Basic Audiology Review Flashcards
What is the function of the outer ear?
Protect ME and IE from foreign bodies
Amplify high frequency sounds via Pinna
Provide cues to assist in localization of sound
Difference between infant and adult ET
Infant: shorter and wider and more horizontal plane
Causes more ear infections
What happens when air pressure is equal on both sides of the tympanic membrane (TM)?
The movement of the TM is maximized.
What does the Eustachian Tube (ET) do?
The ET maintains atmospheric pressure in the middle ear space.
How often does the ET open when awake?
Once a minute.
How often does the ET open when sleeping?
Once every 5 minutes.
How does the middle ear function?
mechanical fashion, carrying vibrations to the inner ear via the ossicles.
What type of system is the inner ear described as?
The inner ear is a hydromechanical system.
It converts mechanical vibrations into neuroelectrical impulses.
What is the role of the inner ear in hearing?
transduces energy into neuroelectrical impulses
transmits sound to the brain via the auditory nerve.
Fill in the blank: The outer ear resonates at particular _______.
frequencies
True or False: The middle ear transmits sound to the brain directly.
False
The middle ear transmits vibrations to the inner ear, which then sends signals to the brain.
What is the first step in the auditory process?
Sound is collected and funneled into the EAC
What role does the stapes play in the auditory process?
stapes taps the OW increasing sound energy to cause movement in the inner ear
What is the function of the middle ear?
impedance matching system
allows sound to flow from the air-filled ME cavity to the fluid-filled lE cavity
boosts volume
What is the traveling wave in the auditory process?
Moves along the basilar membrane and displaces the area where the specific frequency is ‘tuned’: tonotopic
How is auditory information transmitted to the brain?
by way of the auditory pathway - tonotopic as well
Auditory Nervous system characteristics
Primarily afferent from cochlea to brain
Info processed binaurally
-loss in right ear more difficulty with language b/c language is critical in left cortex
What is the hallmark of audiology?
Assessment of hearing sensitivity
What is sensitivity
The capacity of a sense organ to detect a stimulus
Quantified by determining the threshold of audibility
What is absolute threshold
Threshold of audibility
lowest intensity level which an acoustic signal is detected 50% of the time
What is the audiogram measured in?
DB hearing level,
Octave or mid-octave intervals
125-8000 Hz
What is audiometric zero?
The SPL at which the threshold of audibility occurs in average normal listeners
0 dB
Ways an audiogram can be obtained
Pure tone audiometry
Bone conduction testing
Sound field testing
Play audiometry
Speech testing
How are pure tones delivered to the ears?
Air and bone conduction testing
Air versus bone conduction
Air tests the hearing throughout the entire ear
Bone bypasses the outer and middle ear and ONLY tests the cochlea up to the auditory nerve
What can sound field testing be used for?
Verify hearing aid, cochlear implant and other ALD’s
Test infants and young children
What type of hearing loss can sound field testing miss
Unilateral because it is not ear specific
What does VRA stand for?
Visual Reinforcement Audiometry
What is the purpose of Visual Reinforcement Audiometry (VRA)?
To assess hearing in infants and toddlers too young for normal tests
What age group is VRA designed for?
Children aged 6 months to around 2 to 3 years
How does VRA work?
It relies on behavioral conditioning to train very young kids to respond to sounds
What types of visual reinforcers are used in VRA?
Video animations or lighted toys
True or False: VRA can use earphones.
True
Fill in the blank: VRA is designed for children aged 6 months to around _______.
2 to 3 years
What is Conditioned Play Audiometry (CPA)?
A method of hearing assessment that occurs in a soundproof isolated booth
CPA is designed to engage children in a playful manner while testing their hearing.
What are the two parts of Conditioned Play Audiometry?
- Conditioning
- Screening
These two components help in effectively assessing a child’s hearing ability.
What is the purpose of the conditioning phase in CPA?
To use a game or toy to indicate a response from the child
The child is asked to place a block in a basket each time she hears a beep.
In the conditioning phase, what task is the child asked to perform?
Place the block in a basket every time she hears the beep
This helps the child associate the sound with a physical action.
What happens once the child understands the game during CPA?
Testing can begin
The audiologist works with the child to perform the task as quickly as possible.
What occurs during the screening phase of CPA?
The audiologist reduces the intensity of the sound until the child’s minimum hearing threshold is achieved
This phase continues testing different frequencies.
What is the goal of screening in Conditioned Play Audiometry?
To achieve a complete set of data about hearing in both ears
The audiologist tests various frequencies to gather comprehensive hearing information.
True or False: Conditioned Play Audiometry can be conducted in a noisy environment.
False
CPA takes place in a soundproof isolated booth to ensure accurate results.
What is tympanometry
Graphic representation of impedance and air pressure of middle ear
Mobility of TM
How is compliance plotted on the tympanogram
Vertically
When does maximum compliance occur in the middle ear?
pressure in me is equal to the pressure in the eac
Where is pressure indicated on the tympanogram?
Horizontal axis
What type of probe used for tympanogram
226 Hz for anyone over 6 months
1000 Hz under 6 months
Parameters of tympanogram
Peak pressure
Width
Static immittance
ECV
Shape
Important for SLP ECV, shape and peak
Type A tympanogram
Indicates normal middle ear fucntion
Type B tympanogram indicative of
Middle ear pathology
Fluid in ear, infection behind TM or perforation (PE tubes)
Large ECV on Type B tympanogram
Indicates perforation or PE tubes
Larger than 2.5 is a red flag
Type C tympanogram is indicative of…
Negative pressure within the ME
Consistent with sinus or allergy congestion, end stages of cold or OM, can be exposed to second had smoke
What is Speech Audiometry used to assess?
Word understanding
It is part of a routine hearing test and verifies hearing aid (HA), cochlear implant (CI), or assistive listening device (ALD) benefit.
How is Speech Audiometry results expressed
As a percent correct
This is obtained for each ear using phonetically balanced (PB) monosyllabic words.
What type of words are used in Speech Audiometry?
Phonetically balanced monosyllabic words
These are age-appropriate word lists.
What is the recommended presentation method for Speech Audiometry?
Recorded presentation
This method is standardized, though monitored live voice presentation may also be used.
What is the typical length of word lists used in Speech Audiometry?
25-50 words
Testing may stop after 10 words if all are correct.
At what volume level is the speech presented during Speech Audiometry?
At a comfortable, suprathreshold level
This ensures that the test is effective for the individual being assessed.
True or False: Speech Audiometry can only be used for children.
False
It is used for individuals of all ages, as long as age-appropriate word lists are utilized.
Fill in the blank: Speech Audiometry is typically obtained for each year using _______.
Phonetically balanced (PB) monosyllabic words
What is the purpose of using age-appropriate word lists in Speech Audiometry?
To ensure valid assessment of word understanding
This makes the test relevant to the individual’s developmental level.
What happens if all 10 words are correct in a Speech Audiometry test?
Testing may stop
This allows for a more efficient assessment process.
What does OAE reveal
Abnormalities in the inner ear
Identifies cochlear function
When is OAE used
Newborn hearing or early intervention screening
What does OAE rule out
Anything more than mild hearing loss in speech frequencies if PASS
What are otoacoustic emissions (OAEs)?
Sounds given off by the inner ear when the cochlea is stimulated by a sound
OAEs are produced when the cochlea’s outer hair cells vibrate in response to sound.
What happens when sound stimulates the cochlea?
The outer hair cells vibrate, producing a nearly inaudible sound that echoes back into the middle ear
This echo can be measured with a small probe inserted into the ear canal.
Who produces otoacoustic emissions?
People with normal hearing
Those with hearing loss greater than 25-30 decibels do not produce these soft sounds.
What does the absence of OAEs indicate?
Hearing loss greater than 25-30 decibels
OAEs disappear in individuals with significant hearing loss.
What is the purpose of the OAE test?
It can detect blockage in the outer ear canal
presence of middle ear fluid
damage to outer hair cells.
What additional test can help determine if there is a middle ear problem?
Tympanometry
Tympanometry can help rule out middle ear issues.
True or False: Individuals with hearing loss can produce OAEs.
False
Individuals with hearing loss greater than 25-30 decibels do not produce OAEs.
Fill in the blank: OAEs are measured with a small probe inserted into the _______.
ear canal
This measurement helps in assessing the function of the cochlea.
What is the primary use of otoacoustic emissions testing?
To screen newborns and infants up to 90 days old
Otoacoustic emissions testing helps identify potential hearing issues early in life.
Up to what age is OAE testing sometimes used to identify hearing problems in children?
Up to four years of age
This is particularly relevant for children with delayed speech or language disorders.
Who can benefit from OAE testing aside from newborns?
Kids with developmental disabilities
those who don’t tolerate other types of hearing tests
What condition of the patient allows the OAE test to be performed?
If the patient is still or sleeping
This ensures accurate results as movement can affect the test outcome.
What if get REFER on OAE and Type B tympanogram
Refer is middle ear dysfunction, refer to medical
What if get REFER on OAE and Type A tympanogram
Refer to audiologist
tympanometry shows normal middle ear
but cochlear damage on OAE
What does Auditory Brainstem Response (ABR) test for?
evaluate the the hearing nerve and brainstem pathways
Is Auditory Brainstem Response (ABR) testing invasive?
No, it is non-invasive
What is used to perform ABR testing?
Recording electrodes placed on the forehead and ears
Who may benefit from ABR testing?
Infants, developmentally delayed individuals, and others as needed
What conditions may indicate the need for ABR testing?
Neurological signs, symptoms, or complaints suggesting hearing loss in the brain or a brain pathway
What is required from the patient during ABR testing?
No response; the patient can rest quietly or sleep
Is ABR testing behavioral?
No, it is not behavioral
How is ABR used in newborn hearing screening programs?
As a screening test where only one intensity level is checked
What are the possible outcomes of the ABR screening test in newborns?
The baby either passes or fails the screen
How is ABR testing completed
Place 4 electrodes on head
Each side of earlobe
One on forehead and one on top of head
Prep using alcohol
Sound introduced in earphones
Electrical activity generated by hearing nerve and brainstem pathways in response to clicking noise
Recorded with electrodes and fed to computer
Know ABR diagram
