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106 Cards in this Set
- Front
- Back
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The perception of increased loudness of a bone conduction signal when the outer ear is occluded is called the ______________ effect. |
Occlusion |
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Hearing loss produced by an abnormality of the inner ear or auditory nerve is a ________ ________ hearing loss. |
Sensori neural |
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Conduction of sound to the inner ear by way of the outer and middle ear is called ______ ______________. |
Air conduction |
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Sounds that are conducted to the inner ear by vibration of the bones of the skull is called ___________ ________________. |
Bone conduction |
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Can a tuning fork test establish whether a hearing loss is sensorineural or conductive? |
Yes |
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Can a tuning fork provide thresholds? |
No |
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What are three tuning fork tests used today? |
Rinne Webber Schwabbach |
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Describe one tuning fork test and possible results. |
Weber: strike fork on forehead, ask if they can hear in both ears equally, if tere is unilateral conductive loss the test will localize to the bad ear. Now block bad ear and repeat the test, will localize to the good ear |
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With the Weber tuning fork test, the patient will say he hears the tone in the __________ (better/worse) ear if the loss is conductive and in the ___________ (better/worse) ear if the loss is sensorineural. |
With the Weber tuning fork test, the patient will say he hears the tone in the __worse__ ear if the loss is conductive and in the _ better_ ear if the loss is sensorineural. |
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If the patient hears the tuning fork better by air than by bone conduction he has a __________ Rinne. If they hear it better by bone than air than they have ____________ Rinne. A positive Rinne would indicate a ____________ hearing loss while a negative Rinne is indicative of a _________________ hearing loss. |
If the patient hears the tuning fork better by air than by bone conduction he has a __Positive_Rinne. If they hear it better by bone than air than they have __negative__Rinne. A positive Rinne would indicate a _sensorineural hearing loss while a negative Rinne is indicative of a __conductive___ hearing loss. |
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Are audiometers calibrated using an SPL or HL measurement? |
SPL |
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The dB in SPL for TDH earphones is _______, for insert earphones its _______, and for bone conduction vibrators its _____ at 1000 Hz. |
TDH earphones is 7.5 Insert earphones 0 Bone conduction vibrators its 42.5 at 1000 Hz. |
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Three advantages of insert earphones are greater __________, improved ____________, and __________. |
Greater Comfort Improved stability to the TM Cleaner |
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What is the dB in SPL for 1000 Hz at 20 dB HL? ____; 40 dB HL_______; 80 dBHL______. |
20dB HL - 27.5 40dB HL - 47.5 80dB HL - 87.5 |
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What 4 controls are found on every audiometer? ____ , ______ , ________ , _________. |
Output selector switch Frequency selector Hearing level Masking level |
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A red headphone is always used on the ____________ ear while a blue headphone is used on the ______ ear. |
Red = right Blue = left |
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What frequencies are tested minimally during a normal pure tone exam? |
250, 500, 1000, 2000, 4000, 8000 |
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When do you need to test the mid octaves during pure tone testing? |
When there’s a diff of 20 dB or more seen in the threshold of adjacent octaves |
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What % is used for establishing thresholds?________% |
40% |
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With the ascending method for determining thresholds we start at ____ d B at ________ Hz. If we get no response we increase our signal by _____ dB and repeat the signal. If the patient responds we decrease by _____.Once the patient has responded once, all other increases are in ____ dB steps. |
Start at 0 dB at 1000 Hz. If no response, increase signal by 10 dB repeat. If the patient responds, decrease by 10. Once the patient has responded once, all other increases are in 5 dB steps. |
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The ascending method is preferable for any patient that you suspect may present with a _________________ loss? The ascending method is better for non-organic hearing losses because it provides no ____________ point? |
Conductive loss Reference point |
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Tillie Tinnitus is having her hearing tested. We are using an ascending method. Her first response does not occur until you reach 30 dB, you would then go to ____ dB. She does not respond so you go to ____ dB. She responds and you then go to ____ dB, she does not respond so you go to ___ dB and she still does not respond, you then increase by ____ dB and she responds. Her threshold is what dB? _______ |
No response until 30 dB. You would then go to 20 dB. She does not respond so you go to 25 dB. She responds and you then go to 15 dB. She does not respond so you go to 20 dB She still does not respond, you then increase by 5 dB and she responds. Her threshold is 25 |
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Otto Otosclerosis is having his hearing tested. His first response is at 40 dB SL above his SRT which was 20 db HL. His initial response was at what dB HL____. After his initital response you went to ____ dB and he again responded so you went to ____ dB. When you presented he did not respond so you go to ____ db, still no response so you go to ____ and he responds. His threshold is ____ dB HL |
His initial response was at what dB HL 60. After his initital response you went to 50dB. He responded so you went to 40 dB. He did not respond so you go to 45 db, still no response so you go to 50 and he responds. His threshold is 50 dB HL |
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With a descending method you start at ____ dB HL if no response you increase in ___ dB steps until the patient responds and then ____________ by ____ dB. You then use the same method of limits used to determine the threshold. |
Start at 30 dB HL If no response you increase in 20 dB steps until the patient responds. Then decrease by 10 dB. Use the same method of limits used to determine the threshold. |
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Paula Presbyacusis is being seen for a hearing test. You are using the descending method. You present initially at ___ dB HL and she responds. You then adjust the attenuator to ____ and she again responds so you go to ____ and she does not respond. You _______ by ___ dB to ___ and she doesn’t respond so you ________ by ____ and she responds. Her threshold is ____ dB HL. |
You present initially at 30 dB HL and she responds. You then adjust the attenuator to 20 and she again responds so you go to 10 and she does not respond. You increase by 5 dB to 15 She doesn’t respond so you increase by 5 and she responds. Her threshold is 20 dB HL. |
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Bobby Basilar is having his hearing tested. He reports he was in an MVA so you decide to use an ___________________ method. His first response occurs after two presentations without a response, so his first response occurred at _____ dB HL. |
Ascending method 20 dB HL |
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Air conduction thresholds provide us with the ___________ of the hearing loss but bone conduction thresholds provide us with the ________________ of the hearing loss. |
Severity, etiology |
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The bone conduction threshold is considered to be a true representation of cochlear reserve T/F |
True |
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The three mechanism that make up the bone conduction threshold are : Match 1) Fluid ___A) Osseotympanic Bone Conduction 2) Ossicular___B) Distortional Bone Conduction 3) Canal ___C) Inertial Bone Conduction |
1) Fluid - B) Distortional Bone Conduction 2) Ossicular C) Inertial Bone ConductionBCA 3) Canal - A) Osseotympanic Bone Conduction |
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Bone conduction testing is required any time the air conduction threshold is greater than ____ dB. |
10 dB |
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How do air and bone conduction thresholds vary by etiology? Ex. In normal hearing, air conduction thresholds are normal and bone conduction thresholds would also be normal. With a conductive hearing loss, air conduction thresholds would be_____ but bone conduction thresholds would be ______. With a sensorineural loss air conduction thresholds are ____ and bone conduction thresholds are ______. With a mixed hearing loss air conduction thresholds are _____ and bone conduction thresholds are_____. |
With a conductive hearing loss, air conduction thresholds would be Abnormal but bone conduction thresholds would be normal. With a sensorineural loss air conduction thresholds are abnormal and bone conduction thresholds are equally abnormal. With a mixed hearing loss air conduction thresholds are abnormal and bone conduction thresholds are abnormal. |
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In sound field testing, thresholds are always for which ear? |
Better ear |
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An obstruction of cerumen in the canal could cause the air conduction threshold to be better than the bone conduction threshold? T/F |
False |
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An obstruction of cerumen in the canal could cause the bone conduction threshold to be better than the air conduction threshold? T/F |
True |
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With a mixed loss the bone conduction threshold is poorer than the air conduction threshold? T/F |
False |
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Bone conduction thresholds let us know if there is a cochlear (neural) loss. T/F |
True |
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A difference where the bone conduction threshold is better than the air conduction threshold indicates an obstruction or disease process in the outer or middle ear? T/F |
True |
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A hearing loss by bone conduction that is normal by air conduction is a ________________ hearing loss. |
Sensorineural |
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A hearing loss that is abnormal by bone conduction and equally bad by air conduction is a ____________________________ hearing loss. |
Conductive |
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A hearing loss that is abnormal by bone conduction and worse still by greater than 10 dB by air conduction is a _____________ hearing loss. |
Mixed |
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Identify these symbols by ear and mode tested a. O________ ______ ________ __________ b. X________ ______ ________ __________ c. ∆________ ______ ________ __________ d. _______ _______ _______ __________ e. <________ ______ ________ __________ f. >________ ______ ________ __________ g. [ _______ _______ _______ __________ h. ] _______ _______ _______ __________ |
O. Right unmasked air conduction X. Left unmasked air conduction ∆. Right masked air conduction . Left masked air conduction <. Right unmasked bone conduction >. Left unmasked bone conduction [. Right masked bone conduction ]. Left masked bone conduction |
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A hearing loss is sensorineural if a. The air bone gap is greater than 10 dB b.The air bone gap is less than 10 dB c.The SRT and PTA are in agreement d.None of the above |
b.The air bone gap is less than 10 dBc. |
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A slight loss is never a concern and never needs any mitigation. T/F |
False |
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The audiogram showing a conductive hearing loss will indicate a.Impaired bone conduction, normal air conduction b.Impaired air conduction, normal bone conduction c.Impaired bone conduction, impaired air conduction d.Normal bone conduction, normal air conduction |
b. Impaired air conduction |
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The audiogram showing a mixed hearing loss will indicate a. Impaired bone conduction, and an air bone gap b.Impaired air conduction, and no air bone gap c.Impaired bone conduction, and no air bone gap d.Normal bone conduction, and an air bone gap |
a.Impaired bone conduction, and an air bone gap |
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The frequency range for bone conduction for most audiometers is a.125-6000 Hz b.250-8000 Hz c.250-4000 Hz d.125-8000 Hz |
C. 250-4000 Hz |
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The audiogram showing a sensorineural hearing loss will indicate a.Impaired bone conduction, and an air bone gap b.Impaired air conduction, and no air bone gap c.Impaired bone conduction, and normal air conduction d.Normal bone conduction, and an air bone gap |
B. Impaired air conduction, and no air bone gap |
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The frequency range for air conduction on most audiometers is a.125-6000 Hz b.250-8000 Hz c.250-4000 Hz d.125-8000 Hz |
D.125-8000 Hz |
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Tactile responses to pure tones may be seen when stimuli are a.Bone conduction only b.Air conduction only c.Bone conduction and air conduction d.Sound field |
C.Bone conduction and air conduction |
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An apparent sensorineural hearing loss with an air bone gap only at 4000 and 6000 Hz is probably due to a. A collapsed ear canal b.Cross hearing by air conduction c.Acoustic radiations from the bone-conduction vibrator d.Acoustic radiations from the air-conduction receiver |
A. A collapsed ear canal |
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A traditional pure tone average is composed of which three frequencies a.250, 500, 1000 Hz b.1000, 2000, 4000 Hz c.500, 1000, 2000 Hz d.250, 1000, 4000 Hz |
C.500, 1000, 2000 Hz |
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In a unilateral conductive hearing loss, the Weber will result in the sound being heard in the a.Better ear b.Worse ear c.Both ears d.Neither ear |
B.Worse ear |
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A problem that tuning-fork tests have in common with any measurement using bone conduction is that a.The nontest ear may hear the tone by bone conduction b.The patient may feel the vibration c.Pressure against the skull is variable d. All of the above |
D. All of the above |
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Speech tests can aid determining etiology. For each of the results below, list what types of thresholds, or etiologies might be expected with each. a. Excellent word recognition is found with ______ and with ________ _____. b.Slightly reduced word recognition scores are often found with ____ Hz hearing losses resulting from ________ or __________. c.A unilateral hearing loss with word recognition scores that are poorer than expected in one ear only can often be an indicator of a ______________ _______________. If it is in both ears you might suspect ____________ presbycusis. |
a. Excellent word recognition is found with Normal and with conductive hearing loss. b. Slightly reduced word recognition scores are often found with higher Hz hearing losses resulting from noise or Presbycusis. c. A unilateral hearing loss with word recognition scores that are poorer than expected in one ear only can often be an indicator of a Acoustic neuroma. If it is in both ears you might suspect Neural presbycusis. |
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What can an otoscopic exam tell you? |
Canal blockageInfectionTM conditionHealth of ear |
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What can an otoscopic exam tell you? |
Canal blockage Infection TM condition Health of ear |
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Why do you take a case history? |
To determine if there are any lesions in the auditory system (degree and etiology of HL). Always good to look at fam history |
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Thisaudiogram is an example of a____ hearing loss. The PTA is ____ dB. We would expect the word recognition to be_______. |
Conductive, 20, normal |
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The following audiogram would raise concerns about an ______ ____ because of the following feature ___. What are three red flags noted on this exam?_____, _________, _____. The PTA is ____ dB in the right ear and ___ dB in the left ear. |
Acoustic neuroma Asymmetry Age, Assymetry, Rollover on WR scores, 36 and 0 |
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This audiogram is an example of a ______ _____hearing loss. Can we infer from the audiogram what the probable etiology is? ___. How could an otoscopic exam help in determining the etiology of this loss?_____________. The PTA is ____ dB in the right and ___ in the left. We would expect the word recognition to be ______. |
Conductive, No, Yes, it could tell us if there is blockage and possible problems with TM 40 20 Normal |
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This audiogram is an example of a ______ ____hearing loss. Dependent upon age, and history of noise the etiology for this loss could be either due to ___ or ________ _____. |
Sensorineural, Noise, Presbyacusis |
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The interaural attenuation for TDH earphones is _______, for insert earphones its _______, and for bone conduction vibrators its _____ at 1000 Hz. |
TDH earphones 40 insert earphones 70 one conduction vibrators 0 |
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What is masking? |
Textbook: the process by which the threshold of a sound is elevated by the simultaneous introduction of another sound. Lecture: to keep one ear “busy” while testing the opposite side. |
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When you mask, do you put the masking noise in the test ear or the non-test ear? |
Non-test ear |
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A shadow curve occurs when the threshold of the TE exceeds the _____ _________ _____________ of the Hz being tested on the NTE and crossover occurs. |
Interaural attenuation |
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MCL stands for ____ _________ __________ and is the level that the patient prefers for the speech signal. |
Most comfortable loudness |
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The _ _ _ stands for the ______________ loudness level and it the level where the patient states the presentation level is too high for comfort. |
UCL – uncomfortable loudness |
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The SDT or __________ __________ _________ is the lowest level that the patient perceives the speech signal but does not understand it. |
Speech detection threshold |
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The _ _ _ is the lowest level that a patient can repeat ___________ words that they have been familiarized with ___% of the time. |
SRT, Spondee, 50% |
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_______________ words are two syllable words with equal emphasis on both syllables. |
Spondee |
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The SRT and PTA should be within ___ dB of each other. If the difference is greater, than a ______ ___________ hearing loss should be suspected and counseling is in order. |
10dB, Non-organic |
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What are spondaic words? |
Two syllable word, pronounced with equal stress on both syllables |
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What is the SRT? |
Threshold of intelligibility of speech (the lowest intensity at which at least 50% are correct) |
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How do we get the SRT? |
Familiarize with Spondee, Ascending or descending method of testing Repeat and record level they can respond 50% correct |
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What are phonetically balanced word lists? |
Lists that contain all the phonetic elements of connected English discourse in their normal proportion to one another |
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What are three phonetically balance word list names? |
W22 CNC CID |
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What is a carrier phrase? |
“say the word” or “you will say” |
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The relationship between the SRT and SDT is usually a.The SRT is 10 dB higher (poorer) than the SDT b.The SRT is 10 dB lower (better) than the SDT c.The SRT and SDT are the same d.No relationship exists |
A.The SRT is 10 dB higher (poorer) than the SDT |
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In audiograms showing sharply falling ( in the higher frequencies) sensorineural hearing loss the SRT is best predicted by the average of the thresholds at ____ Hz a. 500 and 1000 b. 500, 1000, and 2000 c. 500, 1000, 2000, and 3000 d. 500, 2000, and 4000 |
a. 500 and 1000 |
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The speech recognition score expected of a patient with a mild cochlear hearing loss is ___ % |
80% |
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The speech recognition score of a patient with moderate conductive hearing loss is __ %. |
100% |
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Positive rollover is considered to be a difference of greater than or equal to what ___% of the PB Max. |
20% |
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An indication of a central processing disorder during speech testing is |
Poorer than expected word recognition scores in the presence of normal hearing and Poorer word recognition scores in the presence of a competing message |
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Redundancy will cause word recognition scores to be best in which order a.Discourse, words, sentences, speech in noise, syllables b.Discourse, sentences, words, syllables, speech in noise c.Words, sentences, discourse, speech in noise, syllables d.Syllables, discourse, words, sentences, speech in noise |
b.Discourse, sentences, words, syllables, speech in noise |
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What is the purpose of word recognition testing and how does etiology affect performance? |
Purpose = relative indication of difficulty a person has; alerts audiologist about persons who have unuasually poor (or unusually good) scores. Very poor scores = retrocochlear lesion (further testing needed)Determination of benefit; patient may or may not obtain from hearing aids
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Label the three curves shown that illustrate PI function of normal, phonemic regression, and rollover. |
From left to right – normal, rollover, phonemic regression |
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This audiogram illustrates____ The predicted SRT for the left ear would be ___dB HL. Predicted SRS for the left ear would be___. If the HL had been sensorineural a predicted SRS for the right ear would be___. A predicted MCL for the left ear is___dB HL. A predicted UCL for the left ear would be___ |
Conductive Hearing Loss in both ears. 20dbHL SRT 100 SRS 80 MCL 65 UCL 100
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An audiometer is |
A device for determining the threshold for hearing |
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Bone Conduction |
Measurement made of hearing sensitivity by using earphones. |
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A pure tone average is… |
The average of a patient’s thresholds obtained at 500, 1000 and 2000 Hz. |
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What is the threshold |
The level at which a stimulus is barely perceptible 50% of the time. |
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What is the air bone gap? |
The term used to describe the difference between the air conduction and the bone conduction threshold. |
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What is an audiogram? |
A graph representing hearing sensitivity in decibels as a function of frequency. |
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a false negative |
Failure of a patient to respond to a stimulus that has been heard |
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Air conduction |
Measurement made that tests hearing sensitivity exclusive of the outer and middle ears. |
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False positive |
A response during testing when no stimulus was presented |
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What is SRT? |
Lowest level spondees are repeated 50% of the time. |
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What is WIPI? |
A test that uses pictures to determine word recognition scores in children |
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What is PB MAX? |
The highest word recognition score possible regardless of the sensation level |
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What is UCL? |
The SPL at which speech becomes uncomfortably loud |
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What is PI function? |
A graph showing the percentage correct on speech recognition tests as a function of intensity |
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What is CNC? |
Monosyllabic words containing three phonemes each that are used in word recognition tests |
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What is SDT? |
The lowest level that a patient can detect the presence of speech and recognize it as speech |
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What is PB word list? |
Phonetically balanced :A list of monosyllabic words used for determination of speech recognition scores |
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What is Carrier? |
A short phrase that precedes the stimulus word during speech audiometry |
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List the seven different categories of hearing and indicate the dB range associated with each of them (ex. Normal 0-15, Ok, I gave you the first one.a_____; b_____c_____; d _____ e ____; f__ |
normal 0-15 slight 16-25 mild 26-40 moderate 41-55 moderately severe 56-70 severe 71-90 profound above 90 |
