class review questions Flashcards
PBmax
highest percent correct score
-the best they can do
what are the 3 components of evidence based practice?
client perspective, clinical experience and external scientific evidence
word recognition score (WRS)
percent correct of a given word list at a supra threshold level
-PBmax, discrimination
-presented above threhsold
how are WRS used diagnostically?
site of lesion testing (cochlear vs. retrocochlear) and can compare over time
-only if tested correctly
how are WRS used for treatment?
sense of the impact of hearing loss on speech understanding, monaural vs. binaural amplification, unaided vs. aided, and CI candidacy
speech materials for WR testing
single words (monosyllabic)
-phonetically balanced
-often with carrier phase
-homogeneous
-closed or open set
what does it mean to say a word list is phonetically balanced?
the word list encompasses all the sounds of language
closed set vs. open set
closed set - choices are limited, single digits, familiarized
open set - choices are one of many words with no context, not familiar, single syllable words
what type of set is easier (meaning there is a higher percent correct score)?
closed set
how is a word recognition test administered ?
how to determine the starting level for WRS
what is the highest level we will present for WRS
100 dB
-if exceeds this, we find UCL and present 5 below that number
-if it comes in at 100, check to see if too loud and if it is bump off 5
why is a word recognition test not a test of communicative function?
overestimate
underestimate
how does a speakers voice affect WRS?
better scores with male voices than female voices
-within lab setting
what does it mean when we say we are concerned about variability for WRS?
we want to make sure our scores are reliable
-if they are highly variable that is not useful
how does decreasing the size of the word list increase variability?
the shorter the word list, the greater the variability (decreased reliability)
regardless of word list size, which of the following has greater or less variability : 0, 44, 60, 100%?
44% and 60% have greater variability ; 0 and 100 have less variability
how is the rollover index (RI) calculated
RI = (PBmax - PBmin) / PBmax
what is a significant rollover index?
greater than .25
what does a a high or low rollover index tell us?
low : tell’s us NH, CHL, SNHL (cochlear)
high : tell’s us retrocochlear
what is a quick way to screen for rollover?
why is a single-level percent correct score a weak indicator of a retrocochlear parthology?
it is using 1 ear at 1 level
what type of testing does immittance testing encompass
tympanometry, ear canal volume measurement, acoustic reflex testing and eustachian tube function tests
what structures are assessed using immittance measures
tympanic membrane, middle ear space (including ossicles) and middle ear reflex (ME, cochlea, auditory nerve, brainstem pathways, facial nerve)
what are the components of an immittance meter
probe/probe tip, probe signal generator, microphone and air pressure signal
how is immittance testing conducted
based on the idea that changing the pressure in the ear canal and measuring sound levels within the canal
what is tympapnometric peak pressure measuring? will it shift along the x or y axis? adult norms? which structure will affect this measurement if not functioning properly?
-measuring the pressure point where the middle ear system is most efficient
-will shift right or left (X)
-(-100) to +50
-eustachian tube function
what is static admittance measuring? will this shift along the x or y axis? adult norms? which structure will affect this measurement if not functioning properly?
- measuring stiffness vs. floppiness of the system
-will shift up or down (Y)
-0.3 to 1.7
-ossicular chain and the tympanic membrane function
what is ear canal volume measuring? what affects this measure? what are adult norms for ear canal volume?
what is tymapnogram width? what are adult norms for tymapnogram width? what is one condition that would likely result in an abnormally large tymapnogram width?
which muscle is involved with MEMR in humans?
stapedius muscle
what are the two clinical uses of the MEMR/ASR?
cross check of behavioral testing and to differentiate site of lesion
parts of the stapedial reflex pathway
middle ear, cochlea, 8th nerve,
brainstem (VCN, MSO), CN 7
what measurement from the tympanogram changes in the ASR?
peak admittance
what is the minimum amount of change in this measurement that would be considered a reflex?
0.02
-this is the minimum amount, so anything greater than or equal to this
-we want to be the closest we can to this number
what are the 5 criteria for a reflex?
lowest level for change (0.02), time locked to stimulus onset, replicability, growth, reflex is stronger the further you go above threshold, decrease in admittance and these things can be achieved in any order
how is the test administered?
-do tymp first
-present around 80 dB HL, increase in 5 dB steps as needed until you get an admittance greater than or equal to 0.02
-check for replicability
-increase an additional 5 dB to check for growth
what is considered a normal ASR?
70-90 dB
