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Chapter 3 (Part 2)
Intro Audiology (Exam 2)
| Question | Answer |
|---|---|
| What types of tone stimuli can be tested during air conduction threshold testing? | steady, pulsed, and warble |
| When is a pulsed stimuli commonly used? | with tinnitus patients |
| How long are stimuli presented during air conduction threshold testing? | usually for one second at a time, vary intervals between presentations |
| What is the usual intensity step size for air conduction threshold testing? | 5 dB |
| What are the air conduction earphone options? | circumaural earphones, supra-aural earphones, and insert earphones |
| What are the qualities of circumoral earphones? | not common in most clinical settings, the bulky looking headphones (like Beats) |
| What are the qualities of supra-aural earphones? | possible collapsed ear canals |
| What are the qualities of insert earphones? | attenuation is noise is more effective with foam tip insert receivers, deeper the insertion into the canal, better the attenuation, not an option for those without ear canal |
| What is the correct placement for supra-aural headphones? | extend the headband to most extended position, [place headband on pt's head, hold earphones so loudspeaker is DIRECTLY over opening of ear canal, shrink headband so it is tight over head, make sure no hair or earrings are under earphones, remove glasses |
| What is the correct placement for insert earphones? | Attach insert foam pieces to tubing, squeeze foam until completely flattened, insert foam into ear canal until just the wire is sticking out of ear, hold insert for a moment while insert expands to fill canal |
| What is the purpose of bone conduction audiometry? | to specify the type of hearing loss at various frequencies |
| What can bone conduction audiometry NOT tell us? | the degree or hearing loss |
| What frequencies are available to test for bone conduction audiometry? | 250-4000 Hz |
| What frequencies are typically tested for bone conduction audiometry? | 500, 1000, 2000, and 4000 Hz (sometimes 250 and 3000) |
| Why are the maximum outputs for bone conduction lower than air conduction? | power required to drive a bone conduction is higher, at high intensities, there is a higher level of harmonic distortion, patient may "feel" the stimulus on their mastoid as opposed to hearing it |
| What is Vibrotactile? | when patients can feel the stimulus on their mastoid from bone conduction testing instead of hearing it, usually happens with low frequencies |
| What is the correct placement of bone conduction vibrators? | placement is usually mastoid, forehead is also an option, must be sure that the vibrator is snug against the skull and make sure there is no hair underneath |
| How does one place the bone conduction vibrator? | hold the vibrator against the mastoid, put the string steel headband over pt's head, place anchor end of headband on patient's upper each, make sure vibrator doesn't slide or pinch patient |
| What is the occlusion effect? | plugging the ears (happens when you have a cold), results in elevated bone conduction |
| What is the goal of pure tone testing? | to measure a person's hearing sensitivity, determines the threshold at which they hear a particular frequency |
| What is a threshold? | the lowest level at which the patient can correctly identify at least 2/3 tone presentations at that specific test frequency |
| What is the first step in pure tone audiometry? | start at 1000 Hz at 30 dB HL (ASHA recommended), present a pure tone signal for 1-2 seconds, if no response, increase to 50 dB |
| What is the second step in pure tone audiometry? | if the patient responds at the starting frequency, decrease intensity by 10 dB HL, if no response, increase by 5 dB HL |
| What is the third step in pure tone audiometry? | Once the patient starts responding, continue lowering the intensity by 10 dB HL until the patient does not respond. This starts the ascending provess |
| What is the fourth step in pure tone audiometry? | increase intensity by 5 dB HL until patient responds, continue the Down 10, Up 5 process until a threshold is identified |
| How is a threshold identified in pure tone audiometry> | two responses are recorded at a specific intensity level during the ascending process |
| What is the Modified Hughson-Westlake Procedure? | the Down 10 dB, Up 5 dB process |
| What does one do to document results? | after finding thresholds at each frequency, you must write down the level where the person responded in black in or color code to match each ear |
| What is an audiogram? | graphs that plot hearing loss results |
| What color is the right ear? | red |
| What color is the left ear? | blue |
| What is the horizontal axis of the audiogram? | Frequency (Hz), lower Hz is left, higher Hz is right |
| What is the vertical axis of the audiogram? | intensity (dB HL), soft at the top and loud at the bottom |
| What does a lower threshold indicate? | better hearing |
| What does an audiogram with lower thresholds look like? | symbols higher on the audiogram |
| What does a higher threshold indicate? | worse hearing |
| What does an audiogram with higher thresholds look like? | symbols lower on the audiogram |
| How do you record data on an audiogram? | once a threshold is found, mark the appropriate symbol at the intersection of the frequency and intensity level |
| Which symbols are connected on an audiogram? | air conduction symbols |
| Which symbols are NOT connected on an audiogram? | bone conduction symbols |
| What is the symbol for unmasked air conduction in the RIGHT ear? | o |
| What is the symbol for unmasked air conduction in the LEFT ear? | x |
| What is the symbol for masked air conduction in the RIGHT ear? | [triangle] |
| What is the symbol for masked air conduction in the LEFT ear? | [square] |
| What is the symbol for unmasked bone conduction in the RIGHT ear? | < |
| What is the symbol for unmasked bone conduction in the LEFT ear? | > |
| What is the symbol for masked bone conduction in the RIGHT ear? | [ |
| What is the symbol for masked bone conduction in the LEFT ear? | ] |
| What does an audiogram tell us? | the degree and type of hearing loss, helps us discuss HL in terms of the impact it may have on a person's ability to communicate |
| What four aspects are needed to define hearing loss? | degree, type, configuration, uni/bi-lateral, symmetry |
| What is the range for a normal degree of hearing loss? | -10 to 25 dB HL |
| What is the range for a mild hearing loss? | 26 to 40 dB HL |
| What is the range for a moderate hearing loss? | 41 to 55 dB HL |
| What is the range for a moderately severe hearing loss? | 56 to 70 dB HL |
| What is the range for a severe hearing loss? | 71 to 90 dB HL |
| What is the range for a profound hearing loss? | >90 dB HL |
| What is a slight hearing loss? | 15 to 25 dB HL, not commonly used |
| What is the impact of a minimal hearing loss? | difficulty with faint speech in noise |
| What is the impact of a mild hearing loss? | difficulty with faint or distant speech |
| What is the impact of a moderate hearing loss? | hears conversation only at a close distance |
| What is the impact of a moderately severe hearing loss? | hears loud conversation |
| What is the impact of a severe hearing loss? | cannot hear conversation |
| What is the impact of a profound hearing loss? | may hear loud sounds |
| How does one determine a type of hearing loss? | comparing ear specific air and bone conduction thresholds (right AC to right BC, Left AC to left BC) |
| What is the definition of normal hearing? | both air conduction and bone conduction thresholds in that ear are within normal limits |
| What is the definition of a sensorineural hearing loss (SNHL)? | both air conduction and bone conduction thresholds in that ear have hearing loss and their air conduction and bone conduction thresholds are within 10 dB HL of each other (equal amounts of AC and BC hearing loss) |
| What is the definition of a conductive hearing loss (CHL)? | bone conduction thresholds in that ear are normal and air conduction thresholds indicate a hearing loss in that ear |
| What is the definition of a mixed hearing loss? | both air conduction and bone conduction thresholds in that ear have hearing loss, but the AC thresholds are worse that the BC thresholds by more than 10 dB HL |
| What is the air bone gap? | the dB difference between air conduction and bone conduction thresholds, shows the amount of conductive involvement |
| When is an air bone gap present? | in conductive and mixed hearing losses |
| When is an air bone gap considered significant? | if there is a difference between air conduction and bone conduction that is greater than 10 dB |
Created by:
hrshook0104
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