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Hearing Assessments
Audiology Exam 2
| Question | Answer |
|---|---|
| A significant amount of diagnostic information can be obtained by completing a thorough ___________ | Case History |
| When performing an otoscopy, what tools are used? | Otoscope (with a replaceable speculum), or a video otoscope (if available) |
| ________ otoscopes have become much more available in recent years | Video |
| The purpose of visual inspection is to inspect the? | Auricle, External Auditory Meatus, Tympanic membrane, and Middle ear (sometimes) |
| What is the otoscope proper method? | -Always brace, you must place some part of both of your hands on the patient's head when looking inside the ear. - Be careful not to push the speculum too far into the EAM. -Lift on the auricle to straighten out the EAM to see the TM. |
| When performing an otoscopy, what should you look for in the Auricle? | -Ear tags -Malformations in landmarks -Presence of external auditory meatus |
| When performing an otoscopy, why should you look at cerumen? | -To see if there is a complete blocked (occlusion) of the external auditory meatus with cerumen as it can cause hearing loss -You need to remove the cerumen before continuing with diagnostic assessment |
| When performing an otoscopy, what should you look for in the tympanic membrane? | -Cone of light -Perforations -Middle ear fluid/swelling -Retracted- middle ear negative pressure - Abnormal structures in the middle ear space |
| Using an __________, pure tone audiometry provides audiologists with the _______ and ______ of hearing loss | Audiometer, degree, type |
| Pure tone audiometry measures an ________ | Audiometric threshold |
| Audiometric threshold | The softest sound a person can hear at least 50% of the time |
| Transducers | Method of presenting stimuli for testing the audiometric threshold |
| What are some examples of transducers? | Supra-aural, Circum-Aural, Inserts, Bone |
| Stimulus | Pure tones (250, 500, 1000, 3000, 4000, 6000, 8,000 Hz) |
| Pure tones are important for speech understanding, these are frequencies ranging from _____ to ______ Hz | 250-8,000 |
| What are pure tones used for? | Testing the audiometric threshold |
| When it comes to transducers, what should always be used for full diagnostic evaluations? | Bone conduction oscillator (vibrator) |
| Audiometers | Used to measure hearing sensitivity (thresholds) and supra-threshold tests (Ex: speech testing) |
| Audiometers generates pure tones from _____-_____kHz | .125-20 |
| With audiometers, we typically test from _______-______ Hz | 250-8,000 |
| In audiometers, tones presented from _____ - _____ dB HL depends on the transducer | -10-~110 |
| In addition to pure tones, audiometers also present what four things? | -Mic/Live voice -CD recorded and integrated speech testing files -Noise -Warble tones/Pulsed tones |
| Every audiometer has at minimum three primary components, what are they? | -Oscillator -Interrupt (presentation switch) -Attenuator |
| Oscillator | Generates pure tones |
| Interrupt (presentation) switch | Controls the duration of signal presentation |
| Attenuator | Controls the Intensity Level (dB HL) of the Signal |
| If the attenuator has a high signal, the attenuation is going to be very _______, meaning the reduction in __________ is going to be very low | Low, sound intensity |
| If you are presenting a very soft signal, the attenuation is going to be very ________ | High |
| How do transducers work? | Converts electrical signal from the audiometer into sound for the ear to detect. There is a diaphragm that moves back and forth with electrical signal that changes it, moving the sound particles in the environment turning it back into an acoustic signal |
| Transducers are used in _________ assessments | Hearing |
| Identify four air conduction transducers | -Supra-Aural headphones -Circum-Aural headphones -Inserts -Sound-Field Speakers |
| Identify a bone conduction transducer | Bone conduction oscillator (vibrator) |
| When doing pure tone assessments, what kind of transducers are used? | Air conduction transducers |
| Air conduction (AC) measures what? | The entire auditory system |
| Name the pathway air conduction takes | External Ear > Middle Ear > Inner Ear > Central Pathway |
| Bone Conduction (BC) bypasses the _______ and _______ ear and stimulates the ________ directly through bone vibrations | External, Middle, Cochlea |
| Name the pathway bone conduction takes | Inner Ear > Central Pathway |
| Comparing the two different thresholds of AC and BC tells us information on the ______________ and _______________ | Site of lesion and type of hearing loss |
| If the Bone conduction thresholds are similar or equal to the Air conduction thresholds, the damage is in the ______ or beyond. This is called a _________ hearing loss | Inner ear, sensorineural |
| If you hear better if you put the bone oscillator on, then there is damage in the _______ or ________ . This is called a ________ hearing loss | External ear or Middle ear, conductive |
| A combination of a sensorineural hearing loss and conductive hearing loss is called? | A mixed hearing loss |
| (Test considerations) __________ - Is the test results ___________? | Reliability, repeatable |
| (Test considerations) __________ - Does the test measure what it is ____________? | Validity, supposed to measure |
| (Test considerations) __________ - How well does a test ___________ a disorder | Sensitivity, correctly identify |
| (Test considerations) __________ - How well does a test _________ a disorder | Specificity, correctly reject |
| (Test considerations) ________ - Percentage of ____________________ results | Efficiency, false positive and false negative |
| True postive | Correctly identifies disorder; Patient with a hearing loss is identified with a hearing loss |
| True negative | Correctly eliminates an incorrect diagnosis; Patient without hearing loss is identified as not having hearing loss |
| False positive | Incorrectly indicates disorder; Patient has normal hearing but test results show a hearing loss |
| False negative | Incorrectly indicates normal hearing; Patient has hearing loss but test results show normal hearing |
| Thresholds should be measured in a ___________ or similar environment | Sound treated booth |
| Most recently, audiometric booths can be replaced by ______________________ | Ear-level noise canceling muffs (KUDUwave) |
| Anechoic Chamber | Used for research purposes and has eliminated reverberation for sound waves |
| Patient positioning for testing, make sure they don't get any _______. They should be sitting at a right angle or with their back towards the tester | Ques |
| How patient responds to sounds while testing | -Hand Raising (one of the best methods) -Finger Raising -Signal Button -Vocal Response -Conditioned Play Audiometry – (Pediatric Lecture) -Visual Reinforcement Audiometry – (Pediatric Lecture) |
| In air conduction audiometry, generally test ________ Hz first, it has the best test re-test reliability | 1,000 |
| In air conduction audiometry, present ______ for 1-2 seconds. Constant or pulsed | Pure tones |
| In air conduction audiometry, presenting pulsed pure tones help detect ___________ | Tinnitus |
| In air conduction audiometry, present at an intensity level of ___________. If there is no response, raise to _____. if still no response, raise by _____ increments until patient responds | 30 dB HL, 50 dB HL, 10 dB HL |
| In air conduction audiometry, once a patient responds to a certain intensity level, ______,________ rule | Down 10, up 5 |
| In air conduction audiometry, you want to get _____ out of ______ responses on the ascending run. This allows you to find the threshold | 2 out of 3 |
| In air conduction audiometry, repeat threshold search for all octave frequencies from ______ - _______ kHZ in each ear | .25-8 |
| What are the octave frequencies in air conduction audiometry? | 250, 500, 1000, 2000, 4000, 8000 Hz |
| In air conduction audiometry, also obtain pure tone thresholds at ________ when thresholds between octaves differ ≥ 20 dB | Inter-octaves |
| What are the inter-octaves in air conduction audiometry? | 750, 1500, 3000, 6000 Hz |
| Hearing aid patients should always have thresholds obtained at __________ for the purpose of programming hearing aids | Inter-octaves |
| Air conduction audiometry purpose? | Provides degree of hearing loss |
| In dB SPL, auditory thresholds vary at __________. This makes interpreting thresholds more difficult when comparing among frequencies | Different frequencies |
| dB HL (Hearing Level) normalizes dB SPL thresholds to 0 to make ______________ of the audiogram easier | Interpretation |
| ______ represents the average adult hearing thresholds | 0 dB HL |
| The normal range of hearing for an adult is? | -10-25 dB HL |
| The normal range for pediatrics is considered? | -10-15 dB HL |
| Thresholds are marked for each ear ___________ | Individually |
| The field of audiology consistently marks the ________ ear with red, and the ________ ear with blue | Right, left |
| No response air conduction is represented by? | An arrow |
| Normal hearing loss is | -12-25 dB HL (adult) |
| Minimal hearing loss is | 10-25 dB HL |
| Mild hearing loss is | 30-40 dB HL |
| Moderate hearing loss is | 45-55 dB HL |
| Moderately-Severe hearing loss is | 60-70 dB HL |
| Profound hearing loss is | > 90 dB HL |
| Bone oscillator transducer that stimulates the _________ directly through vibrations of the cranial bones | Cochlea |
| Oscillator is placed on the ___________ of the temporal bone of either ear or the ____________ | Mastoid process, center of the forehead |
| Typically, _______ placement gives more accurate thresholds | Mastoid |
| Bone conduction is _______ ear specific | Not |
| It does not matter where the Bone Oscillator is placed- when performing Bone Conduction you will always get the threshold of the ___________ | Better hearing cochlea |
| The cochlea's are imbedded in cranial bones- whenever you vibrate the cranial bones you stimulate _____ cochlea's - it does not matter the placement of the oscillator | Both |
| Bone conduction does not give you ________ results, unless you _____ | Ear-specific, mask |
| You should _________ see two red and blue hashmark symbols performed for the same frequency on an audiogram. This is an indication that the person doing the testing doesn't understand the measurement they are performing | Never |
| What is the purpose of bone conduction? | Determines type of hearing loss |
| What are the three types of hearing loss? | Sensorineural Hearing Loss, Conductive hearing loss, and mix hearing loss |
| Sensorineural Hearing Loss | Hearing Loss Comes from damage to cochlea or neural pathway |
| Conductive hearing loss | Hearing Loss Comes from damage to the outer or middle ear |
| Mixed hearing loss | You have both a sensorineural and conductive component to hearing loss |
| Air-Bone Gap | There is an Air-Bone Gap when the Bone thresholds are >10 dB better (lower in number) than the Air thresholds |
| Determining Conductive hearing loss | Air Bone Gaps are present, and Bone thresholds are within normal limits |
| Determining Sensorineural hearing loss | Air Conduction thresholds are outside normal limits and there are no air bone gaps (Ex: Bone conduction thresholds are also outside normal limits) |
| Determining Mixed hearing loss | Air Bone Gaps are present, AND Bone Thresholds are outside of normal limits |
| Testing bone conduction, less frequencies than ________ | Air conduction |
| Testing bone conduction are tested at what frequencies? | Only 500, 1000, 2000, 4000 Hz |
| When testing bone conduction, you don't need to test all the same frequencies as air conduction because of _________. The only purpose is determining the _____ of hearing loss | Calibration, type |
| Bone conduction has a _________ level of testing than air conduction (50-70 dB HL) | Lower maximum |
| Bone conduction's level of testing than air conduction: | -More power needed to drive bone oscillator -Distortion – makes stimuli less frequency specific at higher intensities -Vibrotactile Response – Felt, not heard at higher intensities. |
| How to determine type of hearing loss, Is there any air-bone gap? If you the answer is yes, then ask? | Are all bone conduction thresholds within normal limits |
| How to determine type of hearing loss, Is there any air-bone gap? If you the answer is no, then? | The patient has sensorineural hearing loss or they are normal |
| How to determine type of hearing loss, are all bone conduction thresholds within normal limits? If the answer is yes, then? | The patient has conductive hearing loss |
| How to determine type of hearing loss, are all bone conduction thresholds within normal limits? If the answer is no, then? | The patient has mixed hearing loss |
| (Normal hearing) All ________ thresholds are better than 25 dB HL | Air conduction |
| (Normal hearing) There are no gaps where _________ is 15 dB better than air conduction at any frequency | Bone conduction |
| (Conductive hearing loss) _____ is worse (higher) than normal hearing range (25 dB HL) | Air conduction |
| (Conductive Hearing loss) Bone conduction thresholds are 25-35 dB better than air conduction thresholds –meaning there _____ an air-bone gap >10 dB | Is |
| (Conductive hearing loss) Bone conduction are _____ outside the normal hearing range | Not |
| (Sensorineural hearing loss) Air conduction thresholds are outside the ______ range of hearing | Normal |
| (Sensorineural hearing loss) there are ____ air-bone gaps | No |
| (Mixed hearing loss) Air conduction thresholds are ______ normal limits | Outside |
| (Mixed hearing loss) there _____ air-bone gaps greater than 10 dB | Are |
| (Mixed hearing loss) bone conduction thresholds are outside the normal ________ | Limits |
| Severe hearing loss | 75-90 dB HL |
Created by:
RachelJClark
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