Hearing Loss - Exam 3 Flashcards
Briefly describe how hearing works
auricle catches sound waves, waves vibrate the TM which causes the ossicles to move in a piston-like effect of the stapes pushes the vibrating sound waves into the cochlea, sound vibrations makes the fluid in the cochlea move which stimulates the hair cells, hair cells generate a nerve impulse to that travels to the brain to create a meaningful sound
Name 3 life events during which people are screened for hearing loss
birth
kindergarden
pre-employment or military physicals
All newborns should be screened before they reach ____ of age. Either _____ or _____. **If you fail, need to have Audiologic assessment by ____ of age. Intervention needs to be completed by ___ of age. Why is it important?
one month
otoacoustic emissions (OAE)
automated auditory brainstem response (AABR)
**3 months
6 months
early invention is important for SPEECH
Describe the Otoacoustic Emissions (OAE) test. What is normal? abnormal?
Sound generated in inner ear; checks inner ear’s response. The hair cells respond by sending back vibrations; echoes in mid ear. Small earphone in the baby’s ear that plays a sound that should echo into the baby’s ear canal
Normal: hair cells in normal functioning ear send back vibrations
Abnormal: no echo aka hearing loss
Describe the Auditory Brainstem Response (ABR). What is normal? abnormal?
electrodes patches placed on baby’s head and soft earphones in ears. A computer checks the baby’s brain waves to see how the brain is reacting to the sound. Test can show if the brain isn’t getting sound information in a clear manner
usually performed after surgery
What does a full workup for a baby who failed their first hearing evaluation include?
-repeat ABR testing
- test that measures how a baby reacts to sound
-how early respond to sound
**Name 5 signs that indicate that a baby is having trouble hearing
-Not being startled by loud sounds
-Not turning toward a sound after he’s 6 months old
-Not saying single words like “mama” or “dada” by the time he’s 1 year old
-Turns his head if he sees you, but not if you only call out his name
-Seems to hear some sounds but not others
Children who are at risk for acquired, progressive or delayed onset hearing loss should repeat hearing test by _____
2 1/2 years
_____ is the testing method of choice used 6 months to 2 years. Describe the test.
Visual Reinforcement Audiometry (VRA)
Child is trained to look toward a sound source. When child gives a correct response, they are rewarded with visual reinforcement (such as a toy)
What age range is Conditioned Play Audiometry (CPA) used? Describe the test.
ages 2-5 years old
Child is trained to perform activity when a sound is heard. Activity may include putting a block in a box or peg in a hole
_____ determines the faintest tones in decibels (dB) a person can hear at selected frequencies (pitches), from low to high
Earphones are worn and patient is in sound proof booth to prevent outside extraneous stimulation. What are 2 limitations?
Pure Tone Audiogram
- subjective to patient behavior
- limited to children and adults old enough to cooperate with testing
the audiogram graph, what does the y axis represent? x axis? where are soft sounds heard? loud sounds? what is the normal range?
X: pitch or frequency
Y: intensity of sound
soft sounds are graphed at the top and loud sounds are at the bottom
normal: is -10 to 20
Audiogram: Testing with headphones is called ______ testing because the sound must travel through the air of the ear canal to reach the inner ear. ______ testing, in which a device is placed behind the ear in order to transmit sound through the vibration of the mastoid bone
air conduction
Bone conduction
air conduction results right ear are ___. left ___
Bone conduction: are _____
air right: O
air left: X
bone: [ or <
**What is mixed hearing loss defined as ?
decrease in both air and bone conduction with at least 15 decibal difference between the two
_____ measures the mobility (or compliance) of the tympanic membrane and the small bones in the middle ear. The eardrum moves in and out when varying pressures are applied to the ear canal
When the eardrum is activated by a sound wave, part of the sound is absorbed and sent through the middle ear, while the other part of the sound wave is reflected.
What are the 3 types?
Tymphanogram
Type A
Type B
Type C
Name 5 reasons you would order an tympanogram.
Otitis media
Fluid in middle ear space
Eustachian tube dysfunction
Indirectly can diagnose hearing loss
Tympanic membrane perforation
Information obtained with _____ includes compliance (flexibility or stiffness) of the middle ear system, ear canal volume, and an estimate of middle ear pressure. Where is the probe placed?
tympanometry
placed snugly in the external ear canal
Describe this finding. What test?
type A: normal, middle ear system without fluid and normal conduction to cochlea. Shows maximal peak compliance
tympanogram
Describe this finding. What test?
Type B: abnormal, no compliance. Indicates a severely restricted mobility of the middle ear system, and often is consistent with otitis media.
**aka middle ear pathology, effusion or perforation
tympanogram
Describe this finding. What test?
Type C: abnormal, eustachian tube dysfunction due to inadequate ventilation of the middle ear space.
indicates negative pressure in the **middle ear space consistent with middle ear infection or cold
tympanogram
Describe what test results you would expect from a person with sensorineural and conductive hearing loss when you conduct the Rinne and Weber test
What are the 3 categories of hearing loss. Name some causes of each
conductive: aka anything that blocks the sound from coming through the canal
sensorineural
mixed (both)
Conductive hearing loss occurs when sound is not conducted efficiently through the ______ to the ____ ear which is composed of ____ and _____
outer ear canal to the middle ear
tympanic membrane and ossicles
What is this?
“flamingo flush” or Schwartz sign in otosclerosis
What is this?
Tympanosclerosis
