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Hearing Loss for CSD, Study notes of Conduct disorder (CD)

From 2022 Intro into Audiology class that was completely online

Typology: Study notes

2022/2023

Uploaded on 09/04/2024

savannah-everett
savannah-everett 🇺🇸

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Hearing and the Human Ear
Notes
Part 1:
First, we need to remember that the ear can be divided into three sections – the outer,
middle, and inner ears.
The outer ear collects sounds and funnels them to the Tympanic membrane (ear drum).
Embedded within the Tympanic membrane is the Malleus – the first of the three middle ear
ossicles. The middle ear is an air-filled cavity with the three tiniest bones in your body.
The middle ear is ventilated by the Eustachian tube and its purpose is to amplify sound
before it is sent to the fluid-filled cochlea.
The movement of the malleus starts a chain reaction of the ossicles. The last of the ossicle,
the stapes, pushes on the oval window of the cochlea. The force of the stapes movement
sends a wave of fluid up the basilar membrane of the cochlea.
The cochlea marks the start of the inner ear. It is lined with three rows of outer hair cells
and one row of inner hair cells. The outer hair cells move up and down in response to
sound stimulation. The also amplify sounds before sending them to the inner hair cells
which then tell the auditory nerve fibers to fire and send the message up to the auditory
cortex.
Part 2:
Hearing can be tested in two ways:
1) Air conduction
2) Bone conduction
With air conduction the subject wears headphones or insert earphone. Sounds are sent
through the outer ear, the middle ear, the inner ear, up the auditory nerve and to the
auditory cortex. The subject will then signal that the sound was heard. Air conduction
tests the whole auditory system.
Bone conduction bypasses the outer and middle ear and directly stimulates the fluid of the
cochlea. To test bone conduction, a person wears a bone oscillator (vibrator) somewhere
on his / her skull. The oscillator is usually placed on the mastoid bone behind the pinna of
the outer ear. The movement of the ossiclator vibrates the skull, the bones of the middle
ear, and ultimately the fluid in the cochlea. A vibration of fluid in the cochlea will cause
sounds to be sent up the auditory nerve to the auditory cortex where the subject will again
signal when the sound was heard.
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Hearing and the Human Ear Notes Part 1: First, we need to remember that the ear can be divided into three sections – the outer, middle, and inner ears. The outer ear collects sounds and funnels them to the Tympanic membrane (ear drum). Embedded within the Tympanic membrane is the Malleus – the first of the three middle ear ossicles. The middle ear is an air-filled cavity with the three tiniest bones in your body. The middle ear is ventilated by the Eustachian tube and its purpose is to amplify sound before it is sent to the fluid-filled cochlea. The movement of the malleus starts a chain reaction of the ossicles. The last of the ossicle, the stapes, pushes on the oval window of the cochlea. The force of the stapes movement sends a wave of fluid up the basilar membrane of the cochlea. The cochlea marks the start of the inner ear. It is lined with three rows of outer hair cells and one row of inner hair cells. The outer hair cells move up and down in response to sound stimulation. The also amplify sounds before sending them to the inner hair cells which then tell the auditory nerve fibers to fire and send the message up to the auditory cortex. Part 2: Hearing can be tested in two ways:

  1. Air conduction
  2. Bone conduction With air conduction the subject wears headphones or insert earphone. Sounds are sent through the outer ear, the middle ear, the inner ear, up the auditory nerve and to the auditory cortex. The subject will then signal that the sound was heard. Air conduction tests the whole auditory system. Bone conduction bypasses the outer and middle ear and directly stimulates the fluid of the cochlea. To test bone conduction, a person wears a bone oscillator (vibrator) somewhere on his / her skull. The oscillator is usually placed on the mastoid bone behind the pinna of the outer ear. The movement of the ossiclator vibrates the skull, the bones of the middle ear, and ultimately the fluid in the cochlea. A vibration of fluid in the cochlea will cause sounds to be sent up the auditory nerve to the auditory cortex where the subject will again signal when the sound was heard.

Part 3: Describing Hearing Losses There are three types of hearing losses:

  1. Conductive hearing losses
  2. Sensorineural (SnHL) hearing losses
  3. Mixed hearing losses Conductive hearing losses occur in the outer or middle ear ears. An example of conductive hearing losses would be impacted wax, fluid in the middle ear (otitis media), or fractured middle ear bones. Conductive hearing losses are often treatable and therefore less serious then sensorineural hearing losses. Sensorienural hearing losses occur in the cochlea, auditory nerve, or further up the auditory pathway. Cochlear hearing losses are the most common. They include outer hair cell damage related to noise exposure – or age related hearing loss. The outer hair cells are essential for processing sounds. Once they are damaged or destroyed nothing can be done to fix them. This type of hearing loss is very common as we age. Hearing aids can amplify sounds for people with sensorineural hearing losses, but unfortunately, the damage is already done and the outer hair cells, which are supposed to process the sounds, are unable to do so effectively. A person with a SnHL will often say “I can hear you but I can’t understand what you are saying”. A person with this type of loss will recognize that sounds are happening, but not be able to completely process them. Mixed hearing losses have both a conductive component and a sensorineural component. For example, a person may have fluid in their middle ear and outer hair cell damage in the cochlea. With this type of hearing loss, there are two problems. Summary: By testing hearing two ways we can parse out whether the hearing loss is conductive, sensorineural, or mixed. If a person has a conductive hearing loss, then the scores on the Air Conduction testing will be worse than the scores obtained with Bone Conduction testing. This is because the AC scores are getting “tripped up” by an obstruction in the outer or middle ear. BC, which tests the inner ear not affected by the obstruction and will therefore have normal scores. With a sensorineural hearing loss, there is one problem in the inner ear. The AC and BC scores will be the same because both tests are being affected by the same problem – usually in the cochlea.