assessment of hearing

Question 1

conductive mechanism

Answer 1

outer ear and middle ear

Question 2

sensorineural mechanism

Answer 2

cochlea and auditory nerve and higher pathways

Question 3

4 areas of concern that the case history presents

Answer 3

1. past status of hearing
2. present status of hearing
3. estimate of prognosis
4. etiology of hearing loss

Question 4

otoscopy

Answer 4

provides illumination for examining the external auditory canal and tympanic membrane

Question 5

portable audiometers

Answer 5

can only test pure tone air conduction and bone conduction

-cannot conduct speech testing

Question 6

diagnostic audiometer

Answer 6

capable of producing pure tones, speech, and special audiometeric tests
-has a microphone for other tests

Question 7

environment for testing

Answer 7

• standards set by the ANSI or ISO

- sound treated booth

Question 8

bone conduction tests

Answer 8

bone oscillators are used 
-oscillator placed on mastoid bone 
-have to watch for vibrotactile responses
-1000,2000,4000,500 Hz 
tells us the type of hearing loss

Question 9

air conduction tests

Answer 9

-2 types of headphones
-supra-aural and insert headphones
tells us the degree or amount of hearing loss

Question 10

supra-aural headphones

Answer 10

need to check for collapsing ear canals

• cheaper
• used if the ear is infected or if there is a malformation
• kids don’t want things going into their ear

Question 11

insert headphones

Answer 11

• no collapsing canals
• greater noise suppression
• comfort when masking
• reduces signal crossover

Question 12

conductive loss

Answer 12

pathology in the outer and middle ear.

air conduction thresholds will be elevated but bone conduction will be in normal limits

Question 13

testing tips

Answer 13

• seat client facing away
• check for collapsing canals
• talk before- give directions
• red= right and left= blue
• before testing: take of glasses, client spit out gum/candy, etc
• always start the testing with their better ear

Question 14

psychoacoustically pure tone threshold

Answer 14

lowest level at which a person gives a response 50% of the time

Question 15

clinically pure tone thresholds

Answer 15

lowest level at which a person responds to a tone 3 times (in the ascending mode)

Question 16

technique for testing

Answer 16

preparatory phase: begin at 30 dB HL or at a level in which the client can hear. decrease in 10 dB increments until you no longer get a response.
-then ascend in 5 dB steps until you get a response
-then drop down 10 dB until you get no response
-then ascend in 5 dB until you get a response
-repeat above sequence until you have the lowest level at which the person responded 3 times
CAN ONLY GET THRESHOLDS ON ASCENDING

Question 17

air conduction testing frequencies

Answer 17

1000,2000,4000,8000,1000,500,250 -start with 1000 becasue its the easiest freq to percieeve and gives good test/retest reliabilty

Question 18

bone conduction testing freq

Answer 18

250-4000 Hz

-dont test high freq bc the client will be more prone to a vibratory response

Question 19

symbols for right ear

Answer 19

red o= right ear AC

red

Question 20

symbols for left ear

Answer 20

blue x = left ear AC
blue > = left eat BC
blue square= left ear air masked
blue ] = left ear bone masked

Question 21

4 categories for degree of hearing loss

Answer 21

mild, moderate, moderately severe, and profound

Question 22

STUDY RANGES FOR EACH CATEGORY OF HEARING LOSS

Answer 22

slide 44

Question 23

air-bone gap

Answer 23

difference of greater than 10 dB between air conduction thresholds and bone conduction thresholds
describes conductive and mixed losses

Question 24

false positives

Answer 24

the person responds when there is no tone

Question 25

inconsistent response

Answer 25

the person responds at 5 dB one time and 10 dB the next time, etc

Question 26

masking

Answer 26

presenting a signal to one ear to mask the ability to respond when a signal is presented to the opposite ear
-looking to get a true threshold for the test ear

Question 27

crossover

Answer 27

signals presented to one ear can be transmitted via bone or air conduction to the other ear

Question 28

interaural attinuation

Answer 28

blocks some of the sound that is being transferred from one ear to the other

Question 29

bone conduction IA

Answer 29

is always zero

-crossing hearing is not possible

Question 30

insert headphones IA

Answer 30

70 and cross over hearing is possible

Question 31

supra-aural earphones IA

Answer 31

40 and cross over is possible

Question 32

formula for figuring out cross over

Answer 32

dB presented to test ear - IA of transducer = dB heard in non-test ear
IF the dB heard in the non-test ear is above the bone-conduction threshold of the non-test ear, crossover occurred and we need to mask

Question 33

masking for bone conduction

Answer 33

when there is a 15 dB or greater gap between air and bone conduction thresholds

Question 34

how to mask

Answer 34

use narrow band noise for pure tones; speech noise for speech
noise presented to the non test ear by air conduction
level of noise depends on air conduction threshold of the non-test ear

Question 35

procedure for masking

Answer 35

• establish unmasked thresholds
• put masking noise at 5 dB above the air conduction threshold of the non-test ear
• re-measure threshold in the test ear. increase 5 dB if no response until a response is obtained
• add 5 dB of noise and re-meaure threshold in test ear
• continue adding 5 db of noise and measuring threshold in test ear until you have added 15 dB of noise with no change in threshold of test ear