Final Exam Flashcards
The typical probe tone for tympanometry is:
A.) 300 Hz
B.) 275 Hz
C.) 226 Hz
D.) 400 Hz
E.) 700 Hz
C - 226 Hz
When conducting tympanometry on infants, it is best to use either ____ Hz or _____.
800 / 1000
This is the measurment of tympanic membrane and middle ear mobility
Static immittance
Normative data for adults:
Mean: ____ mmho
___% range = ___ to ____ mmho
0.8 / 90/ 0.3/ 1.4
Normative data for children:
Mean: ____ mmho
____% range: ____ to ____ mmho
0.5 / 90 / 0.2 / 0.9
True or False: Ear canal volume normative data for adults is: mean - 1.5 mL
True
Mean: 1.5mL
90% range: 0.6 to 1.5 mL
Ear Canal Volume Normative Data for children:
Mean: ____ mL
90% range: _____ to _____ mL
0.7 / 0.4 / 1.0
As suggested by ASHA you take the tympanometric shape by using the ____ of the tympanogram at the ___% amplitude point.
width / 50
Normative for tympanometric width for adults:
Mean: ___ daPa
90% range: ____ to ____ daPa
80 / 50 / 110
Normative data for tympanometric width for children:
Mean: ____ daPa
90% range: ____ to _____ daPa
100 / 60 / 150
Normal
Type As : normal middle ear pressure with decreased static compliance (hypomobile tympanic membrane)
Type Ad : normal middle ear pressure with increased static compliance, hypermobile tympanic membrane
Type B: flat tympanogram, signs of middle ear effusion or perforation
Type C: excessive negative pressure; eustachian tube dysfuntion or middle ear pathology
a : Vec normal –> M.E. effusion
b: Vec small –> improper placement of cerumen
c: Vec large –> perforation of PE tube
These three things affect tympanometry measurement:
tympanic membrane size, thickness, and angle
mastoid pneumatization
ear canal wall stiffness
True or False: as the tympanic membrane becomes thinner, it becomes less stiff and more compliant
True
True or False: Instead of using 226 Hz tone for infants, it is recommended to use 800 or 1000 Hz to see true tympanometry
True
What is the source of the otoacoustic emissions?
Outer Hair Cells
OHC motility generates movements of the __ and fluid in the cochlea
Basilar Membrane
There are two types of emissions (OAEs):
spontaneous
evoked
True or False: Evoked Otoacoustic emissions are a threshold measure.
False
True or False: Transient Evoked Otoacoustic Emissions are presented with two tones and a distortion production
False - Distortion Product OAEs present two tones and the distortion product is only used for measure
True or False:
DPOAE is broadspectrum
False - TEOAE are broadspectrum
DPOAE are frequency specific
True or False:
The stimulus for TEOAEs are short clicks (broadband)
True
The measured tone for DPOAE is done by:
_f1 - f2
2
i.e. F1 = 1500 ; F2 = 2000
2(1500) - 2000
3000 - 2000 = 1000 Hz
True or False: DPOAEs are created due to the interaction of two pure tones presented at the same time
True
True or False:
Infants have low amplitude, and narrowband spectrum emissions
False - high amplitude; broadband
True or False:
Some clinical considerations mentioned by Widen (1996); you should imittance first before you do OAEs
True - check for middle ear effusion
The tools for measuring OAE:
the ____ : delivers the working stimulus
the ____ : records the emissions
transducer
microphone
True or False:
For TEOAEs there are two separate transducers when conducting measurments
False ; only for DPOAE
In TEOAE, the recorded response goes through a amplifier, filter, and _______.
time averager
In DPOAE, the recorded response goes through an amplifier, filter, and a _______.
spectrum analyzer
OAEs for pediatrics is useful for the following reasons:
A.) Neonatal hearinig screening
B.) Predicting hearing status or for pseudohypoacoustic patients
C.) Montior cochlear status during ototoxic drug administration
D.) Distinguish from retrocochlear hearing loss
E.) all of the above
E -all of the above
True or False: ABR is the most common AEP used for diagnostic purposes
True
AEP is divided into three segements:
____ : 1 to 10 msec
_____ : 10 - 100 msec
_____ : 100 - 1000 msec
ABR / MLR / LLR
Auditory brainstem response / middle latency response / long latency response
AEP is defined as:
measure of synchronous electrical imipulses of the auditory pathway in response to an auditory stimulus
The following are recorded responses rarely seen in infants and children:
A.) MLR
B.) ECoG
C.) CAEP
D.) LLR
E.) all of the above
E - all of the above
Match the ABR Wave Generators: Waves I - V
A.) Wave I Inferior Colliculus
B.) Wave II Cochlear Nucleus
C.) Wave III Lateral Lemniscus
D.) Wave IV VIIIth Nerve
E.) Wave V Superior Olivary Complex
A.) Wave I - VIIIth Nerve
B.) Wave II - Cochlear Nucleus
C.) Wave III - Superior Olivary Complex
D.) Wave IV - Lateral Lemniscus
E.) Wave V - Inferior Colliculus
The interwave latencies for Waves I - III are:
about 1.5 - 4 msec
The interwave latencies for Waves I - V are:
about 1.5 - 5.5 msec
The interwave latencies for waves III - V are:
about 4 - 5.5 msec
Maturation of the Auditory System:
True or False:
Maturation begins at the periphery - adult-like at birth
True
Maturation of the response and latency of the ABR waveforms reaches around:
A.) 18 months
B.) 15 months
C.) 24 months
D.) 10 months
E.) 20 months
C - 24 months
(2 years)
Brief stimulus or broad spectrum consists of what type of sounds?
Click
tone burst
True or False:
Clicks consists of a duration of 5 msec
False - .1 msec (100 micro seconds)
*elicits response from the basal end of the BM (between 2 and 4 kHz)
What is the difference between a tone burst and click?
Clicks last for .1 msec and is great for eliciting response from the Basilar of the BM
Tone Bursts are sinusoidal which last 5 msec and are great threshold estimation at specific frequency regions
What are the three main uses for ABR?
1 - Neonatal hearing screening
2 - Evaluate hearing
3 - Dx evaluation of the integrity of the neural pathway
What are the ABCs of High Risk Register for deafness?
A - asphyxia
B - Bacterial Meningitis
C - Congenital Perinatal Infections
D - Defects of head and neck
E - Elevated bilirubin
F - Family History
G - gram birth weight
What are newborn hearing screening techniques?
OAE (Otoacoustic Emissions)
ABR (Auditory brainstem response)
Two Stage (OAE + ABR)
Explain the procedure of OAE
sounds are presented to ear canal and a small microphone measures the response in the ear canal
avg. test time is 5-15 minutes
Explain the procedure of ABR
sounds are presented to the ear and surface electrodes measure an EEG type response from the auditory nerve. a response from the nerve constitutes a pass
avg. time to complete: 20 minutes
Explain two stage OAE + ABR
babies who fail the OAE screening receive an ABR screening prior to leaving the hospital
in some facilities, 2 stage process may include a second OAE screening within 24 hours beforer procedding with ABR.
What if infant fails UNHS?
babies who fail initial hearing screening will actually have normal hearing
What is the role of the ‘medical home’?
as clinicians we need to understand testing results at screening and diagnostic phases and implications to follow up
assure follow-up screening: refer for diagnostic and medical specialty evaluations
support family in understanding severity and type of hearing loss
What are some useful recommendations offered by JCIH?
check for auditory skills, middle ear status, dev. milestones, parental concerns (in each visit)
- if concerned, refer to audiologist and SLP for evaluationi
- if hearing loss is eval’d, refer siblings of infant for audiological evaluatioin
- refer infants with any RISK factors
What are some follow-up testing procedures?
*referral for follow-up testing : repeat OAE/ABR testing
*if hearing loss still suspect: refer to ped. audiologist, use freq. specific ABR to estimate degree and config. of hearing loss
True or False:
The hearing screening for school age children is a threshold measure
False
What are you actually doing when conducting hearing screening on school-age children?
*screen for presence of hearing loss
*screen for presence of middle ear dysfunction
According to the ASHA guidelines:
* use pure tone screening
*screening level or “fence” 20 dB HL
*frequencies - 1000, 2000, 4000 Hz
True or False:
A failure is considered in any frequency in both ears
False -
a failure is considered in any frequency in one ear
During the immittance screening a clinician should be:
looking for middle ear dysfunction; not a hearing loss
*may need to refer to do tympanometry
True or False:
A failure in immittance screening is considered when you get a flat tympanogram in both ears
False -
a failure in immittance screening is considered when you get a flat tympanogram in any ear
