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42 Cards in this Set
- Front
- Back
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aural rehabilitation centers
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otology+speech pathology with some influence from psychology
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prevalence of hearing loss
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25 million are affected by hearing loss. 90% of children have had an ear infection with effusion by age 6. treatment of hearing loss = 1 million a year.
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audiologist
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academic degree, clinical training, certification--> assessment and rehab-->for auditory or vestibular impairment and work against these impairments
(fewer audiologists do rehabilitation) |
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medical audiology
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largest segment. work in hospitals and try to establish where the problem is. monitor when dr is operating near aud nerve and do newborn hearing screenings
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educational audiology
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train screeners but dont usually diagnose. work with teachers of deaf and slp on identifying hl and working on skills. also amplification and parents
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pediatric audiology
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diagnose, advise, must know about cochlear implants
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dispensing/rehabilitative audiology
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asha ban on hearing aid dispensing until 1975. work out of hospitals or dr office, private practice is fastest growing setting.
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industrial audiology
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30 million workers damaged. hearing protection, noise modification, monitoring of employee hearing
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asha
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also includes teachers of the deaf, included audiology in 1947
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american academy of audiology
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1988
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outer ear
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pinna, external auditory meatus, tympanic membrane.
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middle ear
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air-filled space, 3 tiny connected bones
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inner ear
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cochlea: responsible for hearing, filled with fluid, converts waves to neural impulses. also balance mechanism. loss here is permanent.
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auditory nerve
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transmits neural impulses to brainstem. series of waystations that receive, analyze and further transmit impulses.
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conductive portion
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outer and middle ear (up to oval window)
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sensorineural portion
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inner ear and auditory nerve
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air conduction
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sound travels through outer, middle, inner ear. uses all parts of the ear. tests integrity of the entire system.
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bone conduction
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bones of the skull are contiguous and convey sound to inner ear directly, bypassing outer and middle ear. tests integrity of the inner ear
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hearing aids and cochlear implants
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DO NOT RESTORE NORMAL HEARING
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AC vs BC
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theoretically, air conduction cannot be better than bone conduction because air conduction requires the whole ear
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conductive hearing loss
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mose common, results in sound attenuation via AC (all hearing loss results in AC problem). some barrier or interruption to outer or middle ear. bone conduction is heard normally.
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sensorineural hearing loss
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lesion is in the inner ear and/or auditory nerve. will result in air conduction loss but sound introduced through bc will show JUST AS MUCH hearing loss as through AC
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mixed hearing loss
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lesion in both conductive and sensorineural mechanisms. loss via AC will be greater than via BC because there are 2 places of damace along the AC while only 1 along the BC.
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tuning forks
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only pure tone other than audiometer. rarely used by audiologists. only 1 frequency. metal (steel, aluminum, magnesium). frequency relates to length, mass and density. can be placed at forehead, mastoid and ear canal.
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the schwabach test
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compares patient's BC to examiner's BC. when the patient no longer hears the tone, the examiner places on his own mastoid.
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normal schwabach
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patient and examiner stop hearing fork at the same time
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diminished schwabach
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examiner hears fork longer than the patient, indicates sensorineural hearing loss
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prolonged schwabach
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can indicate conductive hearing loss (sometimes exaggerates bone conduction hearing)
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rinne test
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compares pateints BC to AC. is the tone louder when the fork is held near EAM or on mastoid? normal ear hears more efficiently through AC
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positive rinne
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hearing louder through AC means normal ear or slight sensorineural hearing loss
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negative rinne
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if the tone is louder through BC, indicates conductive hearing loss
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the bing test
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uses the occlusion effect. tuning fork placed on the mastoid. examiner opens and closes the canal with finger. usually when you plug your ear, you hear yourself louder due to bone conduction
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negative bing
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no change, means conductive hearing loss
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positive bing
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the tone gets louder and softer, normal hearing
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occlusion effect
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when a normal ear is blocked up, the loudness of a BC tone increases. mainly noticeable with low pitch sounds, also noticeable in patients in SNHL. does not make a diff if already have conductive loss.
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the weber test
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tests lateralization. tuning fork is placed at the midline. patient states if tone is heard in left ear, right ear, both ears or midline. patients with CHL will hear it in their poorer ear because it is better at BC than AC. Patients with SNHL in 1 ear will hear it in the better ear. Normal will hear at midline.
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stenger effect
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for two tones that are indentical except for loudness that are introduced simultaneously to both ears, only the louder tone will be heard
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not normal hearing
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if anything falls below 20 dBL. the further down on the audiogram, the worse it is. look at the relationship between the two lines on the audiogram.
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amplitude of conversational speech
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60 dB with as much as 30 dB variability for different speech sounds
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conductive high frequency hearing loss
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this is rare. most likely SNHL
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sensorineural hearing loss on audiogram
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if the distance between air conduction and masked bone conduction is more than 15 dB, it is probably a sensorineural HL. also if bone and air conduction look the same on audiogram.
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switching to good ear
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once a tone is 45 dB louder to the poorer ear, you run the chance that bone conduction will transfer sound to the good ear
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