lecture 6 - exam 1 Flashcards
what problems can cerumen cause
impacted cerumen can give conductive hearing loss
mechanical removal
most common
using metal or plastic tools
curette, loop, hooks, forceps
irrigation removal
room temperature water squirted into ear
must be room temp or patients will get dizzy
suction removal
removal using a suction
when not to remove cerumen
ear drum perforation
middle ear infection
ear canal injury / inflammation
when not to use irrigation removal
you cannot see TM
could cause serious damage to ossicles if there is a hole
what is audiometry
assessment of hearing sensitivity
determines if there is hearing loss
- degree & severit
- configuration
- type
assessment of hearing sensitivity is what
frequency specific
ear specific
what info does type of hearing loss give us
where it is
informs treatment plan
equipment used for audiometry
sound booth
audiometer & transducer
intensity in audiometry is measured using what
dB HL
what types of pure tone stimuli are used
continuous
pulsed
frequency modulated / warble tone
which frequencies do we test at for air conduction
250-8000 Hz
mainly octaves
(250, 500, 1000, 2000, 4000, 8000)
which frequencies do we test at for bone conduction
250/500 - 4000 Hz
can feel low freqs vibrating even when you can’t hear them
make sure test ear is uncovered - occlusion effect
occlusion effect
your own voice is louder in your head when you plug your ears
transducer types
supra-aural headphones = on ear
circumaural headphones = around ear
insert headphones
soundfield
bone oscillator = mastoid or forehead
- tests sensorineural pathway
what type of hearing loss are we looking for w/ AC
conductive & sensorineural
if there is hearing loss w/ AC, then test BC
what type of hearing loss are we looking for w/ BC
sensorineural
threshold
lowest intensity at which a patient is able to detect pure tones
when to test high freqs
aging
ototoxic monitoring
monitoring noise exposure
monitoring hearing loss from surgery
finding the starting point
familiarize patient w/ stimulus at an audible level
if yes –> threshold search beings
if no –> increase level until patient responds
threshold procedure - Hughson-Westlake
decrease intensity in 10 dB steps until patient stops responding
- yes = down 10
increase intensity in 5 dB steps until patient responds
- no = up 5
how long do you repeat threshold procdedure
until the patient responds to 2/3 ASCENDING presentations
when are false positives likely
tinnitus
bottom thresholds
during long silent periods between presentations
