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73 Cards in this Set

  • Front
  • Back
What are some of the topics asked about an adult's case history?
Pertinent history – name, age, address, referral source, etc.
Nature of hearing problem (past and present)
Other medical problems
What are some of the topics asked about an child's case history?
Developmental milestones
Detailed questions of pregnancy and child birth
Speech/Language development
Medical History
Pure Tone audiometers have the capacity of measuring hearing thresholds (θ ) by ______ and _________ conduction
air, bone
Air conduction measurements
measurements that are obtained by ear phones
Ear phones that fit over the ear are called ___________ ear phones while ear phones that go into the ear canal are called _______ ear phones
supraoral, insert
Bone conduction measurements
Measurements made by bone vibrator on mastoid (usually) or sometimes forehead
The primary instrument used to measure hearing threshold
audiometer
Audiometer component that determines how the signal will be delivered (either by bone conduction or air conduction)
Output selector
Audiometer component that allows presentation of several frequencies (tones)/selects different pure tone frequencies
Frequency selector dial
Most audiometers are frequency selective between ________ Hz – ______ Hz.
125, 8000
Audiometer component that allows for stimulus (tone) presentation
interrupter switch/presentation button
A graphic illustration of hearing thresholds/a graph used to record hearing thresholds and other test results
Audiogram
The _______ is recorded on abscissa (x-axis) in _________ (unit) and the _________ is recorded on ordinate (y-axis) in _____ (unit)
Frequency, Hertz
Hearing Level, dB
Intensity scale is labeled dB HL for _________________
hearing level
What are the two types of audiologic assessment?
Minimum Audible Field (MAF) & minimum audible pressure
corrects for differences in hearing sensitivity across frequencies
Calibration
One octave on the frequency scale = _____ dB on the hearing level scale
20
For normal hearing, air and bone conduction thresholds are between _____ and ____ dB HL
-10 and 25 dB HL
Mild hearing loss occurs between______ and ____ dB HL and consists of having difficulty with _________ speech
26-40 dB
faint
Moderate hearing loss occurs between______ and ____ dB HL and consists of having difficulty with _________ speech
41 and 55 dB HL
conversational
Moderate hearing loss is between ____ and ____ dB HL difficulty with conversational level speech
41 and 55
Moderate-Severe hearing loss is between____ and ____ dB HL difficulty with _________________. People with Moderate-Severe hearing loss could benefit from _____________
56, 70
some loud speech
amplification
Severe hearing loss is between ______ and _______ dB HL having difficulty with __________. May possibly have difficulty with ______________ as well.
71 and 90
loud speech
hearing aids
Profound hearing loss is above ____ dB hearing aids for these folks may not be helpful
90.
The speech frequencies that the schemes of hearing impairment were based on puretone thresholds between ________ and _________ Hz
500 and 2000
Speech recognition threshold and ____________________ correlate well with one another.
pure tone average
Pure tone and speech audiometric θ s are determined via two stimulus modes.
air conduction = _____________ Hz
bone conduction = ___________ Hz
air conduction 250-8000
bone conduction 250-4000
AC θ obtained by presenting various pure tone stimuli through _______________.
supraoral earphones or inserts
______________ thresholds include all parts of the auditory system.
Air Conduction
True or False. Location of hearing loss not identified by AC alone
True
BC θ helps to ________ the hearing problem
localize
BC measurements are obtained with a bone vibrator somewhere on ________________
skull (usually mastoid or forehead)
Describe Distortional or Compressional Bone Conduction-


(bone conduction thresholds)
when we put vibrator on mastoid bone we present stimulus to vibrator which is then presented to head. It causes mastoid bone to vibrate. Because the inner ear is also composed of bone, it vibrates which causes the fluids in the inner ear to vibrate. WE VIBRATE THE BONES OF THE SKULL & BECAUSE THE BONES OF THE SKULL ARE VIBRATING, THE INNER EAR VIBRATES BECAUSE IT’S COMPOSED OF BONES. WE THUS (for the most part) EFFECTIVELY BYPASS USING THE OUTER EAR AND THE MIDDLE EAR. We are directly stimulating the inner ear by vibrating the mastoid bone. The biggest response comes from the inner ear.
Describe Inertial Bone Conduction


(bone conduction thresholds)
the middle ear is composed of three bones (ossicles), the incus, the stapes and the malleus. When the bones of the skull begin to vibrate, they cause the ossicles to move as well due to inertia. This causes the stapes to move in and out of the oval window. Thus, a little bit of the chain of events that occurs in the inner ear is due to the vibrating of the ossicles due to inertia.
Describe Osseotympanic Bone Conduction


(bone conduction thresholds)
reflects the fact that the inner 2/3 of the outer ear is bony. If the bones of the skull are vibrating, the inner 2/3 of the outer ear will vibrate which will cause the tympanic membrane to vibrate. Thus, the outer ear plays a minor role in hearing as well.
When we do bone conduction measurements, we know that the majority of the response comes from the _________ ear, which helps us to identify which part of the ear is malfunctioning in hearing loss.
inner
True or False. The Initial test ear is arbitrary. You can pick whatever ear to begin with, but we generally start with the better hearing ear, unless there is no perceivable difference.
(Air conduction thresholds)
True
Begin testing at ________ Hz, ascending order to higher frequencies, descending order to lower frequencies. (goes up and then goes down)
(Air conduction thresholds)
1000
A modified method of limits used to find air conduction thresholds in which we descend until we don’t get a response and then ascend right away.
(Air conduction thresholds)
Ascending Technique
With the ascending technique we always measure the threshold on the ___________

(Air conduction thresholds)
ascend
With the ascending method we descend at ____ dB steps until they don’t hear it ascend at __ dB steps until they respond at the threshold level 50% of the time. This threshold is known as the ____________ threshold
10, 5
audiometric
The lowest level at which speech can be recognized 50 % of the time
speech recognition threshold
Bone conduction procedures are similar to those for air conduction, except responses are obtained for frequencies between ________ Hz and ______Hz.
250 and 4000
If a patient shows reduced hearing sensitivity by air conduction, while bone conduction responses are normal (hearing loss by air conduction & normal hearing by bone conduction) what kind of hearing loss do they have?
Conductive
People with conductive hearing loss have problems due to the ________ or _________ ear conductive mechanisms.
outer, middle
How do we know that people with conductive hearing loss have problems due to the outer or middle ear conductive mechanisms?
Because we know that normal bone conduction responses indicate normal inner ear functioning.
What are some causes on conductive hearing loss?
Several causes such as otitis media, ossicular chain abnormalities, cerumen
Difference b/t bone conduction thresholds & air conduction thresholds in the same ear
Air bone gap
The air bone gap is the difference between the ___________________ & _________________ in the same ear
bone conduction thresholds, air conduction thresholds
Conductive hearing loss occurs if your bone conduction thresholds are _____ dB and air conduction thresholds are _______ dB. (This still constitutes normal hearing). However, if an air-bone gap of 10 db + exists you can have conductive hearing loss.
0, 25
What amount of dB air bone gap equates to conductive hearing loss?
10 dB
Hearing loss that occurs when air conduction and bone conduction θ ‘s are equivalent (within +/- 5dB of each other) at all test frequencies
sensorineural hearing loss
What are some examples of congenital sensorineural hearing loss?
hereditary, viral, bacterial, maternal infections, birth trauma.
What are some examples of acquired sensorineural hearing loss?
noise, aging, inflammatory disease, ototoxic drugs.
Which type of hearing loss can be corrected with surgery or medicine?
Conductive
Pattern of sensorineural hearing loss in which the thresholds are the same in both ears across frequencies (audiogram looks flat)
flat
Pattern of sensorineural hearing loss in which there is more hearing loss in the mid frequencies (rather than in the low and high frequencies)
Trough Shaped
Pattern of sensorineural hearing loss which is most common acquired; slopes from high to low
Sloping High Frequency
Pattern of sensorineural hearing loss which rises from low to high (e.g.,Méniere’s Disease)
Low frequency rising
Hearing loss in which hearing sensitivity is reduced by both air conduction and bone conduction, but loss is greater by air conduction; Partially conductive, partially sensorineural
Mixed Hearing Loss
With mixed hearing loss, which aspects of hearing loss can sometimes be corrected with surgery or medication?
conductive
What are the three types of tuning fork tests?
Weber and Rhine tests
Test in which the physician places vibrating tuning fork on top of head and asks what ear do you hear the sound in. Responses could be one ear or both ears.
Weber
After taking the Weber test if it is conductive hearing loss, the tuning fork will cause an ___________ effect. The sound will lateralize (sound louder) to the _____________________.
occlusion; occluded side (the side with the hearing loss)
After taking the Weber test if a person has conductive hearing loss in right ear, the patient will hear the sound in the _________ ear.
right
After taking the Weber test, with a sensorineural hearing loss , the vibration of the tuning fork will lateralize to which ear?
The ear that doesn't have the hearing loss.
After taking the Weber test with a sensorineural hearing loss in the right ear, the vibration of the tuning fork will lateralize to which ear?
the left ear
Tuning fork test in which the physician takes vibrating tuning fork, holds it to ear and asks patient to say when the sound goes away. When the patient indicates that the sound has gone away, the dr places the tuning fork to the mastoid bone and asks if the patient hears the sound again
Rinne
With the Rinne test, if it’s a sensorineural hearing loss, will the patient hear the tuning fork when it is placed against the mastoid bone? Why?
No,This is because people with sensorineual hearing loss hear better by air conduction. When the tuning fork is placed against the mastoid bone, it stimulates inner ear hearing, which someone with sensorineural hearing loss has hearing loss problems with.
With the Rinne test, if it is a conductive hearing loss, will the patient hear the tuning fork when it is placed again the mastoid bone? Why?
Yes,This is because with conductive hearing loss you hear better bone conduction responses better and the sound has been placed directly to the inner ear.
Use bone conductor to do tests instead of tuning fork. Unlike the tuning fork, the signal will never go away unless the signal is changed.
Audiometric tuning fork
The amount that the skull attenuates the sound introduced to one ear from being heard by the other ear.
interaural attenuation
The amount of interaural attenuation observed for air conducted stimuli varies with frequency. The minimum value for AC stimuli is ____dB (supra aural); ___ dB (insert).
For BC, the minimum interaural attenuation is __dB.
AC: 40, 70
BC: 0