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CMSD 5020 Hearing Measurement > Pure-Tone Audiometry > Flashcards

Pure-Tone Audiometry Flashcards

1
Q

Why do we measure thresholds?

A

To see if someone can detect sounds

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2
Q

1 octave = mm on the basilar membrane

A

5 mm

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3
Q

Why do we use 1 frequency in pure-tone audiometry?

A

for Place Specificity and we use low sound pressure to be as place-specific as possible

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4
Q

What affects performance in real life? (5)

A

Accent/Language issues
Background noise
Cognitive issues (Dementia)
Age
Attention

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5
Q

Why is the audiogram upside down?

A

As the hearing level goes up then the fact that it goes down it shows hearing loss

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6
Q

Why does the audiogram go in steps of 10dB

A

Because of the variability of the results and the fact that adding 10 is roughly two times as intense

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7
Q

Why do we use octaves in the audiogram?

A

Frequency discrimination gets broader as you go up in frequency

1 speech feature/piece of information per octave

Regular physical tonotopic on the BM (5m)

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8
Q

What does the 0 represent on the audiogram?

A

The lowest sound level we can detect on average

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9
Q

Why does the transfer function in the ME is low before and after 1000 Hz?

A

Stiffness of the ossicles affects the transmission of low Frequencies and Mass of the ossicles affect the high frequencies

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10
Q

What is RETSPL? (2)

A
  • Reference equivalent threshold sound pressure level
  • level of average threshold
  • this is subtracted so that average is zero
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11
Q

How do we calculate HL using RETSPL?

A

If someone hears 26.5 dB at 250 Hz you subtract the RETSPL at this frequency 26.5 -26.5 so the HL is 0

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12
Q

What is a threshold?

A
  • The level at which a person hears a tone 50% of the time (i.e., a hit rate of 50% or .5)
  • The point of Maximum uncertainty
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13
Q

In what dB steps and Octave steps do we do our Pure-tone test?

A

5 dB steps
1 octave (125, 250, 500, 1000, 2000, 4000, 8000)5mm steps along BM

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14
Q

On the audiogram, what do the O and X represent?

A

O = Right air conduction
X = Left air conduction

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15
Q

On the audiogram, on what side is the right ear and left ear charts?

A

Right ear on theLeft side of the audiogram
Left ear on the Right side

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16
Q

What are the degree levels of hearing?

A

Normal -10 to 25 dB
Mild up 26 - 40 dB
Moderate up 41 - 55 dB
Moderately Severe up 56 -70 dB
Severe up 71 - 90 dB
Profound up 91 dB

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17
Q

What is the device/machine we use for testing?

A

The Clinical Audiometer

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18
Q

What does the clinical audiometer do? (9)

A

Oscillator (for pure tones)
Noise generator
Amplifier/Attenuator
Signal router
Presentation Ctl

Interrupt (Plays sound continuously)
Talk Forward Lvl
Talk Forward Btn
Microphone Lvl

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19
Q

Which device is this?

A

Ipad base audiometer called Shoebox

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20
Q

Which device is this?

A

Most popular audiometer GSI

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21
Q

Which device is this?

A

The Screening Audiometer

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22
Q

What is the first step in measuring?

A

Control

Calibrate the earphone/microphone using 6cc 2cc couplers

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23
Q

What does this table represent?

A

Ambient Noise is permissible depending on RETSPL

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24
Q

What is the difference between these devices?

A

On the left: supra-aural Earphones
On the right: Inserts Earphones

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25
Q

Which earphones do we use the most in clinic?

A

TDH 49/50

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26
Q

What are the pros of Insert Earphones?

A

Pros:
More Stable
More Hygenic
No collapsing canal
Better in areas of higher ambient noise than was previously possible
Improved patient comfort

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27
Q

What are the pros and cons of Supra-aural Earphones?

A

Pros:
Much easier to store, carry, and wear during daily activities and commutes

Cons:
Can cause collapsing canal
Less hygienic (used over and over again)

28
Q

When would we use speakers (sound field)?

A
  • If kids won’t accept earphones
  • Spatial hearing
  • Environment testing
29
Q

What are dial readings?

A

This means my audiometer is creating a certain dB HL in the coupler, not the same level in every. Helps to match the same dB HL in the earphones.

30
Q

What is the difference between sending 40 dB SPL in huge vs baby ears?

A

Can make wrong conclusions hearing loss of huge ears because less pressure will be felt compared to baby ears

31
Q

What device do we use for BC audiometry?

A

Bone Oscillator on the mastoid bone

32
Q

What is Cochlear fluid inertial stimulation?

A
  • when the bone of the cochlea is vibrating, the perilymph will try to “stay put”
  • this is fluid inertia (from the mass of the fluid) and because there is a little space in the round window, the fluid will be able to move back and forth
33
Q

What is Cochlear fluid inertial stimulation?

A
  • First and most important mechanism of BC
  • when the bone of the cochlea is vibrating, the perilymph will try to “stay put”
  • this is fluid inertia (from the mass of the fluid) and because there is a little space in the round window, the fluid will be able to move back and forth
34
Q

Why is cochlear inertial stimulation useful?

A

Bypass OE and ME and help diagnose SNHL

35
Q

What is the second Mechanism in BC?

A

Ossicles Inertial Stimulation helpful to diagnose Otosclerosis

36
Q

What is the third mechanism of BC?

A

Osseotympanic stimulation

37
Q

What are the types of Hearing loss?

A

Conductive HL
Sensorineural HL
Mixed loss

38
Q

Explain this picture:

A
39
Q

What does an ABG mean in the audiogram

A

Conductive Loss

40
Q

What is the Weber test?

A
  • Tuning fork is placed on center of forehead to measure for lateralization/centered for SNHL
  • Sound heard on side with better cochlea, or on side with conductive loss
41
Q

What is the Rinne test?

A
  • Principle: sound decays faster via bone conduction
  • Fork is held on mastoid until no longer heard, then immediately placed in from of canal
  • If sound is still heard (via AC), this means no conductive loss: a POSITIVE RINNE
  • If sound is not heard (via AC), this suggests conductive loss: a NEGATIVE RINNE
42
Q

What is the Bing test?

A
  • tuning fork is held on mastoid, while tragus is held against canal
  • sound should get louder when ear is plugged (occlusion effect), but this will not likely occur with conductive loss
  • If sound gets louder (no conductive loss), this is a POSITIVE BING
  • If sound does not get louder (conductive loss), this is a NEGATIVE BING
43
Q

What are the ways ORL’s use to report hearing loss?

A

Percentages:

% Impairment
avg threshold at (.5,1,2,3 kHz) - 25 dB x 1.5
0% = 25 dB = No hearing loss
100% ≈ 90 dB = Profound

or

% Disability
(better ear x 5 + worse ear) / 6

44
Q

What are the second of way to describe hearing loss?

A

The Pure Tone Average:

average of 500, 1000 & 2000 Hz

the Fletcher average: best two of three

45
Q

What is the best way to describe hearing loss?

A

Degree, Type, Configuration

46
Q

What are 5 configurations (shapes) of hearing loss and what is the rule?

A

Rules of 20 dB change Slopping, Rise, Flat, Ski slope, Cookie bite

47
Q

How would you describe this audiogram? (Degree and configuration)

A
48
Q

How would you describe this audiogram? (Degree and configuration)

A
49
Q

How would you describe this audiogram? (Degree and configuration)

A
50
Q

How would you describe this audiogram? (Degree and configuration)

A
51
Q

How would you describe this audiogram? (Degree and configuration)

A
52
Q

How would you describe this audiogram? (Degree and configuration)

A
53
Q

What is the difference between Congenital, Acquired and Adventitious?

A

Congenital : present at birth
Acquired: obtained after birth
Adventitious: acquired from an external source (not innate)

54
Q

Acute:

A

sudden and short

55
Q

Chronic:

A

long duration (not used for pure tone thresholds)

56
Q

Sudden:

A

rapid onset

57
Q

Gradual:

A

occurring in small degrees

58
Q

Temporary:

A

limited duration

59
Q

Permanent:

A

irreversible (PTS vs. TTS)

60
Q

Progressive:

A

advancing in severity

61
Q

Fluctuating:

A

a periodic change in degree

62
Q

What are the symbols for:

  • Right/Left Unmasked:
    Earphone, Mastoid Bone
  • Right/Left Masked:
    Earphone
    Mastoid Bone
  • Unspecified
    Mastoid Bone
    Forehead Bone
    Soundfield
A
63
Q

What is this screening arrangement?

A

Typical screening arrangement

64
Q

What is this screening arrangement?

A

Diagnostic arrangement

65
Q

Who should place the transducer?

A

Clinician only

CMSD 5020 Hearing Measurement (10 decks)

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