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AUDE 6150 > midterm 1 with review topics > Flashcards

midterm 1 with review topics Flashcards

1
Q

how does frequency resolution changes with SNHL

A

when the OHCs can no longer amplify soft signals, the BM can no longer produce the sharp tuning curve which results in the loss of these and there is difficulty hearing in noise
-not fixable with HA’s

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2
Q

frequency resoltution

A

the auditory system ability to detect discrete frequencies in the cochlea

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3
Q

how does a reduced frequency resolution make it difficult to understand speech in noise

A

the primary signal is no longer enhanced so the brain cannot untangle the speech signal from the noise

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4
Q

temporal resolution

A

the auditory systems ability to detect small time related changes within the acoustic stimuli over time
-not fixable with HA’s
-you can have people talk slower and produce clearer sounds

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5
Q

what are auditory processes that support temporal resolution

A

gap detection, phonemic duration, temporal ordering and suprasegmentals

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6
Q

what are some benefits of spatial hearing

A

localization, allows us to focus on one sound and suppress another, inter aural level differences (binaural squelch and summation) and inter aural timing differences

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7
Q

which frequencies supply the most information on interaural level differences

A

higher frequencies

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8
Q

how are receivers designed to achieve the greatest high frequency output for severe HL

A

we can use dual receivers with a severe HL that needs higher access to high frequencies

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9
Q

smaller receivers give more _________ frequencies due to having a smaller diaphragm

A

higher

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10
Q

WDRC

A

aims to expand the dynamic range where more gain is added to soft signals and less is added to louder signals
-lower TK
-low CR
-slower AT and slower RT

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11
Q

OLC

A

compression is applied to protect from over amplified sounds
-bigger TK
-high CR

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12
Q

what is the general rule for what Medicare will and will not reimburse

A

they will not reimburse anything that relates to HA’s, but they will reimburse anything medically necessary

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13
Q

what are 3 methods used to reduce external feedback

A

reduce feedback loop (increasing snugness of mold and decreasing vent size), digital notch filtering (notch in the 2-4 kHz range) and digital feedback cancellation

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14
Q

what are the 3 types of frequency lowering

A

linear frequency transposition, nonlinear frequency compression and spectral envelope warping

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15
Q

what is the main importance of having a review of systems and how can it support clinical decision making

A

the anticipation of the progression of loss can occur by :
-highlighting correlation between systemic disease and HL progression in medical reports
-using the presence of systemic disease to justify the medical necessity of future diagnostic monitoring
-considering potential for progression when recommending audiological rehabilitation

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16
Q

what are some common comorbidities that are linked to HL

A

gastrointestinal, musculoskeletal, respiratory, cardiac, lymphatic, hematology, integumentary, nervous system and the endocrine system can all be associated with HL

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17
Q

what are some common comorbidities seen within the older populations

A

visual impairments, cognitive issues, depression, falls and hypertension

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18
Q

what does it mean when we say ‘the audiogram is not an indicator of the degree of communication deficit’

A

the audiogram is simply a sign of if the patient can hear it or not
-measuring how loud a sound needs to be for audibility
-does not tell us anything about frequency or temporal resolution

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19
Q

puretone threshold loss is …..

A

-a good indicator of overall degree of functional impairment
-moderate indicator of activity limitation
-poor indicator of participation restriction

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20
Q

what limits the ability to use WRS

A

in general calculation errors and wrong presentation levels used

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21
Q

what can inaccurate WRS lead to

A

inaccurate assumptions of intelligibility, disconnected counseling and less than ideal recommendations

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22
Q

explain the calculation errors that occur with WRS

A

calculation is based on the whole 50 word phonetically balanced list
-when these are cut in half or even shorter, it can lead to not presenting a list that is phonetically balanced
-leading to us not being able to make any diagnostic statement off of the data based on not following the instructions of the test

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23
Q

explain the general rules to ensure that proper presentation levels are used

A

using the frequency at 2,000 Hz :
-if below 50, add 25 dB
-if between 50 and 55, add 20 dB
-if between 60 and 65, add 15 dB
-if between 70 and 75, add 10 dB

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24
Q

what are some techniques that offer a more realistic method of speech understand

A

add bianural speech assessments, use sentence based test stimuli, assess performance with and without visual cues, and assess speech intelligibility within the sound field

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25
Q

functional limitations

A

problem within the body function or structure
-the diagnosis

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26
Q

activity limitations

A

difficulties experienced when executing a task or action
-immediate results, not the patient’s choice

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27
Q

participation restrictions

A

involvement in activities an individual would like to participate in
-it is what you do once you are given the disorder, the patient’s choice in a way

28
Q

what does backward synergy mean

A

treatment or rehabilitation that results in increased participation supplies communication practice and experiences that may result in neural changes to improve activity limitations
-in other words, when we improve participation, we start improving some of the earlier areas

29
Q

how to avoid communication mismatch in professional reports

A

improve interdisciplinary communications (report writing to assist interpretation of the impact of HL), reduce communication mismatch and conduct communication assessments

30
Q

how to properly make clearer statement related to identified concerns

A

include statement of purpose, what test signal was used, the test condition and discuss audibility

31
Q

speech intelligibility index (SII)

A

tells us what is audible to the patient and what is not audible to the patient
-it is based on the importance of frequencies
-the % of speech signals that are audible to the patient

32
Q

what does it mean to be based on the importance of frequencies

A

it correlates to speech meaning and there are less in the low frequencies and more within the high frequencies
-more importance is held within the highs within speech

33
Q

what can be viewed within the SII chart

A

the SII along with the prediction of how many digits, sentences and NU6 words they will understand

34
Q

what are clinical uses for the SII

A

helps other professionals better understand threshold loss impact, helps patients better understand their diagnostic findings, reduced counseling mismatch and helps audiologist determine amplification candidacy

35
Q

loudness discomfort levels (LDL)

A

level that is too loud for the patient
-used to measure the MPO
-measured as levels vary, helps with amplification and it can be used to program and verify the output is within the limits

36
Q

what frequencies to test for LDL

A

always measure at 2 or 3 kHz and for additional frequencies :
-skip measurement for any frequency with normal sensitivity
-are the LF thresholds greater than or equal to 40 dB HL
-is there a precipitous inter-octave change
-does the device supply output in an extended frequency range

37
Q

QuickSIN

A

a test of speech with varying levels of background noise, testing SNR and SNR loss
-can lead to recommendations for technology

38
Q

what level do we use to present the QuickSIN at

A

it is based on the PTA
-if PTA is less than or equal to 45 dB, present the list at 70 dB HL
-if PTA is greater than 45 dB, present sentence lists at an intensity perceived as loud by okay

39
Q

SNR-50

A

SNR that allows an individual to understand 50% of the test signal

40
Q

SNR loss

A

this is the amount of SNR differences between the patient than the normal listener

41
Q

ANL

A

measuring a persons tolerance for background noise
-this is using the sound field option with both channels
-supports the recommendations for specific settings or technology

42
Q

how is the ANL calculated

A

subtracting BNL from MCL

43
Q

what do small ANL scores mean? high ANL scores mean?

A

small (less than 7) : tolerates background noise
large (greater than 13) : cannot tolerate background noise

44
Q

what are the 4 steps of the developed multidimensional plan of care

A

-auditory assessment and diagnosis
-objective functional communication needs assessments
-subjective functional communication needs assessment
-non auditory needs assessment

45
Q

what must a FCNA do

A

identify activity limitations/participation restrictions, identify environmental factors which may impact plan of care, and identify personal factors which may impact plan of care

46
Q

what are benefits of questionnaires

A

standardization allows comparison to normative data and questionnaires are completed independently/prior to the scheduled appointment

47
Q

social network index

A

shows how often the patient communicates with others as well as the communications methods use
-asks about social relationships

48
Q

ECHO

A

designed to assess 4 sub-scales related to patient expectations of amplification

49
Q

what are the sub-scales of the ECHO

A

expected acoustic and psychological benefits, expectations of service and cost, estimates factors that often detract from satisfactory outcomes and perceptions of self image

50
Q

HASP

A

self perceptions outside of amplification to evaluate core beliefs

51
Q

COSI

A

prioritizes patient centered goals
-ranks perceived importance of up to 5 situations
-either cognitive or affective goals

52
Q

cognitive goals

A

difficult environments that require improvement to reduce the impact of the impairment
-factors within the environment

53
Q

affective goals

A

desired improvements as they relate to feelings/emotional needs

54
Q

CPHI

A

used to find out how hearing loss affects daily life and what problems the patient is having, if any
-can correlate to information on those who are more likely to keep or return the devices

55
Q

what is the importance of including these assessments

A

-involves the patient within plan of care
-focuses on the individuals needs when planning rehabilitation
-assists with counseling by opens discussions related to technology needs and identifies unrealistic expectations

56
Q

importance of dexterity screening

A

it can give us a insight of their dexterity abilities and can help our device recommendations
-as they may not be successful with smaller devices

57
Q

importance of visual screening

A

can impact the ability to see small buttons

58
Q

what is the audiologist’s role to ensure best practices are met

A

begin with a comprehensive investigative assessment followed by functional and communication needs assessment to give proper rehabilitation options

59
Q

hearing loss and related communication difficulties increase with age due to several comorbidities, including …..

A

chronic systemic disease, declining cognition/motor function and reduced social engagement

60
Q

importance of identifying systemic diseases

A

these can result in a progressive HL

61
Q

over reliance of the audiogram results in ….

A

counseling miscommunications that reduce post treatment satisfaction

62
Q

what are some common activity limitations

A

detection of sounds, intelligibility in quiet, intelligibility in noise, auditory localization

63
Q

is LDL a test of body structure/function or activity limitation? what about QuickSIN?

A

LDL : body structure and function
QuickSIN : activity limitation

64
Q

what is used to calculate the SNR loss?

A

SNR 50
-we deduct 2 dB from this

65
Q

presentation level for ANL

A

based on the PTA
-less than or equal to 45, present at 70 dB HL
-greater than 45, present at a level that is loud but okay

66
Q

what is the data that can be derived from the social network index

A

correlations between relationship of loneliness and cognitive decline are beginning to emerge with results from this test

67
Q

what is the data that can be derived from both the ECHO and CPHI

A

correlations are shown between who is more likely to keep their devices or return the devices

AUDE 6150 (4 decks)

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