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Audiology Test 1 Study Guide | 100% Correct
Answers | Verified | Latest 202 6 Version
What does an Audiologist do? - ✔✔
- Prevention of hearing loss (monitoring school/industries programs)
- Identification of hearing loss (screening)
- Evaluations (hearing and balance assessments) o Balance = vestibular system (semicircular canals)
- Selecting and dispensing hearing aids
- Habilitation & rehabilitation of H impaired (90% of the job) o Habilitation is educating/counseling those who are born deaf o Rehabilitation is educating/counseling those who became deaf Among older adults, hearing loss is related to... - ✔✔
- Poor health
- Decreased physical activity
- Depression
- Isolation What are the two most prevalent Audiologist jobs? - ✔✔
- Medical and Dispensing/Rehabilitative Audiologists o ENT/Physician's office and Private Practice What are the 5 employment settings for Audiologists? - ✔✔
- Medical
- Education
- Pediatric
- Dispensing/Rehabilitative
- Industrial How do we hear? - ✔✔Sound is captured by the pinna, goes down the ear canal, hits the ear drum (tympanic membrane), sound pressure waves set the ear drum in motion, then the 3 ossicle bones of the incus, malleus, and stapes moves in the oval window of the inner ear, the fluid in the inner ear then gets set into motion, and the basilar membrane gets moved and the tectorial membrane is moved the opposite way, then the hairs send neural impulses to the auditory nerve. The middle ear is an _____ filled cavity - ✔✔air What does the Eustachian Tube do? - ✔✔equalizes pressure on both sides of the eardrum What are the properties/functions of the middle ear? - ✔✔• To transmit sound from the tympanic membrane to the cochlea
- Impedance matching transformer o Energy transfer from air filled outer and middle ear space to fluid filled inner ear space o Provides about a 30dB boost in sound energy to account for the reduction in energy for sound traveling from an air filled medium to a fluid filled medium What are the two middle ear muscles? (used for impedance) - ✔✔• The tensor tympani and the stapedius muscle o The two muscles contract and the ear drum stiffens which allows for the sound to get reflected off the eardrum; protects the inner ear! The cochlea is ________ arranged! - ✔✔tonotopically
- Lower frequencies are located towards the apex and higher tones are located towards the base
- Travelling wave depending on it's frequency will peak on a certain point on the Basilar membrane The inner ear is ____ filled (cochlear) - ✔✔FLUID
Define SPL - ✔✔• Sound pressure level (SPL) is a logarithmic measure of the effective sound pressure of a sound relative to a reference value. It is measured in decibels (dB) above a standard reference level. o When dealing with hearing, the perceived loudness of a sound correlates roughly logarithmically to its sound pressure. Most measurements of audio equipment will be made relative to this level Define HL - ✔✔Hearing Level is a perceptual measurement for normal hearing. This is the softest sound that the average Normal Hearing person can hear. o What we use in Audiology Define SL - ✔✔Sensation Level is the difference between a person's threshold of hearing and the presentation level of a stimulus. o If a person's speech reception threshold (SRT) is 10 dB on an audiometer (dB HL) and you present a speech stimulus to them at 50 dB HL on the audiometer, their sensation level would be derived thus: 50 dB (presentation level) minus 10 dB (threshold), which equals a sensation level of 40 dB SL.
- dB sensation level is simply the number of decibels above threshold, so that 0 dB HL means "at threshold" and 40dB SL means 40dB above threshold HL to SPL conversions - ✔✔Add whatever the dB SPL on the chart is for 0 dB HL to whatever the db HL is HL to SL conversions - ✔✔Subtract the threshold from the presented stimuli What is the quietest sound you can hear - ✔✔20 Pascals What are the four basic elements of audiometric testing? - ✔✔1. Stimuli - noise presented to the auditory system (pure tone, speech, noise or clicking-splatter of energy)
- Transducers - used to present the stimuli
- Responses - reaction to the stimuli
- Interpretation - what is the degree/type/severity of hearing loss
What is a sinusoid? - ✔✔The wave form of a pure tone - smooth, repetitive oscillation at one level of frequency Define what a transducer is - ✔✔A device that changes one form of energy to another form of energy
- For hearing, we're changing mechanical to acoustic energy or electrical to acoustic energy Why are pure tones important as a stimuli? - ✔✔• Because they stimulate a very discrete area on the basilar membrane in the cochlea
- Exploits the tonotopic arrangement of the cochlea Clicks and transient stimuli are a more _____________ signal (compared to the narrowband signal of a pure tone) - ✔✔broadband Noise stimulus has energy present at __________ frequencies - masking - ✔✔many Equal energy at all frequencies - ✔✔White noise Noise centered around a particular frequency - used when masking. - ✔✔Narrow band noise (USED WHEN MASKING) Noise where more energy is at low frequencies than at high frequencies - ✔✔Speech-shaped noise What are the differences between insert receivers and supra-aural headphones? - ✔✔• Audiometric benefits for insert receivers
- They provide greater attenuation (reduction of effect) of background noise
- Insert receivers can be used on children and adults, nor do people have to take their glasses off
- Helpful for situations with people with collapsed ear canals!
- Cost benefits for supra-aural headphones
o Subjective testing - see if the listener can tell a change in pitch raise/drop Why is calibration important? - ✔✔• So that each Audiology clinic defines normal hearing (0 dB HL) at each frequency in exactly the same way!
- Current standard for audiometers is ANSI (1996) - calibration done yearly What does the perceptual diagnostic battery include? - ✔✔• Pure tone air conduction
- Pure tone bone conduction
- Masking (if needed)
- Speech testing How do we test Audiometric battery? - ✔✔Present different 'tones' or 'pitches' ranging from low frequency to high frequency and low intensity to a high intensity to the right and left ear SEPERATELY Determine threshold: softest sound they can hear 50% of the time Purpose: to specify the amount of a patient's hearing sensitivity at various frequencies Define threshold - ✔✔Softest sound they can hear 50% of the time What order do we do Audiometric battery testing? - ✔✔1. Air Conduction
- Bone Conduction (mask if needed)
- Speech Testing
- SPEECH RECOGNTION THRESHOLD
- WORD RECOGNTION TESTING Before you start any sort of audiometric testing, must do _________! - ✔✔Otoscopy How was normal hearing determined? - ✔✔1. Tested a large number of young, normal listeners
- Used pure-tone stimuli to get frequency specific information
- Assessed detection threshold of these pure tones across many frequencies
- Averaged resulting data
- Resultant function is called the threshold curve of hearing
- shows sensitivity of the human ear to different frequencies
- The ear is most sensitive between 1,000 - 4,000 Hz With normal hearing, the ear is LEAST sensitive to _______________ - ✔✔very high and very low frequencies Normal hearing is sensitive at _______ to _________ Hz - result of ear canal resonance - ✔✔2000 to 3500 Normal hearing is sensitive at ______ Hz - result of middle ear resonance - ✔✔ 1500 Define Loudness discomfort level - ✔✔loudest sounds that can be tolerated by young normal listeners (about 130 dB SPL) What is the threshold of pain? - ✔✔A flat level of about 140 dB SPL What is the difference between the Threshold curve and the Loudness Discomfort level? - ✔✔The difference gives you the dynamic range! Define Dynamic range - ✔✔The range of hearing for a certain frequency; greatest where the ear is most sensitive (middle frequencies) AC tells us the ________ of hearing loss. What does it not? - ✔✔TOTAL amount (total loss of sensitivity) It does not specify what kind you have What is "normal" hearing? - ✔✔0 dB HL
What are the threshold search method for AC? - ✔✔Every time the listeners raises their hand to indicate the sound, decrease tone by 10 dB HL, if they can't hear it then raise it by 5 dB HL (THIS IS FOR THE SAME FREQUENCY!); Looking for 3 ascending responses!! The weakest audible sound is detected __________ - ✔✔50% of the time! (threshold) With the threshold search method, we're looking for three ________ responses. - ✔✔ASCENDING! When searching for the AC threshold, the recommended technique for testing pure-tone thresholds is called an ________ - ✔✔ascending technique At what point do you discover the severity of hearing loss? - ✔✔When masking is done! T or F: PTA must be done for both air conduction and bone conduction - ✔✔FALSE. PTA is not done for Bone Conduction The PTA and SRT (speech recognition threshold) are usually between _____ dB of each other - ✔✔10 dB < = ________ [ = _________ > = ________ ] = _________ - ✔✔R ear for no masking R ear for masking L ear for no masking L ear for masking What would cause a hearing loss via Air Conduction? - ✔✔Fluid in the middle ear, collapsed ear canal, otosclorosis, build up of wax or mass on the ossicle bones
T or F : Wide band noise is always used for testing speech - ✔✔False, Speech shaped noise is always used! If there is a large ABG for either ear, you can tell what type of hearing loss and severity it is... - ✔✔Conductive Hearing loss, and depending on the Hearing Level you could say it's moderate-mild- severe-profound Define Otitis Externa - ✔✔Infection of the outer ear
- Could be caused from a collapsed ear canal, wax build up, or an infection Anotia = ______ Microtia = _______ Atresia = ______ - ✔✔No pinna Small pinna No ear canal Define Otitis Media - ✔✔Fluid in the ear (infection or sterile fluid) Define Otosclerosis - ✔✔Build up on the stapes footplate (usually calcium), which hinders it's function of pushing into the oval window. What is the mode of Sound Transmission for Bone Conduction? - ✔✔Stimulation on the mastoid process, directly to the cochlear! What is the purpose of BC testing? - ✔✔To determine the patient's sensorineural sensitivity T or F: Bone conduction oscillators test on the mastoid process only - ✔✔False! Also a band to test on the forehead
If the ABG shows that hearing by air conduction is equal to hearing by bone conduction, then we know that the hearing loss can be _______ or ______ - ✔✔Sensorineural or normal If the ABG shows that hearing by air conduction is poorer than hearing by bone conduction with a gap greater than 10 dB, then we know that the hearing loss can be _______ or _______ - ✔✔Conduction or mixed T or F: Theoretically, hearing by bone conduction that is poorer than hearing by air conduction should not occur - ✔✔True, because bone conduction involves inner ear (sensorineural) hearing loss and air conduction involves the outer/middle/inner ECs, but sometimes it does! Define tactile responses. - ✔✔A response to a stimuli that may have been caused by the feeling of vibrations from the bone oscillator rather than hearing the actual sound T or F: For patients with severe hearing impairment, it's almost impossible to know for certain whether responses obtained at the highest limits of the audiometer are auditory or tactile - ✔✔True! Frequencies on the basilar membrane that are specifically tuned frequencies are referred to as _____________; We use pure tones in our stimuli to determine the severity of hearing loss - ✔✔characteristic frequencies Explain the tuning curve - ✔✔Auditory nerve fibers (neurons) respond best, and have better thresholds at the fibers characteristic frequency and frequencies immediately surrounding it. The basilar membrane is said to be 'sharply tuned' due to the sharp 'V' shaped curve, with its 'tip' centered at the auditory fibers characteristic frequency. This shape shows how few frequencies a fiber responds to. If the tuning curve were a broader 'V' shape, it would be responding to _____ frequencies - ✔✔more On a tuning curve, if there was a sharp peak at a lower sound level, that would indicate what kind of hearing? What about if it was peaked the same way, just at a higher dB level? - ✔✔Normal hearing Conductive hearing loss (because it needs more volume to be able to perceive it)
Explain why someone might say, "I can hear you, I just can't understand you" - ✔✔Tuning curve isn't as defined - more broad. This is indicative of a sensorineural hearing loss. If hearing sensitivity is considerably ______ in one ear than in the other, then you can assume cross hearing is occurring! - ✔✔better Define cross-hearing - ✔✔It is possible that before the threshold of the poorer ear is reached, the intensity of the signal may be great enough for the sound to escape from beneath the air-conduction earphone into the room and be heard by the BETTER EAR or the sound could be loud enough to cause vibration by distortional bone conduction. T or F: Cross-hearing and Interaural attenuation go hand-in-hand - ✔✔TRUE! Sound loses some of it's momentum and energy when it travels to other ear (either bone vibration or leaking out of the supra- aural headphones) For _____ Conduction - the Interaural Attenuation will vary among individuals and with frequency - ✔✔Air - vary by size of head and different transducers When calculating the Inerarual Attenuation for air conduction, there's a _____ dB loss of energy while wearing supra-aural headphones and a _______ dB loss of energy while wearing insert receivers. - ✔✔40 dB 70 dB If a child has a small head, then that means they will have ______ IA than an adult with a larger head - ✔✔less - because there's less room for the energy to travel. The ___________ Approach states that we cannot know in advance the interaural attenuation of a given patient before testing for cross-hearing. - ✔✔Conservative
- Because the transducer will have an effect on the IA for air conduction (supra-aural = 40 dB and insert- receivers = 70 dB) When testing for IA for bone conduction, regardless of where the bone oscillator is (forehead or mastoid process), the interaural attenuation for bone conduction should be considered ____ dB - ✔✔0 dB
When should we expect cross hearing to be occurring for air conduction? - ✔✔When there is a 40dB or MORE difference between the air conduction threshold of the TEST EAR and the bone conduction threshold of the NON TEST EAR Explain the masking procedure - ✔✔You do this when you suspect cross hearing is occurring. Isolate testing of the test ear by presenting noise to the non test ear. The noise takes the non test ear out of the equation by elevating the threshold of the NTE T or F: In audiology, we use ipsilateral masking - ✔✔False! We use contralateral (opposite ear) masking The purpose of masking is to elevate the threshold of the ________ ear - ✔✔non-test At 2k Hz, we need to mask for Air Conduction. What would the best masking noise would be? - ✔✔Best masking noise is the critical band (narrowband noise) at 2K Hz How do we determine how much noise gets put into the non test ear? - ✔✔The Plateau Method If cross hearing is suspected, then the _______ and _______ of hearing loss cannot be determined. - ✔✔degree and type For the Plateau Method, present tone into the test ear and noise into the non test ear ____________. - ✔✔simultaneously What's the purpose of the noise masking? - ✔✔It slightly elevates the threshold of the non-test ear! Centered around the frequency of the pure tone. Define Occlusion Effect - ✔✔When people close off the opening into the ear canal (ex: with a headphone, hearing aid, tragus, etc) the loudness of a tone presented by bone conduction increases, because that bone-conducted sound vibrations are reverberating off the object filling the ear canal (Observed primarily in low frequency sounds; 250Hz, 500Hz, 1000Hz)
With the OE, when the ear canal is blocked, the vibrations are reflected _______ the eardrum. - ✔✔toward Smaller heads = ________ Interaural Attenuation - ✔✔More Define undermasking - ✔✔When cross-hearing is still occurring in the non-test ear. The tone (by cross-hearing) continues to be heard in the masked ear despite the noise since the tone level is below the threshold of the test ear. Define overmasking - ✔✔As masker level is further increased, threshold in the test ear increases again. The masking level is so intense that it crosses to the test ear, resulting in continuous shifts in the threshold of the tone with increases in the masking noise Define Masking Dilemma - ✔✔When the initial masking level already produces overmasking (because of bone conduction) What is the formula for Masking Dilemma? - ✔✔ML (Nte) > IA + BC (te) If this is taking place, then the masking dilemma is occurring! What is one way to avoid the masking dilemma? - ✔✔Use insert earphones, which produce a larger amount of interaural attenuation What is the shotgun approach to pure-tone masking? - ✔✔When you just put any amount of noise in the TE; runs the risk of over masking (masking noise crosses over to the test ear) if it's too loud or it could be not loud enough and the TE wouldn't hear anything. What is acoustic neuroma? - ✔✔Growths on the auditory nerve - Would have a unilateral slope audiogram configuration. One ear is in normal hearing range, other is in the moderate hearing range.
What are the problems with giving percentage for hearing loss? - ✔✔It doesn't tell you anything about the degree, type, or severity. It ignores the audiometric configuration. Looks only at the average hearing loss. Also is time consuming! What is presbycusis? - ✔✔A sensorineural hearing disorder. It is most commonly caused by gradual changes in the inner ear. The loss associated with presbycusis is usually greater for ______ frequency sounds. - ✔✔high. Normal in lower frequencies for RE and LE, but drops in the higher frequencies. T or F: Presbycusis is always a sensorineural hearing loss - ✔✔False! Can sometimes be conductive hearing loss caused by abnormalities of the outer ear and/or middle ear (e.g. reduced function of the tympanic membrane) Down syndrome is related to a specific type of __________________ - ✔✔chromosome abnormality What is Otitis media with effusion? - ✔✔Follows Eustachian tube dysfunction and does not tend to resolve; Ear drum get sucked into the middle ear and builds up negative pressure... tissue in the middle ear starts to secrete a fluid (Glue ear = thick stuff that accumulates in the middle ear) What ear related disorder is common for people with Down Syndrome? - ✔✔Otitis media with effusion What is Treacher Collins Syndrome? - ✔✔Treacher-Collins syndrome is a condition that is passed down through families (hereditary) and leads to defects of the face. It is caused by a defective protein called treacle; gene changes (mutations) - A lot of times they have microtia, atrocia, or atresia. What is the treatment for Treacher Collins Syndrome? - ✔✔BAHA surgery - a small titanium implant behind the ear. The sound travels via the bone to the inner ear. What is Otosclerosis? - ✔✔an abnormal bone growth (calcium build up on the stapes footplate) in the middle ear that causes hearing loss. This growth prevents the ear from vibrating in response to sound waves. Such vibrations are needed in order for you to hear.
At what notch does Otosclerosis occur at? - ✔✔2,000 Hz What is Otitis Media? - ✔✔Inflammation of the middle ear or a middle ear infection For adults, an otoscopy test requires pulling _____ and _____ on the ear - ✔✔Up and back What's the difference between Speech Recognition Threshold (SRT) and Word Recognition Testing (WRT)
- ✔✔For SRT-LOOKING FOR A THRESHOLD; softest level someone can identify speech 50% of the time For WRT - Not looking for a threshold Speech Audiometry allows us to get a patients' what? - ✔✔1. Their degree of hearing loss for speech
- The levels required for their most comfortable and uncomfortable loudness levels 3.Their range of comfortable loudness
- THEIR ABILITY TO RECOGNIZE AND DISCRIMINATE THE SOUND OF SPEECH SLPs and Audiologists use speech audiometry results for? - ✔✔therapy planning and client and family counseling What are two stimuli for speech audiometry? - ✔✔monitored live voice testing (MLV) and Pre-recorded test material What is a VU meter? - ✔✔An electronic dial on the audiometer - before you test speech, you want to calibrate your own voice (peak around 0 on the dial) What is the patient's role in speech audiometry? - ✔✔Patient must know and understand the words with which they will be tested on!
