedance) resulting in less sound being admitted through the middle ear.
In humans - most of the acoustic reflex stems from contraction of the _____________ Stapedius muscle
What are the two different ways that acoustic reflexes can be stimulated? Ipsilateral stimulation and contralateral stimulation
Ipsilateral Stimulation Present sound to the same ear you measure reflex from (uncrossed)
Contralateral Stimulation Present sound to one ear, then measure reflex from the other (crossed)
An acoustic reflex occurs __________ where? In both ears
An acoustic reflex occurs in both ears, so we can measure from either the ________ or the _________ that receives the stimulus Same ear (ipsi), Opposite ear (Contra)
Example of Ipsilateral reflex- Measuring probe in right ear and sound presented to the _____ ear Right
Example of Contralateral reflex- Measure probe in right ear and sound presented to the ______ ear Left
Why measure both Ipsi and Contra reflex's? It tells us about different central pathways
What is the reflex pathway? Cochlea, Auditory Nerve, Cochlear Nucleus, Superior Olivary Complex, Facial Nerve, Middle Ear
What is the Right Ipsilateral Acoustic Reflex pathway? Right Cochlea, Right Auditory Nerve, Right Cochlear Nucleus, Right Superior Olivary Complex, Right Facial Nerve, Right Middle Ear
What is the Left Ipsilateral Acoustic Reflex pathway? Left Cochlea, Left Auditory Nerve, Left Cochlear Nucleus, Left Superior Olivary Complex, Left Facial Nerve, Left Middle Ear
What is the Right Contralateral Acoustic Reflex pathway? Left Cochlea, Auditory Nerve, Cochlear Nucleus, Right Superior Olivary Complex, Right Facial Nerve, Right Middle Ear
What is the Left Contralateral Acoustic Reflex Pathway? Right Cochlea, Right Auditory Nerve, Right Cochlear Nucleus, Left Superior Olivary Complex, Left Facial Nerve, Left Middle Ear
Acoustic Reflex uses the same equipment as _________ Tympanometry (Immittance System)
Tympanometry Measures how much sound is reflected off the Tympanic Membrane when EAM pressure is changed from positive to negative pressure
Measure probe has? Air Pump, Speaker, Microphone
What we are actually measuring with Acoustic Reflex is? How much sound is reflected off the TM when loud sound is presented
If there is more sound reflection in Acoustic Reflex? The stronger the acoustic reflex
If there is less or no sound reflection in Acoustic Reflex? Weaker or absent acoustic reflex
What are the two common ways of quantifying an acoustic reflex? 1- Acoustic Reflex Threshold 2- Acoustic Reflex Decay
Acoustic Reflex Threshold Lowest intensity level that provokes a middle ear Immitance change
Normal Reflex Thresholds Between 70-100 dB HL
What is an average reflex threshold? ~85 dB HL
Acoustic Reflex Decay Measures how long the middle ear muscles can stay contracted in response to continuous loud sound
What does acoustic reflex decay help determine? If hearing loss stems from cochlea or retro-cochlear (auditory nerve or central pathway)
Stimulus of reflex thresholds Typically pure tones presented at 500, 1000, and 2000 Hz
When measuring reflex thresholds, move intensity (dB HL) up or down until what? Immitance system shows a reduction in sound admittance (or rather an increase in sound reflectance off TM).
When measuring reflex thresholds, what does immitance system showing a reduction in sound admittance indicate? The presence of an acoustic reflex
When measuring reflex thresholds, what should you always double check? Reflect thresholds
Why should you always double check reflect thresholds when measuring reflex thresholds? Artifacts can occur from patient movement, swallowing etc
What are two reasons why we should measure reflex thresholds? Serves as a powerful Cross-Check tool for hearing sensitivity, Helps differentiate between Cochlear or Retro cochlear hearing loss
Malingering Better acoustic reflex thresholds than expected for pure tone thresholds
Retro-cochlear damage show thresholds? Elevated above what would be expected based on pure tone thresholds
Normal pure tone thresholds, but absent acoustic reflex could be a sing of? Retro-cochlear pathology
When measuring reflex decay, present tone at? 10 dB SL (above reflex threshold) for 10 continuous seconds
Normal Reflex Decay Acoustic reflex does NOT decay more than 50% (Negative Decay)
Abnormal Reflex Decay Reflex decays more than 50% (Positive Decay)
Negative Decay Acoustic reflex does NOT decay more than 50%
Positive Decay Reflex decays more than 50%
Acoustic Reflex Decay is a utility of? Acoustic Reflex Decay Testing
Acoustic Reflex Decay is sensitive to what pathologies? Located where? Retro-cochlear pathologies, located at the auditory nerve and brainstem
In acoustic reflex decay, what is an example of retro-cochlear pathologies located at the auditory nerve and brainstem? Acoustic Neuroma or Cerebellar Pontine Angle Tumor
In acoustic reflex decay, when tumor or other neurological pathology exists, the ________ is weakened and will not allow a ____________ for extended periods Neural pathway, strong contraction
You cannot measure reflex decay if patient has ______________ Absent reflex thresholds
If you have type B tympanograms, you won't be able to? Measure acoustic reflexes
Acoustic reflexes are highly sensitive to ________ disorders Middle Ear
Interpreting Reflexes accurately requires the audiologist to understand what two things? What is required to cause a reflex AND what it is they are actually measuring with the Immitance equipment
Created by: RachelJClark
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