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Audiology > Final > Flashcards

Final Flashcards

1
Q

What is conductive hearing loss?

A

outer or middle ear sound is not conducted well

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2
Q

What is the effect of disorders in the outer or middle ear on sound energy?

A

They reduce or attenuate the energy that reaches the cochlea

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3
Q

How is conductive hearing loss measured?

A

By comparing air- and bone-conduction thresholds on an audiogram

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4
Q

What indicates that attenuation of sound is likely occurring at the level of the outer or middle ears?

A

If air-conduction thresholds are poorer than bone-conduction thresholds

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5
Q

What aids can be used for conductive hearing loss?

A

Amplification or hearing aids

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6
Q

Fill in the blank: A conductive hearing loss is best measured by comparing _______ and bone-conduction thresholds.

A

air-conduction

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7
Q

What happens to cochlea function in conductive hearing loss?

A

Cochlea still functioning

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8
Q

What is sensorineural hearing loss?

A

sensory or neural cells or their connections within the cochlea are absent or not functioning.

Permanent loss that cannot be medically or surgically corrected

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9
Q

What does it indicate if air-conduction thresholds accurately represent cochlear sensitivity?

A

It indicates that the outer and middle ears are functioning properly

In this case, air-conduction thresholds are equal to bone-conduction thresholds.

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10
Q

What structures are affected with mixed hearing loss?

A

Outer, middle and inner ear

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11
Q

What is the purpose of immittance audiometry?

A

It is the best means for assessing outer and middle ear function

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12
Q

What can be some results from immittance audiometry?

A

Negative pressure in the middle ear cavity
Increase in mass of the middle ear system
Increase in stiffness of the middle ear
Reduction in stiffness of middle ear

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13
Q

What is the best single indicator of hearing loss?

A

Pure tone audiogram

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14
Q

What structure is involved with retrocochlear disorder?

A

Changes to the VIIIth nerve or auditory brainstem

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15
Q

What does air conduction test?

A

The ENTIRE auditory system
Outer, middle, and inner ear
If results are normal than auditory system is function
If results are abnormal conduct BC to determine the TYPE OF LOSS

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16
Q

What does Bone conduction test?

A

It bypasses outer and middle ear so testing function of cochlea/inner ear and auditory nerve

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17
Q

What confounds air and bone conduction testing?

A

Contralateralization or crossover of the signal

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18
Q

What is contralateralization or crossover in AC/BC testing?

A

Signal presented to one ear can be perceived by the other ear
Aka cross hearing of the signal

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19
Q

How do you account for cross hearing? How do you isolate the testing ear?

A

Masking the non test ear

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20
Q

What is masking?

A

Procedure where noise is placed in one ear to keep it from hearing the signal that is being present to the other ear

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21
Q

What is an air bone gap

A

Difference between the air- and bone-conduction thresholds
Must be at least 15 dB

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22
Q

What does an air bone gap indicate?

A

If there is 15 dB or greater difference:
If BC is normal then it indicates conductive hearing loss
If gap is within 10 dB and it’s abnormal, then it is sensorineural hearing loss
If there is a gap but bother air and bone are abnormal then it is mixed loss

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23
Q

How do you obtain the pure tone average? PTA

A

The threshold from air conduction at 500, 1000, and 2000 Hz divided by 3

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24
Q

Why compare SRT to PTA?

A

To determine test reliability. Must be within 10 dB

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25
Q

What is speech awareness threshold? SAT

A

aka speech detection threshold (SRT)
Refers to the LOWEST level at which speech can either be detected or recognized

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26
Q

What is speech recognition threshold (SRT)?

A

The lowest level at which SPONDEE words can be identified or repeated back

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27
Q

What is interaural symmetry

A

Extent to which hearing sensitivity is the SAME in both ears (symmetrical) or better in one ear than the other (asymmetrical)

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28
Q

What is bilateral mean?

A

When a disorder involves both ears

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29
Q

How do you obtain the degree of hearing loss?

A

By air conduction thresholds

30
Q

How do you obtain symmetry of hearing loss?

A

Air conduction testing

31
Q

How do you obtain the type of hearing loss?

A

Air and bone conduction testing

32
Q

What does a no response symbol mean on an audiogram?

A

Means that the limits of the audiometer were unable to detect the presence of high level sound.
Issue with sever hearing loss b/c BC limits are much softer. Cannot go as high as AC.
No response symbol is NR or arrow
IT IS NOT AN INDICATION OF AN AIR BONE GAP

33
Q

Tympanometry definition

A

Graph of pressure compliance of middle ear
Measures how acoustic immittance of the middle ear vibratory system changes
As AIR PRESSURE is varied in the ear canal
Max sound transmission occurs when air pressure is equal on both sides of the TM

34
Q

Limitation of tympanometry

A

It tells NOTHING about degree of loss, or normal vs. abnormal hearing

35
Q

What is Type B tympanometry indicative of?

A

Flat curve
Indicative of otitis media or fluid behind the ear drum
No mobility of the ear drum

36
Q

What is Type C tympanometry indicative of?

A

Eaustachian tube dysfunction
Will see negative pressure to the left
-200 or worse

37
Q

What is Type As tympanogram indicative of?

A

‘S’ shallow
Disarticulation - this may be for Ad
Could be scarring, residual ear infection, residual fluid
Ear drum may be moving some but very stiff

38
Q

What does Ad tympanogram mean?

A

Peak is off the chart
Disarticulation as well, could be from a TBI
Flaccid

39
Q

What does Ear Canal Value tell us?

A

Only care about if Type B tympanogram
Tell us there is a perforation or person has tubes

40
Q

What is a large ECV?

A

2.0 or greater

41
Q

What does normal ECV with Type B tympanogram mean?

A

Indicative of an ear infection

42
Q

What are otoacoustic emissions (OAE)

A

Low-intensity sounds generated by the cochlea
By-product of active processing of outer hair cells

43
Q

What can we learn from OAE’s

A

If present then outer hair cells are healthy
When absent outer hair cells are damaged
TREMENDOUS potential for revealing integrity of cochlea function

44
Q

What are limitations to OAE’s?

A

If there is fluid in the ear then the test may indicate that OAE’s are absent
Could have mild hearing loss but still show OAE’s

45
Q

Use for OAE’s

A

Common for screenings
Use for infants and ped
Good for ototoxicity monitoring because can test the high frequencies
Rule out anything more than mild hearing loss

46
Q

What are applications for ABR?

A

Threshold for infants and children
Threshold for exaggerated loss
Distinguish cochlear from retrocochlear
Distinguish VIIIth nerve from brainstem disorder
Intraoperative monitoring
Patient state does not matter - does not require a behavioral response

47
Q

What can OAE’s miss?

A

Mild hearing loss

48
Q

What can OAE’s miss?

A

Mild hearing loss

49
Q

Do absent OAE’s indicate hearing loss?

A

NOOOOO. We cannot say a patient has hearing loss if showing absent and test was done in isolation

50
Q

What are the clinical applications of OAE’s?

A

Infant screening
Pediatric assessmentnot a behavioral test
Cochlear function monitoring - e.g. ototoxicity
Otological diagnosis

51
Q

Candidacy for hearing aids

A

Sensorineural hearing loss that is causing a communication disorder
Conductive hearing loss AFTER a referral for a medical evaluation is cleared
EVERYONE WITH HEARING LOSS STARTS WITH TRYING HEARING AIDS FOR TREATMENT

52
Q

How can conductive hearing loss be treated?

A

Bone conduction devices
Hearing aids may be possible after a medical evaluation clears
Implanted osseointegrated hearing devices

53
Q

How is binaural hearing loss treated

A

Two hearing aids

54
Q

Assessment for treatment candidacy for hearing aids

A

Case history
Otoscopic inspection
Immittance audiometry
Pure tone audiometry
Speech audiometry
Loudness discomfort level (LDL)

55
Q

Candidacy for contralateral routing of signals (CROS)

A

Single sided deafness
Severe to Profound unilateral hearing loss

56
Q

How does a CROS device work?

A

Sound picked up by microphone on the poor functioning ear
Transmitted to receiver/hearing aid fitted on the Better ear
Wear 2 hearing aids

57
Q

Bone anchored hearing aid (BAHA)/bone conduction implant candidate aka osseointegrated device

A

Intractable or inoperable hearing loss
-atresia that has not or cannot be surgically repaired
-conductive hearing loss can not be surgically repaired, usually b/c of long-standing disease process/multiple surgeries
Patients with profound unilateral hearing loss or single-sided deafness
- hearing implant acts as a CROS
Must have some level of cochlear hearing sensitivity

58
Q

Candidacy for cochlear implants

A

Hearing aid trail must be conducted before implants
Severe to profound sensorineural hearing loss without benefit from hearing aid. Has poor word understanding

59
Q

Clinical application for Ecog (electrocochleographpy)

A

Differentiating endolymphatic hydrops (Meniere’s disease) from cochlear hearing loss
Intraoperative monitory
Confirm auditory neuropathy

60
Q

Limitation of ABR

A

Infant can fail because of brain maturation

61
Q

Tests that do not require a behavioral response

A

OAE, ABR, tympanometry

62
Q

Benefits of binaural hearing aids

A

Better to amplify if have loss in both ears to keep cells from dying
Better for localization
Better hearing in noise
Better high frequency

63
Q

What is Meniere’s Disease?

A

Excessive accumulation of endolymph in cochlear and vestibular labyrinths
Causes episodic vertigo, hearing loss, tinnitus, and aural fullness, dizziness

64
Q

What type of hearing loss is associated with Meniere’s?

A

Unilateral
Fluctuating
Progressive
Sensorineural
Early stages usually low frequency in nature, over time progresses to flat, moderate-severe hearing loss

65
Q

What is a common feature of Ménière’s disease?

A

Poor speech-recognition ability
Poorer than expected from the degree of hearing sensitivity loss

66
Q

Max threshold for bone conduction

A

Cannot test 6k and 8k

67
Q

What is behavioral observation audiometry (BOA)

A

Controlled presentation of signals in a sound field
Observation of infants response to signals
NOT ear specific
0-6 months of age
Use b/c are not developmentally able to respond to a beep

68
Q

What is visual reinforcement audiometry (VRA)

A

Child’s behavioral response to sound in sound field is
Conditioned by reinforcement with visual stimuli
6 mos-2 yrs

69
Q

What is conditioned play audiometry. (CPA)

A

Reinforcer is some type of pay activity
Usually with headphones2-4 years

70
Q

What is auditory processing disorder?

A

Look it up……..

71
Q

What is auditory processing disorder?

A

Look it up……..

72
Q

What is ABR?

A

Electrophysiological test
Does not require a behavioral response
Great for peds
Can obtain threshold

Audiology (2 decks)

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