exam 2 Flashcards
Pediatric thresholds for typical hearing and mild HL
typical: -10 to 20 dB HL - kids need to be able to hear softer sounds for learning speech, lots of listening in school, etc
Mild HL: 21-40 dB HL
Adult thresholds for typical hearing and mild HL
typical: -10 to 25 dB HL
Mild HL: 26-40 dB HL
threshold range for moderate, severe, moderately severe, profound (same for peds & adult)
Moderate: 41-55 dB HL
Moderately severe: 56-70 dB HL
Severe 71-90 dB HL
profound : above 90 dB HL
drawing tymps- where on the graph is pressure, compliance, gradient, volume
volume: not on the graph
pressure: x axis coordinate of where the peak is
compliance: peak height- y axis coordinate of where the peak is
gradient: width of the peak at half of its height - go halfway down the compliance value and half of the gradient value out on each side.
pressure (tymp)
the pressure at which the peak occurs is an estimate of the pressure in the middle ear as related to atmospheric pressure
pressure near 0 (atmospheric pressure) = ET is functioning normally
NORM: -100 to 100 daPa (not a concern unless it’s +/- 200)
gradient
indicates how the eardrum responds to pressure change (quick vs slow eardrum movement)
when drawing- its the width of the peak at 1/2 its height, go halfway down the compliance value and half of the gradient level out on each side
NORM: less than 250 dPa
if gradient is higher than 250, fail tymp and refer for rescreen. if they fail the rescreen, refer to MD and then AuD
what does high gradient indicate
response of TM is more sluggish than normal- could be because of a middle ear problem but its not our job to figure out why
if ECV is greater than 2.0
it could mean perforation of TM OR patent PE tube
- if TM perforation, refer to MD
- if you see in otoscopy that PE tube that is open and functioning, pass + let school know and note on screening form that PE tube is functioning
inability to maintain a seal with the probe is sometimes an indication of PE tube (open)
ECV greater than 2.0 and tymp has no peak- what does this mean
perforation (refer) or PE tube (pass as long as its functioning)
why? bc this tymp result means there is a hole in the eardrum –> ECV becomes volume in ear canal + volume of middle ear –> large ECV –> no measurements for other tymp criteria bc TM is not showing any resistance to changes in pressure (bc of hole)
gradent, pressure, compliance: – (bc no peak)
what does tymp for TM perf or PE tube look like
flat line
pressure, gradient, compliance be —-
large ECV
in what situation would you refer when ECV is below 2.0
when you see a PE tube but ECV is normal, refer to MD to clear the tube. Normal ECV with PE tube indicates that the tube is blocked.
Tube needs to be open so pressure can equalize between the middle ear and ear canal
ECV is normal bc were just pressurizing the ear canal (not ear canal + middle ear) and can get some movement of TM when the PE is blocke
what does a very low (below 0.4) ECV indicate
could be a very small ear canal, impacted cerumen, or it could be that the probe is positioned incorrectly (against the ear canal)
what does negative pressure indicate
the ET is not working to equalize pressure in the middle ear with ambient pressure- often occurs from cold or allergy. Negative pressure isn’t criteria for referral. If you see negative pressure but peak height and gradient are WNL, pass.
what would tymp for ear infection look like (go through what volume, gradient, pressure and compliance would look like)
ECV: typical (0.3-2.0)
gradient: atypically high (above 250 daPa) - eardrum has to push against fluid
compliance: atypically low (less than 0.2) - eardrum won’t be able to move as much against fluid
compliance
the height of the peak- mobility of the eardrum in response to pressure change, how much the eardrum is moving
