Final Exam

Question 1

The typical probe tone for tympanometry is:

A.) 300 Hz

B.) 275 Hz

C.) 226 Hz

D.) 400 Hz

E.) 700 Hz

Answer 1

C - 226 Hz

Question 2

When conducting tympanometry on infants, it is best to use either ____ Hz or _____.

Answer 2

800 / 1000

Question 3

This is the measurment of tympanic membrane and middle ear mobility

Answer 3

Static immittance

Question 4

Normative data for adults:

Mean: ____ mmho

___% range = ___ to ____ mmho

Answer 4

0.8 / 90/ 0.3/ 1.4

Question 5

Normative data for children:

Mean: ____ mmho

____% range: ____ to ____ mmho

Answer 5

0.5 / 90 / 0.2 / 0.9

Question 6

True or False: Ear canal volume normative data for adults is: mean - 1.5 mL

Answer 6

True

Mean: 1.5mL

90% range: 0.6 to 1.5 mL

Question 7

Ear Canal Volume Normative Data for children:

Mean: ____ mL

90% range: _____ to _____ mL

Answer 7

0.7 / 0.4 / 1.0

Question 8

As suggested by ASHA you take the tympanometric shape by using the ____ of the tympanogram at the ___% amplitude point.

Answer 8

width / 50

Question 9

Normative for tympanometric width for adults:

Mean: ___ daPa

90% range: ____ to ____ daPa

Answer 9

80 / 50 / 110

Question 10

Normative data for tympanometric width for children:

Mean: ____ daPa

90% range: ____ to _____ daPa

Answer 10

100 / 60 / 150

Question 11

Answer 11

Normal

Question 12

Answer 12

Type As : normal middle ear pressure with decreased static compliance (hypomobile tympanic membrane)

Question 13

Answer 13

Type Ad : normal middle ear pressure with increased static compliance, hypermobile tympanic membrane

Question 14

Answer 14

Type B: flat tympanogram, signs of middle ear effusion or perforation

Question 15

Answer 15

Type C: excessive negative pressure; eustachian tube dysfuntion or middle ear pathology

Question 16

Answer 16

a : Vec normal –> M.E. effusion

b: Vec small –> improper placement of cerumen
c: Vec large –> perforation of PE tube

Question 17

These three things affect tympanometry measurement:

Answer 17

tympanic membrane size, thickness, and angle

mastoid pneumatization

ear canal wall stiffness

Question 18

True or False: as the tympanic membrane becomes thinner, it becomes less stiff and more compliant

Answer 18

True

Question 19

True or False: Instead of using 226 Hz tone for infants, it is recommended to use 800 or 1000 Hz to see true tympanometry

Answer 19

True

Question 20

What is the source of the otoacoustic emissions?

Answer 20

Outer Hair Cells

Question 21

OHC motility generates movements of the __ and fluid in the cochlea

Answer 21

Basilar Membrane

Question 22

There are two types of emissions (OAEs):

Answer 22

spontaneous

evoked

Question 23

True or False: Evoked Otoacoustic emissions are a threshold measure.

Answer 23

False

Question 24

True or False: Transient Evoked Otoacoustic Emissions are presented with two tones and a distortion production

Answer 24

False - Distortion Product OAEs present two tones and the distortion product is only used for measure

Question 25

True or False: DPOAE is broadspectrum

Answer 25

False - TEOAE are broadspectrum DPOAE are frequency specific

Question 26

True or False: The stimulus for TEOAEs are short clicks (broadband)

Answer 26

True

Question 27

The measured tone for DPOAE is done by: \_f1 - f2

Answer 27

2 i.e. F1 = 1500 ; F2 = 2000 2(1500) - 2000 3000 - 2000 = 1000 Hz

Question 28

True or False: DPOAEs are created due to the interaction of two pure tones presented at the same time

Answer 28

True

Question 29

True or False: Infants have low amplitude, and narrowband spectrum emissions

Answer 29

False - high amplitude; broadband

Question 30

True or False: Some clinical considerations mentioned by Widen (1996); you should imittance first before you do OAEs

Answer 30

True - check for middle ear effusion

Question 31

The tools for measuring OAE: the ____ : delivers the working stimulus the ____ : records the emissions

Answer 31

transducer microphone

Question 32

True or False: For TEOAEs there are two separate transducers when conducting measurments

Answer 32

False ; only for DPOAE

Question 33

In TEOAE, the recorded response goes through a amplifier, filter, and \_\_\_\_\_\_\_.

Answer 33

time averager

Question 34

In DPOAE, the recorded response goes through an amplifier, filter, and a \_\_\_\_\_\_\_.

Answer 34

spectrum analyzer

Question 35

OAEs for pediatrics is useful for the following reasons: ## Footnote A.) Neonatal hearinig screening B.) Predicting hearing status or for pseudohypoacoustic patients C.) Montior cochlear status during ototoxic drug administration D.) Distinguish from retrocochlear hearing loss E.) all of the above

Answer 35

E -all of the above

Question 36

True or False: ABR is the most common AEP used for diagnostic purposes

Answer 36

True

Question 37

AEP is divided into three segements: \_\_\_\_ : 1 to 10 msec \_\_\_\_\_ : 10 - 100 msec \_\_\_\_\_ : 100 - 1000 msec

Answer 37

ABR / MLR / LLR Auditory brainstem response / middle latency response / long latency response

Question 38

AEP is defined as:

Answer 38

measure of synchronous electrical imipulses of the auditory pathway in response to an auditory stimulus

Question 39

The following are recorded responses rarely seen in infants and children: ## Footnote A.) MLR B.) ECoG C.) CAEP D.) LLR E.) all of the above

Answer 39

E - all of the above

Question 40

Match the ABR Wave Generators: Waves I - V ## Footnote A.) Wave I Inferior Colliculus B.) Wave II Cochlear Nucleus C.) Wave III Lateral Lemniscus D.) Wave IV VIIIth Nerve E.) Wave V Superior Olivary Complex

Answer 40

A.) Wave I - VIIIth Nerve B.) Wave II - Cochlear Nucleus C.) Wave III - Superior Olivary Complex D.) Wave IV - Lateral Lemniscus E.) Wave V - Inferior Colliculus

Question 41

The interwave latencies for Waves I - III are:

Answer 41

about 1.5 - 4 msec

Question 42

The interwave latencies for Waves I - V are:

Answer 42

about 1.5 - 5.5 msec

Question 43

The interwave latencies for waves III - V are:

Answer 43

about 4 - 5.5 msec

Question 44

Maturation of the Auditory System: True or False: Maturation begins at the periphery - adult-like at birth

Answer 44

True

Question 45

Maturation of the response and latency of the ABR waveforms reaches around: ## Footnote A.) 18 months B.) 15 months C.) 24 months D.) 10 months E.) 20 months

Answer 45

C - 24 months (2 years)

Question 46

Brief stimulus or broad spectrum consists of what type of sounds?

Answer 46

Click tone burst

Question 47

True or False: Clicks consists of a duration of 5 msec

Answer 47

False - .1 msec (100 micro seconds) \*elicits response from the basal end of the BM (between 2 and 4 kHz)

Question 48

What is the difference between a tone burst and click?

Answer 48

Clicks last for .1 msec and is great for eliciting response from the Basilar of the BM Tone Bursts are sinusoidal which last 5 msec and are great threshold estimation at specific frequency regions

Question 49

What are the three main uses for ABR?

Answer 49

1 - Neonatal hearing screening 2 - Evaluate hearing 3 - Dx evaluation of the integrity of the neural pathway

Question 50

What are the ABCs of High Risk Register for deafness?

Answer 50

A - asphyxia B - Bacterial Meningitis C - Congenital Perinatal Infections D - Defects of head and neck E - Elevated bilirubin F - Family History G - gram birth weight

Question 51

What are newborn hearing screening techniques?

Answer 51

OAE (Otoacoustic Emissions) ABR (Auditory brainstem response) Two Stage (OAE + ABR)

Question 52

Explain the procedure of OAE

Answer 52

sounds are presented to ear canal and a small microphone measures the response in the ear canal avg. test time is 5-15 minutes

Question 53

Explain the procedure of ABR

Answer 53

sounds are presented to the ear and surface electrodes measure an EEG type response from the auditory nerve. a response from the nerve constitutes a pass avg. time to complete: 20 minutes

Question 54

Explain two stage OAE + ABR

Answer 54

babies who fail the OAE screening receive an ABR screening prior to leaving the hospital in some facilities, 2 stage process may include a second OAE screening within 24 hours beforer procedding with ABR.

Question 55

What if infant fails UNHS?

Answer 55

babies who fail initial hearing screening will actually have normal hearing

Question 56

What is the role of the 'medical home'?

Answer 56

as clinicians we need to understand testing results at screening and diagnostic phases and implications to follow up assure follow-up screening: refer for diagnostic and medical specialty evaluations support family in understanding severity and type of hearing loss

Question 57

What are some useful recommendations offered by JCIH?

Answer 57

check for auditory skills, middle ear status, dev. milestones, parental concerns (in each visit) - if concerned, refer to audiologist and SLP for evaluationi - if hearing loss is eval'd, refer siblings of infant for audiological evaluatioin - refer infants with any RISK factors

Question 58

What are some follow-up testing procedures?

Answer 58

\*referral for follow-up testing : repeat OAE/ABR testing \*if hearing loss still suspect: refer to ped. audiologist, use freq. specific ABR to estimate degree and config. of hearing loss

Question 59

True or False: The hearing screening for school age children is a threshold measure

Answer 59

False

Question 60

What are you actually doing when conducting hearing screening on school-age children?

Answer 60

\*screen for presence of hearing loss \*screen for presence of middle ear dysfunction

Question 61

According to the ASHA guidelines:

Answer 61

\* use pure tone screening \*screening level or "fence" 20 dB HL \*frequencies - 1000, 2000, 4000 Hz

Question 62

True or False: A failure is considered in any frequency in both ears

Answer 62

False - a failure is considered in any frequency *in one ear*

Question 63

During the immittance screening a clinician should be:

Answer 63

looking for middle ear dysfunction; not a hearing loss \*may need to refer to do tympanometry

Question 64

True or False: A failure in immittance screening is considered when you get a flat tympanogram in both ears

Answer 64

False - a failure in immittance screening is considered when you get a flat tympanogram in any ear