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SPPA 461 - Basic Audiometry > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

What range of frequencies can humans hear?

A

20 - 20,000 Hz

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2
Q

1 Hertz = 1 ____ per _____

A

cycle/second

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3
Q

What range of intensity/pressure levels can humans hear?

A

0 - 120 dB

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4
Q

What is the period of a sound?

A

The time the wave takes to complete one cycle.

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5
Q

How are frequency and period relateed?

A

Indirectly

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6
Q

Pitch

A

Psychological correlate of frequency

  • Measured in mels
  • Directly related to frequency
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7
Q

Loudness

A

Psychological correlate of intensity/pressure

  • Measured in phons/sones
  • Directly related to intensity/pressure
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8
Q

Simple sounds

A

Frequency specific (only one frequency)

Ex: puretones

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9
Q

Complex sounds

A

Many frequencies

Ex: speech and noise

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10
Q

Complex periodic sounds

A

Has fundamental frequency

  • All other tones are harmonics of it
  • Ex: voiced speech sounds
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11
Q

Complex aperiodic sounds

A

No fundamental frequency or harmonics

  • Ex: voiceless speech sounds
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12
Q

What is the purpose of puretone audiometry?

A

To determine:

  1. degree and
  2. type

of hearing loss.

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13
Q

What are the two types of measurement in puretone audiometry?

A
  1. Air conduction threshold
  2. Bone conduction threshold
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14
Q

Conductive vs. sensorineural vs. hybrid hearing loss

A
  • Conductive: outer and/or middle ear
  • Sensorineural: inner - cochlea and/or nerve
  • Hybrid: both
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15
Q

What is the purpose of speech audiometry?

A

To validate puretone audiometry

  • More power/validity since we hear speech in real life

For accurate differential diagnosis

  • Where the problem is in the ear
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16
Q

What are the two measurements in speech audiometry?

A
  • Speech reception threshold

Speech discrimination score

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17
Q

What is the purpose of tympanometry?

A

To objectively (no patient participation) assess the middle ear function

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18
Q

Tympanogram

A

Graphical plot of the eardrum mobility at different air-pressure values

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19
Q

Behavioral Observation Audiometry (BOA)

A

Subjective assesment for ~6 mos - 3 yrs population

  • Sounds presented through speakers
  • Effective with visual reinforcement (must be able to turn their head)
  • Tests localization
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20
Q

Play audiometry

A

Subjective assessment for 3-5 population

  • For a/c and b/c threshold assessment
  • Play a game where child completes a task after each sound
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21
Q

Otoacoustic Emissions (OAEs)

A

Objectively evaluate the inner ear/cochlear (OHC) function

  • Very fast - <5 min/ear
  • Present clicking sounds, read echoes coming away from hair cells, look @ amplitude
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22
Q

Auditory Brainstem Response (ABR)

A

Objectively evaluates auditory nerve & brainstem function

  • Preceded OAEs
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23
Q

Immittance Audiometry

A

Objective assessment that preceded ABR

  • Directly evaluates middle ear status
  • Indirectly evaluates inner ear status (stapedius function)
  • Includes tympanometry
24
Q

Audiogram

A

Graphical plot of a/c & b/c thresholds across puretone frequencies

25
Q

Audiometer

A

Electronic device for hearing assessment

26
Q

Audiometry

A

Procedure for hearing assessment

Ex: speech or pure tone

27
Q

Hearing Threshold Level (HTL)

A
  • Lowest level you can hear 50% of the time (2/4)

OR

  • lowest level you can hear 3 out of 4 times

OR

  • Lowest level you can hear 3 repeated times
  • Whichever comes first*
28
Q

External/Middle ear function

A

Conducts sounds to the inner ear

29
Q

Inner ear function

A

Sound analysis & discrimination

  • does complex Fourier analysis
30
Q

Air Conduction Audiometry: device

A

Pure tone Audiometer

31
Q

Air Conduction Audiometry: purpose

A
  • Obtain a/c thresholds across audiometric frequencies
  • Compute pure tone average (PTA)
  • Compute degree/extent of hearing loss
32
Q

Air Conduction Audiometry: procedure

A
  • Frequency sequence: 1, 2, 4, 8, 0.25, 0.5, and 1 kHz
  • Initial intensity dial setting: 30 dB
  • Starting ear: better ear or right ear
  • Threshold level: 50% correct or 3 repeated responses
33
Q

Air Conduction Audiometry: symbols for plotting a/c thresholds

A
34
Q

The pure tone average (PTA) tells you the _____ of hearing loss.

A

degree

35
Q

PTA (PTA1)

A

Average of a/c thresholds at 500, 1000 & 2000 Hz

36
Q

PTA2

A

Average of a/c thresholds at 1000, 2000, and 4000 Hz

37
Q

Two Frequency Average/Fletcher Average

A

Average of best a/c thresholds @ two frequencies between 500, 1000 and 2000 Hz

38
Q

Hearing loss classifications for children 5 and under

A

0-15 dB HTL - Normal

16-30 dB HTL - Mild

31-50 dB HTL - Moderate

51-80 dB HTL - Severe

>81 dB HTL - Profound

39
Q

Hearing loss classifications for children older than 5 & adults

A

0-25 dB HTL - Normal

26-40 dB HTL - Mild

41-55 dB HTL - Moderate

56-70 dB HTL - Moderate-Severe

71-90 dB HTL - Severe

>91 dB HTL - Profound

40
Q

When do we test mid-octive frequencies?

A

When the difference between two octaves tested (e.g., 1,000 and 2,000 Hz) is ≥20 dB

41
Q

What is the maximum acceptable difference between test-retest thresholds?

A

10 dB

42
Q

Symbols for plotting bone conduction threshold levels

A

masked are brackets []

43
Q

Procedure for audiometric threshold

A

Start @ 30 dB:

  • If correct, do down 10 up 5:
    • If correct, go down 10
    • If that’s incorrect, go up 5
    • Continue until you reach threshold
  • If no response, go to 50 dB
    • Move up in 10 dB steps until you get a response
    • When you get a response, do down 10 up 5 procedure until you get threshold
44
Q

What is the purpose of bone conduction audiometry?

A
  • Evaluates the inner ear status
  • Helps us make a differential diagnosis of the site of pathology
45
Q

Procedure for bone conduction audiometry

A
  • Test at 1, 2, 4, .25 and .5 kHz (no retest)
  • Start at 30 dB
  • Placement: mastoid
46
Q

Normal B/C thresholds

A
  • 0-5 yrs: 0 to 15 dB across 250-4,000 Hz
  • 5+ yrs: 0 to 25 dB across 250-4,000 Hz
47
Q

How will a/c and b/c thresholds differ for people with sensorineural, conductive, or mixed hearing loss?

A
  • Sensorineural: a/c and b/c both abnormal, equally affected
  • Conductive: a/c normal, b/c abnormal
  • Mixed: a/c and b/c both abnormal, a/c worse (passes through two damaged areas)
48
Q

What is Interaural Attenuation (IA)?

A

AKA cross hearing. Refers to loss of sound energy as test travels from the test ear to the nontest ear

  • for A/C, IA = 40 dB
  • for B/C, IA = 0 dB (no loss of energy)
49
Q

When & how much masking: air conduction

A

Mask if:

  • unmasked AC threshold in the test ear - 40 dB (IA) ≥ the unmasked BC threshold in the non-test ear

How much:

  • Minimum masking = unmasked AC threshold in the nontest ear
50
Q

When & how much masking: bone conduction

A

Mask if:

  • Air-Bone gap in the test ear ≥ 10 dB

How much:

  • Minimum masking = Unmasked AC threshold in the non-test ear + Occlusion Effect (freq. dependent)
51
Q

When do we use the occlusion effect?

A

With normal or sensorineural loss.

52
Q

Puretone audiometric criteria for Normal Hearing

A
  • A/c & b/c within 15 or 25 dB (age dependent)
  • A/c = b/c
  • Air-bone difference ≤ 10 (clinically insignificant)
53
Q

Puretone audiometric criteria for Conductive Loss

A
  • B/c = normal
  • A/c = abnormal
  • A/c ≠ B/c
  • Air-bone difference > 10 (clinically significant)

Ex: otitis media

54
Q

Puretone audiometric criteria for Sensorineural Loss

A
  • A/c = abnormal
  • B/c = abnormal
  • A/c = B/c
  • Air bone difference ≤ 10 (clinically insignificant)

Ex: Presbycusis (age-related sensorineural loss)

55
Q

Puretone audiometric criteria for Mixed Loss

A
  • A/c = abnormal
  • B/c = abnormal
  • A/c ≠ B/c
  • Air bone difference > 10 (clinically significant)

Ex: Presbycusis + otitis media

56
Q

ASHA guidelines for hearing screening

A
  • 1, 2, and 4 kHz at 20 dB HL
  • Criteria: child fails if he/she fails to respond @ any frequency in either ear

SPPA 461 - Basic Audiometry (3 decks)

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