IHS ILE Study Guide: Comprehensive Hearing Healthcare Fundamentals, Exams of Nursing

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What two actions MUST a hearing healthcare professional perform before testing an existing patients hearing - .......🔷ANSWERS🔷......✔✔ Clean hands in view of patient and clean or replace speculum from otoscope How does osteoma present - .......🔷ANSWERS🔷......✔✔ Bony growth in external auditory canal What should a hearing healthcare professional do prior to administering a speech reception threshold test - .......🔷ANSWERS🔷......✔✔ Familiarize patient with the word list A 36- year old female restaurant worker with history of hearing loss reports she is unable to hear as well as she did 2 years ago testing reveals moderate conductive loss what is a likely cause of the patients change in hearing

• .......🔷ANSWERS🔷......✔✔ Otosclerosis What portion of the ear contains sebaceous glands - .......🔷ANSWERS🔷......✔✔ Outer portion of external auditory canal Which factor will affect patients acceptance in hearing instruments?
• .......🔷ANSWERS🔷......✔✔ Cosmetic preferences Why should otoblock be placed beyond second bend of ear canal
• .......🔷ANSWERS🔷......✔✔ Results in complete impression of the canal What validation method can be effectively performed in a sound field environment - .......🔷ANSWERS🔷......✔✔ NU-

A hearing health care professional is counseling a patient about expectations of amplification what information should the hearing healthcare professional include in this therapy - .......🔷ANSWERS🔷......✔✔ Outside factors that can hinder hearing A patient has been using an ITC hearing instrument for approx 16 mos the patient has a new job that requires use of telephone with a headset

• .......🔷ANSWERS🔷......✔✔ Add an amplifier to existing phone A patient complains that the hearing instrument works intermittently After initial inspection the hearing healthcare professional squeezes and taps on the case What is the suspected problem - .......🔷ANSWERS🔷......✔✔ An amplifier problem Germicidal wipes are an example of - .......🔷ANSWERS🔷......✔✔ Disinfectant 4 modes of transmission - .......🔷ANSWERS🔷......✔✔ Contact, Indirect contact, Droplet, Vehicle, Airborne, vectorborne Contact - .......🔷ANSWERS🔷......✔✔ Directly infected by the host Indirect contact - .......🔷ANSWERS🔷......✔✔ Touching something contaminated by an infected person. Surfaces or objects Droplet - .......🔷ANSWERS🔷......✔✔ transmission via airborne droplets Vehicle - .......🔷ANSWERS🔷......✔✔ Transmitted by contaminated substances such as water, food, blood or bodily substance Airborne - .......🔷ANSWERS🔷......✔✔ Droplet or neucli or dust transmission Vectorborne - .......🔷ANSWERS🔷......✔✔ Animals or insects carries pathogen

Characteristics of tympanic membrane - .......🔷ANSWERS🔷......✔✔ Pinkish- gray in color oval shaped Audiometric zero - .......🔷ANSWERS🔷......✔✔ The average softest intensity that someone with normal hearing can detect Tympanometry - .......🔷ANSWERS🔷......✔✔ Measures middle ear function and compliance is also known as imittence audiometry Acoustic Reflex - .......🔷ANSWERS🔷......✔✔ Middle ear muscle reflex, tympanometer is used to measure activity of stapedius muscle TPP - .......🔷ANSWERS🔷......✔✔ Tympanometric peak pressure- 0.6-144cc ECV - .......🔷ANSWERS🔷......✔✔ Ear canal volume +200 to 400 mH2o or dapa The most common cause of sudden loss of of hearing at 4000Hz is

• .......🔷ANSWERS🔷......✔✔ Acoustic trauma What condition would not be a concern in establishing pure tone air conduction threshold - .......🔷ANSWERS🔷......✔✔ Otosclerosis A large dip at 6000Hz in ONE ear only with a positive tone decay is an indicative of
• .......🔷ANSWERS🔷......✔✔ A possible retrocochlear tumor A patient who has worn hearing aids for a long time reports his ears are stopped up he recently had a cold, What will give the MOST information about this patients complaint - .......🔷ANSWERS🔷......✔✔ Impedance audiometery What programmable adjustment would be BEST to control loud sharp sounds
• .......🔷ANSWERS🔷......✔✔ Increase the compression ratio

During otoscopic inspection what is NOT a consideration for earmold selection

• .......🔷ANSWERS🔷......✔✔ Compliance of tympanum A patient comes in complaining that his ITC aids were working fine until he had them cleaned now they are week and feeding back What is most likely the cause of the problem - .......🔷ANSWERS🔷......✔✔ Receiver tubing pushed in A patient who has had a radical mastoidectomy has been referred to your office for a new earmold Physician is urging caution due to short canal What would be true about this patient - .......🔷ANSWERS🔷......✔✔ Multiple otoblocks may be needed, Careful placement of otoblock is needed DSP is - .......🔷ANSWERS🔷......✔✔ digital signal processing What is the test to determine the effectiveness of directional microphones
• .......🔷ANSWERS🔷......✔✔ QuickSIN Cochlea can only clarify and purify up to - .......🔷ANSWERS🔷......✔✔ 90dB Vagus nerve - .......🔷ANSWERS🔷......✔✔ is the 10th cranial nerve it lies at the bottom of the ear canal and when irritated can cause Arnolds Reflux Cochlear Dead spot signs - .......🔷ANSWERS🔷......✔✔ High frequencies are greater than 65dB HL and pure tones sound like crackles Stria Vascularis - .......🔷ANSWERS🔷......✔✔ Produces endolymph fluid Organ of corti is located - .......🔷ANSWERS🔷......✔✔ On the basilar membrane Inner hair cell characteristics - .......🔷ANSWERS🔷......✔✔ Are afferent approx 3, in each ear and damage results in severe hearing loss with poor word recognition scores

Outer Hair cell characteristics - .......🔷ANSWERS🔷......✔✔ Are efferent approx 12- 15,000 in each ear and damage will results in up to a 50dB hearing loss they are also embeded in the tectorial membrane A space occupying lesion (tumor) arising from auditory nerve is called

• .......🔷ANSWERS🔷......✔✔ Acoustic neuroma and vestibular schwannaoma Sensorineural Hearing loss - .......🔷ANSWERS🔷......✔✔ Damage to sensory structures, PURELY inner ear, Noise induced loss, presbycusis and most congenital hearing loss falls into this category. Air conduction thresholds and Bone conduction thresholds are close if not equal Presbycusis - .......🔷ANSWERS🔷......✔✔ Age related hearing loss Mixed loss - .......🔷ANSWERS🔷......✔✔ A combination of sensorineural and conductive hearing loss. a High frequency loss with conductive components. Displays air-bone gaps bone conduction thresholds as well as air conduction thresholds are out of normal ranges Central Hearing loss - .......🔷ANSWERS🔷......✔✔ Damage to the brain causing inability to distinguish what is being said. Hearing aids will not help with this type of loss Conductive Loss - .......🔷ANSWERS🔷......✔✔ PURELY outer ear. Mechanical disruption air-bone gaps of 15dB or greater exist Bone conduction thresholds are in normal limits Air conduction is not Non-organic/Functional Loss - .......🔷ANSWERS🔷......✔✔ Malingering there is nothing physically wrong with the anatomy. Exaggerated hearing loss Outer and Middle ear are part of - .......🔷ANSWERS🔷......✔✔ the peripheral auditory system Resonant frequency of an open ear canal - .......🔷ANSWERS🔷......✔✔ 3000-4000Hz

Role of the pinna - .......🔷ANSWERS🔷......✔✔ Pinna collects sound like a funnel aids in localization of sound and enhances the high frequencies Acoustic Impedance - .......🔷ANSWERS🔷......✔✔ Resistance of the flow of sound through the mechanism, opposition of flow of sound across a surface Areal Transfer and lever action - .......🔷ANSWERS🔷......✔✔ Responsible for recovering 26dB of sound energy Eustachian Tube Function - .......🔷ANSWERS🔷......✔✔ 1. Drains fluid from middle ear to back of the throat 2. Equalizes pressure between middle ear and outside world Pocket of debris - .......🔷ANSWERS🔷......✔✔ Cholesteatoma Chronic Supprative otitis media - .......🔷ANSWERS🔷......✔✔ Otitis media with reoccuring bacterial infection Carhart notch in bone conduction testing at the 2000Hz frequency is usually associated with - .......🔷ANSWERS🔷......✔✔ Otosclerosis Meniere's Disease - .......🔷ANSWERS🔷......✔✔ Results from an over secretion of endolymph Tinnitus - .......🔷ANSWERS🔷......✔✔ Ringing, popping and other sounds with no external source Recruitment - .......🔷ANSWERS🔷......✔✔ Abnormal growth in loudness Fistula - .......🔷ANSWERS🔷......✔✔ A leakage of fluid from inner ear tear in the oval or round window

Tympanosclerosis - .......🔷ANSWERS🔷......✔✔ Usually caused from re-occurring ear infections, it is the stiffening of the tympanic membrane Mass effect otitis media - .......🔷ANSWERS🔷......✔✔ High frequency have air-bone gaps the low frequencies do not Serous Otitis media - .......🔷ANSWERS🔷......✔✔ No pain in associated clearly visible bubbles and fluid ear drum, no cone of light will be present Stenosis - .......🔷ANSWERS🔷......✔✔ Narrowing of the ear canal Atresia - .......🔷ANSWERS🔷......✔✔ Absence of an ear canal Microtia - .......🔷ANSWERS🔷......✔✔ A smaller than normal pinna Anaotia - .......🔷ANSWERS🔷......✔✔ Absence of one or both external ears Cupping hand behind the hearing by - .......🔷ANSWERS🔷......✔✔ 5-8dB Wearable hearing instruments were first possible due to - .......🔷ANSWERS🔷......✔✔ Miniature vacuum tubes Ohms Law - .......🔷ANSWERS🔷......✔✔ Voltage/Resistance= sound pressure voltage/resistance=ohm If your input level increases 20 and output increases 5 Input/Output= Compression ratio according to this scenario what would the compression ratio be

• .......🔷ANSWERS🔷......✔✔ 20/5=4 you would have a 4:1 ratio Law of conservation energy states - .......🔷ANSWERS🔷......✔✔ Energy can neither be created nor destroyed

A battery with 5mA drain worn 12 hours a day with a rated 250mA hour expectancy would need to be changed how often - .......🔷ANSWERS🔷......✔✔ Every 6 weeks mA - .......🔷ANSWERS🔷......✔✔ battery drain How to calculate battery life - .......🔷ANSWERS🔷......✔✔ Battery capacity/Load current *.70 gives you hours Directivity is depicted by - .......🔷ANSWERS🔷......✔✔ polar patterns Increase in voltage results in - .......🔷ANSWERS🔷......✔✔ More sound pressure Denser the medium - .......🔷ANSWERS🔷......✔✔ the faster sound will travel, sound travels fastest through steel .0002 dynes per sq cm2 - .......🔷ANSWERS🔷......✔✔ Faintest sound that can be detected 6400Hz is the 5th octave of what frequency - .......🔷ANSWERS🔷......✔✔ 400Hz PTA should agree with SRT - .......🔷ANSWERS🔷......✔✔ By +/- 10dB Direct Contact Transmission - .......🔷ANSWERS🔷......✔✔ requires close association between infected and susceptible host Kissing, sexual, etc indirect transmission - .......🔷ANSWERS🔷......✔✔ When and infected hosts touches a surface and another person comes into contact with the infected surface Droplet Contact Transmission - .......🔷ANSWERS🔷......✔✔ Droplets of mucus

Exit by coughing, exhaling, and sneezing vehicle transmission - .......🔷ANSWERS🔷......✔✔ When a contaminant is ingested or there is exposure to contaminated substance via food, water or bodily substance ex: Salmonella and e-coli Airborne Transmission - .......🔷ANSWERS🔷......✔✔ When droplets or dust particles stay in the air for long periods of time vectorborne transmission - .......🔷ANSWERS🔷......✔✔ an animal contains and transmits an infectious organism to humans Disinfection - .......🔷ANSWERS🔷......✔✔ kills, inhibits, or removes most microbes from inanimate surfaces: towelettes, hospital grade liquid sprays etch Sterilization - .......🔷ANSWERS🔷......✔✔ The process that completely destroys all microbial life, including spores. Used for critical instruments like curettes and speculas Type A tympanogram - .......🔷ANSWERS🔷......✔✔ normal middle ear function- if hearing loss is on the audiogram should be SNHL, No air bone gaps, normal TPP, PMC, ECV Type B tympanogram - .......🔷ANSWERS🔷......✔✔ Flat. Fluid or perforation or obstruction, Air bone gaps are typical there is something in the middle ear space keeping the system from moving with pressure change Type As Tympanogram or A-Shallow - .......🔷ANSWERS🔷......✔✔ Normal middle-ear pressure, normal ear canal volume with reduced tympanic membrane mobility (low compliance). Middle-ear system with increased mass and high resistance. Common in otosclerosis, cholesteatoma, tympanoesclerosis, and ossicular fixation

Type Ad Tympanogram(deep) - .......🔷ANSWERS🔷......✔✔ Intact TM, normal Eustachian tube function, energy flow is reduced. 1). Ossicular discontinuity (incomplete chain) flaccid movement of the membrane, or 2). a Monomeric membrane(behind the membrane). Type C tympanogram - .......🔷ANSWERS🔷......✔✔ normal compliance and negative ME pressure, Retracted TM can be suspected Normal PMC,ECV but negative TPP Atypically large ECV - .......🔷ANSWERS🔷......✔✔ unpredictable impact on hearing usually seen with ventilation tube or TM perforation PMC flat, No TPP and ECV is atypically large