Final Exam Flashcards
Pure tone audiometry tests the patient’s hearing thresholds at frequencies from….
125 to 8,000 Hz
What is pure tone audiometry?
A test that determines hearing thresholds, the lowest intensity sound a person can hear 50% of the time. It is often conducted inside a soundproof booth to eliminate interferences.
Unmasked bone conduction gives thresholds for:
The better ear only
The “noise notch” is a dip in hearing thresholds at:
4,000 Hz
The ______________ gives an estimate of how much conversational speech is accessible to the listener.
Audibility Index
The primary purpose of masking is:
To ensure testing is accurate when one ear is better than the other
Type A Tympanometry
- Normal
- Normal mobility of the TM
- Normal middle ear pressure
Type B Tympanometry
- Restricted mobility of the TM
- Cerumen impaction
- Middle ear fluid
- OM
Type C Tympanometry
- Normal mobility of TM
- Negative middle ear pressure
- Eustachian tube dysfunction
Type As Tympanometry
- Reduced mobility of TM and ossicles
- Normal middle ear pressure
- Otosclerosis
Type Ad Tympanometry
- Hypermobility of TM and ossicles
- Normal middle ear pressure
- Disarticulation of ossicular chain
ASHA recommends screening children at:
1,000, 2,000, & 4,000 Hz at 20 dB
“Nonorganic hearing loss” refers to a hearing loss that:
Is intentionally fabricated for financial gain and attention or psychologically related
An assessment which requires the patient to wear goggles that track their eye movement is called:
Videonystagmography
Conductive hearing loss can be managed using:
BC hearing aids
Cochlear implants might be recommended for a patient who has:
A severe/profound hearing loss and does NOT benefit from hearing aids
Auditory Verbal Therapy focuses on:
Hearing only, with no gestures or sign language
Conductive hearing loss (audiogram)
AC thresholds in one or both ears are greater than 20 dB, but BC is normal; air-bone gap is 10 dB or more
Sensorineural hearing loss (audiogram)
AC thresholds in one or both ears are greater than 20 dB and BC thresholds are at the same or similar levels
Mixed hearing loss (audiogram)
AC and BC thresholds in one or both ears greater than 20 dB, but BC thresholds are better than AC thresholds by 15 dB or more
Asymmetrical hearing loss
Hearing loss in each ear with one being significantly more impaired than the other
Masked left ear BC
]
Masked right ear BC
[
Pure Tone Averages (PTAs)
Average of AC thresholds at 500, 1,000, and 2,000 Hz in each ear
The bilingual-bicultural model of aural habilitation is the preferred approach of:
The Deaf community
Speech Reception Threshold (SRT)
AKA speech recognition threshold, the minimum hearing level at which a patient can UNDERSTAND speech 50% of the time
Ability to balance relies on:
- Visual Input- provides direct information about orientation
- Proprioceptive Input- provides tactile information from body tissues about body part positioning
- Vestibular Input- provides information based on inertia and gravity
Vestibular System
Vestibule of cochlea contains the utricle (detects movement in a horizontal plane) and saccule (detects movement in the vertical plane). Semicircular canals allow us to detect nodding, shaking, or tilting as fluids shift due to head movement.
Speech Detection Threshold (SDT) vs Speech Recognition Threshold (SRT)
SDT is the minimum hearing level one can DETECT the presence of speech while SRT is the minimum hearing level one can UNDERSTAND speech. SDTs are expected to be lower than SRTs (about 5-10 dB lower) because detection is possible at a softer level than understanding
SRT testing uses spondee words which are:
Words with 2 syllables that are equally stressed (hotdog, pancake, mailbox)
Caloric Test
Water is introduced against the TM to observe eye movements; COWS (Cold Opposite, Warm Same)
Nystagmus (jerking movements of the eye) beats away to the opposite ear when using cold water and beats towards the same ear with warm water
Computerized Dynamic Posturography (CDP)
Tests patient’s ability to compensate for changes to their position; assesses balance and determines postural stability
Dynamic Range
Difference between a person’s thresholds and uncomfortable loudness level (UCL)
AC vs BC
AC is tested using headphones or inserts and BC is tested using a BC transducer which rests on the mastoid bone (bone oscillator is used); highest tested for AC is 8,000 and BC is 4,000 because if it gets any higher it is heard via AC and if it’s lower than 250 Hz there is a vibrotactile response (so slow they can feel it)
Word recognition scores
Poor scores may be due to a language barrier rather than poor speech understanding; word lists are available in different languages and examiner must be competent of the language being used
Tympanometry procedure
- A probe tip is placed in the ear canal and a seal is obtained
- A puff of air and tone are presented to the ear
- Patient must be still (no chewing or swallowing)
Tinnitus
Ringing, hissing, roaring, or buzzing in the ears that may be due to noise exposure, ear infection, Meniere’s disease, trauma, medications, presbycusis, fatigue, anxiety, etc.
Masked AC right ear
Red triangle
Masked AC left ear
Blue square
Tympanometry
Measures middle ear pressure in response to changes in air pressure in the EAM to assess movement of the tympanic membrane
Masking
Isolates the test ear by “distracting” the non-test ear with white noise. It’s applied for BC if an air-bone gap exists (>10 dB)
Treatment for tinnitus includes:
- Amplification
- Masking noise
- Biofeedback
- Cognitive therapy/counseling/mindfulness/relaxation
- Neuromonics
- Tinnitus Retraining Therapy (TRT)
- Audiologic Tinnitus Management (ATM)
Hearing Aids
Sound enters the microphone, transduces acoustic energy into electrical, processor/amplifier filters the signal and amplifies the sound; earmold made of silicone that fits in patient’s ear and is easily and cheaply replaceable
BC Aids
Adhesive, worn on soft headband, or connected to head via magnetic or button attachment; transmits the electrical signal transcutaneously to the internal receiver/stimulator
Aural rehabilitation for adults
Communication strategies training
- Assertiveness, environmental management, breakdown repair, anticipatory strategies, reduce maladaptive strategies
Counseling/support groups
Frequent partner training
Aural habilitation with children
- Auditory Verbal Therapy
- Auditory Oral Approach: emphasizes use of hearing for language development, but uses lip reading, body language, and gestural cues
- Total communication: any and all modalities for language development (spoken and sign language, written language, gestures, lip reading)
- Manual approach: uses manual language only
Unmasked left BC
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Unmasked right BC
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SRTs and PTAs
If they differ by 13 dB or more, it is considered poor (Auditory Neuropathy)
