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75 Cards in this Set
- Front
- Back
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Cross-Over Hearing
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Signal presented to one ear being transmitted to the other
Via bone OR air conduction Simulates binaural hearing, provides better than actual threshold in poorer ear |
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Interaural Attenuation (IA)
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amount of dB loss during cross-ver effect
40dB Loss for supra-aural headphones 60dB loss for interaural headphones |
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Masking
(what is it?) |
process of obtaining "true" threshold in POOR EAR
presenting noise to GOOD EAR -- prevents perception of crossover energy |
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When to mask?
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AC masking: Tac:te - IA >/= Tbc:nte
BC masking: ABgap >/= 10dB |
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Importance of Speech Audiometry
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helps confirm accuracy of PT audiogram
gives estimate of speech recognition/comprehension tests confort levels of speech |
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Threshold Measures of Speech Audiometry
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Speech Detection/Awareness Threshold (SDT/SAT)
Speech Recognition Threshold (SRT) Spondee Threshold (ST) |
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Speech Awareness Threshold
(definition?) |
dB HL at which patient can DETECT 50% of target words
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Speech Recognition Threshold (SRT)
(definition?, procedure?) |
dB HL at which patient can REPEAT 50% of target words
Follows 10 up, 5 down rule Patients familiarized with stimuli (spondee words) before testing ALWAYS +/-8dB PTA |
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Suprathreshold Recognition Measures of Speech Audiometry
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Word Recognition Tests (WRTs)
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Word Recognition Tests
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Provides Word Recognition Score (WRS)
stimuli include phonetically balanced monosyllabic words (perch, math, bone, wife, etc.) Stimuli presented in closed- or open-sets |
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Word Recognition Score (WRS)
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% of words correct at given level
NOT a threshold measure |
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Suprathreshold Sensation Measures of Speech Audiometry
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Most Comfortable Loudness Level (MCL)
Uncomfortable Loudness Level (UCL) |
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Types of Speech Tests
(pros and cons of each?) |
LIVE VOICE
(pros: naturalistic, good for children cons: not standardized) RECORDED (pros: standardized, uniform levels of presentation cons: cold, impersonal, not good for children) |
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Sensation Level (SL)
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perceived intensity of presented sound
(dB HTL - dB HL) |
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Hearing Threshold Level
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an individual's personal threshold
(0dB HTL) |
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Suprathreshold
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category for sounds above threshold
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Most Comfortable Loudness Level (MCL)
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level at which sound is most easily perceived
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Uncomfortable Loudness Level (UCL)
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level at which sound becomes uncomfortably loud to listen to
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Dynamic Range
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span of intensity levels a person is able to listen to
(UCL-SRT) |
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Speech Awareness Threshold
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level at which speech is known to be presented (NOT UNDERSTOOD)
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Speech Recognition Threshold
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level at which speech can be understood
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Word Recognition Score
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% of words correctly identified during a Word Recognition Test
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Open-Set Lists
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large set of words presented (patient must rely on word knowledge AND hearing)
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Closed-Set Lists
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small set of words presented
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Signal-to-Noise Ratio (S/N)
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difference between signal being presented, noise being used to mask
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Immittance
(definition?, uses?) |
Impedance -- total opposition to flow of energy
admittance -- ease with which energy flows through system Used to determine OE/ME/IE/RC pathology, brainstem pathology, facial nerve disorder |
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Immittance Procedure?
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presentation of signal to ear -- measures sound energy remaining in ear canal
high admittance/low impedance -- dislocation of ossicular chain low admittance/high impedance -- fluid in ME, cerumen impaction |
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Tympanograms
(what are they?, what do they measure?) |
The graphic display of immittance.
measures peak pressure, static admittance, equivalent ear canal volume |
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Static Admittance
(definition?, normal values?) |
admittance within ME, correlated to ME function
(peak admittance) - (admittance @ +200daPa) average range: 0.3-1.5 mmho |
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Equivalent Volume
(definition?, normal values?) |
Volume of EAM
measured at +200daPa adult normal: 0.65-1.75 cc child normal: 0.3-1.0cc |
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Type A Tympanogram
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NORMAL
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Type B Tympanogram
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"Flat" -- no peak admittance suggests no point at which TM is mobile
EAM volume may/may not be normal large volume -- perforation of TM, PE tubes low volume -- cerumen impaction |
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Type C Tympanogram
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Negative peak admittance
EAM volume normal Suggests Eustachian Tube disfunction, ongoing/recovering otitis media |
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Type As Tympanogram
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Normal peak admittance
Low static admittance -- suggests "stiff" system Tympanosclerosis, otosclerosis |
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Type Ad Tympanogram
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Normal peak admittance
High static admittance -- suggests overly mobile system Ossicular chain disarticulation, thin/flaccid TM |
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Acoustic Reflex
(definition?, correlated to?, properties?, normal range?) |
The response of stapedius muscle to loud sound
Correlated to lowest intensity at which a change in immittance is detectable BILATERAL REFLEX Normal reflex decreases admittance, increases impedance -- stapedius contracts, stiffens TM Normal range: 85-100 dB SPL |
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Acoustic Reflex Arc
(specified by?, general pathway?) |
Specified by: stimulated ear, ipsilateral/contralateral
Cochlea - CN8 - SON - facial nerve nucleus - CN7 - stapedius decussation @ SON CN7 first location containing bilateral information |
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Diagonal Pattern
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Retrocochlear loss
Problem with CN7, cochlear nerve, or stapedius muscle |
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Vertical Pattern
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sensorineural loss
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Horizontal Pattern
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brainstem pathology -- affecting crossover
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All Absent
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deafness, cerumen impaction, fluid in both ears
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Otoacoustic Emmissions (OAEs)
(originate from?, types?) |
Result from pre-neural activity of OHCs
OHCs lengthen, contract in cyclical fashion -- cochlear amplifier Spontaneous Otoacoustic Emissions (SOAEs) Transient Evoked Otoacoustic Emissions (TEOAEs) Distortion Product Otoacoustic Emissions (DPOAEs) |
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Transient Evoked Otoacoustic Emissions (TEOAEs)
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response to transient stimulus
tests IF there is a response |
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Distortion Product Otoacoustic Emissions
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Interaction of two pure-tones presented simultaneously
cochlear generations 3rd tone (2F1-F2) F2/F1 ration of 1.22 produces most robust response Tests WHERE there is a response |
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Auditory Brainstem Responses (ABRs)
(uses?, latency?) |
hearing screening, evaluation of hearing status, neurodiagnosis
normal latency: 1-10ms middle latency: 10-100ms late latency: +100ms |
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Neonate
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birth - 1 month
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Infant
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1 month - 3 years
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Preschooler
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3 - 5 years
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School Age
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+5 years
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Gestational Age
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length of pregnancy
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Conceptional Age
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from conception to birth
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Mental Age
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based on performance on standardized tests
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Developmental Age
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based on physical and mental development
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Comprehensive Evaluation
(includes?) |
case history, informal observation, physical inspection of ears, assessment
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Behavioral Observation Audiometry (BOA)
(purpose?, variability?) |
Looks for behavioral responses to auditory stimuli -- startle reflex, etc.
Variability from examiner bias, infant responsiveness, variability in responses, habituation. |
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Visual Reinforcement Audiometry (VRA)
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Not recommended for infants 0-5 months -- ideal between 5-30 months
Includes conditioning phase, test phase |
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Conditioned Play Audiometry
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Used for children 30 months - 5 years
Incudes conditioning phase, test phase |
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Physiological, Behavioral Tests for Infants (0 - 3 months)
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Physiological: ABR, OAE, Tympanometry
Behavioral: -- |
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Physiological, Behavioral Tests for Infants (3 - 6 months)
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Physiological: ABR, OAE, Tympanometry
Behavioral: VRA |
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Physiological, Behavioral Tests for Infants (6 months - 2.5 years)
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Physiological: ABR, OAE, Tympanometry
Behavioral: VRA, Conditioned Play Audiometry |
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Physiological, Behavioral Tests for Preschooler (2.5 - 5 years)
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Physiological: ABR, OAE, immittance
Behavioral: Conditioned Play Audiometry |
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Physiological, Behavioral Tests for School Age Children (+5 years)
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Physiological: ABR, OAE, immittance
Behavioral: Conventional Audiometry |
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Nonorganic Hearing Loss
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hearing loss without a physiological/anatomical origin
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Functional hearing Loss
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some degree of organic loss, exaggerated by nonorganic loss
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Psychogenic Hearing Loss
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psychological cause manifesting itself as hearing loss
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Disorder
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anatomical anomaly
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Impairment
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area of physiological dysfunction
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Disability
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difficulty with performance
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Sensitivity
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number of hits from a screening
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Specificity
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number of true negatives from a screening
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Infant Hearing Screening
(specific tests?, procedures?) |
OAEs, ABRs
1-3-6 rule (screening by 1 month, diagnosis by 3 months, treatment by 6 months) |
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OE/ME disorder screening (children)
(tests?, referrals?) |
otoscopy, tympanometry, reviewing case history
otoscopy referral -- drainage, ear pain, structural anomolies tympanometry referral -- Type B |
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Hearing Impairment Screening (children)
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OAEs, ABRs, audiogram
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Hearing Impairment Screening (adults)
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OAEs, ABRs, audiogram
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Hearing Disability screening (children)
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early language milestone scale
Preschool Screening Instrument for Target Educational Risk (SIFTER) |
