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Audiological Procedures > Final Exam!! > Flashcards

Final Exam!! Flashcards

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1
Q

What is interaural attenuation?

A

The difference in intensity between the stimulus delivered to the TE and the amount heard in the NTE

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2
Q

What are the different IA values?

A

BC vibrator: 0 dB

Supra-aural headphones: 40 dB

Insert earphones: 55 dB

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3
Q

When do you need to mask?

A

If the difference between the two ears at the same frequency is greater than the interaural attenuation

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4
Q

What is the initial masking level?

A

The initial masking level is always 10 dB above the NTE AC

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5
Q

What is the minimum masking level?

A

The lowest level of masker that begins the plateau

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6
Q

What is the final masking level?

A

The highest level of masker used in defining the plateau

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7
Q

When are you overmasking?

A

When the masking sound exceeds the IA

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8
Q

What does the occlusion effect do, and where does it occur?

A

Occlusion effect creates a false improvement in BC thresholds in the low frequencies

Only a concern with supra-aural headphones

Only occurs at 250, 500, and 1000 Hz (add 20, 15, or 5 dB to the initial masking level, which is already 10 above the threshold)

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9
Q

What is central masking?

A

When there is a small elevation in the TE threshold - 5 dB roughly (likely due to a CNS reaction to the masking noise)

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10
Q

What does tympanography test?

A

The middle and outer ear

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11
Q

What is a type A tympanogram?

A

A normal one

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12
Q

What is a type Ad tympanogram?

A

High peak admittance, suggests ossicular disarticulation or a flaccid tympanic membrane

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13
Q

What is a type As tympanogram?

A

Low peak admittance, suggests otosclerosis or tympanic membrane scarring

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14
Q

What is a type B tympanogram?

A

No peak, flat, suggests middle ear fluid, tympanic membrane perforation, or impacted cerumen

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15
Q

What is a type C tympanogram?

A

Negative peak, suggests eustachian tube dysfunction

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16
Q

What is an acoustic reflex threshold?

A

The lowest intensity level that elicits a repeatable reflex

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17
Q

What does an acoustic reflex measure?

A

The involuntary contraction of the stapedius muscle when stimulated by loud sounds

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18
Q

What are the 3 rules to elicit an acoustic reflex?

A

The probe ear can’t have any outer or middle ear pathology

The stim ear has to receive a tone that’s loud enough

The integrity of the neural pathway must be adequate to activate the stapedius muscle contraction

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19
Q

What are the notes concerning the integrity of the nueral pathway for ARs?

A

Concerning 8th nerve disorders
- Present: stim is in the opposite ear
- Absent: stim is in the ear with the disorder

Concerning 7th nerve disorders (Bell’s Palsy), when the probe ear has the disorder
- Present: the problem is distal to the stapedial branch of the 7th nerve
- Absent: the problem is proximal to the stapedial branch of the 7th nerve

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20
Q

What do present OAEs suggest?

A

Normal cochlear function

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21
Q

What moves to give us OAEs?

A

The outer hair cells of the cochlea

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22
Q

Can OAEs tell us the degree/amount of hearing loss?

A

NOPE

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23
Q

What are ABRs related to?

A

The brainstem

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24
Q

What is signal averaging?

A

When the computer enhances the evoked response and minimizes the background electrical activity

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25
What anatomical structures create the ABR waves?
Wave I: 8th-distal Wave II: 8th-proximal Wave III: cochlear nucleus Wave IV: superior olivary complex Wave V: lateral lemniscus and inferior colliculus
26
How is the latency of ABRs affected by intensity, rate, and frequency?
Intensity: latencies increase as intensity decreases Rate: latency of wave V increases as rate increases (lower rate = better wave morphology) Frequency: latency of wave V increases as the frequency of the tone burst decreases
27
What are ABRs used for?
To ID nerve pathologies
28
What will an acoustic neuroma look like on an ABR?
Acoustic neuroma on the proximal portion of the 8th nerve will see wave I present and all other waves absent
29
What is the purpose of a hearing screening?
To determine if an individual needs further testing/to identify individuals who may have a hearing loss
30
Who are the target populations for hearing screenings?
Those who don’t know they have a problem (newborns and young children) Those who aren’t able to or are reluctant to get the services they need (elderly) Employees at risk for NIHL
31
What is reliability?
When testing again gets the same results
32
What is validity?
When the test is capable of measuring what it's supposed to measure
33
What are the three criteria for screening populations?
They do not show or act upon symptoms of the disorder There is a good chance of finding those with the disorder The disorder is important enough to identify in the larger population
34
What is the 1-3-6 rule?
1 (screened by one) -3 (diagnosed by three) -6 (fit with a device and enrolled by six)
35
What is the goal of UNHS?
To identify permanent hearing loss
36
What is sensitivity?
How well the test correctly identifies the disorder TP/TP + FN
37
What is specificity?
How well the test correctly identifies those without the disorder TN/TN + FP
38
What is the positive predictive value?
The level of confidence you have in the true positive outcome TP/TP + FP
39
What is the negative predictive value?
The level of confidence you have in the true negative outcome TN/TN + FN
40
What are the steps of hearing aid selection and fitting?
Assessment Treatment planning Selection Verification Orientation Validation
41
What are the hearing aid components?
Microphone - Collects acoustic signals from the environment - Converts signals into electrical signals that are sent to the amplifier Analog-to-digital conversion (ADC) - Turns electrical signals into digital components Amplifier - Signal is amplified and filtered Digital-to-analog conversion Receiver - Amplified electrical signal to acoustic signal - Sent into ear canal
42
What are some hearing aid styles?
CIC (completely in canal) ITC (invisible in the canal) ITE (in the canal) BTE (behind the ear Body aid
43
Tell me about the ITC HA.
Fills lower ¼ of concha Not as powerful as ITE Smallest size that accommodates directional mics For those with: - Less hearing loss - Good dexterity - Possible cosmetic concerns
44
Who is the traditional BTE used for?
- Infants and children - Severe to profound hearing losses - Visual or dexterity problems
45
Tell me about the body aid.
- Developing countries - Body-worn unit with microphone - No DSP (digital signal processing)
46
How does a cochlear implant work, and who is it for?
Function: converts acoustic signals into electrical signals and sends them directly to the nerve Used for severe to profound bilateral hearing loss (corner audiogram) Unsuccessful hearing aid trial
47
Tell me about a bone-anchored implant.
For those with bilateral conductive, mixed hearing loss, and single-sided deafness Can be either: - Percutaneous (direct-drive) - Transcutaneous (skin-drive) Model examples: Baha Connect, Baha Attract, Ponto Baha Softband is used for those too young to undergo surgery How it works: vibrations through the bone go to the cochlea
48
Tell me about a middle ear implant.
Stable SNHL (less than or equal to 65-70 dB) Piezoelectric method How it works: electrically encoded signals are sent to a middle ear crystal on the ossicular chain
49
What do we see for Meniere's?
Rising sensorineural hearing loss (unilaterally) Normal tymps Low-pitched tinnitus Severe vertigo Aural fullness Fluctuating hearing loss
50
What do we see for otosclerosis?
Rising conductive loss Normal or shallow tymps Absent acoustic reflexes
51
What do we see for otitis media?
Conductive loss ECV is normal Flat tymps Otoscopy shows no cerumen and a reddened TM Symptoms: fever, ear pain, difficulty hearing, tugging on ears, change in school performance
52
What do we see for NIHL?
Notched hearing loss Tinnitus
53
What do we see for presbycusis?
Sloping sensorineural hearing loss Normal tymps High-pitched tinnitus Difficulty hearing in background noise
54
What do we see for a cholesteotoma?
Conductive loss Otoscopy: no cerumen, whitish mass behind the TM Flat tymps
55
What do we see for an acoustic neuroma?
Slight or more sloping sensorineural hearing loss High-pitched unilateral tinnitus Difficulty understanding speech in affected ear Some dizziness Absent acoustic reflexes in affected ear
56
What do we see for ossicular disarticulation?
Conductive loss Type Ad tymps
57
What do we see for ototoxicity?
Hearing loss sudden drop/slope High-pitched tinnitus Usually the patient is very sick from other medical conditions that warrant medications
58
What do we see for malingering?
Straining behavior IA values exceeded without masking Responds with half-spondees
59
What do we see for a tymp perforation?
ECV is large Tymps are flat
60
What do we see for auditory neuropathy spectrum disorder?
Acoustic reflexes are absent OAEs are present ABR is absent WRS is poor
61
What do we see for SSNHL?
Severe sensorineural hearing loss in one ear Sudden Tinnitus and aural fullness
62
What do we see for enlarged vestibular aqueducts?
Sudden drop at 4k ARTs are present

Audiological Procedures (3 decks)

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