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409 Cards in this Set
- Front
- Back
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How can disease transmission happen? |
Contact, Vehicle,airborne & vectorborne |
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What is direct contact disease transmission? |
Kissing, body lesions, sexual contact, etc |
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What is an example of direct contact disease transmission? |
Common cold |
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What is indirect contact disease transmission? |
Through the person or the hearing aid touching a surface and then someone else comes in contact with that surface |
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What is an example of indirect contact disease transmission? |
MRSA or herpes |
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What does the vehicle mean when talking about disease transmission? |
When a contaminant is ingested or food,water,etc is exposed to the contaminant |
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What is an example of a vehicle for disease transmission? |
HIV and ecoli |
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What does airborne mean when talking about disease transmission? |
When droplets/dust particles remain suspended in the air for long periods of time |
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What is an example of a disease that can be transmitted through airborne contaminants? |
Tuberculosis and chicken pox |
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What does vectorborne mean when talking about disease transmission? |
Disease transmission via an animal/insect that can transmit disease |
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What is an example of a disease that can be transmitted through vectorborne transmission? |
West Nile virus or dengue fever |
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What is the most important thing when it comes to proper infection control? |
Hand hygiene |
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What is an alternative to hand washing if there is not a station readily available? |
Hand sanitizer that is at least 60% alcohol based solution |
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What are the 3 steps to proper infection control: |
1. Cleaning- the removal of gross contamination without involving killing germs 2.Disinfection- Killing germs (Will not kill ALL germs) 3. Sterilization- Kills ALL germs |
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What is the preferred method of sterilization? |
Cold sterilization |
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What are PPE? |
Personal protective equipment |
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What are examples of PPE? |
Gloves, face masks, gowns and protective glasses |
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When should you use gloves? |
1. When eat drainage, blood or sores are evident 2. When handling ear molds/aids directly from patients 3. During removal/handling of impressions 4. Cerumen management 5. Cleaning and disinfecting aids 6. Handling waste materials 7. Cleaning spills of body fluids |
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When should you wash your hands when using gloves? |
Prior to using gloves and after disposing them |
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What are considered critical instruments with sanitization? |
Reusable instruments or objects that are either: 1. Introduced into the blood stream Or 2. Non invasive instruments that come in contact with intact mucous membranes or bodily substances Ex: blood, saliva, mucous discharge, pus, cerumen Or 3. Noninvasive instruments that can nick skin surfaces |
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What kind of cleaning do non-critical instruments require? |
Cleaning and low/high level disinfecting |
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What kind of cleaning do critical instruments require? |
Cleaning and sterilization |
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What are the cold sterilent requirements? |
7.5% or higher concentration of hydrogen peroxide (H2O2) |
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Where should you never brace the head? |
Never behind or below the head (posterior and inferior) |
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What type of ear phone should be used when dealing with a collapsed canal? |
Inserts |
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What are 3 examples of congenital outer ear disorders? |
1. Microsia 2. Atresia 3. Anotia |
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What is microtia? |
Small pinna |
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What is anotia? |
Absense of the pinna |
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What is atresia? |
Just the canal, middle and inner ear system there is essentially no outer ear at all |
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What are some conditions of the EAC (external auditory canal)? |
Cerumen impaction, congenital deformities, surgical alterations, abscess, growths, itching, pain and drainage |
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What are two thinks you may want to check for on the TM during otoscopy? |
Redness and scarring (thin white streaks or spots) |
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What are the transducers on your audiometer? |
Inserts or the headphones |
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When should you perform a biological check on your audiometer? |
Everyday |
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What should you do if the client does not respond for AC testing right away? |
Increase the dB level in 20dB steps until a response is made |
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What should you do during a test when the first response is made during pure tone testing? |
Repeat descending technique until they respond 2 out of 4 times to determine threshold |
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What is the AC IA for inserts m? |
70dB |
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What is the AC IA for headphones? |
40dB |
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What is the BC IA? |
0dB |
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What is IA? |
Interaural Attenuation |
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When should you mask for air conduction while using inserts? |
If there is a 70dB or greater difference between ears |
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When should you mask AC while using headphones? |
When there is a 40dB or greater difference between both ears |
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What is the formula for AC masking? |
NTE=AC of the NTE + 10dB |
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What is the formula for masking BC? |
NTE=AC of NTE +10dB + OE |
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What is the formula for masking BC? |
NTE=AC of NTE +10dB + OE |
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What does OE mean? |
Occlusion effect |
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What is the occlusion effect of 250 & 500k? |
15dB |
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What is the OE of 1k? |
10dB |
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What is the OE of 2k & 4K? |
0dB |
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If there is a 40dB difference between unmasked bone and unmasked air what should you do next? |
Mask AC first before performing BC masking |
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What dB level should you start UCL testing and at what frequency? |
1k at 70dB |
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When should you mask for SRT testing? |
When the difference between the unmasked SRT of the TE and the best BC of the NTE at 500,1k,2k & 4K exceeds the amount of IA for the transducer Inserts IA = 40dB Headphones IA = 60dB |
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What is the IA for inserts with BC? |
60dB |
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What is the IA for headphones with BC? |
40dB |
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When should you mask for WRS testing? |
When the difference between the MCL to the TE and the best BC of the NTE exceeds IA for the transducer Inserts = 60dB Headphones= 40dB |
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What dB level should you first present at for SRT testing? |
30-40dB above PTA |
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What dB level should SRT be in reference to the PTA? |
10dB of PTA unless it is a reverse or precipitous loss |
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True or False: SRT is a sole indicator of loss |
False |
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What is the masking formula for SRT? |
NTE=SRT + 10dB |
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When should you use SAT testing? |
For non English speakers or when there is a language barrier |
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Should you mask for MCL? |
No |
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What kind of words are used for WRS? |
Phonetically balanced (PB) |
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What percentage is each word worth with WRS out of 25 words? |
4% |
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What is the masking formula for WRS? |
MCL of TE - 20dB to NTE |
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What is the formula to determine WRS %? |
# of wrong words/25=% incorrect Then 100% - % incorrect = WRS% |
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What is immittance audiometry? |
Middle ear function |
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What is pure tone data? |
The softest sounds that the patient can respond to 50% at the intensity level |
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What is pure tone data? |
The softest sounds that the patient can respond to 50% at the intensity level |
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How is the type of hearing loss determined? |
It is determined by the relationship between AC and BC |
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What is pure tone data? |
The softest sounds that the patient can respond to 50% at the intensity level |
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How is the type of hearing loss determined? |
It is determined by the relationship between AC and BC |
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What does severity mean in reference to hearing? |
The amount that the thresholds are elevated relative to normal hearing |
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How is configuration defined on the audiogram? |
It is defined by the slope and pattern shown on the audiogram |
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What is conductive hearing loss? |
When the cochlea is normal as tested by BC but the MES (middle ear system) is not working properly Ex: Ear infection/effusion, ossicular discontinuity, otosclerosis, etc |
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What is conductive hearing loss? |
When the cochlea is normal as tested by BC but the MES (middle ear system) is not working properly Ex: Ear infection/effusion, ossicular discontinuity, otosclerosis, etc |
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What is sensorineural hearing loss (SNHL)? |
When both AC and BC are beyond range of normal for all or a portion of the audiogram |
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What is conductive hearing loss? |
When the cochlea is normal as tested by BC but the MES (middle ear system) is not working properly Ex: Ear infection/effusion, ossicular discontinuity, otosclerosis, etc |
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What is sensorineural hearing loss (SNHL)? |
When both AC and BC are beyond range of normal for all or a portion of the audiogram |
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What is another indicator of SNHL? |
When AC and BC thresholds are no more than 10dB different for any frequency |
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What is conductive hearing loss? |
When the cochlea is normal as tested by BC but the MES (middle ear system) is not working properly Ex: Ear infection/effusion, ossicular discontinuity, otosclerosis, etc |
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What is sensorineural hearing loss (SNHL)? |
When both AC and BC are beyond range of normal for all or a portion of the audiogram |
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What is another indicator of SNHL? |
When AC and BC thresholds are no more than 10dB different for any frequency |
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Describe a mixed HL |
When part of the loss is due to a disorder of the cochlea or auditory nerve and part is due to an obstruction or breakdown in the outer or middle ear |
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What is conductive hearing loss? |
When the cochlea is normal as tested by BC but the MES (middle ear system) is not working properly Ex: Ear infection/effusion, ossicular discontinuity, otosclerosis, etc |
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What is sensorineural hearing loss (SNHL)? |
When both AC and BC are beyond range of normal for all or a portion of the audiogram |
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What is another indicator of SNHL? |
When AC and BC thresholds are no more than 10dB different for any frequency |
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Describe a mixed HL |
When part of the loss is due to a disorder of the cochlea or auditory nerve and part is due to an obstruction or breakdown in the outer or middle ear |
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What is another way to describe a mixed loss? |
SNHL mixed with conductive loss |
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What does symmetrical loss mean? |
The hearing loss is similar in both ears, usually within 10-15dB at all frequencies |
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What does an asymmetrical loss look like? |
1 ear is significantly different from the other (usually by 20dB or more) over a range of frequencies |
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What does a flat loss indicate? |
Equal hearing loss (within 20dB) across 500k-4k |
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What is a gradually sloping loss? |
Loss becomes gradually worse as frequencies become higher |
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What is a gradually sloping loss? |
Loss becomes gradually worse as frequencies become higher |
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What is a precipitous sloping loss? |
Loss that rapidly worsens as frequencies become higher (change of 20dB per octave) |
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What is a gradually sloping loss? |
Loss becomes gradually worse as frequencies become higher |
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What is a precipitous sloping loss? |
Loss that rapidly worsens as frequencies become higher (change of 20dB per octave) |
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What is a reverse slope? |
Significant loss in the lower frequencies with loss becoming better in the higher frequencies |
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What is a noise notch? |
Normal hearing in the low and mid frequencies with a loss at 3-6k with thresholds improving above the notch |
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What is a cookie bite shaped loss? |
When the client has normal/near normal hearing in the low frequencies, a loss from 1k-4k then returning to normal in the high frequencies |
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What is a cookie bite shaped loss? |
When the client has normal/near normal hearing in the low frequencies, a loss from 1k-4k then returning to normal in the high frequencies |
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True or false: Cookie note shaped loss is often congenital |
True |
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What is a corner audio loss? |
Loss in the very low frequencies with no measurable hearing in the high frequencies |
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True or false: If the SRT score is more than 10dB better than the PTA, you should re-instruct the patient and re-do tones |
True |
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When should thin tube or slim tube hearing aids be considered ? |
When hearing levels are 60dB HL or better |
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True or false: There is significant impact of the smaller tubing on gain and high frequency response when compared to a larger #13 tubing |
True |
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When should an open fitting or large ear mold vent be used in reference to the level of hearing loss? |
If the thresholds are 40dB HL or better at 250 and 500k and 60dB HL or better at 1k |
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When should a closed fitting (Occluding dome or custom mold) be used? |
When hearing levels are worse than 40dB HL at 250-500k and worse than 60dB HL at 1k |
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How can you reduce the occlusion effect (OE) when fitting a hearing aid? |
By choosing an open fitting or make sure a custom ITE aid extends beyond the 2nd bend and into the bony portion of the canal |
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When should a BAHA (bone anchored hearing aid) or a BC device that sits in the mastoid be considered? |
When it is not possible to couple the instrument to the ear with an ear mold |
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When should a BAHA (bone anchored hearing aid) or a BC device that sits in the mastoid be considered? |
When it is not possible to couple the instrument to the ear with an ear mold |
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What are some conditions that might require a BAHA? (2 answers) |
Congenital deformity or draining ear |
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How for s a CROS aid work? |
One mic is on the impaired ear and receives the sound and transmits it to an amplifier and receiver worn on the better ear |
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How does a BiCROS aid work? |
There is a mic on the unaidable side that is connected to a complete hearing aid on the better ear |
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What are some options for a patient who likes the look of a RIC but needs a HP BTE aid? |
Consider looking at power mold options with canal locks or skeleton styles so that an appropriate style and fit can be achieved |
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Where should a sound bore of the mold or shell be directed towards? |
Towards the TM and needs to extend beyond the second bend |
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True or false: The mold should fit snuggly in cartliingous tissue |
True |
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Where does retention occur at with full concha shells or molds? |
At the helix, Tragus and antitragus |
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Where does retention occur for CIC/IIC/canal instruments? |
Between the aperture and the 1st bend of the canal |
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Where does the acoustic seal occur? |
Between the ear canal aperture and the canal’s second bend |
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True or false: When using otoblast, the impression needs to be accurate |
True |
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What material mold should be used when dealing with soft ear texture? |
Hard material when possible |
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When should you consider a soft material for a mold? |
When the patient has firm ear texture |
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What does venting do? |
Modified the low frequencies |
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What does damping do? |
Modified the mid frequencies |
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What does horning do? |
Modified the high frequencies |
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What are the 3 purposes of venting? |
1. Equalize ambient pressure with the atmospheric pressure in the canal 2. Reduce or eliminate the OE 3. Improve audibility and sound quality by acoustically altering the frequency response of the aid |
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What are the 3 types of vents? |
Parallel, diagonal and external |
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What is the preferred type of venting? |
Parallel |
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What type of venting may affect high frequency response and increase feedback? |
Diagonal |
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When should you consider a diagonal vent? |
When a parallel vent cannot fit |
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What is a trench or external vent? |
A vent that runs along side the outside canal portion of the esrmold or shell |
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True or false: SAV (select a vent) is the preferred method for parallel venting |
True |
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True or false: As gain decreases the vent needs to increase to reduce risk of feedback |
False: as gain INCREASES, vent size needs to DECREASE to reduce risk of feedback |
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Can decreasing the vent size cause less ear canal aeration? |
Yes, but this is not an issue for most people. BUT some people can be more at risk for ME infections and therefore may need a large vent even though they may get feedback |
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What is the main benefit of using a pressure vent? |
It alleviates the feeing of fullness by equalizing the ambient air and canal pressure |
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Will a pressure vent reduce OE and the frequency response? |
No, but it will improve wearer’s comfort |
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What type of loss are most pressure vents used for? |
severe-profound high gain fits in custom instruments or molds |
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When the canal is occluded by an ear mold/aid, low frequency sound pressure (usually below 500k) is enhanced or decreased? |
Enhanced |
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What is the biggest complaints from the canal being occluded? |
The OE while chewing, swallowing, breathing is stuffy or hollow. |
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Does occluding the canal enhance the bone conducted sound do to canal closure? |
Yes |
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What is the most effective way of fixing OE? |
Venting |
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How does venting reduce the OE? |
It allows low frequencies to escape from the ear rather than being directed towards the TM |
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What is another technique besides venting to reduce the OE? |
Deep canal fittings |
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40dB or better between 250,500 & 1k = what size vent? |
Medium to large vent |
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40-70dB between 250,500,1k = what size venting? |
Small or standard vent |
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70dB or worse HL between 250,500 & 1k = what size vent? |
Pressure or no vent |
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Mid frequency response can be smoothed for improved sound quality by making what modification to the ear mold? |
Damping |
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Where would damping be located? |
In the mold tubing or in the ear hook of the BTE unit |
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Can damping be used with programming enhancements? |
Yes |
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True or false: High frequency gain can be enhanced with horn theory |
True |
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What is horn theory? |
Change in diameter of the sound channel from smaller to larger |
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What effect can horning have on the high frequencies? |
The instrument response is increased in the high frequencies |
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Programming BTE aids can cause distortion and unnatural sound to the high frequencies, what type of horning can you use to fix this? |
Use a libby horn or a belled/hollowed canal bore |
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What is the best size of tubing to use? |
#13 thick (standard) |
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True or false: When performing a proper fitting soft sounds should not be audible? |
False, soft sounds SHOULD be audible during a fitting |
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Should speech sounds be accessible and within dynamic range during a fitting? |
Yes |
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True or false? Loud sounds should be over amplified during a fitting |
False. Loud sounds should NOT be over amplified during a fitting |
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True or false: During a fitting you do not need to use confirm verification and validation. |
false. always confirm verification and validation while performing a fitting |
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True or false: During a fitting, acoustic and physical comfort should be achieved |
True |
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What measurement is performed to verify prescriptive targets are matched? |
REM with probe mic measures |
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If REM is off target what should you do next? |
Reprogram the aids as necessary to meet targets and achieve patient satisfaction with sound quality |
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What are the 3 most important factor when performing a fitting? |
1. Proper sound quality 2. Audibility 3. Comfort |
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When is REM recommended to be performed? |
At fitting and after adjustments are made |
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What type of fitting usually does not have any trouble with the phone? |
Open fittings |
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What is a another programming option for the phone? |
Auto phone or a t-coil |
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True or false: Custom style aids can hold the phone over the concha to activate the t-coil and BTE’s or RIC’s need to hold it over the receiver |
True |
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What is the frequency response with REM? |
The aids gain curve across the frequencies |
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How is the frequency response influenced by the patients audiogram? |
It is significantly influenced by the patients audiometric configuration since the threshold date is required for programming |
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What is the max output? |
The highest SPL (sound pressure level) it can generate |
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What are the 3 things REM ensures the fit does? |
That the fit meets: Gain, frequency response and output |
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True or false: REM does not account for the natural acoustic of the wearer’s external ear canal |
False. It DOES account for the natural acoustics of the external canal |
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What is speech mapping? |
Probe mic measurements |
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When performing speech mapping, how far away does the patient need to be from the REM speaker? |
1 meter |
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What degree should the patient face the REM speaker? |
0 degrees azimuth |
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True or false: Always stick the probe tube through the vent holes with custom aids during REM measurements |
False. Do not put the probe tubes through the vent holes |
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How close do you want the probe tube to be to the TM? |
5mm |
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True or false: The lower the SII, the more LTASS is achieved |
False. The HIGHER the SII, the more LTASS was achieved |
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Is sound field testing recommended for verification? |
No |
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What is SADL validation? |
Satisfaction with Amplification in Daily Life |
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What is the benefit for SADL validation? |
Good for novice aid wearer’s and it is completed after they have had time to wear the aids |
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What is APHAB validation? |
Abbreviated Profile of Hearing Aid Benefit |
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What is the benefit of APHAB validation? |
Focuses on the benefit the wearer derived from fitting and is given before and after the hearing aid fitting |
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What is COSI? |
Client Oriented Scale of Improvement |
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What are the benefits of using COSI? |
It is completely individualized approach by reporting up to 5 listening situations that they are seeking to improve with amplification. |
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What may COSI reveal? |
The client responses may reveal or suggest ALD’s (assistive learning devices) |
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What is HHIE? |
Hearing Handicap Inventory for the Elderly |
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What is the purpose of HHIE? |
To assess the social and emotional impact of loss |
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What is IOI-HA? |
International Outcome Inventory for Hearing Aids |
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What is the purpose of IOI-HA? |
7 core outcome questions that probe separate areas related to hearing aid use. Scores from 1-5 and you add all the scores together. The higher the score the more favorable the outcome will be. |
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Is Quick SIN a validation or verification measure? |
Validation |
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What are the 2 aspects of personal adjustment counseling? |
Ask open ended questions and be a good listener |
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What are good tools for motivational interviewing (MI)? |
COSI and APHAB |
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What is the benefit of Performance-Perceptual Counseling (PPC) at follow up appointments? |
Uses comparative data to explain and compare loss |
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Follow up appts are very important, how often should you have them after initial fitting (5 appts)? |
1. Call after 24hrs to make sure they are doing well 2. 1-2 weeks after fitting 3. 3-4 weeks after first follow up 4. 6 months after fitting 5. 1 yr after fitting retest reprogram |
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What does auditory training involve? |
It involves exercises that the patients can do to improve listening and communication |
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What is the purpose of auditory training? |
To improve auditory memory and comprehension |
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What does CASPERSent mean? |
Computer-Assisted Speech Perception Testing and Training at the Sentence Level |
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What is the benefit of CASPERSent? |
Trains perceptual skill |
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What does CATS mean? |
Computer-Assisted Tracking Simulation and Computer-Assisted Speech Training |
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What is the benefit of CATS? |
Allows patient and other person to communicate |
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What does CAST mean? |
Computer Assisted Speech Training |
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What is the benefit of CAST? |
It uses unique words for training |
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What does LACE mean? |
Listening And Communication Enhancement |
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What is the benefit of using LACE? |
It boosts auditory memory and speed of processing |
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What is Hear Coach? |
Smart phone app with listening games |
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What is the “Learning to hear again program”? |
Hearing practitioners and speech language pathologists provide rehab and education |
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What is the hearing program ACE (active communication education)? |
Group training designed to help hearing impaired people over 50 become more effective at communicating in everyday life |
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When should you have scheduled hearing aid maintenance scheduled for your clients? |
Every 6 months |
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What 3 things should you do at the 6 month check up? |
Otoscopy, cleaning the aids and perform a listening check |
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What steps should you take when troubleshooting an aid? |
1. Ask to describe problem 2. Perform otoscopy 3. Check over aid/perform listening check 4. Check battery 5. If RIC, replace receiver 6. Clean mic and perform testbox test |
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What is a solution to a problem if there has been cold weather and the hearing aid seems weak (related to the battery)? |
Re-instruct the client in battery issues and how cold weather can have an effect on battery life |
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What is a solution if the hearing aid is intermittent due to the tubing collapsing or the tubing bends when their head turns? |
Replace the tubing |
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What is the next step if there is internal feedback? |
Send aid for repair (always) |
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What is a common cause of distortion that is easily fixable when dealing with trouble shooting? |
Weak battery (replace the battery) |
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What is a solution for troubleshooting if the complaint is of the aid being noisy? |
Check to see if the contacts are corroded, could be due to moisture or defective volume control |
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What is the average tubing life? |
9-15 months |
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When adjusting what is a solution for a new user who feels they are too loud or sharp? |
Utilize the adaptation plan or lower the high frequencies or overall gain for loudness |
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If the client is an experienced user and they complain of aids being too loud or sharp what is an adjustment you could make? |
The frequency response may have excessive peaks and too much high frequency gain or the shell/mold may need to have canal shortened |
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If the client complains of their own voice having an echo or sounds hollow what is an adjustment that can be made? |
Low frequency gain may be too high or you can increase the venting or go with a smaller dome |
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What is the #1 cause of “plugged” ears? |
Cerumen |
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What is another reason/solution for plugged feeling ears? |
There could be inadequate venting or they need a shorter canal length Solution: use a different size/style dome or shorten canal length |
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If the shell is pressing against the canal wall or beyond the 2nd bend what is a complaint the client might have? |
Plugged feeling ears |
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In reference to gain, what could be a cause of the client feeling like they have plugged ears? |
There could be excessive low frequency gain |
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When is a clinical cause of plugged feeling ears? |
Aural fullness (pressure) |
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What could be causes of aural fullness? |
Eustachian tube disfunction, otitis media with effusion or menieres syndrome |
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Do you need to med ref the patient if they complain of aural fullness? |
Yes |
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What should you always do when checking in an aid from repair? |
Run the test box and run REM |
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What is caused by 2 main sites of involvement of the sclerotic (scar like) lesions? |
Otosclerosis |
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What is 1 main reason that otosclerosis can be caused by? |
Fixation of the stapes footplate to the oval window of the cochlea |
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What is the 2nd main reason otosclerosis can be caused by? |
The round window can become sclerotic and impair movement of sound pressure waves through the inner ear (acoustic coupling) |
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Why does the stapes becoming fixated in the oval window of the cochlea matter with otosclerosis? |
It impairs movement of the stapes and therefore the transmission of sound to the inner ear (ossicular coupling) |
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What is a treatment for otosclerosis? |
Stapendectomy |
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What is a stapendectomy? |
Removing a portion of scarred stapes footplate and replacing it with an implant |
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Can otosclerosis be hereditary? |
Yes |
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True or false: Early stages of otosclerosis may result in a conductive loss |
True |
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What kind of loss may result from later stages of otosclerosis? |
Mixed HL |
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True or false: a stapendectomy will restore otosclerosis caused hearing to normal |
False. A stapendectomy may restore hearing, but it will still not be normal |
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What is a historic “signature” of otosclerosis? |
Car Hart’s notch |
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What does a Carhart’s notch look like on the audiogram? |
Typically a notch in BC at 2k |
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What is otitis media? |
Middle ear effusion |
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What is middle ear effusion? |
An infection in the mucous membrane lining of the middle ear space |
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What is acute otitis media? |
Rapid onset infection |
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What is Chronic otitis media? |
Long standing middle ear infections |
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What kind of loss should you expect from otitis media? |
A conductive loss of 20-30dB |
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What is a treatment for otitis media? |
Ear tubes and antibiotics |
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What can form as a result of a long standing middle ear condition? |
Chlosteotoma |
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What are chlosteotomas considered? |
Low grade tumors |
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What does a cholosteotoma look like? |
A sac that forms with rings of keratin |
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What is a common cause of cholosteotomas forming? |
Patient who have a TM perf where tissue may enter the perf causing the cholosteotoma |
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Why can cholosteotomas be dangerous? |
Because they can erode the bones within the middle ear and can also cause damage to the facial nerve |
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What is the treatment for a cholosteotoma? |
Removal by surgery |
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What type of loss should you expect from a cholosteotoma? |
Conductive loss that is more severe than most other ME conditions of 30-40 dB |
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What is tympanosclerosis? |
White plaques on surface of TM and deposits on ossicles |
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What can result from chronic otitis media? |
Tympanosclerosis |
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What can happen to hearing with tympanosclerosis? |
It can have a stiffening effect on the TM which can result in conductive loss in the low frequencies |
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What is ossicular disarticulation (discontinuity)? |
One of 2 of the joints between the 3 ossicles being pulled apart |
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What are the most common causes of ossicular disarticulation? |
Degenerative diseases and trauma to the head |
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What type of loss may you see with ossicular discontinuity? |
The largest of the conductive losses with usually a fully intact TM and no perfs |
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What is NIHL? |
Noise induced hearing loss |
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What does NIHL usually look like? |
Normal until 3k-6k then back up to normal at 8k (noise notch) |
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What is hyperacusis? |
Increased sensitivity to certain frequencies |
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What is otalgia? |
Pain in the inner or outer ear that may interfere with ability to hear |
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What is often a cause of otalgia? |
Excess fluid or infection in the ear |
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What kind of loss do viral and bacterial diseases usually cause? |
SNHL |
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What are some prenatal conditions that are viral diseases/bacteria that might cause HL? |
Syphilis, rubella and toxoplasmosis |
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What is CMV (cytomegalovirus)? |
Herpes simplex virus |
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What are some postnatal diseases/bacteria that might cause HL? |
Mumps, measles, bacterial meningitis, herpes zoster oticus |
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What are 4 accompaniments to Ménière’s disease? |
1. HL (usually in 1 ear) of sudden or rapid onset 2. A fullness or pressure sensation in the ear 3. brief and sudden episodes of severe dizziness or vertigo 4. Roaring (tinnitus) in the affected ear |
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What are 4 accompaniments to Ménière’s disease? |
1. HL (usually in 1 ear) of sudden or rapid onset 2. A fullness or pressure sensation in the ear 3. brief and sudden episodes of severe dizziness or vertigo 4. Roaring (tinnitus) in the affected ear |
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In relation to meneiers, what is roaring tinnitus in one ear thought to be related to? |
To high drops in the endolymphatic sachs within the vestibular system which is responsible for balance |
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What kind of loss is usually associated with meneiers |
Usually more low frequency loss |
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What to retrocochlear disorders have to do with? |
Usually have to do with the 8th cranial nerve and the low brain stem and central hearing loss Generally involves tumors and asymmetry |
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What is non-organic HL? |
Malingering or faking a loss |
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What is exogenous loss? |
Loss not caused by genetics |
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What are some examples that could cause exogenous HL? |
Toxicity, noise, accident or injury that damages the inner ear |
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What is endogenous loss? |
Hereditary loss |
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What are some examples of what can cause endogenous loss? |
Ushers syndrome and pendred syndrome (recessive losses) |
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Why are BTE’s better for children rather than custom aids? (3 reasons) |
1. Only the ear mold needs replaced as they grow 2. Allows the most amount of power for severe-profound loss 3. Larger battery (good for elderly as well) |
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What are some benefits of having a larger battery BTE aid for children and elderly people? (4 resons) |
1. Stronger t-coil 2. Flexibility for direct audio input 3. Better durability 4. Easier to adjust controls |
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What are some requirements for BTE aids? |
Mild-profound HL No restrictions due to ear canal size Can be connected to wireless listening devices and FM systems |
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Professionalism can be defined as practicing with: A. A high performance standard B. All of the above C. Accountability D. Work ethic |
B. All of the above |
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Professionalism can be defined as practicing with: A. A high performance standard B. All of the above C. Accountability D. Work ethic |
B. All of the above |
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The legal aspects of professional practice are defined through: A. Membership in a professional society B. Ethical conduct C. Local and national laws and regulations D. The FDA |
C. Local and national laws and regulations |
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Professionalism can be defined as practicing with: A. A high performance standard B. All of the above C. Accountability D. Work ethic |
B. All of the above |
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The legal aspects of professional practice are defined through: A. Membership in a professional society B. Ethical conduct C. Local and national laws and regulations D. The FDA |
C. Local and national laws and regulations |
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Ethical conduct _____: A. Is the expectation that a practitioner will conduct themselves in a socially acceptable manner and in a away that is consistent with members of the professional organization B. Has the force of law C. Is defined by local and national laws and regulations D. Is dictated by the apprentices trainer/sponsor |
A |
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Professionalism can be defined as practicing with: A. A high performance standard B. All of the above C. Accountability D. Work ethic |
B. All of the above |
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The legal aspects of professional practice are defined through: A. Membership in a professional society B. Ethical conduct C. Local and national laws and regulations D. The FDA |
C. Local and national laws and regulations |
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Ethical conduct _____: A. Is the expectation that a practitioner will conduct themselves in a socially acceptable manner and in a away that is consistent with members of the professional organization B. Has the force of law C. Is defined by local and national laws and regulations D. Is dictated by the apprentices trainer/sponsor |
A |
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True or false: accurate and precise clinical documentation is important to success and the professional status of a hearing instrument |
True |
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The acronym H-E-A-R can be used as a device to remember how to construct ____ in a logical and consistent manner. A. A purchase agreement B. Clinical notes C. An aural rehabilitation plan D. An amplification management program |
B. Clinical notes |
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Inter-professional collaboration leads to ______ A. More referrals B. Greater status C. Certification D. Improved patient/client care |
D. Improved patient/client care |
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True or false: A code of ethics provides guiding principles for professional conduct and may be used to help you resolve potential conflicts |
True |
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Lifelong learning is another term for ______ A. Certification B. Continued professional development C. Adult education D. Licensure |
B. Continued professional development |
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Lifelong learning is another term for ______ A. Certification B. Continued professional development C. Adult education D. Licensure |
B. Continued professional development |
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The development of a professional library is _____ A. A waste of time and space B. A pursuit of true professionals C. Not necessary in the digital world D. Required by law |
B. A pursuit of true professionals |
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What is the “R” in HEAR notes? |
Recommendations |
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What is the “A” in HEAR notes? |
Assessment |
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What is the “E” in HEAR notes? |
Evaluation |
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What is the “H” in HEAR notes? |
History |
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What is PHI? |
Protected health information |
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Define ethics |
The code that differentiates between right and wrong |
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What are personal ethics? |
Ethics which are ingrained as the result of one’s life experiences |
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What are personal ethics? |
Ethics which are ingrained as the result of one’s life experiences |
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Define business ethics |
Framework or a set of standards or behavior intended to prevent unfair competition or personal gain resulting from business decisions or transactions |
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What are personal ethics? |
Ethics which are ingrained as the result of one’s life experiences |
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Define business ethics |
Framework or a set of standards or behavior intended to prevent unfair competition or personal gain resulting from business decisions or transactions |
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Define professional ethics |
Rules and principles that govern the behavior of the members of a profession |
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Define laws |
Society’s rules for ethical behavior |
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What are the 8 red flag conditions? |
1. Visible congenital or traumatic deformity of the ear 2. Active drainage within the last 90days 3. Sudden or rapid HL within the last 90 days 4. Acute or chronic dizziness 5. Unilateral HL within the last 90 days 6. AB gap greater than 15dB at 500, 1k, 2k and 4K 7. Evidence of cerumen accumulation or foreign body in ear canal 8. Pain or discomfort in the ear |
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Define organizational ethics |
Management of relationships between provider organizations and patient or clients and the public under a set of principles of conduct |
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A violation of code of ethical conduct can result in A. Sanctions by the professional society in which you hold membership B. Criminal and civil penalties C. Revocation of licensure or certification D. All of the above |
All of the above |
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Law formally codifies ethical dilemmas into A. Code of ethics B. Written form and specifies sanctions for non-compliance C. The licensing exam D. Difficult scenarios for the hearing aid specialist |
B. Written form and specifies sanctions for non-compliance |
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True or false: consumer protection laws are enforced alongside other statutes |
True |
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dB SL reference |
Threshold |
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Compression |
When air molecules are pushed together, making the molecular density greater than when at rest |
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Complex wave |
Acoustic combination of several different pure tones presented simultaneously |
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Sound |
Vibratory energy transmitted by pressure waves through a medium |
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Rarefaction |
When air molecules are less dense and spread further apart than normal |
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Period |
The time required for one complete cycle of compression and rarefaction |
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Acoustics |
Branch of physics specializing in sound |
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Acoustics |
Branch of physics specializing in sound |
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Pure tone |
Produced by simple repeated alternations of compression and rarefaction |
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Resonant frequency |
The frequency at which an object vibrates with the greatest amplitude |
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Resonant frequency |
The frequency at which an object vibrates with the greatest amplitude |
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Phase |
Describes the position in the cycle of one sound wave relative to another |
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Resonance |
The natural tendency for an object to vibrate with greater amplitude at one frequency that at others when a driving force is applied |
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Resonance |
The natural tendency for an object to vibrate with greater amplitude at one frequency that at others when a driving force is applied |
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Sound pressure |
The deviation from the ambient atmospheric pressure caused by a sound wave |
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Decibel (dB) |
Logarithmic scale used to denote the intensity of a sound |
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dB SPL reference |
0.0002 dyne/cm^2 or 20uPa |
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Boyle’s law |
States that as the physical volume that contains a gas decreases, the pressure of the gas increases |
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dB HL reference |
Audiometric zero |
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Frequency |
Number of complete compression-rarefaction cycles per second |
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Amplitude |
The intensity of the energy of a vibrating body |
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Amplitude |
The intensity of the energy of a vibrating body |
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Wavelength |
The distance between one wave crest or through to the next |
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A pure tone is specified in A. Decibels B. Acoustics C. Hz or cycles per second D. Sound pressure level |
C. Hz or cycles per second |
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Human hearing extends over such a vast intensity range of ______dynes/cm^2 which is compressed into a range of ____ dB. |
0.0002 to 1000 ; 0-140 |
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True or false: The difference in phase for sounds arriving simultaneously at both ears contributes to a listeners ability to localize a sound source |
True |
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A shorter wave length results in a: A. Lower frequency B. Higher frequency C. Same frequency D. Quieter frequency |
B. Higher frequency |
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The natural tendency for a system to vibrate with greater amplitude at one frequency than at others when a driving force whose frequency is at or close to the natural frequency of the system is called _____ |
Resonance |
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The reference for dB HL is ____ A. 0.0002 dynes per cm^2 B. Audiometric zero C. Another audiometric value D. 0dB SPL |
B. Audiometric zero |
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The reference for dB SPL is ____ A. 0.0002 dynes per ^2 B. Audiometric zero C. Another audiometric value D. 0 dB SPL |
A. 0.0002 dynes per ^cm2 |
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The reference for dB SL is _____ |
Threshold |
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Loudness |
Psychological response to intensity |
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Critical bands |
Represent the frequency resolution abilities of the ear |
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Critical bands |
Represent the frequency resolution abilities of the ear |
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Frequency |
Physical measurement of cycles/second measured in Hz |
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Psycho acoustics |
The listeners perception of sound |
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Pitch |
Psychological perception of frequency |
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Intensity:frequency |
Loudness:pitch |
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Intensity |
Physical measurement that expresses signal amplitude |
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The perceptual match for intensity is _____and the perceptual match for frequency is______ |
Loudness ; pitch |
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The auditory system follows a power level which is a logarithmic scale. In a logarithmic scale, a 10dB increase in intensity _____the loudness over most of the audible range A. Triples B. Doubles C. Increases by 10 times D. Decreases by 10 times |
B. Doubles |
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The normal human ear can respond to a range of frequencies from about _____ |
20-20,000 Hz |
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The concept of critical bands and frequency resolution contribute to our ability to A. Hear effectively in background noise B. Discriminate between two sounds that are very close in frequency C. Hear very soft sounds D. A and B |
D. A and B |
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True or false: low and extremely high frequencies require more intensity to be just barely audible as compared to the middle range of frequencies |
True |
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Pinna |
The outer flap; the collector of sound |
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Autos Dextra (AD) |
Right ear |
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Distal |
Located away from a reference point |
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Proximal |
Located close to a reference point |
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Ear canal |
S-shaped tube ending at the TM |
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Posterior |
Toward the back |
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Three primary functions of the outer ear |
1. Protect structures of middle and inner ears from foreign bodies 2. Aid in the localization of sounds 3. Provide a natural boost in sound in the higher frequencies |
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2 functions of the human ear |
1. Hearing 2. Balance |
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Superior |
Above |
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Auris sinistra (AS) |
Left ear |
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Lateral |
Toward the side |
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Lateral |
Toward the side |
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Medial |
Toward the middle |
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Aures Unitas (AU) |
Both ears |
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Anterior |
Towards the face or front |
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Tympanic membrane |
Also called the eardrum; dividing line between the outer and middle ear |
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Inferior |
Below |
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Natural ear canal resonance |
Contributes to the perception of coins quality |
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The fleshy part of the ear that protrudes from the side of the head is called the: |
Auricle or pinna |
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The average adult ear canal is about ___inch in length and about ___inch in diameter. A. 2.54 and 0.7 B. 1/2 and 3/4 C. 1/4 and 3/8 D. 1 and 1/4 |
D. 1 and 1/4 |
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An important ear canal landmark for ear impressions is the: A. TM B. Annulus C. Second bend D. Vague nerve |
C. Second bend |
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The cone of light is: |
A reflection of the light from an otoscope on the TM |
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The external auditory canals resonant frequency is |
About 2700Hz and varies slightly from person to person |
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The normal TM has a typical appearance characterized as |
Pearly grayish and oval |
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The structure of the TM is made up of : A. 4 layers B. Ceruminous tissue C. An umbo 4. An isthmus and a second bend |
A. 4 layers |
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Polyp |
A mass of tissue growing outward from the canal wall |
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Functional HL |
Non-organic HL that is evident when a person is not or cannot be truthful or accurate in their hearing test responses |
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Effect of conductive hearing loss |
Sound is not readily transmitted through air, bone or tissue |
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Effect of conductive hearing loss |
Sound is not readily transmitted through air, bone or tissue |
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Exotosis |
Growth in the external canal |
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Central hearing loss |
Inability of the brain to process, recognize, or understand sounds or speech accurately |
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Types of hearing loss for which amplification may be recommended |
Conductive, SNHL and mixed |
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Cause of conductive loss |
Abnormalities of the external and or middle ear |
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Prolapsed or collapsed canal |
Breakdown or sag of tissue around the canal that causes the walls of the canal to collapse |
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Tympanosclerosis |
Gardening of the TM caused by calcium deposits |
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Perforations |
Holes in the TM |
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Mixed hearing loss |
Combination of conductive and SNHL |
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Cause of SNHL |
Damage to inner ear and or auditory nerve |
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Atresia |
Closure of the external auditory canal; pinna may be malformed or missing |
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Otitis externa |
Inflammation of the walls of the ear canal |
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True or false: hearing instrument specialists can state the cause of a hearing loss |
False |
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Abnormalities of the outer or middle ear can cause ___ hearing loss. A. SNHL B. Conductive C. Mixed D. Central |
B. Conductive |
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Abnormalities of the outer or middle ear can cause ___ hearing loss. A. SNHL B. Conductive C. Mixed D. Central |
B. Conductive |
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Abnormalities of the brain can cause ___hearing loss. A. SNHL B. Conductive C. Mixed D. Central |
D. Central |
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Abnormalities of the outer or middle ear can cause ___ hearing loss. A. SNHL B. Conductive C. Mixed D. Central |
B. Conductive |
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Abnormalities of the brain can cause ___hearing loss. A. SNHL B. Conductive C. Mixed D. Central |
D. Central |
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Abnormalities of both the inner and outer/middle ear can cause ____hearing loss. A. SNHL B. Conductive C. Mixed D. Central |
C. Mixed |
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Abnormalities of the inner ear can cause ____ hearing loss A. SNHL B. Conductive C. Mixed D. Central |
A. SNHL |
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It is important to know whether the ear canal is clear before testing hearing because: A. Impacted cerumen can cause hearing loss B. Excessive cerumen can prevent full view of the TM C. Cerumen can always be safely removed before testing D. A and B |
D. A and B |
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True or false: ear drainage of any kind required med ref |
True |
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IA (Interaural Attenuation) |
Is the decrease in sound intensity when sound travels through the skull. |
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Crossover |
Is the intensity of the sound that is heard by the opposite cochlea during high intensity monaural stimulation of the other ear. |
