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Audiology > hearing assessment > Flashcards

hearing assessment Flashcards

1
Q

Electronic device that generates pure tones to determine thresholds across a range of frequencies

A

Pure tone audiometer

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2
Q

Two types of pure tone tests

A

AC and BC

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3
Q

Threshold testing environment

A

Sound treated environment

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4
Q

Patient: raising a hand, pressing a response button, dropping a block in a bucket

A

Patient response modes

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5
Q

Patient fails to respond when tone is presented

A

False negative

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6
Q

Patient responds when no tone is presented

A

False positive

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7
Q

Provide clear and concise instructions; minimize visual cues

A

Clinician’s role in pure tone audiometry

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8
Q

Used to determine the degree of hearing sensitivity in both ears- only degree, not type

A

AC audiometry

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9
Q

AC frequency order

A

1k, 2k, 4k, 8k, 500, 250 Hz

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10
Q

Avg of thresholds at 500, 1k, 2k Hz used to determine degree of HL thru AC

A

PTA

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11
Q

16-25 dB

A

Slight HL

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12
Q

56-70 dB

A

Moderately-severe HL

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13
Q

> 90dB

A

Profound HL

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14
Q

Used to determine sensorineural sensitivity

A

BC audiometry

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15
Q

Skull vibrates>shearing of hair cells> VIII nerve

A

Distortional bone conduction

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16
Q

Skull vibrates> column of air in the EAC vibrates> some sound waves escape while others strike TM

A

Osseotympanic BC

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17
Q

While skull vibrates>ossicular chain vibrates> strapes moves in and out of oval window

A

Inertial BC

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18
Q

Frequencies tested for BC

A

500, 1k, 2k, 4k Hz

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19
Q

Softest level an individual can detect the presence of a tone 50% of the time

A

Threshold

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20
Q

Determine HL by AC; determine HL by BC; determine air bone gap

A

Audiogram interpretation

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21
Q

Abnormal bone; abnormal air; gap 10dB/less

A

Sensorineural HL

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22
Q

Abnormal bone; abnormal air; gap +10dB

A

Mixed HL

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23
Q

Normal bone; gap +10 dB

A

Conductive HL

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24
Q

Normal air; normal bone; gap 10dB/less

A

Normal hearing

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25
Q

Any hearing threshold +15 dB

A

Abnormal

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26
Q

Air conduction can never be better than BC

A

Myth

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27
Q

Vibrotactile response during BC testing in low frequencies

A

Tactile responses

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28
Q

Non-test ear picks up tone being presented to test ear when there is a 40 dB difference in thresholds between L and R ears

A

Cross hearing in AC

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29
Q

Loss of energy as the sound travels from one side of the head to the other

A

Interaural (between) attenuation

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30
Q

Interaural attenuation is 0dB/ gap is more than 10 dB

A

Cross hearing in BC

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31
Q

Solution to possible cross hearing

A

Masking

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32
Q

Purpose of masking

A

Determine the true auditory threshold in the ear being tested

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33
Q

Masking using a critical bandwidth around frequency being tested; maximum masking w/ minimum intensity

A

Narrowband noise

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34
Q

Technique used for applying masking

A

Plateau method

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35
Q

Dr. Holguin: “It’s not just about the _.”

A

Tones

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36
Q

Chief complaint in hearing impaired patients

A

Not understanding speech

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37
Q

Oral reply; identification of a picture; written reply

A

Patient’s role

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38
Q

Provide concise, accurate instructions; make sure patient cannot see clinician’s face during examination

A

Clinician’s role

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39
Q

Softest level an individual can BARELY detect the presence of speech 50% of the time

A

Speech-detection threshold SDT/SAT

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40
Q

Softest level an individual can correctly identify spondaic/spondee 50% of the time

A

Speech recognition threshold SRT

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41
Q

Use _ dB steps to obtain SRT and record on audiogram

A

5

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42
Q

Cross hearing in speech reception threshold testing occurs when there is a _dB difference or greater between SRTs of each ear

A

40

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43
Q

Masking for SRT

A

Speech noise which is more broad band of frequencies

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44
Q

Speech recognition test

A

WRS, Word Recognition Score

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45
Q

In WRS, words are presented at or dB above SRT sensation level (SL)

A

30/40

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46
Q

WIPI (young children)

A

Word Intelligibility by Picture Identification

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47
Q

Cross hearing when intensity level is _ dB/greater than SRT of non test ear

A

40

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48
Q

WRS > 90

A

Normal; conductive HL

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49
Q

WRS <90

A

Mixed; sensorineural HL

50
Q

Intensity level at which speech is comfortably loud

A

MCL, Most Comfortable Loud Level

51
Q

Intensity level at which speech is uncomfortable, especially important in SNHL

A

UCL, Uncomfortable Loudness Level/ TD, Threshold of Discomfort

52
Q

UCL-SRT

A

dynamic range

53
Q

part of the routine test battery used to assist in differentiating between middle ear, inner ear, and retrocochlear pathologies

A

Acoustic Immittance /Impedance Audiometry

54
Q

Acoustic Immittance is based on the following knowledge:

A

The middle ear is a stiffness dominated system.

55
Q

applies pressure to EAC

A

Air Pressure Transducer

56
Q

226 Hz tone presented through a probe

A

Probe Tone

57
Q

measures reflection of energy from TM

A

Microphone

58
Q

used to present tones to measure the contralateral acoustic reflexes

A

Earphone

59
Q

volume of air present in the EAC

A

Ear Canal Volume

60
Q

normal ear canal volume values range

A

.2cc-2.0cc

61
Q

values greater than normal range from ear canal volume is an indication of

A

TM perforation

62
Q

measurement of the outer/middle ear mobility

A

static compliance

63
Q

normal static compliance values range

A

.2cc-1.8cc

64
Q

lower than .2cc (static compliance range)

A

stiffness of the system

65
Q

higher than 1.8cc (static compliance range)

A

hypermobility of the system

66
Q

dynamic measurement of the the compliance of the ear, condition of middle ear structures, and amount of pressure in the middle ear

A

tympanometry

67
Q

normal range for middle ear air pressure

A

-150 - +100

68
Q

ECV= .2 to 2.0; static compliance= .2 to 1.8; middle ear pressure= -150 to 100

A

Type A

69
Q

static compliance= below .2cc

A

Type As

70
Q

static compliance= greater than 1.8cc

A

Type Ad

71
Q

middle ear pressure= greater than -150 (e.g. -170)

A

Type C

72
Q

static compliance= no peak; middle ear pressure= no peak; ECV= .2 to 2.0

A

Type B (causes include otitis media or cerumen impaction)

73
Q

static compliance= no peak; middle ear pressure= no peak; ECV= greater than 2.0

A

Type B (causes include TM perforation or Pressure Equalizing Tube dysfunction)

74
Q

Type As causes include:

A

otosclerosis or recurrent middle ear infections

75
Q

Type Ad causes include:

A

disarticulation of the ossicular chain or chronic OM with TM perforation

76
Q

Type C causes include

A

eustachian tube dysfunction or possibly some fluid

77
Q

lowest intensity level that elicits contraction of the stapedius muscle in the stimulated ear (contraction-reflex)

A

acoustic reflex threshold

78
Q

meter picks up change in compliance; measurement begins at _ dB; no response, decrease intensity by _ dB; response, increase by _ dB

A

70; 10; 5

79
Q

acoustic reflex is mediated in the _

A

superior olivary complex (where sound is localized for both ears)

80
Q

measured by introducing a continuous tone fro 10 sec at 10 dB above AR threshold and looking for 50% decay within 5 sec; tested at 500Hz and 1000Hz

A

Reflex Decay

81
Q

Causes of reflex decay

A

acoustic tumors on auditory nerve or facial nerve dysfunction (e.g., facial palsy)

82
Q

sounds that originate in the cochlea that can be detected from the EAC (used to determine outer hair cell function)

A

Otoacoustic Emissions, OAE

83
Q

OAEs are present in the absence of any external stimulus; present in about 40-60% of normal ears at 1k-3k Hz

A

Spontaneous

84
Q

two different primary tones are presented that cause cochlea to produce energy at additional frequencies(distortion)

A

Distortion Product OAE

85
Q

uses short click or tone pip; OAE DISAPPEARS when threshold is about 40 dB

A

transient

86
Q

hearing sensitivity doesn’t exceed 30 dB

A

normal OAEs

87
Q

outer hair cells are damaged; conductive HL; excessive cerumen

A

absent OAEs

88
Q

Newborn hearing screening

A

OAE and/or ABR

89
Q

electrical responses that are generated after the presentation of auditory stimuli and recorded using computerized equipment

A

auditory evoked potentials

90
Q

early auditory evoked potential; occurs 10-15 sec after auditory signal (click); generates waveforms each representing neuroelectric activity along the central auditory brainstem

A

Auditory Brainstem-evoked Response or BEAR, Brainstem Evoked Auditory Response

91
Q

VIIIth nerve

A

Waves I & II

92
Q

superior olivary complex

A

Wave III

93
Q

lateral lemiscus

A

Wave IV

94
Q

inferior colliculus

A

Wave V

95
Q

undetermined

A

Waves VI & VII

96
Q

clinical use of ABR testing

A

determine if hearing loss is cochlear or retrocochlear

97
Q

Waves I, III, & V

A

absolute latencies

98
Q

Waves I-III, I-V, & III-V (between peaks)

A

interpeak latencies

99
Q

Wave V between ears

A

interaural latencies

100
Q

delays in speech & language development; affects psychosocial development; affects academic achievment

A

delay in identification

101
Q

early intervention; lessen affects of hearing loss that increase chance for child to be successful

A

early identification

102
Q

1 in _ babies are born with a hearing loss

A

1000

103
Q

before newborn hearing screening, avg age of identification was _

A

2

104
Q

Neonatal screening types (2)

A

OAE & ABR (if OAE fails)

105
Q

good program for childhood HL (4)

A

follow-up; diagnostic evaluation for infants who fail; intervention program; fitting of appropriate hearing aids

106
Q

eyes shift; cessation of activity; stops sucking bottle to attend to stimulus (BOA)

A

Behavioral Observation Audiometry

107
Q

warbled tones and speech stimuli

A

SAT

108
Q

No responses in the soundfield does not mean _

A

child cannot hear

109
Q

behavioral testing in children 2-6yrs (limits)

A

limit instructions; limit # of frequencies tested

110
Q

significant HL when testing children (alternative testing)

A

BC; use low frequency stimulus

111
Q

excuses from parents concerning their child’s delayed development

A

they’re ignoring me; they’re daydreaming; boys develop later than girls; they’ll grow out of it

112
Q

good case history

A

illnesses; birthweight; family history of HL; developmental delays in other areas

113
Q

first thing to consider contributing to speech & language delay

A

possibility of HL

114
Q

individuals with normal hearing who have difficulty processing auditory information

A

APD, Auditory Processing Disorder

115
Q

APD behaviors (confused with ADHD)

A

poor listening skills; poor reading comprehension; poor auditory memory; short attention span; difficulty understanding speech in the presence of background noise

116
Q

enhance the signal to noise ratio through the use of _

A

FM system, preferential seating, etc.

117
Q

frequencies tested during hearing screenings in the schools

A

1k, 2k, 4k Hz

118
Q

obtain certification through the _

A

Texas Dept of Health

119
Q

Intensity level used during school hearing screenings

A

25dB

120
Q

type of criterion for school hearing screenings

A

pass/fail

121
Q

population screened (schools)

A

K, 1st, 3rd, 5th, 7th, and first time entrants

Audiology (5 decks)

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