Pure Tone Audiometry Flashcards

1
Q

why do we test hearing using pure tones?

A
  • frequency specific thresholds
  • type and severity of hearing loss
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2
Q

standard earphones

A
  • proper placement is quick and easy
  • easier and more comfortable for children
  • inexpensive
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3
Q

insert earphones

A
  • proper placement can be tricky
  • children may not participate with fitting due to discomfort
  • expensive
  • better at reducing ambient noise during testing outside of a sound booth
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4
Q

air conduction audiometry

A

assessing the air conduction pathway which is how we hear normally
outer ear - middle ear - inner ear

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5
Q

threshold

A

the lowest decibel (dB) hearing level in which a person can hear a signal and respond

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6
Q

right ear air conduction symbol

A

O

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7
Q

left ear air conduction symbol

A

X

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8
Q

no response air conduction symbol

A

arrow attached to a symbol
ex: X with arrow

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9
Q

air conduction audiometry, methodology

A
  • 250, 500, 1000, 2000, 4000, 8000 Hz
  • begin in the right ear first (or better ear) at 30 dB and 1000 Hz
  • followed by 2000, 4000, 8000 Hz
  • repeat 1000 Hz
  • then 500 and finally 250 Hz
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10
Q

air conduction methodology: no response?

A

continue in 10 dB steps until response

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10
Q

air conduction methodology: no response at starting level of 30 dB?

A

begin at 50 dB

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11
Q

when searching for threshold, you will use…

A

bracketing
- 10 down, 5 up
- consistent response 3 times at lowest intensity, that is threshold

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12
Q

degree of hearing loss: normal

A

-10-25 dB

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13
Q

degree of hearing loss: mild

A

26-40 dB

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14
Q

degree of hearing loss: moderate

A

41-55 dB

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15
Q

degree of hearing loss: moderately-severe

A

56-70 dB

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16
Q

degree of hearing loss: profound

A

91 dB and above

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17
Q

bone conduction hearing

A

we can bypass the outer and middle ear by stimulating the inner ear through vibration of the skull

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18
Q

components of bone conduction

A
  • distortional
  • inertial
  • osseotympanic
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19
Q

distortional bone conduction

A

distortion of the skull activates structures of the inner ear

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20
Q

inertial bone conduction

A

distortion of the skull causes the ossicular chain to move and it lags behind skull movement due to inertia

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21
Q

osseotympanic bone conduction

A

distortion causes air to vibrate in the ear canal, some sound waves exit ear canal while others continue back the air conduction pathway

22
Q

bone conduction methodology

A

frequencies 500, 1000, 2000, 4000 Hz

23
Q

why do we not test the same frequencies for bone conduction?

A

sometimes 250 Hz can be affected by ambient noise and oscillator cannot vibrate over 4000 Hz

24
Q

bone conduction: intensity limit

A

70-75 dB

25
Q

why do we test different intensities for bone conduction?

A

cannot test above 75 dB since the person will feel it before they hear it

26
Q

bone conduction right ear symbol

A

<

27
Q

bone conduction left ear symbol

A

>

28
Q

is bone conduction testing before or after air conduction testing?

A

after

29
Q

bone conduction methodology: placement

A

directly on the mastoid area behind right or left ear

30
Q

why doesn’t it matter which side to place the bone oscillator?

A
  • the better cochlea will always respond to the tone first
  • can’t vibrate half of your skull
31
Q

why do we test both air and bone?

A

to determine the location of the hearing loss

32
Q

SLPs will likely never perform masking, however, it is important to know how…

A

to interpret an audiogram that has masked thresholds

33
Q

when is masking used?

A
  • during air conduction testing when one ear is significantly better than the other ear at specific frequencies
  • during bone conduction to isolate a cochlea
34
Q

cross hearing

A

when the signal presented to the poorer ear is so loud that it “crosses over” to the better ear and that ear responds

35
Q

shadow curve

A

responses on an audiogram are falsely recorded because the good ear is the ear that actually responded to the stimulus

36
Q

masked right ear air conduction

A

triangle

37
Q

masked left ear air conduction

A

square

38
Q

masked right ear bone conduction

A

[

39
Q

masked left ear bone conducion

A

]

40
Q

if you see an audiogram that has the masking symbols, it means that…

A

the tester used masking and the results are accurate

41
Q

what is masking?

A
  • presenting “noise” to the good ear to keep it “busy” and raise its threshold so that it cannot “help” the bad ear
  • the better ear will have a continuous narrow band noise, while the poorer ear is being presented with the pure tones (or other stimulus)
42
Q

how do we know when to mask?

A
  • based on interaural attenuation
  • rule of thumb for air conduction masking
43
Q

masking: based on interaural attention

A

difference in decibels, between the intensity of sound that was presented to the poorer ear and the amount of sound that actually reached the good ear

44
Q

masking: rule of thumb for air conduction masking

A
  • if at a specific frequency there is a 40 dB or more difference between the right ear and the left ear
  • this is frequency specific, you have to look at each frequency separately
45
Q

sound field testing

A

testing in the sound booth through speakers (can’t test ears individually)

46
Q

sound field testing: used for…

A
  • specialized tests for young children; most will not tolerate wearing headphones of any kind
  • hearing aid functional gain testing
47
Q

visual reinforcement audiometry (VRA)

A
  • conditioned orientation reflex (COR) and tangible reinforcement operant conditioned audiometry (TROCA)
  • uses the sound field
  • signal is presented through either a right or left mounted speaker
48
Q

when the child looks toward the correct speaker, they are visually rewarded…

A
  • a box that lights up with a dancing animal
  • a computer screen with a cartoon
49
Q

behavioral observation audiometry (BOA)

A
  • subjective test for children with a developmental age of up to 6-7 months
  • behavioral technique
  • typically reflexive responses
  • uses noisemakers, warble tones, music, etc.
50
Q

reflexive responses

A
  • eye blinks, startle response
  • changes in sucking behavior or breathing
51
Q

conditioned play audiometry (CPA)

A
  • for children 2 1/2 to 5 years of age
  • condition time to respond to a stimulus through play (ring on peg, block in bucket, tec.)
  • can be done with headphones
52
Q

false negative response

A
  • patient forgets to raise hand
  • patient is exaggerating a hearing loss
  • reinstruct
53
Q
A