WorksheetsElectrophysiology Review 2025
Total questions: 40
Worksheet time: 6hrs 9mins
What are Auditory Evoked Potentials?
Responses within the auditory system stimulated or evoked by sounds
Neuro-electric signals that travel down the axon
Endogenous EEG signals that allow you to infer the health of the cochlea
Behavioral responses generated by pure tones
What are neurons?
Electrically excitable cells that make up the nervous system
Signals that travel down the axon
Potentials evoked by an auditory stimulus
Receptors that bind to neurotransmitters
Where do clicks best stimulate the cochlea?
The first turn of the cochlea around 2-4 kHz
The base of the cochlea around 0.5 kHz
The apex of the cochlea around 5-6 kHz
The middle of the cochlea around 4-5 kHz
How is a dipole generated?
Transmembrane ionic current flow creates negative sink & positive source charges in the extracellular space separated by a small distance
By neurotransmitters binding to receptors
A cell creates a negative source and that negativity propagates through the skin and muscles
A cell becomes positive and then travels through skin
Why are ABR recordings completed twice at the same protocol settings?
To ensure the waves are replicable
To increase the wave amplitudes
To decrease the wave latencies
To enhance the wave frequency
Which is NOT a factor that influences volume conduction of a neural signal?
Dipole negativity
Distance of recording electrode from dipole
Geometric orientation of neuronal population
Temporal synchrony of firing neurons
How does intensity affect AEP latency and amplitude?
Latency decreases and amplitude increases with greater intensities
Latency increases and amplitude decreases with greater intensities
Latency and amplitude both increase with greater intensities
Latency and amplitude both decrease with greater intensities
What causes an action potential?
Membrane potential depolarizes and crosses threshold potential due to excitatory input
Binding of neurotransmitters to receptors leading to more negative intracellular environment
Evoked potentials by an auditory stimulus
Resting potential of -70 mV
What is an ASSR?
A steady-state AEP evoked by periodically varying, continuous stimuli
A rapid response to sudden loud noises
A slow response to low-frequency sounds
A temporary change in hearing sensitivity
How does frequency affect the duration of tone bursts? Assume identical number of cycles
Higher frequency = shorter duration
Higher frequency = longer duration
Lower frequency = shorter duration
Duration does not change if the number of cycles is identical across frequencies
What are the general guidelines for a typical ABR?
85 dB NHL click will have a V latency of 5.5 ms, an amplitude of 0.5 uV, and a I-V IPL upper limit of 4.5 ms
60 dB NHL click will have a V latency of 4.5 ms, an amplitude of 0.3 uV, and a I-V IPL of 3.5 ms
70 dB NHL click will have a V latency of 6.5 ms, an amplitude of 0.4 uV, and a I-V IPL of 5.5 ms
95 dB NHL click will have a V latency of 7.5 ms, an amplitude of 0.6 uV, and a I-V IPL of 6.5 ms
What presentation rate is best for maximizing responses from higher-level auditory structures (e.g., cortex)?
Fast presentation rate
Slow presentation rate
Moderate presentation rate
Variable presentation rate
The dipole generators of which wave(s) are more horizontally oriented?
Wave I
Wave II
Wave IV
Wave V
Which wave is often the most robust wave in an ABR?
Wave V
Wave I
Wave II
Wave IV
What is the approximate resting potential of a typical neuron?
-70 mV relative to the extracellular environment
0 mV relative to the extracellular environment
+70 mV relative to the extracellular environment
-90 mV relative to the extracellular environment
What effect does a contralateral montage have on ABR recordings?
Enhances IV/V but reduces I
Enhances I/II but reduces IV
Enhances II/III but reduces V
Enhances III/IV but reduces II
Why does latency increase at lower frequencies?
The traveling wave delay associated with stimulating apical regions takes longer
The traveling wave delay associated with stimulating basal regions takes longer
The traveling wave delay associated with stimulating middle regions takes longer
The traveling wave delay associated with stimulating distal regions is faster
Which components of the ECochG flip with polarity?
CM
SP
AP
Wave I
What are the typical effects of repetition rates (RR) on adult ABR Wave V latencies?
Latencies will increase ~0.4-0.6 ms with a RR increase from 20-80/sec
Latencies will decrease ~0.4-0.6 ms with a RR increase from 20-80/sec
Latencies will increase ~0.2-0.4 ms with a RR increase from 20-80/sec
Latencies will decrease ~0.2-0.4 ms with a RR increase from 20-80/sec
The dipole generators of which wave(s) are more vertically oriented?
Wave IV
Wave V
Wave I
Wave II
What is an example of neural adaptation?
Fewer natural elements firing at high stimulus rates which causes reduced spatial summation or fewer synchronous neurons firing
Increased firing of neurons at high stimulus rates
Constant firing of neurons regardless of stimulus rates
Increased spatial summation at low stimulus rates
Which of the following is NOT associated with alternating polarity?
Diminished stimulus artifact in the averaged recording
Equal number of condensation and rarefaction trials
Cochlear microphonic is absent in response waveform
Stimulus intensity increases
What is the neural generator of ABR wave I?
Proximal auditory nerve
Outer hair cells
Cochlear nucleus
Distal auditory nerve
What are the components of the MLR?
P0, Na, Pa, Nb, Pb
P1, N1, P2, N2
CM, SP, AP
OHC, IHC, CN
What is a chirp stimulus?
A stimulus that uses input compensation via low to high frequency sweep to account for the traveling wave delay
A stimulus that increases the amplitude of sound waves
A stimulus that decreases the frequency of sound waves
A stimulus that uses output compensation by aligning response waves to generate a bigger response
What effect does a horizontal montage have on ABR recordings?
Enhances I/II
Enhances II/III
Enhances III/IV
Enhances IV/V
The oddball paradigm is often used to elicit which AEP?
Acoustic change complex (ACC)
Auditory late response (ALR)
Mismatch negativity (MMN)
N400
What does a phasor plot depict in ASSR analysis?
Phase lag between the stimulus fm and response
The amplitude of sound waves
The magnitude of different frequencies in a sound
Onset phase of the sound waves
Which of the following is NOT an ECochG component?
Cochlear Microphonic
Summating Potential
Compound Action Potential
Summary Action
What fm produces the largest ASSR amplitudes in adults?
40 Hz
70 Hz
15-20 Hz
60 Hz
The inferior colliculus is involved in generation of which ABR wave?
I
V
None
III
What are the components of the LLR?
P1, N1, P2
P0, Na, Pa, Nb
CM, SP, AP
OHC, IHC, CN
By what age should infants have an appropriate audiologic evaluation if screening shows a concern?
By 1 month of age
By 2 months of age
By 3 months of age
By 6 months of age
Compared with adults, the protocol used for infant ABR is generally:
Wider filter, narrower time window, faster rate
Wider filter, wider time window, slower rate
Narrower filter, wider time window, slower rat
Narrower filter, narrower time window, faster rate
Which statement best describes OAEs as a hearing test?
They are a complete test of hearing on their own
They directly predict pure-tone thresholds
They are not a test of hearing per se, but reflect cochlear status
They only measure middle ear status
On ECochG, which finding is most consistent with Ménière’s disease?
Increased SP/AP ratio due to enlarged SP
Decreased SP/AP ratio due to absent SP
Normal SP/AP ratio with absent AP
No measurable SP or AP
Which test pattern is most consistent with ANSD?
Absent OAEs, normal ABR, present acoustic reflexes, normal ECochG
Present OAEs, abnormal ABR, absent acoustic reflexes, normal CM, poor/absent AP
Absent OAEs, absent ABR, absent acoustic reflexes, ECochG with no response
Present OAEs, normal ABR, present acoustic reflexes, normal ECochG
For a patient with ANSD, which test provides the best objective estimate of auditory thresholds?
CM from Ecochg
ABRs with Chirps
MLR/LLR
DPOAEs
Which statement correctly contrasts MMN and P300?
MMN reflects pre-conscious detection of changes, while P300 reflects active, attention-dependent processing of deviants.
MMN requires the listener’s attention, but P300 does not.
Both MMN and P300 require active attention to the sounds.
MMN and P300 are both purely “pre-conscious” responses.
Which pairing correctly matches each ERP with the type of violation it is most associated with?
N400 – grammatical errors; P600 – semantic anomalies
N400 – semantic anomalies; P600 – grammatical errors
N400 – motor planning; P600 – visual processing
N400 – attention; P600 – pre-conscious change detection
