1st Year Written COMP Flashcards
(296 cards)
1
Q
What agencies/governing bodies deal with infection control?
A
CDC
OSHA
WHO
EPA
FDA
2
Q
What guidelines do they have that we have to follow regarding infection control
A
Standard precautions
Universal precautions - when we have to use PPE and do certain levels of cleaning something
3
Q
Levels of cleaning instruments
A
Disinfection - kills germs, equipment that doesn;t use infectious debris
Sterilize - something that could get blood on it
4
Q
If we dont follow the guidelines…
A
Financial penalties
Clinic closures
5
Q
regulates noise ordinances in the community
A
epa
6
Q
Which agency plays a role in infection control, but more in pharmacology and medical devices
A
FDA
7
Q
The original standard precautions came from
A
CDC
8
Q
What is 1 infection control procedure to help stop the spread of infections from patient to patient
A
hand hygiene
9
Q
Which agency ensures safe and healthful working conditions for workers by setting and enforcing standards and by providing training, outreach, education, and assistance.
A
10
Q
Which agency’s goal is to protect public health and fight disease. “ is one of the major operating components of
the Department of Health and Human Services and is recognized as the nation’s premier health promotion, prevention, and preparedness agency.” It created
guidelines for standard precautions
A
CDC
11
Q
What does OSHA stand for?
A
Occupational Safety and Health Administration
12
Q
What does CDC stand for?
A
Centers for Disease Control and Prevention
13
Q
What does EPA stand for?
A
Environmental Protection Agency
14
Q
Which agency regulates chemical safety, i.e., disinfectants and sterilants, and much more related to the environment and human health
A
EPA
15
Q
United States-based nonprofit 501(c) organization that accredits and certifies more than 22,000 healthcare organizations and programs in the United States.”
A
JCAHO
16
Q
What does JCAHO?
A
The Joint Commission on Accreditation of Healthcare Organizations
17
Q
What does FDA stand for?
A
U.S. Food and Drug
18
Q
which agency acts to protect the public health be ensuring safety of food, drugs, medical devices and cosmetics
A
FDA
19
Q
What is the recommended amount of time the CDC (and OSHA) recommends washing your hands
A
*10-20 seconds
Hum/sing Happy B-Day or Twinkle
Twinkle Little Star Twice
20
Q
Is hand sanitizer better than hand
washing?
A
No, you should wash your hands as soon as
possible even after use of hand sanitizer.
21
Q
What type of menigitis is this:
Most severe meningitis
Can have severe-profound SNHL - affecting the inner ear
Cochlear ossification - affects the ability to choose CIs etc.
It can also be brain damage
A
bacterial meningitis
22
Q
Hospital acquired infection
A
Nosocomial - acquired it in a hospital, reason why JCAHO IS IMPORTANT because they monitor and want to reduce these
23
Q
What is the route for the meninges and the inner ear?
A
Perilymphatic duct - allows route of communication bw meninges and inner ear
Perilymph and csf are very similar in makeup
Endolymphatic duct & sac - absorb from inner ear up to the dural space of the extra endolymph
Endolymph produced in stria vascularis
24
Q
low lying, not overly pervasive, constantly around and we get used to it, ex: flu
A
endemic
25
What does stria create to allow the organ of Corti to work
High concentration of potassium = endocochlear potential (because of stria pumping out, it has high potassium, causing hairs to be ready for stim)
26
regional, in country or area, pops up ex: small pox, west nile, zika, sudden outbreak of disease in community or region during a time period, runs its course
epidemic
27
epidemic on a large scale that crossed borders ex: COVID-19
pandemic
28
Gloves & mask
Eyeglass protection
Shields
robe/gown/lab coat
Shoe covers
Hair net
are examples of...
PPE
29
What is the term used to define microbes that can cause illness and/or disease?
pathogen
30
What virus is responsible for painful infection of the facial nerve near the ear that can lead to blisters, hearing loss, and vertigo?
Herpes Zoster Oticus
31
What bacteria is the most common cause of otitis media?
Streptococcus pneumoniae
32
_________ is the term used to define a common outer ear fungal infection.
otomycosis
33
One benefits at the expense of the other.
Parasitism
34
Both the host and the microbe benefit from each other.
mutualism
35
One benefits but the other does not receive benefit or harm.
Commensalism
36
an epidemic on a large scale, like a continent
Pandemic
37
an infection that is ever-present at a relatively low level, like Valley Fever
Endemic
38
a sudden outbreak when more than the usual number of cases of a disease occurs in a community during a certain time period
Epidemic
39
Non-profit accrediting agency
JCAHO
40
Ensures a safe workplace for all employees
OSHA
41
safety of drugs, medical devices, food, and cosmetics
FDA
42
Created guidelines for standard precautions
CDC
43
Regulates disinfectants and sterilants
EPA
44
A patient was admitted to the hospital for an emergency appendectomy. A couple of days into his hospitalization, he developed MRSA at the incision site. This type of secondary infection is referred to as a ___________________ infection
nosocomial
45
Bacterial meningitis can be deadly within 24 - 48 hours if left untreated. It can also lead to permanent brain damage and severe sensorineural hearing loss (SNHL)
true
46
It is not essential to employ hand hygiene if you wear gloves.
false
47
When performing otoscopy, you should use the largest speculum tip possible.
true
48
What is the leading cause of transmission of germs in health care settings?
Contaminated hands
49
What is the preferred method used to prepare critical audiology tools for use with another patient?
Cold sterilization with gluteraldehyde or hydrogen peroxide solution for several hours.
50
Home-grade disinfectants, like Clorox wipes
Low-level disinfection
51
Dishwasher, bleach, or rubbing alcohol
Mid-level disinfection
52
Hospital-grade disinfectants, like Audiologist’s Choice solution or Cavicide wipes
High-level disinfection
53
Surfaces like chairs and counter tops during everyday encounters with patients should be:
Cleaned
Disinfected
54
First step. Removes gross (visible) contamination from the surface
Clean
55
Kills some of the germs, but not all of them
Disinfect
56
Kills 100% of the germs 100% of the time
Sterilize
57
Whenever we may have contact with potential infectious material
If risk of cerumen, blood, or splatter, wear protection
PPE
58
Method for removing cerumen?
Irrigation, mechanical instrumentations (forceps, curette, scoops, etc.), suction.
59
How do you know when to remove cerumen?
Blockage of the tympanic membrane, to prevent pushing it in further, if it is dry/hard and won’t come out on its own.
60
What are precautions/contraindications for doing cerumen removal?
Do not irrigate without tympanometry and otoscopy, diabetes (infection risk), blood thinners (bleeding risk), patient consent.
61
Why do we have cerumen?
Lubricates and protects the ear, acts as a barrier, and migrates out due to epithelial migration.
62
What agency created the Universal Blood and Bloodborne Pathogen Precautions?
CDC.
63
What forms from the neural tube from ectoderm?
Brain, spinal cord, nerves, and ganglia.
64
What is the first sign of the nervous system forming?
Thickening of the groove in ectoderm that becomes the neural tube.
65
What happens if the neural tube doesn’t zip up?
Can result in an open neural tube; on the caudal side, this is known as spina bifida.
66
What condition is associated with spina bifida?
Arnold Chiari II.
67
Which germ layer is on the outside of the tympanic membrane?
Ectoderm.
68
Which layer is on the middle ear side?
Endoderm.
69
Which germ layer is in the middle making it spiral?
Mesoderm.
70
What does the dorsal portion become?
Utricle, semicircular canals, and endolymphatic duct.
71
What is genetic material and gene mutation called?
Genotype.
72
What are symptoms and physical presentations called?
Phenotype.
73
What is most commonly associated with genetic hearing loss?
Autosomal recessive (AR).
74
What condition is characterized by 3 copies of chromosome 21?
Down syndrome.
## Footnote
Body can function with too much genetic material; associated with conductive hearing loss or mixed hearing loss, stenosis, and facial changes.
75
What is the RETSPL equation for converting hearing level to sound pressure level?
dB HL = dB SPL – RETSPL.
76
What is the RETSPL equation for converting sound pressure level to hearing level?
dB HL = dB SPL + RETSPL.
77
Convert 0 dB HL at 1,000 Hz to dB SPL.
dB SPL = 7.5.
78
What is dB SL?
Difference between presentation level and the patient’s individual threshold.
79
If a patient’s threshold is 25 dB HL and you present a tone at 60 dB HL, what is the dB SL?
35 dB SL.
80
If a patient’s threshold is 45 dB HL and you present a tone that is 10 dB SL, what is the dB HL?
55 dB HL.
81
What is the increase in dB for doubling of intensity?
+3 dB.
82
What is the increase in dB for doubling of sound pressure?
+6 dB.
83
What is the increase in dB for doubling of loudness in typical hearing?
+10 dB.
84
What ensures we are measuring what we think we are measuring?
Test validity.
85
What is the method of constant stimulus?
Stimuli are presented in a pre-determined, random order, with many presentations at each stimulus level.
86
What is the method of limits?
Stimuli are presented at pre-determined starting points.
87
What is the method of adjustment?
Stimulus is controlled by the subject; level change is continuous rather than in discrete steps.
88
What does a conservative criterion result in?
Fewer hits, more correct rejections; less likely to say they heard it.
89
What does a neutral criterion result in?
Equal number of hits and correct rejections.
90
Why does someone with a liberal criterion present with better hearing thresholds?
Because they have a higher tendency to say yes.
91
Why does someone with a conservative criterion present with poorer hearing thresholds?
Because they have a higher tendency to say no and wait until it gets louder.
92
What type of filter only passes energy BELOW a designated upper cutoff frequency?
low pass filter
93
What is 0 dB SNR? Is this a difficult listening situation?
signal and noise are at the same level
## Footnote
Not great situation; most people need a couple dB of signal being louder than noise.
94
What is +10 dB SNR?
where signal is 10 dB level than the interfering noise
95
What is -5 dB SNR?
signal is 5 dB less than the noise
96
Which is the hardest situation to listen in? j0, +10 or -5 dB SNR?
-5 because it is less than the noise
97
What do we set SNR in the booth?
speech in noise testing (both are in the same ear)
98
What type of filter only passes energy ABOVE a designated lower cutoff frequency?
high band pass filter
99
What is a band pass filter?
has high and low cut off and passing between those cut offs (passing band in the middle)
100
What is a band reject filter?
has low and high cut off and passing what is outside of them and rejects what is between them
101
For tonal masking which is correct? Why?
Low frequency tones mask high frequency tones most effectively
## Footnote
Because high frequencies anatomical organization (tonotopic organization) of the base with high and lows at apex makes the lows impact and infect by the travelling waves to the lows (upward spread of masking).
102
Define monotic.
one ear listening with one ear
103
Define diotic.
same signal going to both ears
104
If we play a signal from a speaker in front of the patient, what is the azimuth?
0
105
If we play a signal from a speaker directly behind the patient, what is the azimuth?
180
106
When you increase the frequency of a pure tone, what happens to the wavelength? Why?
it gets shorter because the frequencies get faster and complete the cycle quicker
107
108
If you increase the stiffness of a system, are low or high frequencies reduced more?
Low frequencies are reduced and impacted more.
## Footnote
Anatomically, we increase stiffness on purpose during muscle reflex, which reduces own vocal fold vibrations, allowing highs to pass through.
109
If you are putting sound through a medium with more mass, which frequencies are attenuated more?
High frequencies are attenuated more.
## Footnote
An example is using a bone oscillator, which makes it harder to move the mass through the head compared to air.
110
Define harmonic distortion.
Distortion products are added that are whole number multiples (integers) of the original signal.
111
Define frequency distortion.
Amplitude is reduced at certain frequencies based on the characteristics of the filter.
112
Define transient distortion.
Spectral splatter - with energy spread to other frequencies.
113
How does transient distortion and spectral link to OAE testing?
TEOAEs use a click or short transient stimuli, and results are analyzed by filters in the computer to extract frequency information.
114
Which distortion relates to the other type of OAE, DPOAE?
Harmonic distortion.
## Footnote
This is because of the relationship 2f1-f2, looking at variations of harmonic distortion.
115
What is considered the critical period for language development in children?
Birth to 3 years.
116
What is an example of a fluency disorder?
Stuttering.
117
What other disorder goes with stuttering?
Cluttering.
118
Describe stuttering vs cluttering.
Stuttering is characterized by repetitions, prolongations, or blocks in speech. Cluttering is characterized by rapid and/or irregular speech.
119
What is an example of a motor speech disorder?
Stuttering is characterized by repetitions, prolongations, or blocks in speech.
120
Define diotic.
Same signal going to both ears.
121
Define dichotic.
Different (divergent) signal going to both ears.
## Footnote
For example, one ear gets a 1000 Hz tone while the other ear gets speech.
122
Which one is harder from processing, diotic vs dichotic?
Dichotic is harder because you are getting different signals, stressing the signal as the brain tries to perform binaural fusion.
123
What does 'bilateral' mean?
two sides
124
What does 'binaural' refer to?
listening with two ears
125
What can cause voice/resonance disorders?
polyps and vocal nodules
## Footnote
singers, theatre, those that speak loudly
126
What are advantages of binaural hearing?
binaural summation, binaural squelch, binaural fusion
## Footnote
Some help us listen in noise, localization.
127
Who might be considered the first audiologist?
CC Bunch
## Footnote
Wrote the seminal article on testing hearing with tones in 1920 and the Clinical Audiometry book in 1943.
128
Describe the Modified Hughson-Westlake procedure.
An adaptive psychoacoustic procedure where the method changes based on the PT’s response. Down 10 up 5.
129
What is an example of a motor speech disorder?
apraxia, dysarthria
130
How would you describe prelingual hearing loss?
Develop hearing loss before speech and language development, leading to a poorer prognosis and longer rehabilitation.
131
How would you describe post-lingual hearing loss?
Hearing loss occurs after developing speech and language, providing a foundation and auditory memory.
132
Can post-lingual hearing loss affect speech/language even if amplified right away?
sometimes
133
Does unilateral hearing loss impact a child?
Yes, it can affect localizing and hearing in noise, leading to academic difficulties.
134
What is the auditory feedback loop?
When you speak, hear yourself, and correct yourself if needed.
135
What is typically the reading level achieved by a deaf child using hearing aids?
4th grade level
136
What can be done for unilateral children in the classroom?
Preferential seating, place in front of the class, personal remote mic technology.
137
Historically, what has been the typical reading level of a deaf child using hearing aids?
4th grade
138
What is the national average reading level?
7 or 8th grade in the US
139
What is narrative sampling?
Narrative sampling lets them more naturally speak by reading a passage or an open-ended question and letting them talk, taking a sample of how they did.
## Footnote
Taking a sample of their dialogue and ability to speak.
140
What is dynamic assessment?
Dynamic assessment involves doing a task you assess, training them how to do it, and then reassessing their potential to improve something.
141
When might narrative sampling and dynamic assessment be helpful?
These methods are helpful to get a baseline. Standardized tests are validated with subjects who are English speaking and their first language, so this type of test may not be valid for someone who isn’t.
142
If you have a PT who is Spanish speaking and you do not speak Spanish?
Get an interpreter, find a test in that language, or refer to someone who speaks the language.
143
Describe: Place of articulation, Voicing, Manner of articulation.
Place of articulation refers to where it constricts in the vocal tract. Voicing indicates whether the vocal folds vibrate or not (voiced or voiceless). Manner of articulation describes how the sound is made and how it is flowing (fricative, affricate, nasal, glide, stop).
144
Describe: Broca’s aphasia vs Wernicke’s aphasia.
Broca’s aphasia is associated with frontal lobe damage, while Wernicke’s aphasia is linked to temporal lobe damage. These affect how the sounds are made but not motor function; it is a neurological disorder because it is the brain pathway that is damaged.
145
What is semantics?
Semantics refers to meaning.
146
What is pragmatics?
Pragmatics refers to context and organization.
147
What is syntax?
Syntax refers to the arrangement of words.
148
What is Osteopathic Medicine?
An osteopathic physician (DO) is a doctor with full medical privileges that can utilize all forms of standard medical and surgical treatments, as well as osteopathic manipulation and alternative medicine.
149
What are the 4 Fundamental Principles of Osteopathic Philosophy?
1. The human body is a dynamic unit of function of mind, body, and spirit.
2. The body possesses self-regulatory mechanisms which are self-healing in nature.
3. Structure and function are interrelated at all levels.
4. Rational treatment is based on these principles.
150
Is rational treatment based on an understanding of the basic principles of body unity, self-regulation, and the interrelationship between structure and function… NOT JUST TREATING SYMPTOMS?
True
151
What is the purpose of professional liability insurance?
To protect you if you get sued, cover mistakes that occur during the course of employment, and cover any contingency.
152
What is tort law?
Tort law is civil law about causing damage to a person or property. It is a civil wrong against a person or property that may result in action for damages.
153
What are the objectives of tort law?
Preservation of peace, culpability (find fault for wrongdoing), deterrence (discourage wrongdoer from committing future torts), compensation (indemnify the injured person of wrongdoing).
154
What is negligence?
A tort, a civil or personal wrong. The unintentional commission or omission of an act that a reasonably prudent person would or would not perform under given circumstances.
155
What is negligence or carelessness of a professional person?
Malpractice.
156
What is the reckless disregard for the safety of another?
Criminal negligence.
157
For malpractice cases, what must they prove?
Duty, breach, damages, causation.
158
When do you provide a patient with a notice of privacy practices?
First visit, annually after to remind them. Explains your policies and their rights.
159
What is the purpose of an informed consent document and when would you use it?
Making sure they are ok with being a subject with the things you are doing. Some do it up front for everything or individually depending on the task.
160
What are some state licensure requirements?
Always need a license, degree in audiology: doctoral, clinical practice experience, most states: background check or haven't lost licenses or have had suits, pay the fees.
161
What is a conflict of interest?
Selling an overpriced hearing aid that the patient doesn’t need or can pay for so we benefit from it. Manufacturers give perks: if you sell x amount we will give you a trip to x. Something that has an award to it; quid pro quo. We do not create instances where we are in a COI.
162
What is the purpose of codes of ethics?
Set standards and actions that are acceptable within our profession.
163
Where are guidelines for audiology?
As a profession, we need to be gatekeepers and self-regulate other peers and professionals. Who do we want to mandate what is best for audiology? Audiologists, and if we do not self-regulate ourselves, someone else will.
164
What is the legal obligation to care?
Duty.
165
What is failing to comply with the standard of care required?
Breach.
166
What is the concept that without harm or injury there is no liability?
Injury.
167
What is the reasonable, close, and causal connection between the defendant’s negligent conduct and the resulting damages?
Causation.
168
What results in 4 non-identical haploid daughter cells?
Meiosis
169
What forms gametes?
Meiosis
170
What are gametes?
Egg and sperm cells, germ cells
171
What creates haploid chromosomes?
Meiosis
172
What results in 2 identical daughter cells?
Mitosis
## Footnote
DNA replicated and equally split in mitosis.
173
What are diploid chromosomes?
Mitosis
174
How many chromosomes are in haploid?
Half, only 23
175
How many chromosomes are in diploid?
23 pairs, 46 total
176
What are the characteristics of Treacher Collins syndrome?
Peanut ear, small lower jaw, fish mouth, branchial arch disorder
177
What influences the frequency of the fundamental frequency?
The fundamental frequency is influenced by the rate at which the vocal folds vibrate. Fast vibration is a higher pitch and slow vibration is a lower pitch.
178
What influences the frequency of the first formant?
The first formant is influenced by the tongue height. A high tongue height creates a lower frequency and a low tongue height creates a high frequency.
179
What influences the frequency of the second formant?
The second formant is influenced by the tongue advancement. The tongue in the front of the mouth creates a high frequency and the tongue in the back of the mouth creates a low frequency.
180
What type of cue is Voice Onset Time?
Temporal
181
What is the space between the vocal folds called?
glottis
182
Describe the process of phonation.
Phonation is the vocal fold vibration. The vocal folds are adducted, air pressure from the lungs forces the vocal folds to be forced apart, or abducted. The Bernoulli effect causes them to come back together. This process continues until the brain tells the articulators to stop. When a person breathes while talking, the vocal folds are abducted, or apart.
183
What does the source-filter theory of speech production include?
The source-filter theory of speech production is the compartmentalization of sounds where the source is the vocal folds, the power is the lungs, and the filter is the vocal tract.
184
What would the output of the vocal folds sound like if you could hear it in the absence of the vocal tract?
buzz
185
If you recorded yourself speaking softly and speaking loudly, these differences would be noticeable on which of the following?
spectrogram, spectrum, waveform
186
What are voicing cues?
lf
187
What are manner cues?
mid frequency
188
What are place cues?
high frequency
189
In the long-term average speech spectrum (LTASS), where is sound energy the weakest for average conversational speech?
In the LTASS, the high frequencies have less sound energy during average conversational speech. This is why individuals with high frequency hearing loss have a hard time understanding. Going from average to shouted speech, the energy shifts from the low frequencies to the higher frequencies, around 1,000 Hz.
190
What is the SII accurate at predicting?
Can predict accuracy on a speech recognition task (NU-6 word list) in quiet.
191
Are all frequency bands equally important for speech understanding?
false
192
Must the entire speech signal be audible for high levels of accuracy on a speech recognition task in quiet?
false
193
What are suprasegmental aspects of speech?
They are perceived as variations and contrasts in pitch, loudness, and duration; can be important for recognition of vocal emotion; are also referred to as prosody or prosodic features in the literature.
194
What can indicate whether a question has been asked?
intonation (pitch changes)
195
What can indicate whether a word is a noun or a verb?
stress
196
What identifies word boundaries (example 'I scream' vs. 'ice cream')?
juncture
197
How do the speech sounds /b/ and /m/ differ?
manner
198
What are slow changes in amplitude; the 'outline' of the waveform?
temporal envelope
199
What are rapid changes in amplitude?
temporal fine structure
200
How would you describe American Sign Language?
A natural evolving language and communication system developed in a community, with its own grammar, phonology, morphology, syntax, semantics, and pragmatics.
201
What are the rules for language and combining words?
Grammar
202
What is the sound system/rules of pronunciation?
Phonology
203
What is the structure of words?
Morphology
204
What are the rules governing sentences?
Syntax
205
What is the meaning in language?
Semantics
206
What is the social context of language?
Pragmatics
207
Is Signed Exact English (SEE I or II) a natural or artificial sign system?
An artificial sign system because it took English and placed hand signs into a different order and syntax.
208
What system did ASL originally develop from?
French
209
What is the structure of ASL?
Object Subject Verb or Subject Verb Object (e.g., 'the boy threw the ball').
210
What is cued speech?
A visual communication system that combines handshapes with mouth movements to aid lipreading.
211
What is a bilingual bicultural approach?
The use of ASL and written/spoken English with ASL as primary, encouraging Deaf identity and culture.
212
What is total communication?
Integrates speech, sign, fingerspelling, lipreading, and more to facilitate communication.
213
What is the Auditory-Oral/Verbal Method?
Focuses on oral communication through auditory training, speechreading, and speech production, often with the use of hearing aids and cochlear implants.
214
What is ASL?
A complete natural visual language with handshapes, facial expressions, grammar, and syntax.
215
Why is cued speech helpful?
It helps differentiate sounds that look the same on the lips, providing clarity on voiced/unvoiced sounds.
216
What communities use tactile sign language?
Deafblind communities, such as those with Usher's disorder.
217
What is codeswitching?
Changing between languages, modalities, or dialects depending on the conversation partners.
218
What do you know about communicating with Deaf individuals and the use of interpreters?
Speak to the patient and not the interpreter; maintain normal communication without exaggeration or slowing down.
219
What are the preferred terms for Deaf individuals?
Deaf, deaf, or hard of hearing (not hearing impaired).
220
What is the medical model vs social-cultural model of deafness?
The social-cultural model views deafness as something that doesn’t need to be fixed, while the medical model sees it as a disability that needs fixing.
221
Why is preferred language not 'hearing impaired' or 'hearing loss'?
It implies a disability that needs to be fixed.
222
What are the differences in ASL or the parameters?
Hand shape, orientation, location, movement, and non-verbal/non-manual markers.
223
How do you show past/present/future in ASL?
Towards back (past), close to body (present), going forward (future).
224
What is the concept of health according to A.T. Still?
Within man's body, there is a capacity for health that, if recognized and normalized, can prevent and treat disease.
225
What are the 4 tenets of Osteopathic Medicine?
1. Treat cause rather than symptoms. 2. The human body is a dynamic unit of function of mind, body, and spirit. 3. The body possesses self-regulatory mechanisms that are self-healing in nature. 4. Structure and function are interrelated at all levels.
226
What is a scenario in audiology that represents one of the 4 tenets of OM?
Otitis media can self-mediate; watch and wait as the body often takes care of it.
227
What is the OMM approach?
A therapeutic approach focused on realigning structure to improve function.
228
What is the role of OT vs PT vs medical vs audiology?
PT focuses on improving movement, while OT focuses on activities of daily living; physicians practicing osteopathic medicine focus on the whole person.
229
What is OMM or OMT?
Application of hands-on forces by an osteopathic physician to improve physiologic function, improve motion, and support homeostasis.
230
What is the purpose of professional liability insurance?
To protect you if you get sued.
231
What is Tort Law?
Civil law concerning damage to a person or property.
232
What does tort law handle?
It finds wrongdoing, deters it, and compensates for it.
233
How can you avoid going to court for breach of tort?
Manage risk with best practices, knowledge, standards, communication, and documentation.
234
What is informed consent?
A document given to patients to confirm they are okay with proceeding with procedures.
235
What must a plaintiff prove in a malpractice claim?
Duty, Breach, Damages, Causation.
236
Why do all 4 elements have to be met for malpractice?
If no harm was made from the negligence, it is hard to prove.
237
What is the legal obligation to care?
Duty to care.
238
When do you provide a patient with a notice of privacy practices?
At the first visit and annually thereafter.
239
Do you need a state license in audiology to practice?
Yes, always.
240
What is the purpose of an informed consent document?
To ensure patients are okay with being subjects in the procedures being performed.
241
What is a breach of duty?
Failing to comply with the standard of care required.
242
What is the principle regarding liability?
Without harm or injury, there is no liability.
243
What is causation?
A reasonable, close, and causal connection between the defendant’s negligent conduct and the resulting damages.
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What are some state licensure requirements for audiologists?
Degree in audiology: doctoral, clinical practice experience, most states require a background check or proof of no lost licenses or lawsuits, and payment of fees.
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What is a conflict of interest?
Something that has an award to it; quid pro quo.
## Footnote
Example: Selling an overpriced hearing aid that a patient doesn’t need or can’t afford for personal benefit.
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What is the purpose of codes of ethics?
To set standards and actions that are acceptable within our profession.
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Who should mandate what is best for audiology?
Audiologists; if we do not self-regulate ourselves, someone else will.
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What is the role of professionals in self-regulation?
As a profession, we need to be gatekeepers and self-regulate other peers and professionals.
249
Where are the guidelines for audiology?
Do not do something to a patient they do not need, ensure everyone has access, and avoid conflicts of interest.
## Footnote
ASHA Rule 1 H: Individuals shall not guarantee the results of any treatment or procedure, directly or by implication; however, they may make a reasonable statement of prognosis. AAA Rule 7a: Individuals shall not use professional or commercial affiliations in any way that would mislead or limit services to persons served professionally.
250
What are voicing cues?
Low frequency cues from vocal fold vibrations that give the fundamental frequency (F0) of voice.
251
What are manner cues?
Mid frequency cues such as fricative, plosive, and stop.
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What are place cues?
High frequency cues, some of which are visible for speech reading.
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What are suprasegmentals?
The prosody of speech, including how elements fit together, stress, and emotion, providing cues about what is being said beyond individual sounds.
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Where do voicing cues come from?
Vocal fold vibration.
255
What are the frequency characteristics of manner cues?
Mid frequency cues such as fricative, plosive, and stop.
256
What are the frequency characteristics of place cues?
High frequency cues, some of which are visible for speech reading.
257
What is the difference between extrinsic and intrinsic redundancy?
Extrinsic redundancy comes from the environment and speech signal itself, while intrinsic redundancy comes from internal sources.
258
What does extrinsic redundancy refer to in speech?
The speech signal and syntax.
259
What does intrinsic redundancy refer to?
Binaural listening and central auditory nervous system pathways & memory of words.
260
What is the average conversational speech level in dB HL?
50 dB HL.
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What is the average conversational speech level in SPL?
70 dB SPL.
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What is the RETSPL for supra-aural headphones vs inserts?
20 dB change for supra-aural headphones and 13 dB for inserts.
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Right vs Left Tympanic Membrane
Right: cone of light in right bottom corner & malleus is pointed to bottom left corner.
Left: cone of light in left bottom corner & umbo is pointed to bottom right corner.
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Soft, Moderate, and Loud Sounds in Hearing Loss (HL)
Soft: 40 dB
Moderate: 50 dB
Loud: 70 dB
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What is meiosis?
Four phases resulting in 4 non-identical haploid daughter cells (chromosome recombination from paternal and maternal). Gametes also called germ cells (egg and sperm). Haploid = 'half' or just 23 chromosomes.
266
What is mitosis?
Four phases resulting in 2 identical daughter cells. DNA replicated and equally split into diploid cells. Diploid = double number of chromosomes (23 pairs so 46 chromosomes, with 44 somatic and XX or XY).
267
What creates the gametes (germ cells - egg and sperm)?
Meiosis.
268
Where is mitosis seen?
All other cells aside from gametes.
269
Do all four haploid cells become functional cells?
No, usually only one egg survives.
270
Cochlear hair cells stay in _____ phase.
G0.
271
What is gastrulation?
Formation of germ layers.
272
What are the germ layers?
Ectoderm, Mesoderm, Endoderm.
273
What forms from ectoderm?
CNS, PNS, sensory-ear, eye; skin epidermis, bones of face and teeth.
274
What comes from mesoderm?
Organs - kidneys, spleen, walls of heart, muscle, cartilage, bone.
275
What comes from endoderm?
GI system, lining of respiratory, ET.
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Gastrulation stage
Pre-embryonic; fertilization to about 2 weeks.
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Embryonic stage
Carnegie stages 1-23; about 3rd to 8th week; big head.
278
Fetal period
3rd month (about 9 weeks) to birth; maturation of organs and rapid body growth; looks human.
279
What are branchial arches and which ones play a role in auditory system development?
1 & 2; they are in area of pharyngeal area and they will develop face and head structures including muscles, bones, and nerves of head and neck.
280
Neural tube from ectoderm =
Brain, spinal cord, nerves and ganglia.
281
If neural tube doesn’t zip up from caudal and rostral side, what can happen?
Open neural tube can cause spina bifida.
282
What is Arnold Chiari?
Brainstem and the cerebellum herniate through the foramen magnum and is associated with spina bifida.
283
What comes from branchial arch 1?
Incus & malleus, tensor tympani, CN V.
284
What comes from branchial arch 2?
Stapes, stapedius muscle, CN VII.
285
First sign of nervous system forming is a thickening of groove in ectoderm that becomes?
The neural tube.
286
Neural Crest Cells =
More PNS.
287
Which germ layer is on the outside of the tympanic membrane?
Ectoderm.
288
Which is in the middle making it spiral?
Mesoderm.
289
Which layer is on the middle ear side in moist aerated space?
Endoderm.
290
EAC formed from deepening cleft between 1st and 2nd arch; meatal plug and TM. Pinna from 6 hillocks on either side of 1st cleft (1st and 2nd arches).
True.
291
Tubo becomes and tympanic becomes?
Tubo becomes ET; tympanic becomes tympanic cavity/ME.
292
Some first & second arch syndromes that affect the auditory system resulting in hearing loss and other auditory abnormalities include?
Treacher Collins syndrome, Pierre Robin syndrome/sequence, Stickler syndrome. Craniofacial anomalies, CHL (could be mixed).
293
Describe inner ear development.
Otic placode, future inner ear from ectoderm - invaginates to form otic pit and then otic vesicle (otocyst) - elongates and ventral portion becomes saccule and elongates to cochlear duct - dorsal portion becomes utricle, SCC and endolymphatic duct.
294
Genotype
Genetic material and gene mutation.
295
Phenotype
Symptoms, physical and outward presentation.
296
Prosody of speech
Beyond individual sounds of speech, how it goes together that gives cues.
