SHS 496 Final Exam | Complete Practice Questions, Correct
Answers & Detailed Rationales (2026/2027)
Question 1
Which cortical auditory evoked potential (CAEP) component is an
endogenous, late cognitive potential peaking around 300 ms post-
stimulus, sensitive to task relevance and oddball stimulus probability?
A. Wave V of the ABR
B. P300 (P3) potential
C. Auditory Brainstem Response (ABR) Wave I
D. Cochlear microphonic
Correct Answer: B. P300 (P3) potential
Detailed Rationale: The P300 is a cognitive event-related potential
(ERP) generated within frontoparietal networks and the medial
temporal lobe, reflecting active attention and working memory
updating during oddball paradigms.
Question 2
What physiological reflex is assessed by Cervical Vestibular Evoked
Myogenic Potentials (cVEMPs)?
A. The vestibulo-ocular reflex (VOR) via horizontal semicircular canals
B. The sacculo-collic reflex, reflecting saccular and inferior vestibular
nerve function via sternocleidomastoid muscle inhibition
C. Utricular macula function via superior vestibular nerve activation
,D. Cochlear outer hair cell reverse transduction
Correct Answer: B. The sacculo-collic reflex, reflecting saccular and
inferior vestibular nerve function via sternocleidomastoid muscle
inhibition
Detailed Rationale: cVEMPs record short-latency inhibitory
electromyographic potentials from tonically contracted
sternocleidomastoid muscles in response to high-level acoustic stimuli,
testing the saccule and inferior vestibular nerve pathway.
Question 3
What parameter does the Video Head Impulse Test (vHIT) primarily
quantify to evaluate vestibular end-organ health?
A. Vestibulo-ocular reflex (VOR) gain and catch-up saccades across the
six individual semicircular canals
B. Endolymphatic fluid pressure in the cochlea
C. Stapedius muscle reflex decay latency
D. Central auditory brainstem conduction time
Correct Answer: A. Vestibulo-ocular reflex (VOR) gain and catch-up
saccades across the six individual semicircular canals
Detailed Rationale: vHIT measures high-frequency angular vestibulo-
ocular reflex function by tracking eye velocity relative to rapid head
rotations, identifying semicircular canal hypofunction and covert/overt
saccades.
Question 4
,What is the primary clinical purpose of performing bi-thermal caloric
testing during videonystagmography (VNG)?
A. To evaluate low-frequency function of each horizontal semicircular
canal and superior vestibular nerve independently by inducing
endolymph thermal convection currents.
B. To measure high-frequency acoustic reflex thresholds.
C. To assess cochlear outer hair cell otoacoustic emission latency.
D. To diagnose central auditory processing disorder (CAPD).
Correct Answer: A. To evaluate low-frequency function of each
horizontal semicircular canal and superior vestibular nerve
independently by inducing endolymph thermal convection currents.
Detailed Rationale: Caloric irrigation uses warm and cool water or air to
stimulate the horizontal canal ampulla, allowing clinicians to compare
right versus left vestibular weakness and directional preponderance.
Question 5
In Auditory Neuropathy Spectrum Disorder (ANSD), what characteristic
dissociation is classically observed between otoacoustic emissions
(OAEs) and auditory brainstem responses (ABRs)?
A. Absent OAEs paired with normal ABR wave latencies
B. Present OAEs (indicating normal outer hair cell function) paired with
severely abnormal or absent ABR waveforms (indicating neural
dyssynchrony).
C. Normal pure-tone thresholds with flat tympanograms
D. Hyperactive acoustic reflexes at low decibel levels
, Correct Answer: B. Present OAEs (indicating normal outer hair cell
function) paired with severely abnormal or absent ABR waveforms
(indicating neural dyssynchrony).
Detailed Rationale: ANSD is characterized by intact cochlear mechanical
amplification (OAEs/cochlear microphonics) coupled with impaired
neural synchrony or transmission along the eighth cranial nerve (absent
ABR).
Question 6
What metric derived from High-Resolution Pharyngeal Manometry
(HRM) specifically quantifies the lowest mean pressure across the upper
esophageal sphincter (UES) during its relaxation phase?
A. Integrated Relaxation Pressure (IRP)
B. Peak subglottal air pressure
C. Pharyngeal transit time
D. Maximum phonational frequency range
Correct Answer: A. Integrated Relaxation Pressure (IRP)
Detailed Rationale: IRP measures the completeness of UES relaxation
during swallowing, serving as a key manometric indicator of
cricopharyngeal dysfunction or achalasia.
Question 7
What advanced diagnostic procedure combines traditional endoscopic
swallowing evaluation with objective sensory testing by delivering
controlled air pulses to the laryngeal mucosa?
A. Videofluoroscopic Swallowing Study (VFSS)
Answers & Detailed Rationales (2026/2027)
Question 1
Which cortical auditory evoked potential (CAEP) component is an
endogenous, late cognitive potential peaking around 300 ms post-
stimulus, sensitive to task relevance and oddball stimulus probability?
A. Wave V of the ABR
B. P300 (P3) potential
C. Auditory Brainstem Response (ABR) Wave I
D. Cochlear microphonic
Correct Answer: B. P300 (P3) potential
Detailed Rationale: The P300 is a cognitive event-related potential
(ERP) generated within frontoparietal networks and the medial
temporal lobe, reflecting active attention and working memory
updating during oddball paradigms.
Question 2
What physiological reflex is assessed by Cervical Vestibular Evoked
Myogenic Potentials (cVEMPs)?
A. The vestibulo-ocular reflex (VOR) via horizontal semicircular canals
B. The sacculo-collic reflex, reflecting saccular and inferior vestibular
nerve function via sternocleidomastoid muscle inhibition
C. Utricular macula function via superior vestibular nerve activation
,D. Cochlear outer hair cell reverse transduction
Correct Answer: B. The sacculo-collic reflex, reflecting saccular and
inferior vestibular nerve function via sternocleidomastoid muscle
inhibition
Detailed Rationale: cVEMPs record short-latency inhibitory
electromyographic potentials from tonically contracted
sternocleidomastoid muscles in response to high-level acoustic stimuli,
testing the saccule and inferior vestibular nerve pathway.
Question 3
What parameter does the Video Head Impulse Test (vHIT) primarily
quantify to evaluate vestibular end-organ health?
A. Vestibulo-ocular reflex (VOR) gain and catch-up saccades across the
six individual semicircular canals
B. Endolymphatic fluid pressure in the cochlea
C. Stapedius muscle reflex decay latency
D. Central auditory brainstem conduction time
Correct Answer: A. Vestibulo-ocular reflex (VOR) gain and catch-up
saccades across the six individual semicircular canals
Detailed Rationale: vHIT measures high-frequency angular vestibulo-
ocular reflex function by tracking eye velocity relative to rapid head
rotations, identifying semicircular canal hypofunction and covert/overt
saccades.
Question 4
,What is the primary clinical purpose of performing bi-thermal caloric
testing during videonystagmography (VNG)?
A. To evaluate low-frequency function of each horizontal semicircular
canal and superior vestibular nerve independently by inducing
endolymph thermal convection currents.
B. To measure high-frequency acoustic reflex thresholds.
C. To assess cochlear outer hair cell otoacoustic emission latency.
D. To diagnose central auditory processing disorder (CAPD).
Correct Answer: A. To evaluate low-frequency function of each
horizontal semicircular canal and superior vestibular nerve
independently by inducing endolymph thermal convection currents.
Detailed Rationale: Caloric irrigation uses warm and cool water or air to
stimulate the horizontal canal ampulla, allowing clinicians to compare
right versus left vestibular weakness and directional preponderance.
Question 5
In Auditory Neuropathy Spectrum Disorder (ANSD), what characteristic
dissociation is classically observed between otoacoustic emissions
(OAEs) and auditory brainstem responses (ABRs)?
A. Absent OAEs paired with normal ABR wave latencies
B. Present OAEs (indicating normal outer hair cell function) paired with
severely abnormal or absent ABR waveforms (indicating neural
dyssynchrony).
C. Normal pure-tone thresholds with flat tympanograms
D. Hyperactive acoustic reflexes at low decibel levels
, Correct Answer: B. Present OAEs (indicating normal outer hair cell
function) paired with severely abnormal or absent ABR waveforms
(indicating neural dyssynchrony).
Detailed Rationale: ANSD is characterized by intact cochlear mechanical
amplification (OAEs/cochlear microphonics) coupled with impaired
neural synchrony or transmission along the eighth cranial nerve (absent
ABR).
Question 6
What metric derived from High-Resolution Pharyngeal Manometry
(HRM) specifically quantifies the lowest mean pressure across the upper
esophageal sphincter (UES) during its relaxation phase?
A. Integrated Relaxation Pressure (IRP)
B. Peak subglottal air pressure
C. Pharyngeal transit time
D. Maximum phonational frequency range
Correct Answer: A. Integrated Relaxation Pressure (IRP)
Detailed Rationale: IRP measures the completeness of UES relaxation
during swallowing, serving as a key manometric indicator of
cricopharyngeal dysfunction or achalasia.
Question 7
What advanced diagnostic procedure combines traditional endoscopic
swallowing evaluation with objective sensory testing by delivering
controlled air pulses to the laryngeal mucosa?
A. Videofluoroscopic Swallowing Study (VFSS)
