Test 2 Hearing

Question 1

What is the main purpose of case history?

Answer 1

Identifying information(demographics), nature of auditory complaints, whether the difficulty has affected their life, general health, and medical red flags.

Question 2

What are the five major components of a case history?

Answer 2

-demographics
-hearing and balance concerns
-otologic history
-medical background
-medications

Question 3

Common symptoms reported in a case history…

Answer 3

tinnitus, hearing loss “everything is muffled” “i can hear but can’t understand”, otalgia, otorrhea, vertigo, aural fullness/pressure in the ears

Question 4

Questions specifically related to tinnitus.

Answer 4

-unilateral or bilateral
-pulsatile or non-pulsatile

Question 5

Questions related to hearing loss:

Answer 5

-what situations cause the most hearing difficulty?
-how long have you had hearing loss?
-is there a family history of hearing loss?
-what is the rate of progression of the hearing loss?

Question 6

Speech Recognition Threshold (SRT)

Answer 6

recorded as the lowest intensity level that the patient can detect and recognize speech sounds, at which 50% of a list of spondee words can be correctly identified

Question 7

Purpose of SRT

Answer 7

check on pure tone responses, should agree with PTA (within 10 decibels)

Question 8

SRT Procedure

Answer 8

-SRT is tested one ear at a time, better ear first
-patient repeats words they hear, lower 10 when they get it right, and up 5 when they can’t hear it
-the softest level at which the listener is able to correctly identify 50% of the words is the SRT for that ear

Question 9

Speech Awareness/Detection Threshold (SAT/SDT)

Answer 9

requires that the patient indicates that they are aware that a speech sound is present, without requiring that they know what the sound is
-uses spondee words
-finds the threshold of their awareness of the presence of a speech sound
Ex: “Airplane” “Yes”

Question 10

Word Recognition Score (WRS)

Answer 10

determines a patient’s ability to discriminate speech at a comfortable listening level, NOT threshold
-monosyllabic words are used
-MUST have SRT bc words are presented at 40 dB above the SRT

Question 11

WRS Procedure

Answer 11

-find the presentation lvl (SRT+40dB or 2kHz rule)
-present 25 words(phonetically balanced) at that lvl and determine the percentage correct

Question 12

Factors that influence word recognition testing

Answer 12

-recorded vs MLV presentations
-male vs female presentations
-level of presentation
-partial vs full word lists

Question 13

When is masking necessary?

Answer 13

when we have cross over hearing

Question 14

What is cross over hearing?

Answer 14

when one ear performs better than the other ear, and sound crosses over to the other ear. this causes a better response for the worse ear.

Question 15

Interaural Attenuation

Answer 15

the loss of energy of a sound presented by either AC or BC as it travels from the test ear to the non-test ear (headphones-40, inserts-60, bone oscillator-0)

Question 16

Masking allows us to…

Answer 16

distract the better ear

Question 17

Right mask symbol?

Answer 17

triangle

Question 18

Left mask symbol?

Answer 18

square

Question 19

Rule 1a

Answer 19

look at the difference bn AC thresholds for each ear. if we are exceeding IA, then we need to mask air!

Question 20

Rule 2

Answer 20

when the AC threshold of the test ear and the BC threshold of that same ear is more than 10dB then you have to mask

Question 21

What does it mean to “plateau”?

Answer 21

we want the patient to respond to the tone in the test ear 3 times, while we have increased by 5 dB in the masker going to the non-test ear. then we will record the ending level presented to the test ear and the ending level of masking level in the non-test ear.

Question 22

What is the occlusion effect?

Answer 22

when one ear is occluded, and when we set the skull into vibration, sound gets trapped in the ear canal of the occluded ear. this causes an increase in the sound pressure level of the sound at that ear, this means the patient will respond to the sound at a much lower vol than they can actually hear it.

Question 23

Occlusion effect for different frequencies.

Answer 23

250 Hz- 15dB
500 Hz- 15dB
1000 Hz- 10dB

Question 24

Bone conduction is the _____ _____ time that you will have to mask.

Answer 24

most common

Question 25

When we mask, we are _____ presenting the masking via air conduction.

Answer 25

always

Question 26

Any time you have to mask for AC, you _____ have to mask for BC at that frequency.

Answer 26

also

Question 27

To determine the level to mask with….

Answer 27

you go by the AC scores

Question 28

What is the Carhart/Jerger method for pure tone audiometry?

Answer 28

you go down 10 when they can hear the sound, and up 5 when they can’t.

Question 29

Frequencies to test for air conduction:

Answer 29

1k, 2k, 4k, 8k, 1k, 500, 250

Question 30

Frequencies to test for bone conduction:

Answer 30

500, 1k, 2k, and 4k

Question 31

What is the importance of SRT?

Answer 31

to compare it to the pure tone average, it should be within 10 dB

Question 32

What is word recognition testing?

Answer 32

Should be above their threshold, and 25 words are presented to both ears that are phonetically balanced.

Question 33

What are the two methods of finding WRS?

Answer 33

40 dB above SRT, and the 2k Hz rule.

Question 34

What is SAT/SDT?

Answer 34

Like SRT but instead of repeating the words you have to raise your hand. Focuses on if the patient is aware of the presence of the sound of speech.

Question 35

HL

Answer 35

-10-25: normal
26-40: mild
41-55: moderate
56-70: moderately severe
71-90: severe
>90: profound

Question 36

2kHz Rule

Answer 36

> 50: 25dB
50-55: 20dB
60-65: 15dB
70-75: 10dB