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Comm. Disorders Ex 4
Communication Disorders Exam 4
| Term | Definition |
|---|---|
| Outer ear energy | Acoustic |
| Middle ear energy | Mechanical |
| Inner ear | Electrochemical |
| Hearing threshold | Clinical measurement; listener barely perceives a sound at least 50% of the time |
| Attenuation | Decrease of a sound's strength |
| Conductive hearing loss | Outer or middle ear issue Sound strength reduced when it reaches the cochlea |
| Sensorineural hearing loss | Absent or abnormal sensory cells in cochlea or issue in 8th nerve/brain pathway |
| Mixed hearing loss | Combined conductive and sensorineural hearing loss |
| Roles of the middle ear | Amplification Pressure equalization |
| Bilateral hearing | 75% of sounds entering one ear is processed in the opposite hemisphere Slight differences in timing & frequency help with localization Signals in the right hemisphere travel to left side through the corpus collosum for language processing |
| Step 1 of the hearing process | Pressure waves funnel through pinna & external auditory meatus (acoustic energy) |
| Step 2 of the hearing process | Tympanic membrane vibrates in response to sound (mechanical energy) |
| Step 3 of the hearing process | Ossicular chain attached to TM vibrates (mechanical energy) |
| Step 4 of the hearing process | Movement at oval window sets fluid in cochlea set into motion (mechanical energy) |
| Step 5 of the hearing process | Movement stimulates hair cells on basilar membrane (mechanical energy) |
| Step 6 of the hearing process | Hair cells send neural impulses via VIII Cranial Nerve to the brainstem (electrochemical energy) |
| Step 7 of the hearing process | Impulses travel the auditory pathway in the brainstem to the auditory cortex (electrochemical energy) |
| 4 ways to describe hearing loss | Type, location, degree, configuration |
| Causes of Outer Ear conductive hearing loss | Otitis Externa Impacted Cerumen (ear wax) Foreign Bodies Perforated Tympanic Membrane (eardrum) |
| Otitis Externa | Skin infection of the external auditory meatus Often bacterial infection Itching, some swelling (edema) of ear canal Not typical cause of conductive hearing loss |
| Possible causes of sensorineural hearing loss | Ototoxicity Presbycusis Loud noise exposure (sudden or long-term) |
| Otitis Media | Inflammation/infection of mucous Membrane that's lining the middle ear, with effusion (fluid buildup) in the middle ear Can be caused by upper respiratory infections, allergies, sinus infections, or sore throats Can cause conductive hearing loss |
| Otosclerosis | Usually in adults Bony tissue grows around the stapes footplate Typically hereditary Reduces vibration in cochlea fluid Could be partially removed through surgery |
| Causes of Inner Ear conductive hearing loss | Otitis media Otosclerosis |
| Causes of Inner Ear Sensorineural hearing loss | Genetic issues or in-utero environmental influences Respiratory distress syndrome, Congenital heart disease, Central nervous system disorders, hypoxia Noise-induced Acoustic trauma Tinnitus Presbycusis Acoustic Neuroma |
| Noise induced hearing loss | Public interest increased after WW2 |
| Acoustic trauma | Single event (ex: explosion) or ongoing loud noise |
| Tinnitus | Medical name used to describe a continuous noise (ringing) in the ears |
| Presbycusis | Progressive hearing loss, result of aging process Difficulty understanding speech Slowing rate of voice helps more than increasing loudness Untreated hearing loss associated with cognitive decline in older adults |
| Acoustic neuroma | VIII’s site of entry into brainstem is common site Type of brain tumor (usually bengin) Symptoms: unilateral hearing loss, tinnitus, vertigo, nystagmus, nausea, vomiting Diagnosis: MRI, ENG, and ABR Treatment: Surgical removal |
| Common childhood/postnatal causes of hearing loss | Bacterial meningitis: may cause total deafness. Childhood infections (e.g., measles, mumps, chickenpox, influenza, viral pneumonia) Diabetes mellitus & Kidney disease: can result in sensorineural HL Head trauma |
| Otoscopy | Observing the ear canal for earwax or damage, assesses outer ear |
| Tympanometry | Assesses middle ear pressure & possible presence of fluid, eardrum pressure & mobility, & ear canal volume sign of normal levels: a triangular peak in the graph |
| Otoacoustic emissions (DPOAE) | Assesses inner ear with electrical signals Assesses outer hair cell function |
| Pure-tone audiometry (understand how air- & bone conduction differ) | Air and bone conduction thresholds |
| Speech audiometry | Assesses hearing levels with auditory signals present in everyday communication, provides a more realistic assessment of the effects of hearing loss |
| Auditory brainstem response | Hearing screening method for infants that involves electrodes to the scalp and recording brain's responses to sound |
| Audiogram definition & axis lables | X-axis: Frequency Y-axis: intensity |
| Audiogram configurations | flat sloping rising noise-notch cookie-bite high-frequency |
| Pillars of Aural Rehabilitation | Instruction: Comm. strategies & device use Counseling: Help with adjustment, expectations, emotions, education Perceptual training: Speech-in-noise practice & auditory training Sensory management: Hearing aids, cochlear implants, etc |
| Flat audiogram configuration | Often indicates conductive hearing loss |
| Sloping audiogram configuration | Better hearing in low frequencies, worse in higher frequencies |
| Rising audiogram configuration | hearing loss most prevalent in low frequencies and less in high frequencies |
| Noise-notch audiogram configuration | Dip around 3k-6k Hz indicating noise-induced hearing loss |
| High frequency audiogram configuration | goes down near the higher frequencies - indicative of permanent sensorineural hearing loss |
| Types of communication skills taught in hearing loss | * Use of repair strategies * Phoneme discrimination * Word/phrase/story comp. * Open & honest communication * Education/use/maintenance of hearing assistive technology * Auditory training * Speechreading |
| Air conduction vs bone conduction hearing aids | Air conduction: goes through outer, middle, & inner ear Bone conduction: bypasses outer & middle ear and goes straight to cochlea |
| Purposes of counseling in the fields of communication disorders | Providing education, guidance, support, coping strategies, & referrals within the context of communication disorders |
| Not within the scope of counseling in SLP/Aud | Mental health therapy, diagnosing and treating psychological issues/disorders |
| Parroting | Repeating exactly what you hear |
| Echoing | Repeating back a word/phrase that the client uses, usually with a questioning intonation |
| Restating | Rephrasing what the client said |
| Reflecting emotion | Using verbals/paraverbals to clarify a feeling you have received from the speaker |
| Personal qualities of effective helpers | * Encouraging attitude * Realistic attitude but acknowledging potential * Patience, emotional/mental stability, positive self-esteem & appropriately placed self-worth * Sensitive towards all kinds of differences * Tolerance towards ambiguity |
| Licensure vs certification | Licensure: State, Required, degree & clock hrs & cont. ed reqs every 2 yrs, separate code of ethics Certification: National, commonly recommended, reqs: edu, supervised practice, clinical year, cont ed, yearly membership fee with annual renewal |
| Code of Ethics (ASHA) | Directive: Recommended Conduct Protective: Protects rights of clients/people served and the general public Specific: Ethical that adapt to the times Fundamental principles: Welfare Competence Public edu Professional |
| Scope of practice | All related to communication, speech, language, feeding, swallowing, and/or hearing |
| HIPAA, protected health information | Governs privacy and security of client’s health records & information Anything identifying someone as receiving treatment or their payment, living or dead Legal obligation to keep client’s privacy and information secure, violations impact safety & rep |
| Main functions of outer ear | protection, amplification, localization |
| Outer ear structures | pinna, ear canal, tympanic membrane |
| Main functions of middle ear | impedance matching, oval window stimulation, pressure equalization |
| General audiogram configuration for conductive hearing loss | Hearing through airwaves dec, bone conduction normal, results in "air-bone gap" |
| General audiogram configuration for sensorineural hearing loss | Air and bone hearing levels both decreased, no gap |
| General audiogram configuration for mixed hearing loss | Air more dec than bone dec, gap present |
| Audiogram symbols | Left ear air conduction: X L.E. Bone conduction threshold: < Right ear air conduction: O R.E. Bone conduction threshold: > Aided threshold with hearing aids: A |
| Guidelines for newborn hearing screenings | Screen by 1 month Diagnose by 3 months Intervention by 6 months |
| Colors of ears in graphs | Left: blue Right: red |
| Within normal limits | Hearing around 25 dB |
| Threshold | Lowest level one can consistently hear |
| Perceptual training | Speech-in-noise auditory training |
| Normal hearing range on an audiogram | 0-25 dB |
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