written comp Flashcards
What agencies/governing bodies deal with infection control?
CDC
OSHA
WHO
EPA
FDA
What guidelines do they have that we have to follow regarding infection control
Standard precautions
Universal precautions - when we have to use PPE and do certain levels of cleaning something
Levels of cleaning instruments
Disinfection - kills germs, equipment that doesn;t use infectious debris
Sterilize - something that could get blood on it
If we dont follow the guidelines…
Financial penalties
Clinic closures
regulates noise ordinances in the community
epa
Which agency plays a role in infection control, but more in pharmacology and medical devices
FDA
The original standard precautions came from
CDC
What is 1 infection control procedure to help stop the spread of infections from patient to patient
hand hygiene
Which agency ensures safe and healthful working conditions for workers by setting and enforcing standards and by providing training, outreach, education, and assistance.
Which agency’s goal is to protect public health and fight disease. “ is one of the major operating components of
the Department of Health and Human Services and is recognized as the nation’s premier health promotion, prevention, and preparedness agency.” It created
guidelines for standard precautions
CDC
What does OSHA stand for?
Occupational Safety and Health Administration
What does CDC stand for?
Centers for Disease Control and Prevention
What does EPA stand for?
Environmental Protection Agency
Which agency regulates chemical safety, i.e., disinfectants and sterilants, and much more related to the environment and human health
EPA
United States-based nonprofit 501(c) organization that accredits and certifies more than 22,000 healthcare organizations and programs in the United States.”
JCAHO
What does JCAHO?
The Joint Commission on Accreditation of Healthcare Organizations
What does FDA stand for?
U.S. Food and Drug
which agency acts to protect the public health be ensuring safety of food, drugs, medical devices and cosmetics
FDA
What is the recommended amount of time the CDC (and OSHA) recommends washing your hands
*10-20 seconds
Hum/sing Happy B-Day or Twinkle
Twinkle Little Star Twice
Is hand sanitizer better than hand
washing?
No, you should wash your hands as soon as
possible even after use of hand sanitizer.
What type of menigitis is this:
Most severe meningitis
Can have severe-profound SNHL - affecting the inner ear
Cochlear ossification - affects the ability to choose CIs etc.
It can also be brain damage
bacterial meningitis
Hospital acquired infection
Nosocomial - acquired it in a hospital, reason why JCAHO IS IMPORTANT because they monitor and want to reduce these
What is the route for the meninges and the inner ear?
Perilymphatic duct - allows route of communication bw meninges and inner ear
Perilymph and csf are very similar in makeup
Endolymphatic duct & sac - absorb from inner ear up to the dural space of the extra endolymph
Endolymph produced in stria vascularis
low lying, not overly pervasive, constantly around and we get used to it, ex: flu
endemic
What does stria create to allow the organ of Corti to work
High concentration of potassium = endocochlear potential (because of stria pumping out, it has high potassium, causing hairs to be ready for stim)
regional, in country or area, pops up ex: small pox, west nile, zika, sudden outbreak of disease in community or region during a time period, runs its course
epidemic
epidemic on a large scale that crossed borders ex: COVID-19
pandemic
Gloves & mask
Eyeglass protection
Shields
robe/gown/lab coat
Shoe covers
Hair net
are examples of…
PPE
What is the term used to define microbes that can cause illness and/or disease?
pathogen
What virus is responsible for painful infection of the facial nerve near the ear that can lead to blisters, hearing loss, and vertigo?
Herpes Zoster Oticus
What bacteria is the most common cause of otitis media?
Streptococcus pneumoniae
_________ is the term used to define a common outer ear fungal infection.
otomycosis
One benefits at the expense of the other.
Parasitism
Both the host and the microbe benefit from each other.
mutualism
One benefits but the other does not receive benefit or harm.
Commensalism
an epidemic on a large scale, like a continent
Pandemic
an infection that is ever-present at a relatively low level, like Valley Fever
Endemic
a sudden outbreak when more than the usual number of cases of a disease occurs in a community during a certain time period
Epidemic
Non-profit accrediting agency
JCAHO
Ensures a safe workplace for all employees
OSHA
safety of drugs, medical devices, food, and cosmetics
FDA
Created guidelines for standard precautions
CDC
Regulates disinfectants and sterilants
EPA
A patient was admitted to the hospital for an emergency appendectomy. A couple of days into his hospitalization, he developed MRSA at the incision site. This type of secondary infection is referred to as a ___________________ infection
nosocomial
Bacterial meningitis can be deadly within 24 - 48 hours if left untreated. It can also lead to permanent brain damage and severe sensorineural hearing loss (SNHL)
true
It is not essential to employ hand hygiene if you wear gloves.
false
When performing otoscopy, you should use the largest speculum tip possible.
true
What is the leading cause of transmission of germs in health care settings?
Contaminated hands
What is the preferred method used to prepare critical audiology tools for use with another patient?
Cold sterilization with gluteraldehyde or hydrogen peroxide solution for several hours.
Home-grade disinfectants, like Clorox wipes
Low-level disinfection
Dishwasher, bleach, or rubbing alcohol
Mid-level disinfection
Hospital-grade disinfectants, like Audiologist’s Choice solution or Cavicide wipes
High-level disinfection
Surfaces like chairs and counter tops during everyday encounters with patients should be:
Cleaned
Disinfected
First step. Removes gross (visible) contamination from the surface
Clean
Kills some of the germs, but not all of them
Disinfect
Kills 100% of the germs 100% of the time
Sterilize
Whenever we may have contact with potential infectious material
If risk of cerumen, blood, or splatter, wear protection
PPE
Method for removing cerumen?
Irrigation, mechanical instrumentations (forceps, curette, scoops, etc.), suction.
How do you know when to remove cerumen?
Blockage of the tympanic membrane, to prevent pushing it in further, if it is dry/hard and won’t come out on its own.
What are precautions/contraindications for doing cerumen removal?
Do not irrigate without tympanometry and otoscopy, diabetes (infection risk), blood thinners (bleeding risk), patient consent.
Why do we have cerumen?
Lubricates and protects the ear, acts as a barrier, and migrates out due to epithelial migration.
What agency created the Universal Blood and Bloodborne Pathogen Precautions?
CDC.
What forms from the neural tube from ectoderm?
Brain, spinal cord, nerves, and ganglia.
What is the first sign of the nervous system forming?
Thickening of the groove in ectoderm that becomes the neural tube.
What happens if the neural tube doesn’t zip up?
Can result in an open neural tube; on the caudal side, this is known as spina bifida.
What condition is associated with spina bifida?
Arnold Chiari II.
Which germ layer is on the outside of the tympanic membrane?
Ectoderm.
Which layer is on the middle ear side?
Endoderm.
Which germ layer is in the middle making it spiral?
Mesoderm.
What does the dorsal portion become?
Utricle, semicircular canals, and endolymphatic duct.
What is genetic material and gene mutation called?
Genotype.
What are symptoms and physical presentations called?
Phenotype.
What is most commonly associated with genetic hearing loss?
Autosomal recessive (AR).
What condition is characterized by 3 copies of chromosome 21?
Down syndrome.
Body can function with too much genetic material; associated with conductive hearing loss or mixed hearing loss, stenosis, and facial changes.
What is the RETSPL equation for converting hearing level to sound pressure level?
dB HL = dB SPL – RETSPL.
What is the RETSPL equation for converting sound pressure level to hearing level?
dB HL = dB SPL + RETSPL.
Convert 0 dB HL at 1,000 Hz to dB SPL.
dB SPL = 7.5.
What is dB SL?
Difference between presentation level and the patient’s individual threshold.
If a patient’s threshold is 25 dB HL and you present a tone at 60 dB HL, what is the dB SL?
35 dB SL.
If a patient’s threshold is 45 dB HL and you present a tone that is 10 dB SL, what is the dB HL?
55 dB HL.
What is the increase in dB for doubling of intensity?
+3 dB.
What is the increase in dB for doubling of sound pressure?
+6 dB.
What is the increase in dB for doubling of loudness in typical hearing?
+10 dB.
What ensures we are measuring what we think we are measuring?
Test validity.
What is the method of constant stimulus?
Stimuli are presented in a pre-determined, random order, with many presentations at each stimulus level.
What is the method of limits?
Stimuli are presented at pre-determined starting points.
What is the method of adjustment?
Stimulus is controlled by the subject; level change is continuous rather than in discrete steps.
What does a conservative criterion result in?
Fewer hits, more correct rejections; less likely to say they heard it.
What does a neutral criterion result in?
Equal number of hits and correct rejections.
Why does someone with a liberal criterion present with better hearing thresholds?
Because they have a higher tendency to say yes.
Why does someone with a conservative criterion present with poorer hearing thresholds?
Because they have a higher tendency to say no and wait until it gets louder.
What type of filter only passes energy BELOW a designated upper cutoff frequency?
low pass filter
What is 0 dB SNR? Is this a difficult listening situation?
signal and noise are at the same level
Not great situation; most people need a couple dB of signal being louder than noise.
What is +10 dB SNR?
where signal is 10 dB level than the interfering noise
What is -5 dB SNR?
signal is 5 dB less than the noise
Which is the hardest situation to listen in? j0, +10 or -5 dB SNR?
-5 because it is less than the noise
What do we set SNR in the booth?
speech in noise testing (both are in the same ear)
What type of filter only passes energy ABOVE a designated lower cutoff frequency?
high band pass filter
What is a band pass filter?
has high and low cut off and passing between those cut offs (passing band in the middle)
What is a band reject filter?
has low and high cut off and passing what is outside of them and rejects what is between them
For tonal masking which is correct? Why?
Low frequency tones mask high frequency tones most effectively
Because high frequencies anatomical organization (tonotopic organization) of the base with high and lows at apex makes the lows impact and infect by the travelling waves to the lows (upward spread of masking).
Define monotic.
one ear listening with one ear
Define diotic.
same signal going to both ears
If we play a signal from a speaker in front of the patient, what is the azimuth?
0
If we play a signal from a speaker directly behind the patient, what is the azimuth?
180
When you increase the frequency of a pure tone, what happens to the wavelength? Why?
it gets shorter because the frequencies get faster and complete the cycle quicker
If you increase the stiffness of a system, are low or high frequencies reduced more?
Low frequencies are reduced and impacted more.
Anatomically, we increase stiffness on purpose during muscle reflex, which reduces own vocal fold vibrations, allowing highs to pass through.
If you are putting sound through a medium with more mass, which frequencies are attenuated more?
High frequencies are attenuated more.
An example is using a bone oscillator, which makes it harder to move the mass through the head compared to air.
Define harmonic distortion.
Distortion products are added that are whole number multiples (integers) of the original signal.
Define frequency distortion.
Amplitude is reduced at certain frequencies based on the characteristics of the filter.
Define transient distortion.
Spectral splatter - with energy spread to other frequencies.
How does transient distortion and spectral link to OAE testing?
TEOAEs use a click or short transient stimuli, and results are analyzed by filters in the computer to extract frequency information.
Which distortion relates to the other type of OAE, DPOAE?
Harmonic distortion.
This is because of the relationship 2f1-f2, looking at variations of harmonic distortion.
What is considered the critical period for language development in children?
Birth to 3 years.
What is an example of a fluency disorder?
Stuttering.
What other disorder goes with stuttering?
Cluttering.
Describe stuttering vs cluttering.
Stuttering is characterized by repetitions, prolongations, or blocks in speech. Cluttering is characterized by rapid and/or irregular speech.
What is an example of a motor speech disorder?
Stuttering is characterized by repetitions, prolongations, or blocks in speech.
Define diotic.
Same signal going to both ears.
Define dichotic.
Different (divergent) signal going to both ears.
For example, one ear gets a 1000 Hz tone while the other ear gets speech.
Which one is harder from processing, diotic vs dichotic?
Dichotic is harder because you are getting different signals, stressing the signal as the brain tries to perform binaural fusion.
What does ‘bilateral’ mean?
two sides
What does ‘binaural’ refer to?
listening with two ears
What can cause voice/resonance disorders?
polyps and vocal nodules
singers, theatre, those that speak loudly
What are advantages of binaural hearing?
binaural summation, binaural squelch, binaural fusion
Some help us listen in noise, localization.
Who might be considered the first audiologist?
CC Bunch
Wrote the seminal article on testing hearing with tones in 1920 and the Clinical Audiometry book in 1943.
Describe the Modified Hughson-Westlake procedure.
An adaptive psychoacoustic procedure where the method changes based on the PT’s response. Down 10 up 5.
What is an example of a motor speech disorder?
apraxia, dysarthria
How would you describe prelingual hearing loss?
Develop hearing loss before speech and language development, leading to a poorer prognosis and longer rehabilitation.
How would you describe post-lingual hearing loss?
Hearing loss occurs after developing speech and language, providing a foundation and auditory memory.
Can post-lingual hearing loss affect speech/language even if amplified right away?
sometimes
Does unilateral hearing loss impact a child?
Yes, it can affect localizing and hearing in noise, leading to academic difficulties.
What is the auditory feedback loop?
When you speak, hear yourself, and correct yourself if needed.
What is typically the reading level achieved by a deaf child using hearing aids?
4th grade level
What can be done for unilateral children in the classroom?
Preferential seating, place in front of the class, personal remote mic technology.
Historically, what has been the typical reading level of a deaf child using hearing aids?
4th grade
What is the national average reading level?
7 or 8th grade in the US
What is narrative sampling?
Narrative sampling lets them more naturally speak by reading a passage or an open-ended question and letting them talk, taking a sample of how they did.
Taking a sample of their dialogue and ability to speak.
What is dynamic assessment?
Dynamic assessment involves doing a task you assess, training them how to do it, and then reassessing their potential to improve something.
When might narrative sampling and dynamic assessment be helpful?
These methods are helpful to get a baseline. Standardized tests are validated with subjects who are English speaking and their first language, so this type of test may not be valid for someone who isn’t.
If you have a PT who is Spanish speaking and you do not speak Spanish?
Get an interpreter, find a test in that language, or refer to someone who speaks the language.
Describe: Place of articulation, Voicing, Manner of articulation.
Place of articulation refers to where it constricts in the vocal tract. Voicing indicates whether the vocal folds vibrate or not (voiced or voiceless). Manner of articulation describes how the sound is made and how it is flowing (fricative, affricate, nasal, glide, stop).
Describe: Broca’s aphasia vs Wernicke’s aphasia.
Broca’s aphasia is associated with frontal lobe damage, while Wernicke’s aphasia is linked to temporal lobe damage. These affect how the sounds are made but not motor function; it is a neurological disorder because it is the brain pathway that is damaged.
What is semantics?
Semantics refers to meaning.
What is pragmatics?
Pragmatics refers to context and organization.
What is syntax?
Syntax refers to the arrangement of words.
What is Osteopathic Medicine?
An osteopathic physician (DO) is a doctor with full medical privileges that can utilize all forms of standard medical and surgical treatments, as well as osteopathic manipulation and alternative medicine.
What are the 4 Fundamental Principles of Osteopathic Philosophy?
- The human body is a dynamic unit of function of mind, body, and spirit.
- The body possesses self-regulatory mechanisms which are self-healing in nature.
- Structure and function are interrelated at all levels.
- Rational treatment is based on these principles.
Is rational treatment based on an understanding of the basic principles of body unity, self-regulation, and the interrelationship between structure and function… NOT JUST TREATING SYMPTOMS?
True
What is the purpose of professional liability insurance?
To protect you if you get sued, cover mistakes that occur during the course of employment, and cover any contingency.
What is tort law?
Tort law is civil law about causing damage to a person or property. It is a civil wrong against a person or property that may result in action for damages.
What are the objectives of tort law?
Preservation of peace, culpability (find fault for wrongdoing), deterrence (discourage wrongdoer from committing future torts), compensation (indemnify the injured person of wrongdoing).
What is negligence?
A tort, a civil or personal wrong. The unintentional commission or omission of an act that a reasonably prudent person would or would not perform under given circumstances.
What is negligence or carelessness of a professional person?
Malpractice.
What is the reckless disregard for the safety of another?
Criminal negligence.
For malpractice cases, what must they prove?
Duty, breach, damages, causation.
When do you provide a patient with a notice of privacy practices?
First visit, annually after to remind them. Explains your policies and their rights.
What is the purpose of an informed consent document and when would you use it?
Making sure they are ok with being a subject with the things you are doing. Some do it up front for everything or individually depending on the task.
What are some state licensure requirements?
Always need a license, degree in audiology: doctoral, clinical practice experience, most states: background check or haven’t lost licenses or have had suits, pay the fees.
What is a conflict of interest?
Selling an overpriced hearing aid that the patient doesn’t need or can pay for so we benefit from it. Manufacturers give perks: if you sell x amount we will give you a trip to x. Something that has an award to it; quid pro quo. We do not create instances where we are in a COI.
What is the purpose of codes of ethics?
Set standards and actions that are acceptable within our profession.
Where are guidelines for audiology?
As a profession, we need to be gatekeepers and self-regulate other peers and professionals. Who do we want to mandate what is best for audiology? Audiologists, and if we do not self-regulate ourselves, someone else will.
What is the legal obligation to care?
Duty.
What is failing to comply with the standard of care required?
Breach.
What is the concept that without harm or injury there is no liability?
Injury.
What is the reasonable, close, and causal connection between the defendant’s negligent conduct and the resulting damages?
Causation.
What results in 4 non-identical haploid daughter cells?
Meiosis
What forms gametes?
Meiosis
What are gametes?
Egg and sperm cells, germ cells
What creates haploid chromosomes?
Meiosis
What results in 2 identical daughter cells?
Mitosis
DNA replicated and equally split in mitosis.
What are diploid chromosomes?
Mitosis
How many chromosomes are in haploid?
Half, only 23
How many chromosomes are in diploid?
23 pairs, 46 total
What are the characteristics of Treacher Collins syndrome?
Peanut ear, small lower jaw, fish mouth, branchial arch disorder
What influences the frequency of the fundamental frequency?
The fundamental frequency is influenced by the rate at which the vocal folds vibrate. Fast vibration is a higher pitch and slow vibration is a lower pitch.
What influences the frequency of the first formant?
The first formant is influenced by the tongue height. A high tongue height creates a lower frequency and a low tongue height creates a high frequency.
What influences the frequency of the second formant?
The second formant is influenced by the tongue advancement. The tongue in the front of the mouth creates a high frequency and the tongue in the back of the mouth creates a low frequency.
What type of cue is Voice Onset Time?
Temporal
What is the space between the vocal folds called?
glottis
Describe the process of phonation.
Phonation is the vocal fold vibration. The vocal folds are adducted, air pressure from the lungs forces the vocal folds to be forced apart, or abducted. The Bernoulli effect causes them to come back together. This process continues until the brain tells the articulators to stop. When a person breathes while talking, the vocal folds are abducted, or apart.
What does the source-filter theory of speech production include?
The source-filter theory of speech production is the compartmentalization of sounds where the source is the vocal folds, the power is the lungs, and the filter is the vocal tract.
What would the output of the vocal folds sound like if you could hear it in the absence of the vocal tract?
buzz
If you recorded yourself speaking softly and speaking loudly, these differences would be noticeable on which of the following?
spectrogram, spectrum, waveform
What are voicing cues?
lf
What are manner cues?
mid frequency
What are place cues?
high frequency
In the long-term average speech spectrum (LTASS), where is sound energy the weakest for average conversational speech?
In the LTASS, the high frequencies have less sound energy during average conversational speech. This is why individuals with high frequency hearing loss have a hard time understanding. Going from average to shouted speech, the energy shifts from the low frequencies to the higher frequencies, around 1,000 Hz.
What is the SII accurate at predicting?
Can predict accuracy on a speech recognition task (NU-6 word list) in quiet.
Are all frequency bands equally important for speech understanding?
false
Must the entire speech signal be audible for high levels of accuracy on a speech recognition task in quiet?
false
What are suprasegmental aspects of speech?
They are perceived as variations and contrasts in pitch, loudness, and duration; can be important for recognition of vocal emotion; are also referred to as prosody or prosodic features in the literature.
What can indicate whether a question has been asked?
intonation (pitch changes)
What can indicate whether a word is a noun or a verb?
stress
What identifies word boundaries (example ‘I scream’ vs. ‘ice cream’)?
juncture
How do the speech sounds /b/ and /m/ differ?
manner
What are slow changes in amplitude; the ‘outline’ of the waveform?
temporal envelope
What are rapid changes in amplitude?
temporal fine structure
How would you describe American Sign Language?
A natural evolving language and communication system developed in a community, with its own grammar, phonology, morphology, syntax, semantics, and pragmatics.
What are the rules for language and combining words?
Grammar
What is the sound system/rules of pronunciation?
Phonology
What is the structure of words?
Morphology
What are the rules governing sentences?
Syntax
What is the meaning in language?
Semantics
What is the social context of language?
Pragmatics
Is Signed Exact English (SEE I or II) a natural or artificial sign system?
An artificial sign system because it took English and placed hand signs into a different order and syntax.
What system did ASL originally develop from?
French
What is the structure of ASL?
Object Subject Verb or Subject Verb Object (e.g., ‘the boy threw the ball’).
What is cued speech?
A visual communication system that combines handshapes with mouth movements to aid lipreading.
What is a bilingual bicultural approach?
The use of ASL and written/spoken English with ASL as primary, encouraging Deaf identity and culture.
What is total communication?
Integrates speech, sign, fingerspelling, lipreading, and more to facilitate communication.
What is the Auditory-Oral/Verbal Method?
Focuses on oral communication through auditory training, speechreading, and speech production, often with the use of hearing aids and cochlear implants.
What is ASL?
A complete natural visual language with handshapes, facial expressions, grammar, and syntax.
Why is cued speech helpful?
It helps differentiate sounds that look the same on the lips, providing clarity on voiced/unvoiced sounds.
What communities use tactile sign language?
Deafblind communities, such as those with Usher’s disorder.
What is codeswitching?
Changing between languages, modalities, or dialects depending on the conversation partners.
What do you know about communicating with Deaf individuals and the use of interpreters?
Speak to the patient and not the interpreter; maintain normal communication without exaggeration or slowing down.
What are the preferred terms for Deaf individuals?
Deaf, deaf, or hard of hearing (not hearing impaired).
What is the medical model vs social-cultural model of deafness?
The social-cultural model views deafness as something that doesn’t need to be fixed, while the medical model sees it as a disability that needs fixing.
Why is preferred language not ‘hearing impaired’ or ‘hearing loss’?
It implies a disability that needs to be fixed.
What are the differences in ASL or the parameters?
Hand shape, orientation, location, movement, and non-verbal/non-manual markers.
How do you show past/present/future in ASL?
Towards back (past), close to body (present), going forward (future).
What is the concept of health according to A.T. Still?
Within man’s body, there is a capacity for health that, if recognized and normalized, can prevent and treat disease.
What are the 4 tenets of Osteopathic Medicine?
- Treat cause rather than symptoms. 2. The human body is a dynamic unit of function of mind, body, and spirit. 3. The body possesses self-regulatory mechanisms that are self-healing in nature. 4. Structure and function are interrelated at all levels.
What is a scenario in audiology that represents one of the 4 tenets of OM?
Otitis media can self-mediate; watch and wait as the body often takes care of it.
What is the OMM approach?
A therapeutic approach focused on realigning structure to improve function.
What is the role of OT vs PT vs medical vs audiology?
PT focuses on improving movement, while OT focuses on activities of daily living; physicians practicing osteopathic medicine focus on the whole person.
What is OMM or OMT?
Application of hands-on forces by an osteopathic physician to improve physiologic function, improve motion, and support homeostasis.
What is the purpose of professional liability insurance?
To protect you if you get sued.
What is Tort Law?
Civil law concerning damage to a person or property.
What does tort law handle?
It finds wrongdoing, deters it, and compensates for it.
How can you avoid going to court for breach of tort?
Manage risk with best practices, knowledge, standards, communication, and documentation.
What is informed consent?
A document given to patients to confirm they are okay with proceeding with procedures.
What must a plaintiff prove in a malpractice claim?
Duty, Breach, Damages, Causation.
Why do all 4 elements have to be met for malpractice?
If no harm was made from the negligence, it is hard to prove.
What is the legal obligation to care?
Duty to care.
When do you provide a patient with a notice of privacy practices?
At the first visit and annually thereafter.
Do you need a state license in audiology to practice?
Yes, always.
What is the purpose of an informed consent document?
To ensure patients are okay with being subjects in the procedures being performed.
What is a breach of duty?
Failing to comply with the standard of care required.
What is the principle regarding liability?
Without harm or injury, there is no liability.
What is causation?
A reasonable, close, and causal connection between the defendant’s negligent conduct and the resulting damages.
What are some state licensure requirements for audiologists?
Degree in audiology: doctoral, clinical practice experience, most states require a background check or proof of no lost licenses or lawsuits, and payment of fees.
What is a conflict of interest?
Something that has an award to it; quid pro quo.
Example: Selling an overpriced hearing aid that a patient doesn’t need or can’t afford for personal benefit.
What is the purpose of codes of ethics?
To set standards and actions that are acceptable within our profession.
Who should mandate what is best for audiology?
Audiologists; if we do not self-regulate ourselves, someone else will.
What is the role of professionals in self-regulation?
As a profession, we need to be gatekeepers and self-regulate other peers and professionals.
Where are the guidelines for audiology?
Do not do something to a patient they do not need, ensure everyone has access, and avoid conflicts of interest.
ASHA Rule 1 H: Individuals shall not guarantee the results of any treatment or procedure, directly or by implication; however, they may make a reasonable statement of prognosis. AAA Rule 7a: Individuals shall not use professional or commercial affiliations in any way that would mislead or limit services to persons served professionally.
What are voicing cues?
Low frequency cues from vocal fold vibrations that give the fundamental frequency (F0) of voice.
What are manner cues?
Mid frequency cues such as fricative, plosive, and stop.
What are place cues?
High frequency cues, some of which are visible for speech reading.
What are suprasegmentals?
The prosody of speech, including how elements fit together, stress, and emotion, providing cues about what is being said beyond individual sounds.
Where do voicing cues come from?
Vocal fold vibration.
What are the frequency characteristics of manner cues?
Mid frequency cues such as fricative, plosive, and stop.
What are the frequency characteristics of place cues?
High frequency cues, some of which are visible for speech reading.
What is the difference between extrinsic and intrinsic redundancy?
Extrinsic redundancy comes from the environment and speech signal itself, while intrinsic redundancy comes from internal sources.
What does extrinsic redundancy refer to in speech?
The speech signal and syntax.
What does intrinsic redundancy refer to?
Binaural listening and central auditory nervous system pathways & memory of words.
What is the average conversational speech level in dB HL?
50 dB HL.
What is the average conversational speech level in SPL?
70 dB SPL.
What is the RETSPL for supra-aural headphones vs inserts?
20 dB change for supra-aural headphones and 13 dB for inserts.
Right vs Left Tympanic Membrane
Right: cone of light in right bottom corner & malleus is pointed to bottom left corner.
Left: cone of light in left bottom corner & umbo is pointed to bottom right corner.
Soft, Moderate, and Loud Sounds in Hearing Loss (HL)
Soft: 40 dB
Moderate: 50 dB
Loud: 70 dB
What is meiosis?
Four phases resulting in 4 non-identical haploid daughter cells (chromosome recombination from paternal and maternal). Gametes also called germ cells (egg and sperm). Haploid = ‘half’ or just 23 chromosomes.
What is mitosis?
Four phases resulting in 2 identical daughter cells. DNA replicated and equally split into diploid cells. Diploid = double number of chromosomes (23 pairs so 46 chromosomes, with 44 somatic and XX or XY).
What creates the gametes (germ cells - egg and sperm)?
Meiosis.
Where is mitosis seen?
All other cells aside from gametes.
Do all four haploid cells become functional cells?
No, usually only one egg survives.
Cochlear hair cells stay in _____ phase.
G0.
What is gastrulation?
Formation of germ layers.
What are the germ layers?
Ectoderm, Mesoderm, Endoderm.
What forms from ectoderm?
CNS, PNS, sensory-ear, eye; skin epidermis, bones of face and teeth.
What comes from mesoderm?
Organs - kidneys, spleen, walls of heart, muscle, cartilage, bone.
What comes from endoderm?
GI system, lining of respiratory, ET.
Gastrulation stage
Pre-embryonic; fertilization to about 2 weeks.
Embryonic stage
Carnegie stages 1-23; about 3rd to 8th week; big head.
Fetal period
3rd month (about 9 weeks) to birth; maturation of organs and rapid body growth; looks human.
What are branchial arches and which ones play a role in auditory system development?
1 & 2; they are in area of pharyngeal area and they will develop face and head structures including muscles, bones, and nerves of head and neck.
Neural tube from ectoderm =
Brain, spinal cord, nerves and ganglia.
If neural tube doesn’t zip up from caudal and rostral side, what can happen?
Open neural tube can cause spina bifida.
What is Arnold Chiari?
Brainstem and the cerebellum herniate through the foramen magnum and is associated with spina bifida.
What comes from branchial arch 1?
Incus & malleus, tensor tympani, CN V.
What comes from branchial arch 2?
Stapes, stapedius muscle, CN VII.
First sign of nervous system forming is a thickening of groove in ectoderm that becomes?
The neural tube.
Neural Crest Cells =
More PNS.
Which germ layer is on the outside of the tympanic membrane?
Ectoderm.
Which is in the middle making it spiral?
Mesoderm.
Which layer is on the middle ear side in moist aerated space?
Endoderm.
EAC formed from deepening cleft between 1st and 2nd arch; meatal plug and TM. Pinna from 6 hillocks on either side of 1st cleft (1st and 2nd arches).
True.
Tubo becomes and tympanic becomes?
Tubo becomes ET; tympanic becomes tympanic cavity/ME.
Some first & second arch syndromes that affect the auditory system resulting in hearing loss and other auditory abnormalities include?
Treacher Collins syndrome, Pierre Robin syndrome/sequence, Stickler syndrome. Craniofacial anomalies, CHL (could be mixed).
Describe inner ear development.
Otic placode, future inner ear from ectoderm - invaginates to form otic pit and then otic vesicle (otocyst) - elongates and ventral portion becomes saccule and elongates to cochlear duct - dorsal portion becomes utricle, SCC and endolymphatic duct.
Genotype
Genetic material and gene mutation.
Phenotype
Symptoms, physical and outward presentation.
Prosody of speech
Beyond individual sounds of speech, how it goes together that gives cues.
