Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Audiology and ENT Yr2 > An introduction to pure tone audiometry and tympanometry > Flashcards

An introduction to pure tone audiometry and tympanometry Flashcards

1
Q

Name the 2 ways we hear.

A

Air conduction

Bone conduction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe the pathway of air conduction.

A

Sound passes via the outer ear, middle ear and inner ear (cochlea).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

In bone conduction what does sound wave vibration stimulate?

A

It stimulates the cochlea directly.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

The auditory nerve is near the ___.

A

cochlea.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is a pure tone threshold?

A

the quietest sound you can hear.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Assessment using pure tone thresholds is known as ….

A

Pure Tone Audiometry (PTA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are pure tones characterised by?

A

They are characterised by frequency (pitch) and amplitude (volume).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does Pure-Tone Audiometry tell us?

A
  • Provides information about the type of hearing loss (outer/middle ear problem or inner ear problem)
  • Quantifies frequency specific threshold elevation, giving us more detail about the nature of Hearing Loss.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

PTA is used to assess patient’s hearing acuity over a range of __________. What range do they need to ensure is covered?

A

Frequencies.

The speech banana range.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Hz means what?

A

Waves per second.

Refers to frequency.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

PTA assesses hearing at different frequencies-
eg air conduction = 250-_______ Hz
bone conduction= _____- 4000 Hz

A

8000

500

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

X on the audiogram means…

A

Left ear air conduction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

O on the audiogram means…

A

Right ear air conduction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What sign is used on an audiogram to mark “not masked bone conduction”?

A

A triangle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

[

means ___________ ear _________ _______ on an audiogram.

A

Right ear masked BC (bone conduction)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

]

means ___________ ear _________ _______ on an audiogram.

A

Left ear masked BC (bone conduction)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

We measure hearing using dB HL because…

A

Its easier, it makes the numbers nicer.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

PTA is the single most….

A

sensitive initial measure that can identify pathology.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

PTA is used to give us ________ information (aka. the type of HL) and the ______ of HL.

A

Diagnostic

Degree

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

PTA is a _______ measure.

A

Quantitative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

PTA is used for assessing candidacy for what?

A

Hearing aids and cochlear implants.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

_________ is crucial in fitting hearing aids.

A

PTA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Name the types of hearing loss.

A

Sensory (inner ear)
Conductive (middle/outer ear)
Mixed (combination of both)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

The bone conductor headband rests behind the ______ _______________.

A

mastoid process.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What do Air Conduction thresholds assess?

A

They assess the entire auditory pathway- outer, middle and inner.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is used to assess air conduction?

A

Headphones/earphones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What do Bone Conduction thresholds assess?

A

The inner ear.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is used to assess Bone conduction?

A

Bone conductor headset. (hairband)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

If AC and BC are equal, what can we assume?

A

Inner ear problems.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

If AC is worse than BC, what can we assume?

A

Outer/middle ear problem.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

The test room has to be relatively _____ ________.

A

sound proof.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Tidiness, temperature and ambient noise levels should be controlled for a __________ ________.

A

test room.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What must be followed when carrying out an audiometry test? Why?

A 
Professional standards (specific rules)
So results can be compared to norms, other clinics etc.
34
Q

What is used to check the dB HL presented to the client?

A

a Sound Meter.

35
Q

Make sure to ______ headphones between uses.

A

clean

36
Q

Clear and consistent __________ must be given to the client when about to perform the test.

A

instructions

37
Q

When performing PTA, what ear do they start with?

A

The better ear.

38
Q

Why does PTA procedure involve starting at 1000 Hz, and 30-40 dB above estimated threshold?

A

Allows patient to get comfortable.

39
Q

If there is no response, what procedure do we do?

A

1 down-1 up staircase procedure.

40
Q

Procedure:

  • test best ear
  • test _____ _____
  • repeat for ______ ______
  • assess need for _____.
A

Other ear
Bone condction
masking

41
Q

Name factors that could cause the threshold to be variable.

A
  • Patient eg. tired
  • Equipment
  • Background noise
  • Procedural eg. instructions given.
42
Q

The reliabilitiy of the threshold must consider a 5-10dB error as well as ….

A

The skill of the tester

The patient exaggerating (compensation claims) aka. non-organic hearing loss.

43
Q

Name some limitations of PTA.

A
  • Pure-tones while standard, not ecologically valid (not representative in real life)
  • Doesn’t account for inner hair cell health, cognitive ability, higher auditory processes.
44
Q

Name a practical limitation of PTA.

A

Transcranial transmission (transmission of sound reaching contralateral ear) can lead to cross hearing.

45
Q

Explain the concept of interaural attenuation, if 60dB is presented to the right ear through AC.

A

20dB reaches the left ear (theres always a 40dB loss between ears).

46
Q

Interaural attenuation in bone conduction- what is the loss between the ears?

A

There is 0dB loss/ no loss :)

eg. 20 dB in L > 20 dB in R

47
Q

Why is cross hearing a problem?

A

When testing the worse ear, the better ear (non-test ear) might detect the signal and patient may respond that they heard a noise- but this wouldn’t be a reflection of the worse ear’s ability.

48
Q

When the difference in thresholds of the two ears is greater than the interaural attenuation of the signal, what may occur?

A

Cross hearing may occur.

49
Q

In cross hearing, the apparent threshold of the worse ear may be a ….

A

“shadow” of the better ear.

50
Q

What do we need to avoid to confirm true thresholds?

A

We need to avoid false ear-specific thresholds aka. cross hearing.

51
Q

What is the solution to stop cross hearing?

A

Masking.

52
Q

What is masking?

A

A narrow band level noise is played in the non-test ear, so it makes the test tone inaudible to the non-test ear.

53
Q

Masking removes the possibility of _____ ________.

A

Cross Hearing.

54
Q

What does masking allow?

A

It allows us to isolate and test the test ear without cross hearing.

55
Q

When is bone conduction masking required?

A

When the non-masked BC is better than the unmasked AC threshold by 10 dB or more. This is called an air-bone gap).

56
Q

_______________= masked pure tone threshold

A

plateau

57
Q

When is AC masking required?

A

Where the difference between unmasked L and R AC thresholds id 40 dB or more.

58
Q

Interaural attenuation is _____ dB with ________ headphones.

A

40

circumaural.

59
Q

________ _____________ results in a false picture of a patients’s hearing status.

A

Cross Hearing.

60
Q

Name-

The minimum intensity level which is judged to be uncomfortably loud to the patient when applied monaurally is measured.

A

Uncomfortable Loudness Levels.

61
Q

What is uncomfortable loudness levels used for?

A
  • Used for fitting hearing aids, setting maximum output levels (so hearing aid doesn’t over amplify this level)
  • used in diagnosis of hyperacusis (over sensitivity to everyday sound).
62
Q

Procedure for Uncomfortable Loudness Level-

  • __ ____ presented
  • Increase intensity in ___ dB steps until patient indicates the sound is ____________.
A

Pure Tones
5dB
Uncomfortable.

63
Q

How is hearing tested in Infants (1-2 years old)?

A

Operant conditioning based test:
-visual reinforcement audiology; the tester distracts the child, sound presented at side of child, if the child turns to side- they can hear the sound.
For clear head turn response they get a visually appealing reward.

64
Q

How is hearing tested in Children (2-5 years old)?

A

Classical conditioning based test:
-conditioned play audiometry; tester teaches child to put person in boat only when they hear a noise
Socially reinforced with smiles and praise.

65
Q

What must a test be for a child?

A

stimulating and rewarding.

66
Q

Name some reasons why testing children is challenging?

A
  • some children may not cooperate
  • every child is different
  • chronological age doesn’t determine developmental age, child may find it hard to focus.
67
Q

What does tympanometry measure?

A

Compliance (stiffness) of the middle ear, as a function of pressure.

68
Q

As well as middle ear compliance, what else does tympanometry measure?

A

Also measures ear canal volume.

69
Q

What is tympanometry not a test of?

A

It’s not a test of hearing acuity.

70
Q

Who is tympanometry suitable for?

A

Both adults and paediatrics.

71
Q

Tympanometry measurement:

  • probe tone generated and strikes the _______ which then vibrates the _____ ear
  • The ________ ______ is measured
  • Probe seal allows air pump to measure _________.
A

Tympanic membrane
Middle
reflected sound
pressure.

72
Q

What does a normal tympanogram look like?

A

A nice peak :)

73
Q

Why are colds and otitis media with effusion more common in children?

A

Their Eustachian tubes are not fully developed eg. poorer at ventilation, so more likely to get things like glue ear.

74
Q

Name the characteristics that would show developing otitis media with effusion.

A
  • Blocked Eustachian Tube
  • Retracted Tympanic Membrane
  • high negative pressure (peak more to left) on tympanogram.
75
Q

If there is middle ear fluid, what will the tympanogram look like?

A

straight line (near bottom).

76
Q

If there is a straight line near the top of the tympanogram, what would this suggest?

A

Tympanic Membrane Perforation

77
Q

A small peak on the tympanogram would suggest…

A

Ostosclerosis.

78
Q

What is ostosclerosis?

A

Genetic condition where the ossicles don’t move well aka. they are fixated.

79
Q

If the peak was too big on the tympanogram, what would this show?

A

Ossicular chain discontinuity.

80
Q

what is- Ossicular chain discontinuity?

A

Dislocation of ossicles, so they move too much- this means compliance is through the roof (too much movement).

Audiology and ENT Yr2 (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions