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Audiology > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

What is the “normal” hearing range in children?

A

-10 to 15

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2
Q

What is the “Normal” hearing range in adults?

A

-10 to 25

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3
Q

What is the “slight” hearing loss range in children

A

16 to 25

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4
Q

The range for mild hearing loss

A

26 to 40

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5
Q

The range for moderate hearing loss

A

41 to 55

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6
Q

The range for moderately severe hearing loss

A

56 to 70

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7
Q

The range for severe hearing loss

A

71 to 90

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8
Q

The range for profound hearing loss

A

> 91

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9
Q

On an audiogram, this means it is conductive hearing loss

A

Normal bone conduction, impaired air conduction and a greater than 10dB difference

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10
Q

On an audiogram, this means it is sensory/neural hearing loss

A

Impaired bone conduction, impaired air conduction and less than or equal to 10 dB difference.

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11
Q

On an audiogram, this means it is mixed hearing loss

A

Impaired bone conduction, impaired air conduction and a greater than 10 dB difference.

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12
Q

Graphic representation of audiometric findings showing hearing thresholds as a function of frequency

A

Audiogram

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13
Q

Generally speaking, what is an audiogram testing?

A

How soft of an intensity at different frequencies can someone just be able to hear

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14
Q

List the information that an audiogram provides

A
  1. Degree of hearing loss
  2. Type of hearing loss
  3. Configuration of hearing loss
  4. Inter-aural symmetry
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15
Q

What is inter-aural symmetry?

A

How the ears compare to each other. Is the hearing loss the same or different in each ear? Is it bilateral?

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16
Q

To find degree of hearing loss you…

A

Put the earphones on and present various frequencies at various intensities and try and find the softest intensity at a certain frequency a person can hear.

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17
Q

The auditory nervous system is primarily a ____ system.

A

Afferent. Away from the Cochlea.

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18
Q

The auditory nervous system is _______. Meaning the right ear goes to the left cortex and the left ear goes to the right cortex.

A

Functionally crossed

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19
Q

(start of the auditory pathway)

_____ leave the _____ in an ______ and ______ at the _______

A

NEURONS leave the COCHLEA in an ORDERLY FASHION and then SYNAPSE at the LOWER BRAINSTEM

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20
Q

(also start of the auditory pathway)

_____ exit the _____ and then move ______ toward the ______

A

NERVE FIBERS exit the COCHLEA and then move CENTRALLY toward the MODIOLUS

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21
Q

This is where the cell bodies for the spiral ganglion

A

Modiolus

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22
Q

This is the central core of the Cochlea

A

Modiolus

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23
Q

After the cell bodies form the spiral ganglion, they then form _______

A

The cochlear branch of the auditory (VIII) nerve

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24
Q

Where are the nerve fibers from the apical turn of the cochlea located?

A

The middle of the bundle of the auditory nerve aka CN8

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25
Q

Where are the nerve fibers from the basal end of the cochlea located?

A

On the outside of the bundle of CN8 (The auditory nerve)

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26
Q

Why are the nerve fibers from the basal end and the apical end separated?

A

It keeps low frequency information together and High frequency information together

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27
Q

What is tonotopic arrangement?

A

The spatial representation of the frequency layout of the cochlea in retrocochlear structures

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28
Q

The auditory pathway goes from the ______ to the ______

A

Cochlea; auditory cortex

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29
Q

Nerve fibers from the cochlea pass through the ______

A

Internal Auditory Canal

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30
Q

Where does the internal auditory canal begin and terminate?

A

It begins at the cochlear modiolus and terminates at the base of the brain

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31
Q

The nerve fibers of the vestibular portion of the VIII cranial nerve are innervated by

A

the utricle, saccule, and semicircular canals

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32
Q

Other than CN8, what passes through the internal auditory canal?

A

The facial nerve and the internal auditory artery

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33
Q

How many cochlear neurons carry info to the brain?

A

30,000

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34
Q

After passing through the internal auditory canal, where does CN8 attach?

A

To the brainstem, at the cerebellopontine angle

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35
Q

This is where the cerebellum, medulla and pons are located

A

The cerebellopontine angle

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36
Q

CN8 attaches to the cerebellopontine angle, what happens here next?

A

The auditory and vestibular portions of VIIIth CN separate

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37
Q

One part of the cochlear bundle descends to the ______ and the other ascends to the ______

A

Dorsal cochlear nucleus; ventral cochlear nucleus

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38
Q

After separating from the vestibular portion of CN8, all nerve fibers move _____ into the ______

A

ipsilaterally; cochlear nucleus

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39
Q

Nerve fibers may pass from the _________ to the _______

A

Ventral Cochlear Nucleus; reticular formation

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40
Q

This is the center of the brainstem that communicates with just about all areas of the brain.
Considered a primary CNS control center

A

Reticular formation

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41
Q

From the cochlear nuclei, about ___ percent of nerve fibers ___ to the _____ side of the brain to the _____

A

75%; crossover; contralateral; Superior Olivari Complex

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42
Q

What is done in the Superior Olivary Complex?

A

Sound localization &

Control of the reflex muscles of the middle ear is regulated here (tensor tympani and stepedial muscles)

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43
Q

The point at which the crossover to the superior oliveri complex happens is called the…

A

Trapezoid body of the pons

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44
Q

From the superior oliveri complex, neurons proceed to…..

A

The lateral lemniscus

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45
Q

The lateral lemniscus is a major pathway for…

A

The transmission of impulses from the lower brainstem

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46
Q

This area receives ipsilateral and contralateral impulses from the lateral lemniscus as well as the superior oliveri complex

A

The inferior colliculus

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47
Q

The last subcortical relay station

A

The medial geniculate

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48
Q

After the medial geniculate, impulses ______ in ____ to the _____ in the ______

A

fan out; auditory radiations ;auditory complex; temporal lobe

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49
Q

CCSLIMA is

A

Cochlea, Cochlear nerve, Superior olivary complex, lateral lemniscus, inferior colliculus, medial geniculate, Auditory complex

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50
Q

Where is the primary auditory complex located? What is another name for the area?

A

Superior surface of the temporal lobe; Heschels gyrus

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51
Q

what kind of organization/ representation is seen in the primary auditory complex?

A

Tonotopic arrangement/ selective representation of frequency

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52
Q

Where does processing of speech information occur?

A

Throughout the central auditory system

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53
Q

Primary location for processing speech

A

left temporal lobe (for most)

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54
Q

white matter that connects the left and right hemispheres of the brain

A

Corpus callosum

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55
Q

The dominant ear for processing speech is ____. Why?

A

The right ear. The left temporal lobe is where speech is processed for most people. Speech information travels contralaterally from the right ear to the left temporal lobe. Information from the left ear has further to go since it will be sent to the right hemisphere then have to travel through the corpus callosum to the left.

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56
Q

Explain the efferent system

A

Parallels the afferent system but in reverse from the brain to the cochlea. Some end at the medial geniculate, some continue on to Inferior colliculate and the lateral lemniscus, Project ipsilaterally and contralaterally. Olivocochlear bundles come from the Superior olivary complex and run down the internal auditory canal and end at the inner and outer hair cells of the organ of corti

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57
Q

Processing in the auditory system occurs ___ and ____ the ____ and _____ tracts

A

up; down; afferent; efferent

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58
Q

Vestibular Schwannoma

A

Neoplasms Usually; unilateral;
Begins in IAC (internal auditory canal) and may grow out into cerebellopontine angle;
Very slow growing
Usually benign

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59
Q

What are two early signs of vestibular schwannoma?

A

Facial numbness

tinnitus with no hearing loss

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60
Q

What are 4 symptoms of vestibular schwannoma?

A

Facial numbness
Tinitus
HL
Vertigo

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61
Q

Name 5 tests for Vestibular schwannoma

A 
PET scan
CAT scan 
MRI
Basic audiologic test battery
ABR
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62
Q

What is the go to test for vestibular schwannoma?

A

ABR

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63
Q

What is ABR?

A

specialized objective test an audiologist would use to look at latency times of CNVIII and relay stations

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64
Q

What is used to treat smaller vestibular schwannomas? Larger?

A

Gamma knife, Cyber knife (3-5 treatments); surgery for larger

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65
Q

Inflammation of CNVIII

HL, some vertigo

A

Acoustic neuritis

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66
Q

Plaque swarm on nerves in your body and slow the transmission down
Can affect CNIII translation of stimuli

A

Multiple sclerosis

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67
Q

Normal outer hair cell function but absent CNVIII responses.
When otoacoustic emissions testing is done there are responses (otoacoustic emissions) but when hearing evaluation is done there is at least moderate HL.

A

Auditory neuropathy spectrum disorder

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68
Q

Bile deposits in the CNS and that includes the cochlear nuculi.
Product of the liver
Results in degeneration of the nerve cells coming in contact with that bile.

A

Kernicterus

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69
Q

Could cause damage to cochlear nuclei

A

Cerebra vascular accident (stroke)

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70
Q

Deprivation of oxygen and blood supply to the cochlear nuclei

A

Anoxia

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71
Q

Syndrome that is linked to learning disabilities

Mild hearing loss that occurs from chronic OM affects speech and language skills.

A

Minimal auditory deficiency syndrom

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72
Q

Explain Central Auditory Processing Disorder

A

Difficulty understanding speech when there is background noises present in the environment.
There is no hearing loss.
Not ADHD but could have ADHD along with CAPD
No intellectual difficulties or disabilities.
Delays in speech and language, learning to read, and spelling.

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73
Q

What are some risk factors of CAPD?

A 
prematurity
History of chronic OM
CMV
Metabolic disorders
Family history
Meningitis
Lime disease
74
Q

What are the 4 SCAN screening subtests?

A

Random Gap Detection
Filtered words
Auditory figure ground subtest
Competing word free recall

75
Q

Scan subtests where there are 2 beeps very close together, ask if they hear 1 or 2. screens for timing/ processing disorders

A

Random Gap detection

76
Q

monaural test of degraded speech with single syllable words

A

Filtered words

77
Q

Monosyllabic words are presented within the background noise

A

Auditory figure ground subtest

78
Q

A different word presented to each ear simultaneously, child instructed to repeat words in any order

A

Competing word free recall

79
Q

How many sub-tests do they need to not pass in order to continue with test battery?

A

1

80
Q

different word presented to each ear simultaneously; but child has to say one word first as directed “Repeat the word you hear in the right ear first then the left”

A

Competing words directed ear

81
Q

2 sentences presented at same time to each ear, instructed to repeat only one sentence depending on which ear is being tested

A

Competing sentence test

82
Q

60%-time compressed stimulus (20 sentences in the right ear and then 20 sentences in the left ear) then asked to repeat the sentence at a regular rate

A

Time compressed sentences

83
Q

Recorded test with words repeated multiple times over 15 minutes and every time they hear ”dog” they raise their hand

A

Auditory continuous performance test

84
Q

Dichotic with words in a sentence being alternated ear to ear “I (left ear) love (right ear) to (left ear) play (right ear) outside (left ear)”

A

Rapidly alternating speech perception

85
Q

Patient has to respond with the duration descriptions, “long, short, long”, “short, short, long”, “long, short, short”

A

Duration pattern sequence

86
Q

What are the 2 ways sound can be defined?

A

psychologically and physically

87
Q

What is the psychological definition of sound?

A

An auditory experience

88
Q

What is the physical definition of sound?

A

A series of disturbances of molecules within and propagated through an elastic medium (air, liquid, solid)

89
Q

Sound is a ___ ____ transmitted by ___ ___ through a _____

A

Sound is a VIBRATORY ENERGY transmitted by PRESSURE WAVES through a MEDIUM

90
Q

Hearing is the _____ of sound

A

perception

91
Q

What happens when air molecules are set into motion?

A

They bounce off nearby molecules ten, because of their elasticity, return to their original resting place

92
Q

What is it called when all molecules are pushed closely together?

A

Condensation (compression)

93
Q

What is it called when all the molecules are spread out?

A

Rarefaction (spaces between condensation)

94
Q

This is a graphic representation of compression and rarefaction graphed as a function of time

A

Sine Wave

95
Q

A cycle is…

A

one complete compression and rarefaction

96
Q

When a variety of frequencies are occurring together

A

Complex waves

97
Q

What are complex waves?

A

When a variety of frequencies are occurring together

98
Q

Sound can be characterized by….

A

its intensity and frequency

99
Q

Related to the perception of loudness

A

Intensity

100
Q

This is a unit of power

A

Bel

101
Q

Relative unit of measure of intensity

A

Decibel (1/10 of a bel)

102
Q

What are the 5 important aspects of decibel?

A
  1. calculation involves a ratio.
  2. uses a logarithm
  3. it is non-linear
  4. Several reference levels which must be specified
  5. It is a relative unit of measure
103
Q

What is dB IL?

A

intensity level

104
Q

What is dB SPL?

A

Sound pressure level; what we hear in everyday life

105
Q

What is dB HL?

A

Hearing level

106
Q

When is dB HL used?

A

Only used when you are talking about hearing evaluations with an audiometer.

107
Q

The human ear is more sensitive to…

A

Speech Frequencies

108
Q

Why does the audiometer have different intensities?

A

In the hopes of obtaining a person’s threshold

109
Q

What is dB SL?

A

Sensation level

110
Q

This is related to perception of pitch

A

Frequency

111
Q

How is frequency measured?

A

of complete oscillations per unit of time (usually one second)

112
Q

What 2 units are used to measure frequency?

A

cps or Hz

113
Q

As wavelength ____ , frequency _____.

A

As wavelength decreases, frequency increases

114
Q

As mass ______ , frequency _____.

A

As mass increases, frequency decreases.

115
Q

What is considered low frequency in Hz?

A

below 1000 Hz

116
Q

What is considered “middle of the road” frequency in Hz?

A

1000Hz

117
Q

What is considered high frequency in Hz?

A

2000Hz and above

118
Q

What frequency range is speech?

A

500-2000Hz

119
Q

audiometer

A

An electronic instrument used to quantify hearing

120
Q

What kind of tone does an audiometer produce?

A

Pure tone

121
Q

What are the two types of audiometers?

A

Diagnostic and Screening

122
Q

This type of audiometer can deliver speech signals either recorded or via microphone?

A

Diagnostic Audiometer

123
Q

This audiometer can produce masking

A

Diagnostic audiometer

124
Q

What are the 3 main components of audiometers?

A

Oscillator, Attenuator, and interrupter switch

125
Q

This generates pure tones at specific frequencies in audiometers

A

Oscillator

126
Q

This controls the intensity level of the signal in audiometers

A

Attenuator

127
Q

This is what presents and controls the duration of a signal in audiometers

A

Interrupter Switch

128
Q

Name 3 transducers

A

Insert earphones, supra-aural earphones, and bone oscillator

129
Q

What is a sound level meter?

A

An electronic instrument used to measure environmental sound intensity

130
Q

Why would a client require a sound level meter in therapy?

A

To monitor the intensity of their voice

131
Q

Describe a sound treated room

A

Free standing units that have no contact with room walls, ceiling and floor. It is not sound proof.

132
Q

What are the types of hearing loss?

A

Conductive, Sensory/Neural, and mixed.

133
Q

This type of test assumes examiner’s hearing is normal and does not provide numerical data

A

Tuning fork tests

134
Q

This tuning fork test compares tester’s hearing to the patient’s hearing

A

Schwabach test

135
Q

This tuning fork test compares the patient’s hearing by air conduction to bone conduction

A

Rinne Test

136
Q

This tuning fork test is based on the occlusion effect

A

Bing Test

137
Q

This tuning fork test is a test of lateralization

A

Weber test

138
Q

What is a biologic test?

A

When you put the earphones on yourself to make sure they are working before putting them on the client

139
Q

What are considered false negative/ positive responses?

A

Raising hand without hearing sound/ hearing sound without raising hand. Trying to fake it.

140
Q

During testing, what should you consider for the clients reaction time?

A

Cognition

141
Q

On headphones, what color represents the right ear?

A

Red

142
Q

On headphones, what color represents the left ear?

A

Blue

143
Q

When should testing instructions be given?

A

Prior to earphone placement

144
Q

During testing, should hearing aids be removed?

A

yes

145
Q

During the testing procedure, what are 2 things you should do before you begin?

A

Get a case history, Do an otoscopic examination

146
Q

Lowest dB level at which the patient is able to perceive the tone 50% of the time it is presented

A

Threshold

147
Q

What ear should you start with during testing?

A

The better ear. If unknown, start with the right ear.

148
Q

What Hz and dB should you begin testing at?

A

1000Hz with 30dB

149
Q

If there is no response at 1000Hz with 30dB what do you do?

A

Increase by 10dB

150
Q

If there is a response at 1000Hz with 30dB what do you do?

A

Decrease by 10dB

151
Q

If there was a response at 1000Hz with 30dB and you then decreased by 10dB but there was no response what do you do?

A

increase by 5dB

152
Q

During testing, how long should you continue the “bracketing procedure”?

A

Until you have a response at the same dB 2 out of 3 tries

153
Q

This is an example of threshold testing

A

Present 1000Hz to Right ear at 30dB, response, decrease by 10*
Present at 20dB, no response, increase by 5
Present at 25dB, no response, increase by 5

Present at 30dB, response, decrease by 10**
Present at 20dB, no response, increase by 5
Present at 25dB, no response, increase by 5
Present at 30dB, response***
30dB is threshold at 1000Hz, Right ear

154
Q

What symbol represents right ear air conduction on an audiogram?

A

O

155
Q

What symbol represents left ear air conduction on an audiogram?

A

X

156
Q

Define audiogram

A

A graphic representation of audiometric findings showing hearing thresholds as a function of frequency

157
Q

I a pure tone easier to hear as a pulse or at a steady state?

A

A pulse

158
Q

What is SRT?

A

Speech recognition threshold

159
Q

What is PTA?

A

Pure tone average

160
Q

How do you calculate PTA?

A

500, 1000, and 2000Hz averaged

161
Q

What is calculating PTA useful?

A

It is useful for predicting SRT

162
Q

This is determined by Air conduction thresholds

A

Degree of hearing loss

163
Q

This part of testing can describe the entire auditory system (outer, middle and inner ears)

A

Thresholds by Air conduction

164
Q

What is air conduction testing?

A

Signal is presented through the air via the earphones

165
Q

This is determined by bone conduction testing

A

type of hearing loss

166
Q

What is the occlusion effect?

A

Enhancement of low frequency sound when the ear is covered

167
Q

Where is a bone oscillator placed?

A

Mastoid or forehead. Cannot be touching pinna.

168
Q

Is the activation of the cochleas separate or simultaneous during bone conduction testing?

A

When you stimulate the skull via bone conduction, both cochleas are activated simultaneously

169
Q

This type of conduction has acoustic separation

A

Air conduction

170
Q

This type of conduction lacks acoustic separation

A

Bone conduction

171
Q

What 3 ways does hearing by bone conduction occur? Are they happening all at once or just one at a time?

A
  1. Inertial BC
  2. Distortional BC
  3. Osseotympanic BC
    All 3 happen not just 1
172
Q

When the bones of the skull vibrate/move and they cause air in the EAC to vibrate. Some of those sound waves/ vibrations will move out of the EAC and some will move down the EAC and hit the TM.
What type of bone conduction is this?

A

Osseotympanic BC

173
Q

When the bones of the skull become distorted as the bones of the skull are vibrating and this causes the inner ear structures to become distorted in the same way as they are stimulated via air conducted sounds.
What type of bone conduction is this?

A

Distortional BC

174
Q

When the ossicular chain, owing to its inertia, lags behind so that the stapes moves in and out of the oval window into the cochlea.
What type of bone conduction is this?

A

Inertial BC

175
Q

Describe conductive hearing loss

A

outer and middle issues: ex. too much wax, otosclerosis, otitis media, canal atresia; usually medically treatable

176
Q

Describe sensory neural hearing loss

A

Inner ear and beyond; outer hair cells, inner hair cells, leak in fluid, nerve damage.
Usually not medically treatable.

177
Q

Name 3 types of ear phones

A

supra aural, circum aural, and insert

178
Q

how often does a diagnostic audiometer require calibration?

A

annually

179
Q

Describe infection control procedures for a test environment

A

wipe off everything with an appropriate disinfectant. Not alcohol because it will dry out cushions
There is a fan/vent to circulate air
Disposable tips- one set per person

180
Q

How does bone conduction testing work?

A

it stimulates the cochlea by bypassing the outer and middle ear

181
Q

What does an audiometer do?

A

Produces Pure tones, attenuates (vary the level of intensity) them, delivers them to various transducers
Consistent so you can actually quantify a persons hearing

Audiology (11 decks)

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