120 likes | 196 Views
The Lever Ratio. Purpose of ME. To transmit sound energy from the air space in the EAC to the fluid in the cochlea This is accomplished by vibration of the ossicles. So what if we didn’t have a TM or any ossicles?. 99.9% of sound waves would bounce off the oval window
E N D
Purpose of ME • To transmit sound energy from the air space in the EAC to the fluid in the cochlea • This is accomplished by vibration of the ossicles
So what if we didn’t have a TM or any ossicles? • 99.9% of sound waves would bounce off the oval window • This energy reflected off oval window gives about a 30 dB hearing loss • Purpose of the TM and the ossicles -- eliminate IMPEDANCE MISMATCH • IMPEDANCE – the resistance to flow of energy
Two Forms of Impedance • Resistance • Reactance • Stiffness • Mass
Area Advantage TM 2 OW 55 mm 2 3.2 mm 55 : 3.2 = 17 : 1
Lever Advantage Malleus is 1.3 times longer than the Incus
Area & Lever Ratio 17 * 1.3 = _______ therefore the overall increase in pressure equals: 20 Log 22 = _________________ 22 to 1 26.84 dB or 27 dB
STAPEDIUS vs. TENSOR TYMPANI • 6 mm in length • 25 mm in length • Arises in bony canal • adjoining the facial canal • and inserts on the head • of the stapes • Arises from wall of • Eustachian tube and • inserts on the upper • margin of the • manubrium of malleus • Cranial Nerve VII • Cranial Nerve V • Activates by startle • response and/or tactile • stimulation of the • orbital area • Activates by acoustic • (acoustic reflex) and • nonacoustic means
Clinical Acoustic-Reflex Protocols • Acoustic-reflex thresholds • AR thresholds vs. auditory thresholds • Reduction of .6 - .7 dB per dB 80 80.3 - 80.4 83 - 84 84.5 - 86 88.4 - 91.2 We only measure up to 110 dB HL
Acoustic Reflex Profiles in Specific Pathologies • Middle ear disorders • Facial nerve disorders • Cochlear disorders • Eighth nerve disorders • Central (Brainstem) disorders