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91 Cards in this Set

  • Front
  • Back
ABR discovered by
Jewett and wilson in the 1970s
ABR stimulates
2k-4k region of cochlea
low freq. hearing loss can have normal
ABR is a _____ stimulus delivered via insert earphone
for ABR, as intensity increases, a ______ in latency is seen
ABR is influenced by age
under 10 months and over 60
ABR waveforms correspond to what region?
1 - distal 8th. II proximal 8th III cochlear nucleus IV superior olivary complex V inferior colliculus
at what time do the waves appear post stimulus
how clean and repeatable are the waves
conductive loss ABR
wave I latency delayed. Interwave latencies WNL. Good morphology.
sensory hearing loss ABR
wave I latency delayed, and small interwave latencies WNL. poor morphology.
neural hearing loss ABR
wave I normal. wave I- III latency delayed. interwave latencies delayed. Poor morphology.
the ABR's country cousin. a closer look at wave I. helps to determine mineire's disease.
spontaneous emissions
span 500-7000 hz range. occurs in 40-50% of the population. NOT FOUND with hearing loss above 30dB HL
click evoked OAEs
two pure tones
stimulus frequency emissions
response to very short duration stimuli, clicks. 500-4000 frequency range. present in all normal ears. most commonly used in infant screening
response to two pure tones of different frequency. two pure tones interact to produce strong distortion product. frequency specific information. monitoring hearing status.
presence of OAEs implies
normal middle ear function and normal outer hair cell function. DOES NOT imply normal behavioral thresholds for hearing.
one of the main reasons for pediatric hearing test referral
language disorders
minimum response levels. most children will not respond to threshold but will respond consistently to some point above it. MRLs are always lower (Better) for speech than for tones.
behavioral overservation audiometry - 0-8 months. responses include eye widening/blinking, cessation of activity, imitation, rudimentary head turns
visual reinforcement audiometry - 6-24 months. soundfield or earphones. light up toys reinforce head turn to the side of the signal
Tangible reinforcement operant conditioning audiometry. used with "difficult to test" if the response is correct a reward is dispensed.
conditioned play audiometry. 2-6 years old. response becomes a game.
ling six sounds test
a, u, i - suggest hearing through 1khz. /sh/ suggests hearing through 2kHz. /s/ suggests hearing through 4kHz.
advantages of OAE over ABR
abr takes longer. oae is less invasive. oaes are cost efficient. oae requires less training.
advantages of ABR over OAE
abr is more sensitive and more selective. tests environment can lead to increased failures in teoaes. not affected by middle ear debris.
tetrachoric table
validates the efficiency of a screener. high "true positives" and "true negatives" indicate a good screener.
_______ people who have hearing loss
1/11 people
hearing loss due to aging.
reasons for presbycusis - outer ear and middle ear
loss of tissue elasticity of pinna and ear canal. stiffing of tympanic membrane. degeneration of middle ear musculature. calcification of ligaments. ossification of me bones.
reasons for presbycusis - inner ear
disrupion of cochlear metabolic processese. hyperostosis of internal auditory meatus leading to compression of 8th nerve. devascularization of inner ear capillaries. schuknecht's classification
sensory presbycusis
degeneration of hair cells and supporting cells at the base of the cochlea. produces steeply sloping, high freq sensorineural hearing loss with good WRS
neural presbycusis
loss of cochlear neurons resulting in problems in transmission information coding. results in sloping sensorineural hearing loss with greater loss in highs than lows. poor WRS
strial presbycusis
degeneration of stria vascularis. causes disruption of nutrient supply necessary for maintaining cellular function and causes changes in cochlear electrical potentials. flat sensorineural loss and excellent WRS
mechanical presbycusis
cochlear conductive. resluts from alteration to cochlear mechanics produced by mass/stiffness changes. sensorineural loss affecting low and high frequencies with slowing configuration and poor WRS
CAPD characteristics
normal peripheral hearing. normal cognitive function. poor listening skills. short attention spans. seemingly poor memories. poor reading comp. difficulty in linguistic sequencing.. problems learning to read and spell. difficulty recognizing speech in the presence of background noise.
binaural integration
reporting all stimuli heard
binaural separation
attending to one ear and ignoring the other
monaural low-redundancy speech tests for CAPD
low pass filtered speech, time compressed speech,
speech in noise test for CAPD
SPIN - speech perception in noise.
temporal patterning tests for CAPD
pitch pattern sequence test --> triad of tones. duration patterns test --> report long short long
ferre bellis model primary subprofiles of CAPD
1. decoding disorder 2. integration deficit 3. prosodic deficit
decoding deficit
left auditory cortex disfunction. bilateral deficit on monauroal low redundancy tests and dichotic tests.
integration deficit
corpus callosum dysfunction. test findings - left ear deficit on dichotic speech tests. deficit on temporal patterning tests in linguistic labeling only. mimic is OK
prosodic deficit
deficit - right audiotry cortex and associated areas. test findgins. left ear deficit on dichotic speech tests. deficit on temporal patterning in labeling and mimic.
noise induced permanant threshold shift. two types : acoustic trauma. gradually developing Noise induced hearing loss
characteristics of NIPTS
cochlear hair cell loss. typically starts in 3-6kHz region. will eventually affect lower frequencies if exposure is continued. notch at 4kz
notch factors
in humans, frequency maximally damaged by noise is 1/2 to 1 octave above maximum exposure frequency. pinna and ear canal resonance producing boost in 2-4kHz region.
middle frequencies
are the most damaging.
lower SPL with longer
duration is just as bad
outer hair cells die off
temporary threshold shift. not seen below levels of 80dbA. usually recovers in short period of time. small shifts. 5-10db. don't usually result in permanent damage.
NIPTS grows more
grows more rapidly in the earliest years
equal energy exchange
allowed duration (90dBA for 8 hours) is halved if the sound level increases by 3 and is doubled if the sound level decreases by 3dB.
time weighted average of 85dB or higher.
componants of a hearing aid
receiver, amplifier, microphone, battery
analog hearing aid
electrical signals generated are analogous to sound that comes into the instrument.
digital hearing aid
converts sound waves into binary digits and chantes the electrical signal. converts into separate bits. extremely fast processing of signal.
signal to noise ratio. positive is better for hearing
types of hearing aids
air conduction, bone conduction, implantable, vibrotactile.
CROS - sends signal from bad side to good side. BiCROS - sends signal from bad side to better side and amplifies.
implantible - sound bridge
sound brigde - for sensorineural loss
there is a limit to the sound pressure that an aid con produce. it is set with 90dB input to the aid and the aid set with volume full on.
acoustic gain
difference in dB between input and output signal
frequency response
range of frequencies an aid can amplify
differences between output signal and input signal. frequency and amp distortion
types of Asistive Listening Devices
ALDs - tactile, visual, auditory.
malingering, nonorganic hearing loss, psychogenic hearing loss. hysterical deafness
SRT is almost always ___ than PTA with nonorganic losses.
lombard test
people raise their voices in the presence of background noise
varying intensity story tests
patient is asked questions about the story with will reveal if they heard in both ears or just one.
"take the earphones off, we're done now"
said below SRT level
tinnitus is present in
17% of the populatoin and 33% of the elderly.
tinitus may orriginate from:
1.cochlea 2. auditory nerve 3. brain 4. combo from above
management for tinitus
1. cochlear implant 2. tinnitus masker 3. biological feedback 4. cognitive-behavioral therapy 5. tinnitus retraining therapy - habituation 6. neuromonics - sound therapy based on TRT. 6. drug therapy
auditory - verbal aprouch
relies totally on audition. no signs are involved. early amplification and hearing aids
aural method
miltinensory "auditory - global"
cued speech
hand shapes for speech
helps preserve rules of grammar and syntax
seeing esential english
ASL but with word order as appears in spoken english
signed english
asl vocab in enblish word order. follows rules of english grammar.
Signing exact english
similar to seeing essential english but less rigid about word order
Total communication
most popular for children with severe to profound losses. combines best of aural and sign systems.
3 inputs for balance in humans
1. visual 2. proprioceptive 3. vestibular
utricle and saccule
detect linear acceleration. the macula are the organs inside.
semicircular canals detect
angular acceleration. crista is in the ampula. each ampula contains crista.
utilizes the corneoretinal potential to record changes in position due to nystagmus.
video ENG
uses goggles and video cameras to record eye movements in response to vestibular tests.