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529 Cards in this Set

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  • Back
Carhart Notch appears at 2,000 Hz. BC test results are poorer than the actual sensorineural response in the low frequencies. Caucasion middle aged women are most at risk, worse for pregnant women.
Otosclerosis
Separates scala vestibuli and cochlear duct (scala media)
Reissnners membrane
Separates scala tympani and cochlear duct (scala media)
Basilar membrane
Large perforation of the tympanic membrane can cause how many dB loss
Commonly 30 dB
What hearing loss is often favorable to medical treatment
Conductive
___ si good to find hearing loss. ___ and SRT are within 5 to 10 dB difference
PTA
Parallel vent in a non-occluding earmold enhances what frequencies
High frequencies
What durable, easly modified earmold material is most commonly used
Lucite acrylic
Functional gain provides comparison between
unaided and aided output
SIE or RIC emphasizes what frequency due to the large and or open vent
High frequency
Tympanogram: Significant negative pressure and normal mobility
Type C
Tympanogram: Restricted tympanic membrane mobility. (otitis media)
Type B
Tympanogram: Normal middle ear pressure but reduced mobility. (fixation of the ossicles)
Type As
Tympanogram: Normal middle ear pressure but hypermobility
Type Ad
Non-organic loss shows a acoustic reflex test of how many dB
5 dB
What vent modifies low frequency and in non-occluding earmold enhances high frequency
Parallel vent
Causes of an absent acoustic reflex
Facial nerve problem, bilateral conductive loss, severe and profound sensorineural loss
What does a 5.00 cc measurement of the static compliance indicate
Perforation of the tympanic membrane
Hearing test for children using lights or pictures
Behavioral observation
What Hz range is speech recognition in
1,000 to 10,000 Hz
Earmold Functions:
Seal the ear to prevent acoustic feedback, hold tube to the ear firmly, cosmetically appealing
Best candidate for non-occluding earmold
Unilateral loss
What frequencies does the venting technique effect
Below 1,000 Hz
What frequencies does acoustic modification effect
1,000 to 3,000 Hz
What frequency range do most hearing aids produce
100 to 8,000 Hz
What is the major source of noise in hearing aids
Receiver
What are the types of aided feedback
Acoustic, Mechanical, Magnetic
LDFR (level dependent frequency response) automatically changes
Gain and frequency
Cross fitting uses what type of earmold
Non-occluding
What is a clear indication of a sensorineural loss
AC & BC are almost the same
Retrocochlear loss signs
Poorer WRS, no acoustic reflex, unilateral loss.
Conductive loss signs
Flat configuration, ABG, absent acoustic reflex
OSHA noise exposure levels
90 dB - 8hrs, 95 dB - 4hrs, 100 dB - 2hrs, 105 dB - 1hr, 115 dB - 15min, 120 dB - 7.5min
Subjective acoustic sensation, no cure, surgical or medical intervention is used for the treatment
Tinnitus
Electro mechanical transducer
Receiver
What type of microphone is a FET that has a tolerance for temperature and humidity
Ceramic microphone
Conductive loss signs
UCL is high and absent acoustic reflex
Occlusion effect characteristics
Occures in low frequencies at 250, 500, 1,000 Hz, not common in conductive loss, Osseotympanic bone conduction is related
Complex noise is concentrated in what frequency
Low frequency
Cross earmold is recommended for what type of hearing loss
Mild to moderate and high frequency loss
Skeleton earmold is recommended for what type of hearing loss
Mild to severe
Canal - lok earmold is recommended for what type of hearing loss
Mild to moderate
Shell earmold is recommended for what type of hearing loss
Severe to profound
Immittance test max output is
70 dB
Transducer that converts electrical evergy to acoutstic energy
Receiver
What is the main purpose of an external vent
To reduce the occlusion effect
CIC, the mic is placed closely to the tympanic membrane for
Natural high frequency emphasis
Is it the microphone or the receiver that produces the sound
Receiver
What is the regular gian in SIE or RIC
20 dB
How can you find non-organic loss
Through audiometric testing
What is the best way to find a unilateral non-organic loss
Stenger test
Is the microphone or the receiver a output transducer
The receiver
What are the impression material factors
Acoustic, physical, tubing and earhook
What frequencies are modified by the horn effect
Above 3,000 Hz
Vent modification: Tinny or high sound
Increase the vent size
Vent modification: Small sound
Decrease the vent size
Low pitch whistling created due to the close distance between the mic and receiver(vibration)
Mechanical feedback
AGC, high intensive signals are amplified less than the weak signals that lead to less clipping and distorion
Compression
What fitting is good for unilateral loss of speech intelligibility, unilateral hearing loss of less localization, unilateral loss of less understanding of voice in the noise environment
CROS fitting
Microphone used in modern aids for directionality
Electret microphone
Electrical component that blocks or impedes high frequency
Inductor
What frequencies are effected by the occlusion effect
Below 1,000 Hz
A sudden drop audiogram is not accurate for calculating
PTA
WRS facts
90 - 100% is normal, below 50% is very low, WRS is relatively useful
Earmold material: Good for most allergy cases
Lucite(Poly methyl methacrylate)
Earmold material: Flexable, good for allergy cases
Silicone
Earmold material: Hard, good for severe allergy cases
Polyethyle
Tympanogram: Normal middle ear pressure buy hypermobility. Indicative of a flaccid tympanic membrane due to disarticulation of the ossicular chain or partial atrophy of the eardrum
Type Ad
Monosyllabic words composed of three phonemes
CNC words
What material is used for SRT
Spondaic Words
Rapid monotonous, unemotional speech
Cold running speech
Material used for SRT test
Spondaic Words
Programmable hearing aid class with single channel and single memory
Class 1
Programmable hearing aid class with single channel and multiple memory
Class 2
Programmable hearing aid class with multiple channel and single memory
Class 3
What is the most advanced memory
Electrically erasable programmable read only memory
Capacitors and Inductors are measured in
Ohms
Integrated Circuit components
Trasistors, capacitors, resistors
Class B push-pull amplification charictoristics
More power, more battery consumption, more gain
How many dB to double the sound intensity
6 dB
How many dB SPL increase to get about a two times loudness increase in our perception
10 dB SPL
How do you decrease the occlusion effect due to insertion loss
Decrease the low frequency
What is the least favorable audiogram shape
Sharp falling in the low frequencies
What frequency is attenuated by the shadow effect
High frequency
CIC can decrease wind noise by
23 dB
Noise induced loss effects what frequencies
3,000 - 6,000 Hz
What are the immittance test components
Air pump, amp, oscillator
What is tympanometry main purpose
To check the compliance of the eardrum
relationship between dynamic range and conductive loss
Same dynamic range with the normal
How does conductive loss effect MCL
MCL moves upward than the normal
Wave created by the alteration of compression and rarefraction in the elastic medium
Sine
Tuning fork test to check whether the BC tone is heard in the R or L ear (localization of the ear)
Weber test
What material is used for WRS
PB word list
Two-syllable word with equal stress on each syllable, used in SRT testing
Spondee
Filtered broad band noise designed to simulate the long-term average spectrum of conversational speech, used in masking during speech audiometry
Speech noise
Measure of speech audiometry that assesses a client's ability to identify one-syllable words presented at hearing levels that are above threshold
Word recognition (WR) score
Words with one syllable
Monosyllabic words
Word list in which the sounds represented occur proportionally to their occurrence in spoken English
Phonetically balanced word list
Percentage of speech understood at a variety of intensity levels from near threshold to well above threshold
Performance intensity (PI)
Phenomenon that occurs when increasing intensity results in decreasing word recognition, the formula is PB Max - PB Min/PB Max, values at 0.25 to 0.45 can be significant for retrocochlear pathology
PI rollover
Auditory dysfunction that is beyond the cochlea in the auditory nerve or brain stem
Retrocochlear pathology
Broad spectrum noise sometimes used in masking during speech audiometry
White noise
Material used for WRS
PB word list
Measurement of the pressure compliance in the tympanic membrane
Tympanometry
The impedance that is independent from the frequency
Resistance
What does the acoustic reflex show in a cochlear leasion
Lower than the usual sensation level
The static compliance of otosclerosis
Average
What is the acoustic reflex in a conductive loss
Absenct acoustic reflex
Disorder that causes less tolerance for loud sounds by someone who has tinnitus
Hyperacusis
What material is used in SDT(speech detection threshold)
Cold running speech
Phon:
A unit of the perceived loudness of sounds.
Most useful frequencies in speech intelligibility
2,000 - 5,000 Hz
How many hair cells in the organ of corti
3,000 - 4,000 hair cells
A sound which is generated from within the inner ear. (OAE)
Otoacoustic emission
10 dB increase =
2 times of loudness
Cochlear pathology is related to:
Loundness recruitment
What membrane in the cochlea are the outer hair cells embedded
The tectorial membrane
Most common cause of hearing loss in post-natal period
Measles
Measurement of pitch
Mel
Effect from mild to moderate loss
Defensive attitude toward hearing loss, voice louder or quieter than normal people, talk very subjectively
What earmold reduces the occlusion effect, great for the unilateral hearing loss, good for chronic drainage
Non-occluding earmold
AC need to mask formula
ACte - IA >= BCnte
Tuning fork test where the stem is held against the forehead, frequency must be specified, hearing better ear in sensorineural hearing loss
Weber tuning fork test
Correct amount of masking crosses over and leads to invalide results
Masking dilemma
What class of amplification has an output limiting circuit with peak clipping
Class A
Mastoid BC testing disadvantages
Poor test reliability, most likely affected by middle ear conditions, more affected by bone vibrator pressure
BC test frequency range
250 - 4,000 Hz
IA for supra aural(on the ear) headphone for AC:
Ave 55 (min 40 dB)
Controls the sound intensity associated with feedback circuit
AGC
The microphone is a:
Input transducer
What fitting is good for a unilateral loss
CROS fitting
What kind of distortion is caused by mechanical stress of the hearing aid
Harmonic distortion
Higher rate in males, more severe in males, probably bilateral hearing loss
Noise induced loss
Descending order in the audiometric testing:
Decrease stimulus 10 dB and increase 5 dB until reaching the threshold
Audiometric finding used as an evaluation variable by the government
PTA
What is the reason for the BC test
To find the abnormality of the middle ear
Cannot protect against very excessive sound,most conductive losses shows no or less of this
Acoustic reflex
Retrocochlear impairment result in hearing loss screening:
Absent acoustic reflex, very low unilateral WRS, unilateral sensorineural loss
What is the most unwanted acoustic flaw
Acoustic feedback
If sound from the hearing aid is not loud enough
Reduce vent size
Absence of the auricle, a rare, congenital deformity, a missing auricle, the external, visible part of the ear
Anotia
A congenital deformity where the pinna (external ear) is underdeveloped
Microtia
The patient says they hear their own voice to loud or complains of "head in a barrel" hearing
Autophony
Unit of power
Watt
Unit of measurement of pitch
Mel
How much SP is enhanced by the middle ear structure
27 dB
Number of outer hair cells in the organ of corti
12,000
In behavioral test, what hearing loss results in hyper recruitment and recruitment
Cochlear hearing loss
Earmold for severe and profound loss
Full shell earmold
Earmold for mild to moderate loss
Skeleton
Earmold for mild and moderate with high frequency loss
CROS
What hearing aid eliminates occlusion effect
Open-fit hearing aids
Hearing aid eliminates the natural resonance
Insertion loss
What loss does the patient hear well in noisy places
Conductive loss
Treatments for otitis media
Antibiotics, surgery, pus removal
What position of the eustachain tube can cause "head in a barrel" sensation
Open all the time
Where does the final stage of hearing take place
Organ of corti
Very rare in children, progressive conductive loss, two times more in females that in males
Otosclerosis
What loss commonly shows a high level of UCL
Conductive loss
In hearing aids, what component produces the most noise
The receiver
This circuit changes the gain and frequency together
(LDFR) level dependent frequency response
What hearing loss can cause a patient to talk loud in noisy places
Sensorineural loss
What hearing loss has the greatest problem with overmasking
Unilateral conductive loss
Formula for effective masking level below 1,000 Hz
EM = ACnte + OE
Effective Masking = Air Conduction non test ear + Occlusion Effect
Rollover ratio formula in WRT test
Rollover ratio = PB Min/PB Max
Evoked potential appears 75 msec ofter a large peak at 300 msec of the latency
Auditory event-related

Latency: measure of time delay experienced in a system
Narrowest pass-way between the scala vestibule and scala tympani. Main component of the cochlear apex. The hair cells in this area best detect low frequency sounds.
Helicotrema
BC threshold test at the forehead advantages
Improved test reliability
Non-organic test, sends two different intensities of the same frequency to both ears
Stenger test
What is the size of the adult cochlea
1cm wide and 5mm high
Two syllable words containing equal stress on both syllables, used in SRT test
Spondaic words
Tuning-fork test, compares the sensitivity by BC to AC
Rhine test
During what testing is undermasking more likely to occur
Air conduction
What microphone has all the frequencies of speech but not the good response in very low and very high frequencies
Magnetic microphone
Tympanogram: Shows interrupted ossicular chain and high static compliance
Type Ad
Tympanogram: Showing fluid in the middle ear
Type B
Tuning-fork test to find a localization of the ear
Weber test
What is the result of the interaural attenuation increasing during the masking procedure
Masking plateau becomes wider
Amperage, resistance, and voltage are base unit measurements of
Electricity
Causes of cochlear nuclei disorder
Ototoxic, excessive pressure, trauma
What kind of battery has great price advantage, poor storage life, low energy density, 1.5 volts
Zinc-air battery
What is the frequency range normal people can listen to
20 - 20,000 Hz
At audiometric zero what frequencies can be hear
All frequencies
Does the occlusion effect occur in BC or AC
Bone conduction
Certain harmonics are relatively loud in the sounds spectrum, spectral peaks of the sound spectrum of the voice
Formants
What is a blocked ear canal called
Atresia
UCL procedure
Seat the patient facing you, start at 70 dB, watch the patients face and eyes for reaction
What is the initial effective masking level in AC testing
AC of the none test ear
What is the natural resonant frequency the external ear generates
2,700 Hz
2 sounds are present simultaneously. When a soft sound and loud sound are present simultaneously. The soft sound is masked by the louder sound
Upward spread of masking
What is the IA for insert receiver for the AC test
AVE 85 dB (min 70 dB)
What happens when a low frequency tone is distributed along the basilar membrane
It initiates a neural response for a high frequency
A preceding loud sound masks out a soft sound that follows
Temporal masking
Otoacoustic emissions occurring whit out external stimulus. Unit of subjective loudness, equal to 40 phons
SONE
Test performed to determine recruitment with unilateral sensorineural hearing loss. If recruitment shows it is cochlear loss
(ABLB) Alternating binaural loudness balance
Muscle contraction around the eyes in response to a loud noise
Auropalpebral reflex
Hearing test that verifies localization of sound for children with visual reinforcement by head movement
Condition orientation reflex
What level of hearing loss do we see if the patient has no auricle
No hearing loss
What is the external canal natural resonance
2,000 - 5,000 Hz
What is the initial effective masking level in BC test below 1,000 Hz
AC of non test ear plus the occlusion effect
Narrow passage in external canal that is the beginning of the temporal bone
Isthmus
Common characteristics of severe sensorineural loss
AC configuration is sloping, ABG not present, acoustic reflex is present
Most common configuration in a sensorineural loss
Sloping
Common characteristics of a conductive loss
Acoustic reflex absent, usually good WRS, wide dynamic range
Another name for Menieres disease
Endolymphatic hydrops
Masking dilemma characteristics
Can occur in the bilateral conductive loss, false thresholds are created, occurs commonly with otosclerosis and other bilateral conductive disorders.
When the BC thresholds are within normal limits, bilaterally and the AC thresholds, bilaterally are 40 dB or more poorer than the BC threshold, then proper masking rules and procedures create over-masking. An over-masking situation occurs from the start of the attempt to mask which is known as a "masking dilemma"
What class uses the push - pull amplification
Class B
What amplification class is reliable, has good power and sound quality
Class D
Characteristics of hearing loss we can find in a diagnostic hearing test
Cause, duration, degree
What is the frequency range of the audiometer
125 - 8,000 Hz
What is the first step in audiometric testing
Check for collapsed ear canal
What noise is generally used for masking, its acoustic energy is the same with pure tone, not good for pure tone test
Narrow band noise
This is the point when the hearing aid output is apart from the linearity to the compression
Compression knee point
Another word for fitting
Adaptation
When taking an ear impression you find a small perforation of the tympanic membrane, what should you do
Continue the normal impression procedure
What masking material can be used for the word recognition test
CNC words, cold running speech
Tympanogram: Shows fluid in the middle ear
Type B
What vent modifies low frequency without affecting high frequency with great acoustic integrity
Parallel vent
End part of the malleus that is embedded in the tympanic membrane
Manubrium
How much larger is the vibrating area of the tympanic membrane compared to the oval window
17 times larger
Tympanometry typical air pressure range
+200 daPa to - 400 daPa
Tuning-fork test that examines the occlusion effect that finds any conductive loss
Bing test
Insert receivers minimum Ineraural attenuation level
70 dB
What attaches the incus and neck of malleus
Tensor tympani
Acoustic immittance tester components
Air pump, speaker, microphone
Is the acoustic reflex present or absent in a mild conductive hearing loss
Present
Auditory brainstem response (ABR) test equipment
Normal PC, amplifier, scalp electrodes
A flat tympanogram shows what disorder
Middle ear disorder
What is the knowles electronic manikin and 2 cc hard wall couple used to measure
The aids performance
What microphone improves localization and reduces background noise
Electret directional microphone
The pinna helps in
Localization of sounds
endolymph composition
Sodium, potassium, chloride
What disease has a sudden unilateral loss with vertigo
Meniere's disease
Non-organic loss most common finding
No match between PTA and SRT
SSPL calculation
1,000 + 1,600 + 2,500 Hz divided by 3
CIC hearing aids characteristics
Shorter fitting time, max gain limited, not good for profound loss
SPL and HL relationship
20 dB SPL = 0 dB HL
Dynamic range and sensorineural loss relationship
Narrow dynamic range than normal
MCL and sensorineural loss relationship
MCL same with normal
Why is UCL hard to find in severe conductive loss
Because UCL moves upward in the audiogram
What is the quality of sound
Timbre
What is the strongest sound pressure in normal ears
1,000 dyne/cm2
A measurement of dyne/cm2 in sound pressure
Microbar
Child illness most common cause of unilateral sensorineural loss
Mumps
Abnormal narrowing in a tubular organ or structure
Stenosis
Serous effusion causes a loss in what frequency
Low frequency
What class amplification do in the ear (ITE) hearing aids use that has a longer battery life, higher distortion and peak clipping
Class A
What is the 2 cc couple or manikin KEMAR(Knowles Electronic Manikin for Acoustic Research) performance test a substitute for
For the real ear
What hearing loss do individuals talk soft and hear better in a noisy environment
Conductive loss
Definition of audiometric zero
Lowest intensity most common people can hear all frequencies
Cold running speech is used for
speech detection threshold(SDT), MCL, uncomfortable loudness in WRT
Overmasking in word recognition test(WRT) happens mostly in what hearing loss
Bilateral sensorineural hearing loss
In acoustic reflex test the reflex is decay what is this finding
Retrocochlear lesion
In AC testing when do you mask the better ear
When there is a 40 dB difference in both ears
What material is used for speech recognition threshold(SRT)
Spondaic words
Word recognition score purpose
Find the degree of hearing loss for speech, site of lesion
The number of neurons in the human auditory system
30,000
Rapid movement of the eyes
Nystagmus
Purpose of insert earphones in BC testing
Prevent overmasking
Number of inner hair cells in the organ of corti
4,000
ANSI minimum noise level of test environment of AC test
40 dB
Narrow band noise advantage
More comfortable to listen to
Most important factors in testing procedure for UCL
Patients body and facial response
WRT(word recognition test)
Good WRT patient will get good benefit from hearing aids, use PB words, start test at 40 dB
Most important factor when performing immittance test
Airtight seal
What hearing loss shows good word recognition and some degree of loss
Conductive hearing loss
How deep should impression material be when making a CIC impression
At least 2 mm beyond the second bend
What amplifier class has one channel with 2 memories
Class 2
A/D converter utilize higher bit rates in digital hearing aids. What is the effect
Produce more original sound, produce more dynamic range
In the automatic signal processing circuit, what is the best description of "compression"
Any amplified signal resides in the dynamic range
Real ear measurement by probe microphone, where should the probe be placed
With in 5 mm from the tympanic membrane
What is the voltage of hearing aids
1.3 v
Energy concentration surrounding certain frequencies is called a
Formant
Weakest sound pressure in normal ear
0.002 dyne/cm2
What type of microphone has a broad response range without a feedback problem
Electret
If a patient's (WRS) word recognition score's are poor, what area should be adjusted to enhance word recognition ability
Gain, slope, frequency
Normal characteristics of the eardrum
Translucent, white to grey color, attached to malleus
At what speed does sound travel in the air
1130 f/sec
The SRT and PTA are correlated. What threshold variation can we expect if the pure tone thresholds are not fluctuated
5 dB
During or after the otoscopic inspection in the ear canal, if the client asks the results, how should you handle the question
Do not mention the findings
Advantage in testing the mastoid in the bone conduction test
Getting better (lower) auditory threshold
Type of compression method keeping the output below the knee point independently from the volume control
Input compression
What type of hearing loss is suitable for a contralateral routing of signal (CROS) fitting
Unilateral hearing loss with low SRT
Masking formula for SRT
SRT te >= IA lowest BC nte
Nerve system in the brain creates 5 to 10 dB lower thresholds by the presentation of the noise in the non-test ear. What phenomenon is this
Central masking
Relationship between (SDT) speech detection threshold and (SRT) speech recognition threshold
SRT is 10 dB higher that the SDT
Best noise used for masking (SRT) speech reception threshold and (WRT) word recognition test
Broadband noise
In acoustic reflex test, what kind of hearing loss can we see if the acoustic reflex is elevated
Mild conductive hearing loss
If a patient show acoustic reflex, what type of hearing loss or condition may we anticipate
Sensorineural hearing loss, facial nerve malfunction
Tympanogram: Patient shows otosclerosis
Type As
The muscle that attaches to the malleus, which impedes the movement of the bone
Tensor tympani
Even normal people without any hearing loss speak louder in a noisy place. What phenomenon is this
Lombard voice reflex
What organ is supporting the scala media
Spiral ligament
Specific organ that supplies the nutrients and oxygen to the cochlea
Stria vascularis
Causes of meniere's disease
Inner ear infection, blow to the head, Allergy (to food)
What is a good test to find non-organic hearing loss
Stenger test: a test for detecting simulation of unilateral hearing impairment, in which a tone below the admitted threshold is presented to the test ear and a tone of lesser intensity is presented to the other ear. If the subject is feigning a hearing loss, the lesser tone cannot be appreciated.
A test for detecting simulation of unilateral hearing impairment, in which a tone below the admitted threshold is presented to the test ear and a tone of lesser intensity is presented to the other ear. If the subject is feigning a hearing loss, the lesser tone cannot be appreciated.
Stenger test
Type of battery that has long life, no warm up time needed, and 2% loss per year in storage
Zinc-air
Materials used for (WRT) word recognition test
PB word list, CNC words, Sentence test
Unit of pressure equal to 1 newton per meter square
Pascal
Unit of frequency equal to one cycle per second
Hertz
Another name for automatic gain control in hearing aids
Automatic volume control
Venting effects what frequency range
Low frequency
Damping effects what frequency range
Mid range frequency
Horn effect effects what frequency range
High frequency
CIC fitting, placing the receiver more closely to the eardrum increases the head room in the ear canal. What is the benefit for this placement of the receiver
Undistorted sound with less gain
In early stages of otosclerosis, what type of audiogram can we find in the audiometric test
Low frequency hearing loss
Treatment for meniere's disease
Placebo effect, sedatives, surgical approach to relieve the endolymphic fluid
Tests to verify non-organic hearing loss
Stenger test, lombard test, doerfler-stewart test
Best description of otitis media
Infection of the mucous membrane int eh middle ear
Where the outer hair cells are attached in the inner ear
Tectorial membrane
Where does the organ of corti reside in the cochlea duct
Scala media
Most common symptom if the vestibular mechanism is damaged or has any disorder
Vertigo
Best description of vertigo
True sensation of turning
Methods to reduce or to eliminate acoustic feedback
Reduce vent size on the earmold, use damping material, reduce high frequency output
Consequences of too much low frequency output from a hearing aid
Less speech intelligibility, occlusion effect, blending high frequency
Modifications of the earmold to enhance acoustic quality
Modify vent size, insert dampers, shorten the canal length
If sound is tiny from a hearing aid, what king of earmold modification is needed
Make a larger vent
Logical foundation of the fourier theory in the sense of hearing in the inner ear
Inner ear acts as a frequency analyzer
Benefit of the acoustic reflex test
Verification tool for the bone conduction test
Consequences of sensorineural hearing loss
Poor word recognition score(WRS), recruitment, tinnitus, narrow dynamic range
If a patient complains that their own voice is too loud when using hearing aids, what is the first adjustment you need to do
Decrease low frequency, increase earmold vent size
Rules of masking for air conduction testing
Mask for AC testing whenever a difference of 40 dB or more occurs between the AC threshold of the better ear and the air or bone conduction threshold of the poorer ear. ALWAYS mask when there is a 40 dB or more difference between the AC of the better ear and the air conduction of the poorer ear
Stapedius and tensor tympani are two middle ear muscles jointed with the ossicles. What are their main functions
Connectors of the ossicles, reduce excessive sound to the inner ear, sound amplification
What fitting can reduce the head shadow effect
CROS fitting
Good test for the hearing screening and inner ear functionality for school children and newborn babies
(OAE) otoacoustic emission
(REUR) real ear unaided response:
Formal Definition: SLP, as a function of frequency, at a specified measurement point in the ear canal, for a specified sound field, with the ear canal unoccluded.
Informal Definition: The SPL, across frequencies, measured in the open (unaided) ear canal for a given input signal.
(REAR) real ear aided response:
Formal Definition: SPL, as a function of frequency, at a specified measurement point in the ear canal for a specified sound field, with the hearing aid (and its acoustic coupling) in place and turned on.
An angular measurement in a spherical coordinate system. The vector from an observer (origin) to a point of interest is projected perpendicularly onto a reference plane; the angle between the projected vector and a reference vector on the reference plane is called the
Azimuth
(REUG) real ear unaided gain:
The gain provided by the pinna and the ear canal with consequent head diffraction effects as measured in the ear canal. Subtract the input signal level from the REUR across frequencies to obtain the REUG.
How is it done? (REUR/REUG)
1.Conduct otoscopic examination.
2.Place probe tube in the ear canal, with end of tube at appropriate distance from the intertragal notch (e.g., within 5 mm of the eardrum).
3.Place patient at appropriate distance/azimuth from the loudspeaker.
4.Select desired input level.*
5.Conduct the measurement.
Closely related to the SRT and sometimes called the Speech Detection Threshold (SDT). Your score on this test is the lowest level at which you can identify, but not understand, sound as speech. Normally, this testing is only done if SRT testing cannot be done for some reason.
(SAT) speech awareness threshold
A problem encountered in establishing the bone conduction thresholds in severe bilateral conductive hearing loss, in which the amount of masking of the non-test ear exceeds the interaural attenuation(40 dB) so that enough masking is too much masking. Occurs commonly with otosclerosis and other bilateral conductive disorders, medical referral is necessary.
Masking dilemma
Provides a comparison between unaided and aided output
Functional Gain
Natural resonance of the ear canal
2,700 Hz
Is medical referral necessary for tinnitus
Medical referral is strongly suggested by not necessary
(WDS) word discrimination score
A Word Discrimination score, also known as WDs, is a measurement of a person's ability to correctly understand words spoken at a specific volume. The volume is known as MCL, which stands for most comfortable level. Word Discrimination tests are often given as a part of testing a person's hearing with or without hearing aids. A person's score reflects the percentage of words that he hears and repeats correctly
(SDS) speech discrimination score
The purpose of Speech Discrimination score (SDs) testing (sometimes called word recognition testing) is to determine how well you hear and understand speech when the volume is set at your Most Comfortable Level (MCL).
What are the hardest letters to hear with a profound loss in the high frequencies
f, s, th, p, t
Hearing aid internal feedback troubleshooting
Hold the hearing aid turned on with the volume up, being careful not to cover the microphone. Place your finger over the receiver (speaker) (at the tip that is inserted into your ear). Push tightly for a good seal. If you or a helper can hear the aid whistling with the receiver (speaker) covered, then there is probably an issue inside the hearing aid causing internal feedback. This could be two internal components touching, a whole in the vent, or the speaker could have fallen off of the tubing inside the aid. This should be taken in for repair.
Venting, effects what frequencies
20-1,000 Hz (referred to as the "body")
Three basic functions:
A. to reduce the feeling of fullness caused by the earmold.
B. To reduce a resonant effect the client describes as "hearing in a tunnel"
C. To improve speech clarity through better frequency response
Damping, effects what frequencies
1,000-3,000 Hz (referred to as the "presence")
Horn effects, effects what frequencies
3,000-10,000 Hz (referred to as "brilliance")
What are the 3 basic vent configurations
External vent, Diagonal vent, Parallel vent
When should hearing aid earmolds be replaced
Soft mold, every year
Hard mold, every 2 years
Acoustic modifications of earmold:
Aid sounds tinny
Drill vent hole. Use dampers
Acoustic modification of earmold:
Aid sounds harsh
Reduce volume, drill vent, shorten canal
Acoustic modification of earmold:
Aid sounds hollow
Increase vent size, shorten canal, bell canal
Acoustic modification of earmold:
Doesn't like sound of own voice
Shorten vent, enlarge vent, bell canal
Acoustic modification of earmold:
Not loud enough
Reduce vent size
Acoustic modification of earmold:
Feedback all the time
Close vent entirely, build up canal
Acoustic modification of earmold:
Hears sound, but doesn't understand with aid
Reduce low Hz, enlarge vent, shorten canal
Larger I.D. tubing and horn tubing effect on frequencies above 3,000 Hz
Increase
Smaller I.D. tubing effect on frequencies above 3,000Hz
Reduce by large decrease
Longer tubing effect on frequencies below 750 Hz
Increase
Shorter tubing effect on frequencies below 750 Hz
Slightly decrease
(REM) real ear measurement use
Used primarily in the verification precess of hearing aid fitting.
First they describe the gain and potential benefit of a specific hearing aid.
Second they provide valuable information as to whether specific targets have been achieved.
Third they can be used to identify acoustic changes required to improve a subjects perception of clarity or sound quality.
Finally they provide excellent objective record of a hearing aids function and service as a baseline for future fittings
What does POGO stand for
Prescription of gain and output
REAR test signal stimulus
Speech spectrum or Broad band noise
Normal hearing
0 - 25 dB
Mild hearing loss
26 - 40 dB
Moderate hearing loss
41 - 55 dB
Moderately severe hearing loss
56 - 70 dB
Severe hearing loss
71 - 90 dB
Profound hearing loss
>90 dB
Complete audiological evaluation, order of procedure
1. Hearing history
2. Physical inspection - ear canal & ear drum
3. Tympanometry & acoustic reflexes
4. Pure tone testing
4a. Air conduction testing
4b. Bone conduction testing
4c. Sound field testing
5. Speech recognition threshold (SRT)
6. Most comfortable level (MCL)
7. Uncomfortable loudness level (UCL) or threshold of discomfort (TD) / recruitment testing
8. Word recognition (WR) or speech discrimination (SD) testing
What is impedance
Resistance to movement. Impedance is lowest when the outside air pressure is equal to the air pressure in your middle ear
Type Ad
Taller than normal peak. Indicating one or more of the bones in your middle ear dislocated or damaged, or there may be a loss of elastic fibers in your ear drum
Type As
Shorter peak than normal. Indicating a stiff system such as might occur if you have otosclerosis
Indicates a conductive loss at all frequencies. Typically, a result of middle ear infections where your middle ear fills with fluid thus preventing your ear drum from vibrating freely. May also result from a hole in your ear drum, or from ear wax blocking your ear canal
Type B Tympanogram
Type C
Similar to a type A but the peak is shifted to the left, indicating negative pressure in the middle ear. Your ear drum is sucked in. If the peak shifted to the right it indicates positive pressure in the middle ear. Your ear drum is bulged out. In either case, the result is a conductive loss at both low and high frequencies. Generally indicates that your eustachian tubes are blocked, or otherwise are not working properly
Acoustic reflex test, the muscles automatically contract when your middle ears are exposed to sounds over
About 80 dB
If there is no acoustic reflex
It could indicate you have a conductive loss in your middle ears, you have a severe sensorineural loss or you have a lesion(s) on your auditory nerve
Pure tone testing is to determine
The TYPE (conductive, sensorineural, mixed)
The DEGREE (mild, moderate, severe, etc)
The CONFIGURATION (shape of loss,etc)
What sound should you use if the client has tinnitus
Warbled tones, if the audiometer can't produce warbled tones use double beep
Never say you have a % hearing loss. this is totally meaningless. You cannot express dB as % because dB are not linear units of measurement. You should stick to
dB, or use mild, moderate, severe format
When you wear headphones it takes how many dB of sound to vibrate your skull
40 dB
When you use insert earphones it takes how many dB of sound to vibrate your skull
60 dB
Sound field testing is
Testing while listening to loudspeakers in the sound booth. Usually reserved for testing how well you hear with your hearing aids on compared to how well you hear with your bare ears
What is the first speech test typically done
Speech recognition threshold (SRT)

Its older name is speech reception threshold
SRT Speech recognition threshold uses what word material
Spondee: Two-syllable words that have equal stress on both syllables
Spondee
Two-syllable words that have equal stress on both syllables, typically used in SRT speech recognition threshold testing. Commonly-used spondees include: airplane, baseball, cupcake, hotdog, railroad, cowboy, ice-cream, outside, playground and sidewalk
Speech recognition threshold test serves several purposes
1. It is a measure of the reliability of your pure tone air conduction test. Your SRT should be within 5 dB of your pure tone average(PTA).
2. It suggests the level of loudness at which words should be presented for the word discrimination (WD) testing.
3.It determines how much power (gain) you will need in a hearing aid that is right for your degree of hearing loss
SRT of 5 dB (normal)
You can understand speech perfectly at 21 ft and still catch some words over 100 ft
SRT of 30 dB (mild loss)
You can only hear perfectly at 1 ft and can hear some words at 18 ft.
SRT of 60 dB (moderate severe loss)
You would need the speaker to be only 1 inch from our ear in order to hear perfectly and within 1 ft to still hear some words correctly
SRT of 70 dB or more
You wont hear much at all without hearing aids or other amplification
Speech awareness threshold (SAT)
Sometimes call speech detection threshold (SDT). Is the lowest level at which you can identify, but not understand sound as speech. Usually it is only done if SRT testing cannot be done for some reason
What test is typically done after SRT
Most comfortable (listening) level (MCL)
How many dB louder than your SRT level if you have normal hearing is your MCL
40 dB, if you have a hearing loss it may be different
What test is typically done after MCL
Uncomfortable loudness level (UCL) or threshold of discomfort / recruitment testing
How many dB below UCL should your hearing aid be set
5 dB
What is the proper way to test for recruitment
Test frequency by frequency for each ear in turn
What is the final speech test
Word recognition (WR) testing

formally called speech discrimination (SD) testing
What is the purpose of word recognition (WR) testing
To determine how well you hear and understand speech in a perfectly quiet environment when the volume is set ar your MCL
What test material consists of 25-50 words and is usually used in word recognition (WR) testing
Phonetically balanced (PB) words. Meaning that the percent of time any given sound appears on the list is equal to its occurrence in the English language. Such as chew, what, knees, rat, start, etc
How many dB above your SRT should the volume be set for the presentation of the PB word list for WR word recognition (WR) test if you have normal hearing
40 dB above your SRT.

It may range from 25-50 dB above your SRT level, depending on how you perceive sound. If you have a significant hearing loss, it is set to your MCL
Your word recognition score (WRS) is an important indicator of
Of how much difficulty you will have communicating and how well you may do if you wear a hearing aid
What % WRS (word recognition score) is considered to be normal hearing
90%
What % WRS (word recognition score) is considered to be poor
Below 50%
If your WRS falls below 40% what may you be eligible for
Cochlear implant
People with conductive loss usually show what kind of WRS (also called a SDS speech discrimination score)
They usually show a excellent WRS when the volume is set at their MCL
People with a sensorineural loss usually show what kind of WRS (also called a SDS speech discrimination score)
They usually show a poor WRS.

People with problems in the auditory parts of their brains tend to have even poorer WRS although they may have normal auditory pure tone thresholds
In addition to determining how well you recognize speech, word recognition (WR) testing has another use
To verify that your hearing aids are really helping you
What characteristic of earmold tubing affects acoustic performance
Only the inside diameter affects acoustic performance
The use of thick or double wall tubing is effective in reducing
Acoustic feedback in high gain hearing aid applications
If tubing length is increased
The primary resonant peak will shift downward and the output will increase in the lower frequencies and decrease in the mid and high frequencies. Also the amplitude of the 2nd & 3rd peaks will be reduced
If tubing length is decreased
The primary and secondary peaks will shift upward in frequency. Also the output will decrease in the low frequencies and increase in the mid and high frequencies
Using tubing with a wider internal diameter will
Increase the gain between 1000 and 2000 Hz and decrease the gain in the lower frequencies
Using tubing with a narrower internal diameter will
Increase in the lower frequencies and decrease the gain in the higher frequencies
Skeleton Molds are the most popular earmold available, and provide maximum comfort and retention. This mold is appropriate for fitting what degrees of loss
Mild to severe hearing losses.
Canal lock molds are a discreet option when choosing an earmold. They are appropriate for what degrees of loss
Mild or moderate hearing losses
Shell Molds are exceptionally sturdy and lightweight and are recommended for fitting what degrees of loss
Moderate and severe hearing losses.
Half Shell Molds offer a comfortable and lightweight fit and are suited for what degrees of loss
Mild or moderate hearing losses.
Acoustic modifier molds are suited for what degrees of loss
Mild high-frequency loss
CROS molds are suited for what degree of loss
High frequency losses
Semi-skeleton earmolds are skeleton earmolds without the back ring, these mold work best for people with limited dexterity. They are suited for what degrees of loss
Mild to severe loss
Masking must be performed when
1. the thresholds for the ears are no symmetrical
2. an air/bone gap exists (conductive component)
3. a bilateral conductive component is suspected
When the better ear answers for the poorer ear it is called
Shadow curve
Attenuation definition
Lessening or a weakening of something
the range of interaural attenuation for insert earphones is
70-100 dB
These higher interaural attenuation levels increase the test reliability and reduce the probability for error
Due to the low interaural attenuation for BC, masking for BC should be applied what % of the time
100%
Rules for of masking for bone conduction testing
Mask for BC testing whenever a 15 dB or more difference occurs between the obtained BC threshold of the better ear and the obtained AC threshold of the poorer ear.
Reminder: Interaural attenuation for BC occurs as low as 0 dB
Rules of masking for speech discrimination or speech recognition
Mask for speech discrimination or speech recognition 100 % of the time.
Mask for the remainder of speech audiometry whenever a 40 dB or more difference occurs between the better ear pure tone average (PTA), speech threshold level (speech reception threshold), or best 2 frequency average and the poorer ear presentation level
If you have to mask for AC then you must mask for
Speech audiometry
Once a response is obtained, increase the masking noise by __ dB. If no response is obtained, increase the tone by __ dB
5 dB
A true threshold has been obtained once the masking noise level has increased by ______ dB with no shift in the test ear threshold
15 to 20 dB
Noise presented to the non-test ear even at very low masking level, may create a shift in the test ear threshold, occurring in the central nervous system mechanism is called
Central masking

It may increase the test ear threshold by 5 to 15 dB. It is acceptable to subtract 5 dB from any threshold obtained in the presence of contralateral masking noise to decrease the central masking factor
Occlusion effect will generally alter the BC thresholds between _ to _ Hz
250 to 1,500 Hz
The occlusion effect is essentially nonexistent above 2,000 Hz
Advantages of mid-line or forehead placement of the BC oscillators
1. The bone density of the forehead and skin thickness do not vary as much as the mastoid placement
2. AC leakage through the vibrator is lessened with forehead placement
3. It is suggested that by placing the oscillator on the forehead, one is eliminating the power of suggestion by placement on the correct ear
Recommended occlusion effect levels
15 dB at 250 Hz
15 dB at 500 Hz
10 dB at 1,000 Hz
no effect above 1,500 Hz
A poor speech recognition score may be the first indicator of a
Retrocochlear leasion
Formula for speech masking
Presentation level (PL) - 20 dB = masking level

The only time that speech masking formula is altered is when the client has severe recruitment
PL - 30 = masking level (recruitment)
During what testing is overmasking more likely to occur
Bone conduction
Semi-skeleton and Skeleton earmolds are good for what hearing losses
Mild to severe losses
Shell earmolds are good for what hearing losses
Moderate to severe losses
CROS earmolds are good for what hearing loss
High frequency
Canal-lock and Half shell earmolds are good for what losses
Mild to moderate
Acoustic modifier earmolds are good for what hearing loss
Mild high frequency
Non-organic hearing loss test that uses Spondees with noise to find an insistency of the threshold
Doerfler-Stewart test
The human speech is a very complex sound. What is the correct description for the frequency or speech
Much energy is in 50 to 1,000 Hz and speech recognition is in 1,000 to 10,000 Hz
What does the tympanogram of a person diagnosed with Otosclerosis show
Lower than normal compliance, but not flat
What frequency range do the most common hearing aids produce
100 to 8,000 Hz
In what condition is the AC test result poorer than the BC test result
The outer and middle ear malfunction
What type of hearing loss is the best candidate for the non-occluding earmold
Unilateral
Retrocochlear hearing loss indications
Unilateral hearing loss, no acoustic reflex, poorer word recognition score
Common characteristics of a conductive hearing loss
ABG-present, Configuration-flat, Acoustic reflex-absent
What is the definition of "intensity" of sound
The acoustic energy of sound
Does a sensorineural hearing loss that is the same degree in both ears need the masking procedure
No masking procedure required
What microphone has a (FET) field effect transistor and has great tolerance for temperature and humidity resistance
Ceramic Microphone
When is electric energy created
Electron moves around an atom
True fact of non-organic hearing loss
Some non-organic hearing loss is a form of malingering
What is the most common relationship between SRT and PTA
SRT score is better than PTA
What is the most common problem when you hear intermittent sound from the hearing aid
Battery contact is not good
Most concerning factors in the selection of impression material
Acoustic factor, Physical factor, tubing and earhook factor

Canal depth is not a factor
Tinny or high sound, you should ____ vent size
Increase
Small sound or not loud, you should ___ the vent size
Decrease
Hollow sound or plugged feeling, you should ____ the vent size
Increase
The electrical component in the hearing aid that blocks or impedes high frequencies
Inductor
Cases that benefit from binaural fitting
Narrow dynamic range, UCL is very low in one ear
When can the shadow curve happen
The better ear responds to the poorer ear
What frequency is more attenuated in the head shadow effect
High frequency
What is the main purpose of tympanometry
To check the compliance of the eardrum
What is the tuning-fork test that compares the BC sensitivity of the patient to the examiner
Schwabach test
Multiple waves of different frequencies enter into an amplifier circuit and amplify together, making an uncomfortable and distorted sound. What kind of distortion is this
Intermodulation distortion
What is the output limiting circuit used in Class A amplification
Peak clipping
What is the frequency range for the BC test in a general audiometer
250 to 4,000 Hz
What is the definition of Automatic Gain Control
Control the sound intensity associated with feedback circuit
What is the cause of harmonic distortion
Mechanical stress of the hearing aid
Noise induced hearing loss can occur at what age
Any age
Overmasking is actually increasing the threshold in the test ear that leads to a false threshold in the test. What kind of hearing loss would be the greatest problem in overmasking
Unilateral conductive hearing loss
In the SRT test, there are two syllable words containing equal stress on both syllables. What is this called
Spondaic words
What is the tuning-fork test that compares the sensitivity by BC to AC
Rhine test
What type of microphone has all the frequency range of speech but not a good response in very low or very high frequency
Magnetic microphone
If the interaural attenuation is increased, how does the masking plateau change
The plateau becomes wider
Facing a patient who is very reluctant to wear a hearing aid. What is the right way to approach this client
Ask the patient why they are reluctant to wear hearing aids
What component in the circuit of hearing aid blocks or impedes the low frequency
Capacitor
Air conduction - sloping, ABG - not present, acoustic reflex - present.
These are the common characteristics of what kind of hearing loss
Severe sensorineural hearing loss
What are the dimensions of a functional auditory system
Frequency, intensity, time

(acceleration is not a dimension)
Can occur in the bilateral conductive hearing loss, Masking noise can be heard in the poorer ear, false thresholds are created.
These are characteristics of what
The masking dilemma
Air conduction - sloping, ABG - not present, acoustic reflex - present.
These are the common characteristics of what kind of hearing loss
Severe sensorineural hearing loss
What are the dimensions of a functional auditory system
Frequency, intensity, time

(acceleration is not a dimension)
Can occur in the bilateral conductive hearing loss, Masking noise can be heard in the poorer ear, false thresholds are created.
These are characteristics of what
The masking dilemma
What material is used fro (WRT) word recognition test
Cold running speech
WIPI test
CNC words
In what year was the hearing instrument manufacturers software association (HIMSA) established
1993
What type of vent modifies low frequency without affecting high frequency and has great acoustic integrity
Parallel vent
Tuning-fork test that examines the occlusion effect that finds and conductive loss
Bing test
What material is used for Speech Recognition Threshold in general
Spondaic words
This is a sudden unilateral hearing loss with vertigo
Menieres disease
What is the relationship between MCL and sensorineural hearing loss
MCL is the same with the normal
This is an abnormal narrowing in a blood vessel or other tubular organ or structure.
Stenosis
Serous effusion creates a partial vacuum in the middle ear that allows continuous fluids to flow to the middle ear. What kind of hearing loss can you observe
Low frequency
Most (ITE) in-the-ear aids use this type of amplification. The characteristics of this amplification are a longer battery life, higher distortion, and peak clipping. What type of amplification is this
Class A
What type of hearing loss is the most related for overmasking in the (WRT) word recognition test
Bilateral sensorineural hearing loss
Non English speaking individuals can be given English version of PB word list for this test
WRT Word Recognition Test
Some individuals have a good word recognition ability though they have some degree of hearing loss. What type of hearing loss could it be
Conductive
If the analog to digital converter (A/D converter) utilizes higher bit rates in digital hearing aids, what is closely related to the sound quality
Higher bit rates produce more original sound, and produce more wide dynamic range
Advantages of using electret microphones in hearing aids
More durable because it has less component
Can be directional microphones
More wider frequency response range
Normal characteristics of the eardrum
Translucent, white to grey color, Attached to malleus

(not a bony structure)
Advantage in testing the mastoid in the BC test
Getting better (lower) auditory threshold
This is the type of compression method keeping the output below the knee point independently from the volume control
Input compression
What is the function of the compression method
-Reduce the overall distortion
-Enhance the speech intelligibility
-Reduce the acoustic feedback
How many dB higher is the SRT than the SDT
10 dB
What is the formula for SRT
SRTte - IA >= Lowest BCnte (not 250 Hz)
What kind of hearing loss can we see if the Acoustic reflex is elevated
Mild conductive hearing loss
What material can be used for WRT (word recognition test)
PB word list, CNC words, Sentence testing
(no cold running speech)
What type of Audiogram can we find in the early stages of Otosclerosis
Low frequency hearing loss
If sound is tinny from a hearing aid, what kind of earmold modification is needed
Make a larger vent
What is the benefit of the Acoustic Reflex test
Verification test for the BC test
Abnormal sensitivity to everyday sound levels of noise, often sensitivity to higher pitched sounds, in presence of essentially normal hearing.
Hyperacusis
Neomycin
Most toxic drug to the cochlea. Recommended topical use only
Aspirin
Ototoxic, but reversible once use is discontinued
Ototoxic Antibiotics
Aminoglycosides
Erythromycin
Vancomycin
For this test you use Spondee words (2 syllable). Findings should be within 5 dB of PTA
SRT
This tests results should be within 5 dB of SRT and 6-8 dB of SDT(speech discrimination test)
PTA (pure tone average)
How many dB loss over the course of a year is profound
10 dB
This is the amount of noise which is present in the hearing aid without any input present. Caused by electronic current passing through the amplification system of the High Gain hearing aids. Not a problem because ambient noise is usually enough to mask it out.
Equivalent Input Noise
HL to SPL formula is
HL + 20 = SPL
ex: 20 HL = 40 SPL
Client is asked to indicate the softest level at which speech is heard, regardless of whether or not what is said is understood. Normally only performed if SRT cannot be for some reason.
SAT (speech awareness threshold) or SDT (speech detection threshold) not to be confused with SDT (speech discrimination test, now called the WRT word recognition test)
What level should the hearing aid be set in relationship to UCL
It should be set 5 dB below the clients UCL
HFA stands for?
High Frequency Average
HAE stands for?
Hearing Aid Evaluation
Hearing loss as it relates to DR(dynamic range)
DR of 70-100 dB = normal hearing
DR of 50 dB = moderate loss
DR of 25 dB = severe loss
DR (dynamic range) calculation formula
DR = UCL - threshold

DR varies with frequency
Recruitment is related to this kind of loss
Cochlear loss
What is the difference between Collapsed and Prolapsed
Collapsed means completely shut
Prolapsed means closing of, but still open
Causes of internal feedback
- 2 internal components touching
- whole in the vent
- Speaker could have fallen of the tubing inside the aid
When the sum of the conductive components is greater than the IA value, the ipsilateral(same side of the body) function for the non-test ear will merge with the test ear
Masking Dilemma rule
- This determines how much gain you will need in a hearing aid that is right for the clients degree of loss.
- Should be within 5 dB of PTA
- It suggests the level of loudness at which words should be presented for the WDT (word discrimination test)
SRT (speech recognition threshold)