Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
105 Cards in this Set
- Front
- Back
|
Normal hearing level
|
0-25dB
|
|
|
Mild hearing loss
|
25-40dB
|
|
|
Moderate hearing loss
|
40-55dB
|
|
|
Moderate-severe hearing loss
|
55-70dB
|
|
|
Severe hearing loss
|
70-90dB
|
|
|
Profound hearing loss
|
90-100+dB
|
|
|
Mixed hearing loss
|
Both AC and BC will have a hearing loss, but the loss found through AC will be greater (Air-bone gap with hearing loss in both)
BC will have to be worse than 25dB |
|
|
Conductive hearing loss
|
BC will show a normal hearing level, but AC will show a loss
|
|
|
Sensorineural hearing loss
|
AC and BC hearing levels will be equal, but showing a loss
|
|
|
Air-bone gap
|
Bone conduction has a greater hearing level than the air conduction
It must be a gap of at least 15dB to be significant |
|
|
Way to remember right-ear symbols
|
right, red, round
|
|
|
Why is masking needed?
|
If AC sound is loud enough, it can vibrate through the skull and the non-test ear can pick up on it
|
|
|
Masking is...
|
Presentation of a tone to the non-test ear so you can get a definite response from the test ear
Can be used in AC and BC ` |
|
|
What is flat configuration?
|
within 20dB of each other across all frequencies
|
|
|
What is rising configuration?
|
thresholds for low frequency are at least 20dB poorer than high frequency
|
|
|
What is sloping configuration?
|
the high frequency thresholds are 20dB lower than the low frequency (opposite of rising)
|
|
|
What is a low frequency configuration?
|
Hearing loss is restricted to the low frequency region
|
|
|
What is a high frequency configuration?
|
Hearing loss is restricted to the high frequency region
|
|
|
What is precipitous?
|
Steeply sloping high frequency hearing loss drop of at least 20dB
|
|
|
What are the BC limits of the audiometer?
|
45dB at 250Hz
60dB at 500Hz 70dB at 1,000-4,000Hz |
|
|
What are the AC limits of the audiometer?
|
70dB at 125 Hz
90dB at 250 Hz 100-110dB at 500-8,000Hz |
|
|
When do you test interoctaves?
|
When there is a 20dB difference of more between octaves
|
|
|
What is Fletcher's average?
|
The average of two better hearing levels between 500Hz, 1000Hz, and 2000Hz
|
|
|
When do we use Fletcher's average?
|
When there is a 20dB difference or greater between 500 & 1000 Hz or 1,000 and 2000Hz
|
|
|
SRT stands for
|
Speech Reception Threshold
|
|
|
How do we find the SRT?
|
+/- 8 to the PTA. Use dividends of 5 to find 3 possible SRTS
Ex: PTA = 15 Possible SRT = 10, 15, 20 "SENSITIVITY" It is a threshold |
|
|
WRS stands for...
|
Word Recognition Score
The "ACUITY" |
|
|
How do you find the presentation level for WRS?
|
SRT +30dB
Presentation level is dB Score is % |
|
|
Steps to drawing a speech banana
|
1. Mark WRS as center
2. Height is 30dB 3. Width should range from 250Hz-4000Hz 4. Shade everything under the threshold |
|
|
What is sound localization?
|
The tested individual looks to the source of sound
|
|
|
What is a visual reinforcer?
|
The audiologist confirms the response with a toy
|
|
|
When a child is trained to turn their head after the signal
|
VRA - Visual reinforcement audiometry
|
|
|
What is used when a child can't use headphones?
|
Sound field audiometry - uses speakers
|
|
|
What is a downside to sound field audiometry?
|
You can't have ear-specific information
|
|
|
What is the downside to using speech as a signal rather than pure tone audiometry?
|
You lose frequency-specific info
|
|
|
What is used for 2-5 yr olds?
|
TROCA
VRA conventional or Conditioned play audiometry - use a game to test hearing Ex: stacking rings |
|
|
What is TROCA?
|
Tangible Reinforcement Operant Conditioning Audiometry - Token system
|
|
|
What is the conventional audiometry method?
|
Houghston-Westlake technique: 5 up, down 10
- Familiarization phase - Threshold search phase - Ascending threshold phase |
|
|
During testing, we always recheck the response at...
|
1,000Hz
So we don't get false positives Responses must be latency consistent |
|
|
Who usually uses sound field audiometry or visual reinforcers?
|
0-2 yr olds
|
|
|
What can affect test results?
|
Position of the transducer
Room noise Instructions Subject variability |
|
|
Speech discrimination is...
|
The WRS and acuity
|
|
|
What is MLV?
|
Monitor Live Voice
This is more often used. It is better for beginners and difficult-to-test individuals |
|
|
How is SRT related to WRS?
|
The SRT should reflect the WRS - provides a reference
The SRT is a threshold -- 50% |
|
|
What is a WIPI speech discrimination test?
|
Word intelligibility by picture identification
This is for those who can't verbally respond |
|
|
Why is 40dB the interaural attenuation?
|
It is the most conservative value
Masking needs to be applied |
|
|
What is interaural attenuation?
|
The level of sound intensity that is lost as it travels to the NTE cochlea
|
|
|
What is a shadow curve?
|
An AC threshold 40-45dB worse the BC when masking is not considered
|
|
|
A masking level is...
|
10dB added to the threshold of the NTE
|
|
|
Each time a patient DOES responds when masking...
|
masking needs to be increased by 5dB
|
|
|
Each time a patient DOES NOT respond when masking...
|
the signal is increased by 5dB (conventional)
|
|
|
We continue masking until...
|
the masking level is increased 3 consecutive 5dB steps without a threshold shift
(total of 20dB increase in masking= true threshold) |
|
|
What are the types of masking for speech audiometry?
|
Broad band
White noise Speech noises |
|
|
What are the types of masking for audiometry?
|
Narrow band noise - centered on test frequency
|
|
|
When do we use a confidence level?
|
If we can guess which ear is giving off the bone conduction response.
|
|
|
What is the third condition for masking?
|
When two thresholds are the same
|
|
|
Considering type of hearing loss, when would we not mask?
|
When a hearing loss is SN because there would be no air-bone gap
|
|
|
What would you report if there is only one air-bone gap present?
|
You would say "there is an air-bone gap at ____Hz" but it is not conductive.
|
|
|
SRT signals must have the following criteria:
|
Familiarity
Phonetic dissimilarity Normal sampling of English speech sounds Homogeneity of audibility |
|
|
What are spondees?
|
Two syllables with equal stress
Ex: baseball Ex: hotdog Ex: toothbrush |
|
|
How does SDT relate to SRT?
|
8-9dB better than SRT
|
|
|
What is the procedure like for SRT?
|
Same as pure tone
|
|
|
What are the purposes of a speech discrimination test?
|
to estimate the degree of hadicap
determine site of lesion monitor progress of aural rehabilitation assess hearing aid performance assess central auditory function |
|
|
The stimulus for SDT is...
|
monosyllabic words(PB words) --
commonly used phonetically balanced average/range of difficulty must be equal |
|
|
Open test lists are ...
|
No clues or context
PAL PB-50: 50 items, 20 lists CID W-22: 50 items, 4 lists an, yard, carve NU #6: 50 items, 4 lists boat, pool, nag |
|
|
Closed lists are...
|
Circle the word out of several choices
MRHT: 50 items, 6 lists CCT: 100 items, 2 lists CUNY NST: 100 items, 1 list |
|
|
An example of a word from a kindergarten PB list would be...
|
sled
pants please |
|
|
Examples from a modified rhyme hearing test would be...
|
Vest
rest nest |
|
|
Examples of a California Consonant test would be...
|
back
batch bath |
|
|
Speech discrimination sentence tests include...
|
Synthetic Sentence Identification (SSI)
nonsense? Speech Perception in Noise (SPIN) High predictability vs low (context/no context) |
|
|
What is the conversational level of intensity for speech discrimination tests?
What is MCL? |
50dB HL
Most comfortable listening |
|
|
What descriptors are used for SDT?
|
excellent, good, fair, poor
|
|
|
What is immittance?
|
Either impedance (z) or admittance (y)
|
|
|
What is impedance (z)?
|
The opposition of energy flow into a system
|
|
|
What is admittance (y)?
|
The ease of energy flow into a system
|
|
|
Why do we perform immittance audiometry?
|
To evaluate middle ear function
Evaluate presence of middle ear fluid Eval eustachian tube function facial nerve function presdict audiometric test findings determine nature of loss |
|
|
How does an immittance instrument work?
|
The probe is comprised of 3 tubes
1. A pure tone generator/ loudspeaker 2. Air pump - manometer 3. Measuring device - microphone with a rubber probe tip inserted |
|
|
When the ear drum moves with equal pressure (middle and outer ear) this shows...
|
strong immittance
|
|
|
What do tympanograms measure?
|
The flexibility of the middle ear as air pressure changes from 200 daPa to -400 daPa
|
|
|
A normal typanogram is type...
|
Type A - shows a pressure peak
0.25 - 2.0 for adults 0.2 - 0.9 for child People with SNHL might have type A |
|
|
No air pressure peak is a type B tymp, showing possible...
|
Diagnosis: middle ear fluid, EAM obstruction, Perforation/tubes
|
|
|
An early peak is a type C tymp showing...
|
Early onset of otitis media
resolving otitis media poor eustachian tube function *This will peak before -100 or above 50 |
|
|
The lowest possible intensity needed to elicit a middle ear muscle contraction is called...
|
acoustic reflex threshold (ART)
Ipsilateral - stimulus in TE contralateral - stimulus in NTE |
|
|
Compliance is...
|
the flexibility of the ear drum
High intensity = low compliance. The eardrum absorbs less energy Low intensity = high compliance |
|
|
Tymps are arranged...
|
x-axis - air pressure
y-axis - compliance |
|
|
The course of the acoustic reflex arch travels...
|
Outer ear
Middle ear Inner ear Auditory nerve cochlear nucleus superior olive facial nerve (CN VII) Stapedius muscle in middle ear |
|
|
A normal acoustic reflex threshold will be...
|
65-95dBHL
(Conductive and SNHL will be absent or elevated) |
|
|
How do we measure acoustic reflex decay?
|
sustaining a tone at 10dB above the ART
When the stapedius muscle is contracted by a loud sound, it will gradually relax as the signal persist |
|
|
What are the purposes of hearing screening?
|
Early id
Prevention Early intervention |
|
|
What does it mean if a screening test is acceptable?
|
Simple - easy to administer
Readily interpretable Well received by the public |
|
|
What does it mean if a screening test is reliable?
|
Must achieve similar results every time
|
|
|
What does it mean for a screening test to be valid?
|
Measures what its supposed to
Sensitivity: true pass/fail, Does it capture the problems? Specificity: if there isn't a problem, does it say you're normal? |
|
|
What does it mean for a screening test to be safe & cost effective?
|
Direct expenses: salary of personnel, equipment/maintenance, screening rate
Indirect: audiologic assessment, monitoring, intervention - costs associated with false positives - GAIN - reduced ed costs can reduce kids that need services |
|
|
What are the age groups for hearing screening for children?
|
Neonate, infant, preschool, and school age
|
|
|
What do you do when screening neonates and infants?
|
2 stage screening
Otoacoustic emissions If failed --> auditory brainstem response (at 40dBHL) If failed = hearing eval within 6 months |
|
|
How do we calculate prevalence of a hearing loss?
|
People with hearing loss (true positives + false negatives)/ total screened (all 4 boxes)
High prevalence is good so that the screening test can be used |
|
|
How do we calculate sensitivity (hearing loss)?
|
True positives + all hearing losses
BAD |
|
|
How do we calculate specificity (no hearing loss)?
|
false positives + true negatives
|
|
|
Omnidirectional mics create a...
|
circumpolar diagram - amplifies sound in radius
|
|
|
A hearing aid needed for an FM system that doesn't need a mic is...
|
a telecoil
|
|
|
Directional mics/dual-mics amplify the sound...
|
in front of you, creating a carotid polar diagram
2 mics that allow signal discrimination |
|
|
For someone with a hearing impairment, their SNR should be
|
higher (Signal to noise ratio)
|
|
|
Hearing aids that have a Mic on the unaided ear and a receiver on the aidable ear are called...
|
CROS hearing aids
|
|
|
Hearing aids that have two mics and a receiver on the aided ear are called...
|
BiCROS and are desireable
|
|
|
Feedback indicates..
|
there is a disconnect between the mic and receiver of the hearing aid
|
