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SPPA 461 - Basic Audiometry > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Setup for speech audiometry

A
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2
Q

What is the speech reception threshold?

A

Lowest level an individual can identify spondees:

  • 3 repeated times
  • 50% of the time (2/4)
  • 75% of the time (3/4)
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3
Q

What stimulus is used to determine the speech reception threshold?

A

Central Institute for the Deaf (CID) W-1: two-syllabic words (spondees) with equal stress

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4
Q

What is the purpose of speech reception threshold testing?

A
  • Validates PTA (500, 1000 & 2000 Hz)
  • Baseline for speech discrimination test
  • Hearing aid evaluation for gain (amplification) prescription
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5
Q

What is the procedure for finding the speech reception threshold?

A
  • Starting intensity level: 30 dB above the PTA for each ear
  • Keep going down 10 dB until there’s no response, then go up 5 dB
    • repeat until you reach threshold
  • Presentation mode is usually live voice
    • “Say the word ______.”
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6
Q

What are the criteria for SRT to validate PTA?

A

PTA and SRT should be within +/- 10 dB

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7
Q

Why might PTA and SRT be more than 10 dB apart?

A
  • PTA might be invalid—try using Fletcher/two-freq. average
  • Incorrect test procedure
  • Improper test equipment/calibration
  • Functional hearing loss—they’re faking!
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8
Q

What is another name for speech discrimination testing?

A

Word recognition testing

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9
Q

What is the purpose of speech discrimination (SD) testing?

A
  • Determine extent of speech discrimination ability
  • Determine site of ear pathology
  • Determine candidacy for hearing aid amplification
  • Determine prognosis for aural rehabilitation
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10
Q

What is the procedure for SD testing?

A
  • Start at (and stay at) 30 dB above SRT in each ear
  • Present monosyllabic phonetically-balanced (PB) words via CD
  • **25 **words presented
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11
Q

Open vs. closed word lists

A
  • Open: repeat the words
    • CID W-22 (Central Institute for the Deaf)
    • NU-6(Adu) (Northwestern University)
  • Closed: patient has word lists/pictures
    • WIPI (Word Intelligibility by Picture Identification)
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12
Q

Differences between SRT and SD

A
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13
Q

Interpretation of different SD scores

A
  • 90-100%: Excellent
    • Normal Hearing/Conductive Hearing Loss
  • 60-89%: Moderate to Fair
    • Sensorineural loss (Cochlear lesion)
  • 0-59%: Very poor
    • Sensorineural loss (Neural/8th nerve lesion)
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14
Q

SD at higher intensities

A
  • Extension of SD testing
  • Like a stress test for auditory system
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15
Q

SD in noise

A
  • Ex: SPIN test (Speech Perception in Noise)
  • More generalizable
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16
Q

SD using synthetic sentences

A
  • Ex: SSI test (Synthetic Sentence Identification
  • Closed test (identify from a list of sentences)
  • Synthetic so it’s less predictable
  • Used with auditory processing disorders
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17
Q

SD using high-frequency stimuli

A
  • Ex: CCT (California Consonant Test)
  • Used in patients w/ selective high frequency loss (greater than 2 kHz)
  • Sensitive to high frequency consonant sounds
18
Q

PI-PB Function procedure

A
  • Performance Intensity—Phonetically Balanced
  • Measures SD performance @ different intensity levels
  • Uses PB words (CID W-22 or NU-6)
  • Uses the following intensities:
    • 30 dB SL
    • 45 dB SL
    • 60 dB SL
19
Q

What is meant by SL?

A
  • Sensation Level
  • A level above the threshold
  • If SRT threshold = 20 dB, 30 dB SL = 50 dB
20
Q

How does PI-PB function differ between conductive, cochlear, and neural loss?

A
  • As you increase the intensity in conductive or cochlear loss, performance improves
  • As you increase the intensity in neural loss, performance decreases
    • Nerve can’t conduct sounds to the brain
21
Q

What is the formula for PI-PB rollover ration (ROR)

A
22
Q

How do we interpret PI-PB Roll over Ratio?

A
  • 0.4 or less: normal/conductive/SN cochlear
  • Greater than 0.4: neural lesion
23
Q

What is the purpose of Immittance Audiometry?

A

Directly evaluates middle ear status

  • Tympanometry
  • Stapedial reflex threshold

Indirectly evaluates inner ear status

  • Stapedial reflex threshold
  • Stapedial reflex decay
24
Q

What are some advantages of immittance audiometry?

A
  • It’s objective, so it’s replicable and requires less patient cooperation
  • Determines cause for conductive hearing loss
  • Determines functional integrity of the inner ear
25
Q

Immittance Audiometry: Probe Ear vs. Phone ear

A

Probe ear

  • Test ear

Phone ear

  • Earphone ear
  • Presents sounds to elicit contralateral stapedial reflex
26
Q

Intensity/frequency levels for immittance audiometry

A
  • Probe tone frequency: 220 Hz or 660 Hz
    • (use 660 with babies less than 1)
  • Probe tone intensity: 85 dB SPL in the ear canal
27
Q

What is plotted on a tympanogram?

A
  • Compliance (= mobility): Y axis
  • Pressure: X axis
28
Q

Type A tympanogram

A
  • Normal
  • Peak compliance around 0 to -100 mm air pressure (0.3 to 1.8 mL)
29
Q

Type AS tympanogram

A
  • Stiffness/Shallow peak
  • Limited peak compliance around 0 to -100 mm air pressure (< 0.3 mL)
  • Consistent with otosclerosis (stapedial bone is fixed to oval window)
30
Q

Type AD tympanogram

A
  • Flaccidity
  • Disarticulation of ossicles
  • Deep
  • Abnormally high compliance (hypercompliance) around 0 to -100 mm air pressure (> 1.8 mL)
31
Q

Type B tympanogram

A
  • Middle ear fluid buildup
  • Abnormally low compliance
  • Peak compliance absent (flat line)
32
Q

Type C tympanogram

A
  • Eustachian tube malfunction
  • Normal-height peak below -100 mm air pressure
  • Ear is “plugged up”
33
Q

What are normal values for ear canal volume?

A

0.2 to 2.0 mL

34
Q

What are normal values for peak compliance in tympanometry?

A

0.3 to 1.8 mL

35
Q

What are normal values for middle ear air pressure in tympanometry?

A

-100 to +50 mm

36
Q

What might we see in tympanometry for someone with an eardrum perforation?

A
  • Abnormally high ear canal volume (> 2.0 mL)
  • Low compliance on tympanogram (type B)
37
Q

How do we calculate SD?

A

SD (%) = # correct x 4

38
Q

Air Conduction Audiometry: symbols for plotting a/c thresholds

A
39
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

40
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

41
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)

SPPA 461 - Basic Audiometry (3 decks)

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