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59 Cards in this Set
- Front
- Back
What does an audiologist do?
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Screens hearing--identify problem
Measure hearing loss evaulate and dispense technology teach others to manage/cope with HL moniter hearing in persons with HL risks Evaluate vesibular problems |
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What does _____ measure?
dB SPL dB HL dB SL |
spl- physical scale measurement of sound
HL- hearing compared to normal values SL- amount above an individual's threshold |
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How to convert from...
dB HL to SPL dB SL to HL |
HL-->SPL: Add dBHL at given frequency to "norm" vaule at that frequency
SL-->HL: Add values to get total in HL |
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Layers of the Tympanic Membrane:
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pars tensa: 3 layers (skin fibers, mucus membrane)
Pars flacida: 2 layers (skin and mucus membrane |
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Muscles of the middle ear
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stapedius and tensor tympani
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If a 2000Hz tone is presented at 25dBSL to someone with a threshold at 10dBHL, what level will the tone be in HL?
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25 + 10 = 35dB HL
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A 500Hz tone at 50DBHL is at what level in SPL?
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50 + 11 = 61dB SPL
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Explain occlusion effect and how it influences testing
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Occlusion effect: When ear is occluded, BC sounds appear louder than when not occluded.
This affects testing because the lack of this effect suggests a Conductive hearing loss. |
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What do we look for in an otoscopic check?
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--cone of light
--translucent TM --manubrium of malleus --foreign objects, excessive cerumen |
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Schwabach test:
proceedure, expected results |
--strike fork and place on forehead/mastoid of patient. When tone cannot be heard, tester places on own head.
--diminished: tester can hear longer --prolonged: they hear it longer --normal: both hear it as long |
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Rinne test:
proceedure, expected results |
--strike fork and either outside ear until it cannot be heard and then place on mastoid, or
--alternate fork between mastoid and EAC, ask which is louder --positive: hear better by AC (normal hearning or SN HL) --negative: hear better by BC (conductive HL) |
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Bing Test:
Proceedure, expected results |
--Strike fork, hold on mastoid, have patient press tregus in/out
--Positive: hear "pulse" in sound (normal or SN HL) --negative: no change (conductive HL) |
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Weber test:
proceedure, expected results |
(patient reports Unilateral HL)
--strike fork an place to forehead --Louder in Problem ear: conductive HL --Louder in Good ear: SN HL --Both same: normal, or bilateral HL |
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Air Conduction, Unmasked symbols
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Right: O
Left: X |
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Air Conduction, MASKED
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Right: ^ (triangle)
Left: [] (square) |
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BC, Mastoid, UNmasked
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Right: <
Left: > |
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BC, Mastoid, MASKED
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Right: [
Left: ] |
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BC, Forehead, UNmasked
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Right and Left: l-l
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BC, Forehead, MASKED
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Right: 7
Left: F |
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What do the values on a correction chart mean? How to you account for them on an audiogram?
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+ sound too strong
- sound too weak add or subtract as symbol says to vaule obtained in testing |
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Speech Threshold Testing:
Stimuli Proceedures Scoring |
(lowest level speech can be understood)
--Spondees, 2 syllable equal stress words --familiarize patient with words, present (voice or CD) thru earphones to obtain threshold --threshold reached when 1/2 are correct |
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Speech Detection Threshold:
what it tests when you use it |
--lowest level where PRESENCE of speech can be DETECTED
--done when ST cannot be obtained --often used for infants --use any speech as stimulus |
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Speech Understanding/Word Recognition testing:
Stimuli Proceedure Scoring |
--uses PB (phonetically balanced) word lists, 50 words
--NOT familiarized with words --presented in Carrier Phrase (ie "say ____") --scored in % correct |
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When to use Masking for AC
Minimum masking level |
Level Tone NTE - IA > BC (/) NTE
AC (/) NTE + 15 |
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When to use Masking for BC
Minimum Masking Level |
A-B gap TE > 10
AC (/) NTE + 15 + OE OE Used in Low Frequencies: 250Hz--15 500Hz--15 1000Hz--10 |
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Normal:
Pressure-- compliance-- volume |
P: -100 to +100 daPa or mmH20
C: .3 to 1.6ccs V: Kids: .3 to .9cc Adults: .9 to 2.0cc |
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How does Immittance audiometry work? how can we infer middle ear pressure using this procedure?
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Tones are presented into EAC while pressure is varried; amount of tone reflected from TM is measured. Measures compliance indirectly--most compliant when P on both sides are equal
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What does abnormal middle ear compliance infer?
too low too high |
low: fluid blocking TM from vibrating
high: discontinuity in ossicles or scar tissue over perferation |
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What 2 aspects of the acoustic reflex do we measure?
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AR Threshold: Lowest level at which reflex occurs.
AR Decay: stapedius muscle releases when tone still present. |
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Acoustic reflex response in Conductive HL
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--cannot measure compliance
--reflex appears absent --no decay |
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Acoustic Reflex response in Cochlear HL
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--reflex present at tones <60dBSPL
--reflex absent in severe HL (cannot make it loud enough) --no decay |
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Acoustic Reflex response in 8th nerve/BS problems
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--ABNORMAL reflexes
--absent, or at levels higher than normal --decay present |
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Acoustic Reflext response with Auditory Cortex HL
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--normal reflexes
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Symptoms which may suggest an auditory nervous system problem
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--unilateral SN HL
--unilateral tinnitus --vestibular problems, dizziness --facial nerve problems (numbness, paralysis, twitching) --asymmetric speech perception (with equal hearing abilities in each ear) |
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What is recruitment, and what are two ways to meausure it?
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-->abnormal growth of loudness
-SISI -High Level SISI |
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Describe the SISI test
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Tone presented 20 dB SL, and tone 1dB above is "blipped" into it. Count blips. SN HL can detect changes at low SLs
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describe the High Level SISI test
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play tone around 85 db HL, play "blips" into it.
Auditory nervous problems cannot detect Blips. |
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What is abnormal adaptation, and what are two tests that measure it?
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-->hear tone when first presented, then tone decays in intensity
-threshold tone decay test -super threshold adaptation test (STAT) |
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Describe the threshold tone decay test
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-tone presented at 20dB SL for 60 seconds--indicate how long you can hear tone (hand up, etc)
-increase tone in 5dB increments until tone is heard for all 60 seconds --increase = "x"dB tone decay - >30dB = 8th nerve HL |
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Describe the STAT test
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-present tone at 100db SPL
-if tone ever deays, test is positive for 8th nerve problems |
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Why do we test the Auditory BS Response, and how are the results interpreted?
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-used in neonatal screening or when lesion is suspected in BS or 8th nerve
--look for absolute latency, interpeak latency, and morphology of peaks 1 3 and 5 |
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Decribe the 2 types of Otoacoustic Emitions. When are OAEs absent?
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--Transient evoked OAEs: use clicks as stimulus
--Distortion product OAEs: test 2 tones together, expet response at frequency difference (ie 4K and 1K, response at 3K) --absent when SN HL > 25-30dB |
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Auditory Evoked Potentials: Cochlea
-time -how it's measured -results |
-0 to 2 ms
-surface electrodes deep in ear canal, gives 'clicks' -identifies meniere's disease |
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AEP: Auditory BS Repsonse
-time -how to measure -when it's used |
-2 to 10 ms
-surface electrodes on earlobes and forehead -insert phones deliver clicks -used in neonatal screening -measure info from peaks on graph delivered afer 5 minutes |
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AEP: Middle Latency Response
-time -where problem is |
-15 to 60 ms
-bigh BS, Auditory Cortex -test affected by state of conciousness |
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AEP: Late Responses
-time -where problem is |
-more than 50 ms
-detects problem in cortex -play 2 tones, identify when "oddball" tone is played -used in research, not clinically |
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Audiograms/details: Conductive HL
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-flat accross frequencies, or worse in LOWS
-air-bone gap noticed -may have tinnitus in f of most HL -patients often speak more softly than normal |
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Audiograms/details: Sensorineural HL
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-any configuration audiogram
-attenuation and distortion noticed -caused by noise exposure or aging, affecting high fs more than low recruitment noticed -can have tinnitus in f of most HL |
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Aduiograms/details: mixed HL
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-air bone gap, with BC levels below normal as well.
-characteristics of both types -usually have more than one auditory stystem problem. |
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What does a tympanogram measure?
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Compliance, volume, and pressure relating to the TM
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What are 3 ways to hear via BC?
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Compression: skull vibrates cochlear fluid
Inertial: ossicles lag behind skull movement Osseotympanic: skull vibrates--> pressure waves |
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What might cause a BC threshold to be lower than an AC threshold?
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-machine calibrated improperly
-headphones/BC osscilator not set on head correctly -central masking -statistical variability (machine goes in 5db increments) |
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Levels of severity of HL on an audiogram, in dBHL
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<25: Normal
25-40: Mild 40-55: Moderate 55-70: Moderatly severe 70-90: Severe >90: Profound |
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What is Intraural Attenuation, and what value do we commonly use?
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-how much sound skull attributes to which side of head sound came from.
--40 |
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What is Central Masking?
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-when case is boarderline as to whether masking is necessary
-present masking, threshold goes up by 5db --even at louder levels, 5db increase remains the same |
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what does negative middle ear pressure on a tympanigram indicate
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otitis media
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what does abnormally high volume on a tympanogram indicate?
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perforation in ear drum
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What is shown in a tympanogram of type:
A Ad |
A: nomal pressure/compliance/volume
Ad: normal pressure, too much compliance |
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Type ____ Tympanogram
As: B: C: |
As: norm. pressure, too little compliance
B: "flat," peak is beyond -200, cannot measure compliance (otitis media) C: neg. pressure, normal compliance (eustachian tube not working) |