Week9

Question 1

Structure that generates OAEs

Answer 1

Outer Hair Cells

Question 2

Absent OAE

Answer 2

-Conductive Loss
-Moderate to profound sensorineural loss
-

Question 3

Present OAE

Answer 3

-Normal
-if issue lies beyond outer hair cells (inner hair cells, auditory nerve, brainstem, cortex)

Question 4

May or may not be present OAE

Answer 4

Mild sensorineural hearing loss

Question 5

DPOAE Stimuli

Answer 5

two pure tones, f2 is 1.2 times higher than f1, f1 presented at 65 db HL, f2 presented at 55 dB HL

Question 6

Frequency at which DPOAE occurs

Answer 6

2f1-f2

Question 7

o If given an amplitude and noise value, determine if DPOAE is present or absent

Answer 7

singal to noise ratio must be at least 6 dB to be considered present.

Question 8

ABR wave matching

Answer 8

Wave I = peripheral(distal) portion of auditory nerve,

Wave II=Central (proximal) portion of auditory nerve,

Wave III= cochlear nerve,

Wave IV=Superior olivary complex,

Wave V=Lateral lemniscus

Question 9

How ABR wave latency changes with intensity

Answer 9

latency increases as intensity decreases

Question 10

Definition of ABR threshold

Answer 10

lowest stimulus intensity that results in a wave V- Wave V persists down to threshold but waves I-IV disappear

Question 11

What ABR threshold is used for

Answer 11

to estimate a pure tone audiogram, both air conduction and bone conduction can be done to estimate thresholds.

Question 12

Normal Hearing ABR

Answer 12

Latencies normal, thresholds normal.

Question 13

Conductive Loss ABR

Answer 13

All latencies abnormally long, thresholds outside normal range.

Question 14

Sensory (cochlear loss) ABR

Answer 14

Latencies are normal, thresholds outside normal range.

Question 15

Neural (retrocochlear) Loss ABR

Answer 15

Latencies of normal waves are abnormally long, thresholds are outside normal range, response may be grossly abnormal or absent

Question 16

How tumors of the auditory nerve affect the ABR

Answer 16

presence of tumor affects brainstem transmission time, tumors can cause abnormally long interpeak latencies

Question 17

What the 1-3-6 guidelines refer to

Answer 17

1: hearing screening should take place by 1-month,

3: Children who refer on the screening should receive a diagnostic evaluation by 3 months,

6: Children diagnosed with hearing loss should receive intervention by this age.

Question 18

When a baby would be referred for a diagnostic evaluation

Answer 18

-initial screen and rescreen;

-parent/caregiver concerns about hearing, speech, and or/language;

-infant has risk factors for hearing loss

Question 19

OAE infant screening Limitations

Answer 19

Some with mild sensorineural loss will pass, infants with neural hearing loss will pass, infants with fluid in outer/inner ear may refer

Question 20

AABR screening limitation

Answer 20

Some infants with mild sensorineural loss may pass; infants with neural hearing loss will refer. There will always be overlap.

Question 21

Procedures involved in a diagnostic evaluation for a 3-month-old

Answer 21

1. Case history for child and family;
2. Otoscopy;
3. Tympanograms;
4. Otoacoustic emissions (OAEs);
5. Auditory Brainstem Response thresholds.

Hearing aids can be programmed with ABR thresholds, eventually we want to get a pure-tone audiogram, children with profound sensorineural loss will be referred for cochlear implant evaluation

Question 22

Considerations for tympanometry probe tone frequency depending on age

Answer 22

-Under 6 mos., use 1000 Hz probe tone,

-above 6 mos. Use 226 Hz probe tone.

-Infant ear canal and middle ear properties different

Question 23

Range of thresholds for slight hearing loss degree

Answer 23

16-25 dB HL

Question 24

VRA age range

Answer 24

6 months to 2 years

Question 25

VRA Procedure

Answer 25

Sound field speakers, child looks to toy or video screen when sound is heard

Question 26

VRA Limitations

Answer 26

children may fatigue or lose interest quickly; ensure caregiver is not inadvertently providing cues; not ear-specific

Question 27

CPA age range

Answer 27

2 to 5 years

Question 28

CPA Procedure

Answer 28

play a game (drop block in bucket, put peg in hole; play connect 4)

Question 29

CPA limitations

Answer 29

need to change activities to maintain attention/motivation

Question 30

Sound field testing: Advantages, disadvantages, and what the results tell you

Answer 30

-advantage= no need to use headphones or ear inserts;
-disadvantages= not ear=specific;
-results say=Ex: mild sloping to severe hearing loss in at least one ear

Question 31

Cross-Check Principle

Answer 31

accept a test result only when it is confirmed by one or more independent tests