Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Paeds Osce > Rehab > Flashcards

Rehab Flashcards

1
Q

Management for permanent CHL or significant conductive component for infants < 6mo

A

BAHA on a soft band for ease use and for permanent CHL for eventual implantation

**AAA suggests conventional aids if anatomically possible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Ideal first fitting

A

Fitting within 4wks of diagnosis is recommended by the guideline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Directionality setting

A

Should be SURROUND (not automatic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What must you look out for ADHD or Autism

A

They are sensitive to sensory inputs e.g. loud sounds, touch, light etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Things to check for when looking at programme set up

A
  1. Directionality (or other adaptive features)

2. Prescription target (rationale)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

BCHA fitting notes

A
  1. Different to AC in gain- Approx. 10-15dB gain is attenuated across the skin, so extra gain to account for this
  2. Soft band should be firm but not tight-let 2 fingers to slip in
  3. FB turned on child’s head
  4. With some younger kids with poor head control, HA could be placed on forehead and microphone turned to omni.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Verification of BCHA

A
  1. Behavioural -functional gain using VRA (i.e. Aided SF thresholds but limited freq. resolution, no supra-threshold information) (i.e. In situ audiogram through fitting software so this is PTA through BCHA not SF/ does not assess speech audibility)
  2. Objective (CAEP aided & unaided using filtered speech phonemes)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Electroacoustic verification of BCHA

A
  1. Need a special BAHA transducer for real ear SPL & probe mic in the ear canal.
  2. Measure the Aided LTASS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What’s the most important thing you need to consider when comparing audiometric thresholds for the same baby over time?

A
  1. Ear canal acoustics (and hearing change could be the result of it) due to ear growth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

RECD setting checklist

A
  1. Target: DSL v5 child
  2. Age: choose appropriate age
  3. Transducer: either insert+foam (for foam) OR insert + ear mould OR ABR (eHL)
  4. Bone conduction: user discretion
  5. UCL: Average
  6. RECD: measure (if can’t measure use predicted)
  7. RECD coupling: Foam tip or earmould
  8. Binaural: No
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What’s RECD and what does it show?

A

RECD is the characterisation of the acoustic of the ear canal and obtained by measuring the output from the real ear and the coupler and obtain the difference between the two.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Two purposes of measured RECD

A
  1. To convert HL thresholds to the SPL format used in fitting
    (The reason why we specify insert+mould and insert+foam is because “HL” measure is based on average adult ear canal acoustics so to reflect true threshold, we convert it to SPL)
  2. To allow HA fitting in the test box
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How is RECD measurement captured in predicting real ear performance?

A

The RECD is applied to coupler microphone measurement so that HA instrument performance in the coupler can be predictive of performance in real ear.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

RECD protocol steps

A
  1. Calibrate RECD Transducer (done by connecting the transducer to 2cc-HA2 or BTE coupler or 0.4cc for verifit 2) and obtain measurement of HA1 value but this gets translated automatically
  2. Measure Real Ear using probe mic (tip within 5mm of TM/marker at intertribal notch for correct insertion and check for movement). Connect the insert tip (or mould) to the RECD transducer.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Verifit freq range

A

250-12.5kHz hence Wideband RECD or WRECD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why do we use mould when running RECD?

A

To Capture the tubing characteristic in subsequent applications of the measured RECD.

17
Q

2 cautions when using an ear mould

A
    • It is important to specify when ear mould is used. However select foam ear tip when the total tubing size is less than 35mm so more appropriate correction is applied
  • *When using Ear mould with vent, be sure to plug up the medial vent or lubricate for sealing
18
Q

Why is the coupler response always below the real ear response?

A

Because 2cc coupler is much larger than real ear canal volume and that’s why we always have positive RECD

19
Q

What does LF roll off indicate for RECD

A
  1. Poor seal during the on ear measurement
  2. Perforation of TM
  3. Grommets
20
Q

If the RECD curve > 10dB difference from average esp HF

A
  1. Check placement of the Probe tube or blockage and re-measure
21
Q

With verifit 2 because it’s calibrated to .4cc coupler we see…

A

Much less gap between the RECD and average RECD and negative RECD is typical but steep roll off is something we should check over

22
Q

HA-2

HA-1

A

HA-2 for older software

HA-1 for verifit 2 and above

23
Q

Probe tube measurements for

  1. Infants
  2. Children
  3. Coupling PT with ear moulds
A
  1. 11mm from the canal opening
  2. 15-25mm from the interracial notch for children
  3. 5mm beyond soundbore of the mould
24
Q

3 benefits to applying lubricant when inserting probe tube

A
  1. Help keeping the PT resting on the floor of the canal
  2. Reduce friction when inserting mould or foam tip while keeping PT in place
  3. PT not moving further
25
Q

The cause of negative values between -1 and -9 in the LF region in RECD and solution

A

Cause for Ear mould measurement: probe tube may cause some of the LF sound to escape from around the earmould or mould has vent >1mm causing sound leakage

Cause for Foam tip: tip not fully expanded or the size of the foam tip is too small or foam not inserted properly

Solution:

  1. Use ear mould lubricant (otoease) on the foam tip of ear mould to create better seal around the ear canal
  2. plug the medial vent on e=mould.
  3. If you have appropriate foam tip, ensure the lateral end of the tip is flush with the opening of the canal
26
Q

Cause and solution of Negative RECD values between -10 and -15dB in the LF region

A
  1. Perf TM or grommets

2. It is normal to have them

27
Q

Increased positive values in the LF and MF

A
  1. Possible MEE due to increased mass & stiffness of a fluid filled ear will cause increases in the RECD in the LF & MF.
    (When a child has MEE RECD results are more variable hence more important to have the measure)
28
Q

When to fit BCHA

A
  1. Permanent CHL (structural abnormality or syndromic permanent CHL e.g. Treacher Collins)
  2. Long-term temporary CHL w/ thresholds > or equal to 45dB eHL (e.g. MEE where surgical intervention may be contraindicated)
  3. Significant MHL with majority of the component is CHL (AC level high enough e.g. 90dB that BTE fitting might be technically difficult)
29
Q

BCHA verification clinically

A

No electro-acoustic verification clinically available for BCHA; only available to assess the fitting using aided behavioural measures and validation using questionnaires

Paeds Osce (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions