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Partha Fall 2014 > Exam #1 > Flashcards

Exam #1 Flashcards

1
Q

Name 2 physical parameters of sound?

A
  1. frequency (Hz)

2. Intensity/pressure level (dB)

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2
Q

What is the human auditory frequency range?

A

20Hz to 20,000 Hz (20kHz)

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3
Q

What is the human auditory frequency range for intensity/pressure?

A

0dB to 120dB

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4
Q

What makes a sound psychological?

A

You are not able to quantify it.

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5
Q

Name 2 psychological aspects of sound.

A
  1. Pitch (mels)

2. Loudness (phons/sones)

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6
Q

Does pitch and frequency have a direct or an indirect relationship with each other?

A
  • direct
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7
Q

Does loudness have a direct or indirect relationship with intensity/pressure?

A
  • direct
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8
Q

Name 2 TYPES of sounds.

A
  1. Simple

2. Complex

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9
Q

What is an example of a simple sound.

A

pure tone (one frequency)

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10
Q

What is an example of a complex sound.

A

speech and noise (multiple frequencies)

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11
Q

Name 2 types of frequencies.

A
  1. Aperiodic

2. Periodic

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12
Q

What does aperiodic mean?

A

the frequency does not repeat

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13
Q

What does periodic mean?

A

the frequency repeats

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14
Q

What is another name for a pure tone?

A

sine wave

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15
Q

What is another name for a sine wave?

A

pure tone

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16
Q

What is fundamental frequency?

A
  • the lowest frequency with maximum amplitude
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17
Q

Does a complex periodic sound have a fundamental frequency?

A
  • no
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18
Q

What is the purpose of pure tone audiometry?

A
  • to determine the degree and type of hearing loss
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19
Q

Name 2 types of measurement used in pure tone audiometry?

A
  1. Air conduction threshold

2. Bone conduction threshold

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20
Q

Where does conductive hearing loss occur?

A
  • outer, middle, or both outer and middle
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21
Q

Where does sensorineural hearing loss occur?

A
  • inner ear
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22
Q

What is mixed hearing loss?

A

A combination of conductive and sensorineural hearing loss.

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23
Q

What is the purpose of speech audiometry?

A

To validate pure tone audiometry and for accurate differential diagnosis

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24
Q

What are 2 primary measurements for speech audiometry?

A
  1. Speech reception threshold

2. Speech discrimination score

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25
Q

What is the purpose of a tympanometry?

A

To objectively assess the middle ear function.

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26
Q

What is a tympanogram?

A

A graphical plot of the eardrum mobility at different air-pressure values.

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27
Q

If an audiological assessment is subjective, what does that mean?

A

The subject has to participate (you are at the mercy of the subject)

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28
Q

What does it mean if an audiological assessment is objective?

A

You don’t need active cooperation from the patient.

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29
Q

Is an audiological assessment for 0-5yrs population subjective or objective?

A
  • subjective
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30
Q

What is the name of the subjective audiological assessment for 0-5yrs population?

A

Behavioral Observation audiometry (BOA)

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31
Q

What is the sound of a BOA test represented from?

A
  • speakers
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32
Q

What is effective when conducting a BOA with population for 6 mos and above in the 0-5yrs population?

A
  • visual reinforcement audiometry (puppets) (pinpoints localization)
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33
Q

The visual reinforcement for the BOA is an appropriate technique until what age?

A
  • 3 yrs of age
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34
Q

At what ages is “play audiometry” for conduction of BOA appropriate?

A
  • above 3-5 years of age
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35
Q

What is play audiometry?

A
  • doctor is in the same room with the patient, sitting side by side, attempts to condition a response so young child knows how to conduct the study, this is done with a game
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36
Q

What is the purpose of “play audiometry?”

A
  • to find out what the threshold is for air conduction and bone conduction assessment
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37
Q

Name an objective audiological assessment for 0-5 yrs population.

A
  • OAEs (otoacoustic emissions)
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38
Q

What is the purpose of an OAE in the 0-5yr population?

A
  • to evaluate the inner-ear cochlear function
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39
Q

What is the purpose of the objective auditory brainstem response?

A
  • to evaluate the auditory nerve and brainstem function
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40
Q

What is the name of a test that is conducted under immittance audiometry?

A
  • typanometry
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41
Q

What is the purpose of immitance audiometry?

A
  • to directly evaluate the middle ear status

- to indirectly evaluate the inner ear status

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42
Q

What needs to be working for a tympanometry test?

A
  • outer hair cells
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43
Q

What is an audiogram?

A
  • graphical plot of air conduction and bone conduction thresholds across frequencies
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44
Q

What is an audiometer?

A
  • electronic device for hearing assessment
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45
Q

What is audiometry?

A
  • procedure for hearing assessment
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46
Q

What is a normal tympanogram?

A
  • type A (middle ear drum is working normal)
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47
Q

What does HTL stand for?

A
  • hearing threshold level
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48
Q

What percentage of time can you hear the lowest HTL?

A
  • 50% of the time OR lowest level you can hear three repeated times
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49
Q

What is the basic function of the external and middle ear?

A
  • conduct sounds to the inner ear
50
Q

What is the basic function of the inner ear?

A
  • sound analysis and discrimination
51
Q

What device is used to measure air conduction audiometry?

A
  • pure tone audiometer
52
Q

What is a pure tone audiometer?

A
  • an electronic device for hearing assessment
53
Q

What is the purpose of air conduction audiometry?

A
  • to obtain AC thresholds across audiometric frequencies
  • to compute pure tone average (PTA)
  • to compute degree and extent of hearing loss
54
Q

During audiometric testing, is the clinician facing in the direction of the patient?

A
  • no because this avoids visual cues
55
Q

What is the frequency sequence for air conduction audiometry?

A

1000Hz, 2000Hz, 4000Hz, 8000Hz, 250Hz, 500Hz and 1000Hz retest. (double check with lab sheet)

56
Q

What is the initial intensity dial setting for air-conduction audiometry?

A

30dB

57
Q

Which ear do you start the testing in for air-conduction audiometry?

A
  • better ear or right ear
58
Q

What is the threshold level for air conduction audiometry?

A
  • 50% correct or three repeated responses
59
Q

What is the symbol for plotting A/C threshold in the right ear?

A
  • O red
60
Q

What is the symbol for plotting A/C threshold on the left ear?

A
  • X blue
61
Q

What does PTA stand for?

A
  • pure tone average
62
Q

What is PTA 1?

A

3 frequency average of dB at 500, 1000, and 2000 Hz

63
Q

What is PTA 2?

A

3 frequency average of dB at 1000, 2000, and 4000Hz.

64
Q

When is PTA 2 useful?

A
  • useful when you have a patient with a selective HF loss (2000 and above; normal between 250 to 1000Hz
65
Q

What is pure tone average AKA?

A

fletcher average

66
Q

What is a 2 frequency average/fletcher average?

A

best of thresholds at 2 frequencies between 500, 1000, and 2000Hz

67
Q

What is normal hearing threshold for a child 5yrs or younger?

A

0 - 15dB HTL

68
Q

What is mild hearing threshold for a child 5 yrs or younger?

A

16-30dB HTL

69
Q

What is moderate hearing threshold for child 5yrs or younger?

A

31-50dB HTL

70
Q

What is severe hearing threshold for a child 5 yrs or younger?

A

51-80dB HTL

71
Q

What is profound hearing loss for a child 5yrs or younger?

A

greater than 81dB HTL

72
Q

What is normal hearing loss range for an adult?

A

0 - 25dB

73
Q

What is mild hearing loss range for an adult?

A

26-40dB

74
Q

What is moderate hearing loss for an adult?

A

41 - 55dB

75
Q

What is moderate to severe hearing loss for an adult?

A

56 - 70dB

76
Q

What is severe hearing loss for an adult?

A

71 - 90dB

77
Q

What is profound hearing loss for an adult?

A

greater than 90dB

78
Q

TRUE or FALSE? Mild hearing loss can have a profound effect on development of speech and language skills.

A

TRUE

79
Q

List all of the variables included in audiometric testing.

A
  1. Calibration of equipment
  2. noise levels in the room
  3. attention and motivation of the examiner
  4. response criteria of the examiner
  5. attention, motivation and intelligence of the subject
80
Q

What is the purpose of bone-conduction audiometry?

A

evaluate inner ear status for differential diagnosis of site of pathology

81
Q

Is PTA subjective in audiometric procedures?

A
  • ask Nikki
82
Q

What is the frequency sequence for bone conduction audiometry?

A

1000 Hz, 2000 Hz, 4000Hz, 250 Hz, and 500 Hz

83
Q

What intensity level do you start at for bone conduction testing?

A

same as A/C conduction (30dB)

84
Q

What is the audiometric symbol for plotting B/C thresholds and normal values when unmasked?

A

< red : right ear

> blue : left ear

85
Q

What is normal for B/C threshold?

A

0 to 5 years of age : 0 to 15dB across 250 to 4000 Hz

AND

older than 5 yrs of age : 0 to 25dB across 25 dB across 250 to 4000Hz

86
Q

Where is bone conduction placement for B/C testing?

A
  • the mastoid
87
Q

What is cross hearing or interaural attenuation (IA)?

A

reference to loss of sound energy as sound travels from the test ear to the nontest ear

88
Q

What is IA for A/C sounds?

A

IA = 40dB

89
Q

What is IA for B/C sounds?

A

IA = 0dB (no loss of energy)

90
Q

When should you mask the nontest ear in A/C testing?

A

when unmasked AC threshold (in the test ear) - 40dB (IA) is = or greaer than unmasked BC threshold in the non test ear

91
Q

If you are masking the nontest ear in A/C testing, how much masking should you give?

A

minimum masking = unmasked AC threshold in the nontest ear

92
Q

When do you mask the non test ear during B/C testing?

A

when you have an air-bone gap (test ear) is = or greater than 10dB

93
Q

How much masking noise should you use on the nontest ear during B/C testing?

A

minimum masking : unmasked AC threshold (nontest ear) + occlusion effect (freq. dependent)

94
Q

Practice Masking Problems from HW

A

Masking Example

  • Assume (at 1000Hz)
  • Right Ear A/C is 60dB
  • Right Ear B/C is 10dB

A/C:
Rt. 60 (test ear) - 40 = 20dB (this is greater than B/C threshold in the left ear)
Need to mask left ear with minimum of 10dB masking noise (narrow band noise)

B/C:
Air-bone difference in right ear is greater than 10dB (60-10 = 50dB). Need to mask the left ear with a minimum = 10dB plus 10 (occlusion effect at 1000Hz) = 20dB masking noise in the left air

95
Q

What is the occlusion effect (OE) during B/C testing?

A
  • ref to an increase in perceived loudness of B/C sounds in the occluded ear/non test ear.
96
Q

Is the occluded in the test ear or the nontest ear?

A

non-test ear

97
Q

OE is frequency dependent. List the Hz and and dB equivalents in OE for B/C.

A 
250Hz = 30dB
500 Hz = 20dB
1000Hz = 10dB
2000Hz = 0dB
4000Hz = 0dB
98
Q

What should you take into account during masking in B/C testing?

A

Occlusion effect (OE)

99
Q

What is puretone audiometric criteria for normal hearing?

A

A/C and B/C within 15 or 25dB
A/C = B/C
Air/Bone difference is more than 10db because that would make it clinically insignificant

100
Q

What is the puretone audiometric criteria for conductive hearing loss?

A

B/C = normal
A/C = abnormal
A/C # B/C
Air-bone difference is greater than 10dB because that would be clinically significant
An example of this would be: otitis media

101
Q

What is the puretone audiometric criteria for sensorineural loss?

A 
A/C = abnormal
B/C = abnormal
A/C = B/C
Airbone difference is less than 10dB because that is clinically insignificant
Example: presbycusis
102
Q

What is the puretone audiometric criteria for mixed loss?

A 
A/C = abnormal
B/C = abnormal
A/C # B/C
Airbone difference is greater than 10dB because that is clinically significant
Ex. presbycusis plus otitis media
103
Q

What was the frequency and threshold that ASHA required public schools to screen at when looking for hearing loss in 1984? What kind of criteria did the tests hold?

A

1000 Hz, 2000Hz, 4000Hz at 20 dB HL

pass/fail criteria
- fail to respond at any frequency in either ear

104
Q

Degree of loss as “mild” or “severe” is objective or subjective?

A

subjective because degree of loss is not a direct correlation of hearing loss

105
Q

What is the purpose speech reception threshold (SRT)?

A
  1. validate puretone thresholds at 500, 1000, and 2000Hz (called the “puretone average/PTA”)
  2. Baseline for speech discrimination test
  3. Hearing aid evaluation for gain prescription
106
Q

Review public school guidelines for screening.

A

Review public school guidelines for screening.

107
Q

What pitfalls should you avoid in a hearing screening?

A
  1. child observing the dials
  2. examiner giving visual clues (eye or head movement, facial expressions)
  3. incorrect earphone and/or headband placement
  4. unclear instructions
  5. test tone: too short or too long
108
Q

What would an audiogram showing a conductive type of hearing loss indicate?

A

impaired bone conduction, normal bone conduction

109
Q

What would an audiogram showing a mixed type of hearing loss indicate?

A

impaired bone conduction and an air bone gap

110
Q

What is the frequency range for bone conduction on most audiometers?

A

250Hz - 4000Hz

111
Q

What is the maximum testing hearing level for bone conduction on an audiometer?

A

less than for air conduction

112
Q

What would an audiogram showing a sensorineural hearing loss indicate?

A

impaired air conduction and no air-bone gap

113
Q

What is the frequency range for air conduction on most audiometers?

A

125 to 8000Hz

114
Q

For figure 3A-4 at 500Hz, the conductive portion of the hearing loss in the right ear is ____ dB.

A

30

115
Q

For figure 3A-4 at 2000Hz, the conductive portion of the hearing loss on the right ear is ____ dB.

A

-5

116
Q

For figure 3A-1 at 2000Hz in the left ear, BC is 5dB poorer than AC. What does this suggest?

A

normal variability and may be ignored

117
Q

For figure 3A-2 at 4000Hz in the left ear, what is the loss?

A

completely conductive

118
Q

In determining the pure tone average, what audiometric frequencies are used?

A

500, 1000, 2000Hz

119
Q

An apparent sensorineural hearing loss with an air bone gap only at 3000 Hz and 4000Hz is probably due to____.

A

acoustic radiations from the bone-conduction vibrator

120
Q

If an audiogram is properly constructed, the distance across of one octave should be the same as the distance down of ____.

A

20dB

121
Q

Tactile response to pure tones may be seen when stimuli are_____.

A

bone conduction and air conduction

Partha Fall 2014 (2 decks)

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