Chapter 21

Question 1

List the 3 types of hearing loss.

Answer 1

*Conductive
*Sensorineural
*central

Question 2

Conductive Hearing loss: 2

Answer 2

*external and middle ear
*Decreased sound intensity and/or distortion

Question 3

Sensorineural hearing loss: 4

Answer 3

*inner ear
*Distortion or faintness of sound
*Altered ability to understand speech
*Complete hearing loss

Question 4

Central hearing loss:

(two)

Answer 4

*impaired auditory pathways in the brain
*Problems understanding the meaning of words heard

Question 5

Cite common causes of conductive hearing loss.

(five)

Answer 5

*Otitis media w/ effusion
*Impacted cerumen
*Perforation of TM
*Otosclerosis
*Narrowing of external auditory canal

Question 6

Identify which nerve is impaired that may be one cause of sensorineural hearing loss.

Answer 6

CN VIII: vestibulocochlear nerve

Question 7

Determine which hearing loss results in muffled, often hard to understand sound.

Answer 7

Sensorineural hearing loss

Question 8

Describe factors that may cause inner ear problems leading to sensorineural hearing loss. (7)

Answer 8

1.Impairment of the inner ear
2. CN VIII: vestibulocochlear nerve damage
3. congenital/hereditary factors
4. Noise exposure
5. Aging (presbycusis)
6. Trauma
7. Ototoxicity

Question 9

Describe what is meant by mixed hearing loss.

Answer 9

Combination of both conductive and sensorineural causes.

Question 10

Clarify non-syndromic (four) vs syndromic hearing impairment (one long answer)

Answer 10

1. Non-syndromic hearing impairment: gene mutations
   *Alters cochlear function
   *Increase risk of ototoxicity
   *Structural malformations
2. Syndromic hearing impairment:
   *400 syndromes that include hearing loss along with other clinical abnormalities like structural abnormalities to the external ear.

Question 11

Differentiate normal hearing and profound deafness on the audiogram classification of hearing loss.

Answer 11

*Normal hearing: 0-15 decibels (dB) loss
*Profound deafness: >90 decibels (dB) loss

Question 12

Describe behaviors of a person who may have early signs of hearing loss. (6)

Answer 12

*Answering questions inappropriately
*Not responding when not looking at the speaker
*Straining to hear
*Cupping hand around the ear
*Reading lips
*Increased sensitivity to slight increases in noise level

Question 13

Describe the connection between tinnitus and hearing loss.

Answer 13

1. Tinnitus is the perception of sound in the ears where no external source is present (“ringing in ears” or “head noise”).
2. Tinnitus is sometimes the first symptom of hearing loss, especially in older adults.
3. May be soft or loud, low or high pitched.

Question 14

Discuss why hearing loss is an unseen handicap and how this could impact health care services and access.

Answer 14

You may not realize the difficulty in communication with a deaf person until you begin a conversation with that person.

Question 15

Discuss the impact of congenital rubella syndrome and how it could be avoided by immunizations. (2)

Answer 15

*Impact: Rubella infection during the first 8 wks of pregnancy is associated w/ high incidence of congenital rubella syndrome, which causes sensorineural deafness.
*Cannot receive immunization if already pregnant, must get at least 3 mon before pregnancy or during postpartum period.

Question 16

Goal of hearing aid

Answer 16

improve hearing with consistent use

Question 17

List 4 types of hearing aids and the goal of using hearing aids.

Answer 17

1. Completely in the canal
2. In the canal
3. in the ear
4. Behind the ear

Question 18

Completely in the canal (3: what, advantage, disadvantages)

Answer 18

*(Mild to moderate hearing loss)
*Advantage: smallest and least visible. Protected from sound such as wind noise.
*Disadvantage: Costly, no space for add ons

Question 19

In the canal (3: what, advantage, disadvantages)

Answer 19

1. (mild to severe hearing loss)
2. Advantages: more powerful than completely in the canal aid. Adjustable features
3. Disadvantages: Small size if aid may be hard for pts with visual loss or arthritis to use.

Question 20

In the ear: (3: what, advantage, disadvantages)

Answer 20

1. (Mild to severe hearing loss)
2. Advantages: powerful amplification, inserts and adjusts easily, longer lasting batteries.
3. Disadvantages: Visible. May pick up wind noise.

Question 21

Behind ear: (3: what, advantage, disadvantages)

Answer 21

1. (all types of hearing loss)
2. Advantages: most powerful aid overall. Adjusts easily, longest battery life.
3. Disadvantage: Largest, most visible aid.

Question 22

Describe 2 types of implantable hearing devices who cannot or will not use external hearing aids.

Answer 22

Fully implantable (placed surgically) and and partially implantable (one part surgically implanted, and other part worn behind ear)

Question 23

Describe how a cochlear implant works to help those with severe to profound sensorineural hearing loss in one or both ears. (3)

Answer 23

1. for severe to profound sensorineural hearing loss in one or both ears
2. Bypasses damaged or missing portions of ear and directly activates CN VIII
3. Ideal candidates became deaf after acquiring speech and language

Question 24

Define the term presbycusis and the associated problems with verbal communication. (5)

Answer 24

1. Caused by degeneration of inner ear
2. Noise exposure - common factor
3. Decline in word recognition
4. Psychologic and communication issues
5. Diminished ability to understand speech (cannot differentiate consonants)