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17 Cards in this Set

  • Front
  • Back
air conduction
transducer: phone/inserts
or sound field *cant isolate*
from outer to inner
isolate R & L
bone conduction
transducer: oscillator
bypass outer/middle
only test cochlea
intraoral attenuation
sound lose when going through head
bone cond: 0dB always test both sides b/c vibrates skill so better ear hears
air cond: 40dB thorugh head
conductive HL
attenuation: decrease in a signal's strength
-sound attenuation of outer/middle ear
-blockage of sound transmission to the inner ear
-air conduction vs.bone conduction
Which is always worse: air conduction or bone conduction?
air conduction is always worse than bone conduction
Sensorineural Hearing Loss
-attenuation of sound occurs within some portion of the inner ear
-air conduction vs. bone conduction

sensory=cochlea
neural=above cochlea
Mixed Hearing Loss
-problems can occur simultaneously
-conductive and sensorineural hearing loss
-sound attenuation by outer/middle ear as well as inner ear
-air conduction vs. bone conduction
-bone conduction abnormal & air conduction also abnormal but still gap b/w of 15 dB or more
Tuning Fork Tests
First site of lesion hearing tests

Late 19th to middle 20th century by German otologists
-Schwabach
-Rinne
-Bing
-Weber

*Bing and weber use occlussion effect in ability to diagnosis LOH

Occlussion=phenomenon that occurs when testing bone conduction occluded ears & sound pressure increases
20dB HL-> 15 dB HL
Schwabach Test
-compares patient to tester for SNHL
-stem of tuning fork placed on mastoid bone
-the pt asked to raise his hand when the sound is no longer audible, normal Schwabach test
-if sound is still audible by tester, diminished Schwabach test by however many seconds the sound actually lasts
-limitations: unilateral sensorineural HL can still be positive b/c better cochlea hears
Rinne Test
-rule out conductive HL
-compares pts bone conduction to the pts air conduction
-tuning fork held on mastoid and then next to ear
-pt asked which is louder
-air conduction has better transmission so next to the ear will be better as long as no conductive pathology; Normal Rinne
-abnormal Rinne Test suggests conductive pathology
-Limitations: mixed HL pt hard time differentiating; dont know which ear for bone b/c test both cochlea

(bone should diminish quicker than air due to 3 compensation
The Bing Test
-compares hearing using the occlusion effect to rule out conductive pathology
-tuning fork placed on mastoid
-tester opens and closes the ear
-if pt reports sound gets softer and louder Normal Bing test
-Abnormal Bing test suggests conductive pathology
-Limitations: if mixed HL miss sensorineural component
Weber Test
-compares CHL to SNHL by pts ability to lateralize sound
-tuning fork placed in center of skull
-pt asked which ear the sound is loudest
-response of midline: normal or bilateral same degree/type of HL
-SNHL in one ear report hearing in the better ear
-CHL in one ear report hearing in the poorer ear
-Limitations:if conductive HL hear sound louder in pathology (worst) ear b/c of occlusion effect; if SN hear louder in better ear (lear amt. HL); if B/L semetrical HL can be limit
Acoustic immittance/acoustic reflex testing
middle ear testing

electrophysiologic measure

objective
Electrophysiological Assessment
-objective measures of bodily function
-pt contribution not necessary
ACOUSTIC IMMITTANCE(1970'S)
-used in conjunction with other audiological measures to determine site of lesion
-routine in audiological test battery
-usually performed prior to behavioral testing
-related to volume of air pressure

Impedance (Za): resistance to flow, rejection of energy

Admittance (Ya): ease of flow, acceptance of energy
Acoustic Impedance vs. Admittance
Impedance (stiffness):
-as compliance increases impedance decreases
-as sound pressure increases impedance increases
-as volume increases impedance decreases
Za=measure in ohms
Za-P(sound pressure)/U(volume velocity)

Admittance (compliance):
-as impedance increases admittance decreases
-as sound pressure increases admittance decreases
-as volume increases admittance increase
Ya-measured in mmhos
Ya= U/P

Impedance=stiffness pathologies ie; fluid
Admittance=hypermobile pathologies ie ossicular chain disc.
Acoustic Immitance meter
Parts of Meter: 4 tubes
1) probe tone loudspeaker
2) tiny microphone picks up reflected wave of the probe tone
3) air pump to create positive or negative pressure in the ear canal (daPa)
4) ipsilateral reflex loudspeaker

Tests performed using Immittance Meter:
1) tympanometry(middle ear and ear drum function)
2) acoustic reflex(test neural pathologies)
3) reflex decay (neural pathology)
4) eustachian tube function (how well ET reacts to pressure changes)
Tympanometry
assesses middle ear function

measurements seen in tympanometry:
1.) admittance/compliance(mmho): movement of eardrum
2.) ear canal volume
3.) tympanic peak pressure (daPa): pressure in middle ear space

USE IN CONJUNCTION TO MAKE FULL ASSESSMENT

Graphing measures:
-xaxis= pressure in daPa
-yaxis= admittance compliance in mmho