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AUDE 5240 > midterm 2 > Flashcards

midterm 2 Flashcards

1
Q

important factors of sound field testing

A

-it is the best ear responding
-placement of the patient and the speakers are specifically calibrated, marker on the ceiling and/or floor for reference, nothin should be between the loudspeaker and the patients ear, and use a warbler tone

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2
Q

how do you test for re-test ability

A

go back to 1,000 Hz to check if the threshold is the same as the one that was received originally
-within 5 dB is acceptable as good, but should be marked on the audiogram
-conduct midway through testing (so before advancing to the low frequencies)

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3
Q

what is acceptable variation for a test to be considered reliable

A

variation within methods will occur, however if they are validated that is okay
-within the clinic setting or within the field, explain the method to others if they have a varying method that is altered from the one you use

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4
Q

is it okay to note the lower threhsold when testing for re-test ability

A

yes, a lower threshold is accepted

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5
Q

pattering

A

the act of presenting stimuli in a rhythmic manner

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6
Q

why must pattering be avoided

A

the patient may pick up on the pattern and therefore the test will not be valid

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7
Q

extended high frequencies

A

above 8000 Hz

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8
Q

dB sensation levels of soft, relatively comfortable and potentially too loud

A

typically 40-60 dB HL is comfortable
-60 dB HL or above may cause discomfort

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9
Q

factors that affect pure tone test results

A

patient observing dials, vague instructions, overly long test sessions, incorrect adjustment of headband/earphone placement, and pattering

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10
Q

why are max. permissible ambient sound pressure levels different for different transducers

A

ANSI sets the standards
-different rules apply for headphones, bone conduction, and sound field assessments
-each type of earphone or speaker undergoes separate calibration

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11
Q

disadvantages of supra-aural earphones

A

there is the possibility of a collapsed ear canal, creation of an occlusion effect, leakage of sound, narrow frequency response, poor ambient noise attenuation, and awkward during bone conduction masking

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12
Q

when would supra-aural earphones be indicated (in other words when should inserts be contraindicated)

A

anomalies in ear structure, an ear that exhibits drainage, and the accumualtion of significant earwax

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13
Q

when are circumaural headphones required to be used

A

-extended high frequencies
-enhanced frequency response, particularly for extended higher frequencies

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14
Q

advantages of insert earphones

A

fit/comfort, can fit all but unusual ear canals, ambient noise attenuation, works better for masking
-note these benefits are only present with proper placement

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15
Q

insertion depth for inserts

A

completely within the canal

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16
Q

potential consequence of shallow insert insertion

A

elevated thresholds (within low frequencies especially) and masking benefits disappear

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17
Q

why should you perform otoscopy before placing a transducer on a patient

A

ensures a healthy ear canal for accurate hearing tests
-assess the ear canal condition, size, shape characteristics
-prevents potential harm
-identifies any issues

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18
Q

why should we place a transducer on the patient rather than letting them do it

A

inaccurate placement may impact the accuracy of test results

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19
Q

air conduction transmission route

A

sound waves go into your ear canal, make eardrum vibrate, vibrations move ME bones, bones amplify vibrations and send them to the inner ear, and then the inner ear converts them to electrical signals for your brain to understand

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20
Q

bone conduction transmission route

A

sound travels through the bones and fluids of the skull, skull bones vibrate and transmit the sound to both inner ear, inner ear turns vibrations into electrical signals for your brain

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21
Q

three bone conduction mechanisms

A

distortional, inertial ossicular, and ear canal oseotympanic

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22
Q

distortional mechanism

A

skull vibrating
-cochlea is stimulated
-bones of the skull are vibrating in phase with the stimulus
-BM is displaced

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23
Q

inertial ossicular mechanism

A

ossicular chain
-ossicles are suspended within the middle ear and they vibrate if the skull vibrates
-stapes move in and out of oval window

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24
Q

ear canal oseotympanic

A

how the ear canal is involved
-sound energy escapes from the un-occluded ear
-occlusion effect

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25
Q

what frequencies should be tested with bone conduction

A

any frequency except for 6000 and above

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26
Q

bone conduction transducer limits

A

-250 Hz is 45 dB
-500 Hz is 60 dB
-all the rest are 70 dB HL

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27
Q

what should be done if BC thresholds are poorer than AC

A

check for issues with the equipment or calibration
-confirm that the bone oscillator is placed properly
-repeat the threshold where found
-note on audiogram
-test on other side if need be

28
Q

vibrotactile responses

A

when a patient feels the vibration of the bone conduction oscillatory without actually hearing the sounds
-common at lower frequencies

29
Q

normal limits hearing

A

-10 dB to 15 dB

30
Q

conductive hearing loss

A

-AC elevated
-BC normal
-air bone gaps presents

31
Q

mixed hearing loss

A

-AC and BC elevated
-air bone gaps present

32
Q

sensorineural hearing loss

A

-AC and BC elevated
-no air bone gaps

33
Q

normal hearing

A

-10 to 15

34
Q

slight hearing loss

A

16 to 25

35
Q

mild hearing loss

A

26 to 40

36
Q

moderate hearing loss

A

41 to 55

37
Q

moderately severe hearing loss

A

56 to 70

38
Q

severe hearing loss

A

71 to 90

39
Q

profound hearing loss

A

above 90

40
Q

general purpose of clinical masking

A

to prevent the participation of the NTE within the hearing evaluation

41
Q

attenuation

A

decrease in sound amplitude
-from point A to point B

42
Q

what can cause attenuation

A

decrease due to distance and decrease due to sound absorption

43
Q

audibility

A

if the sound is audible or perceivable by the ear
-are they hearing it

44
Q

how to determine if a tone will be audible

A

if the sound level is greater than or equal to the hearing threshold, then it will be audible

45
Q

shadow curve

A

this occurs when the AC threshold in the poorer ear follows the shape of thresholds in the better ear
-occurs with sound crossing over and the better ear is responding

46
Q

noise for masking pure tones

A

narrow band noise

47
Q

potential consequences of incorrect masking

A

incorrect diagnosis of the type and severity of HL
-improper treatment

48
Q

3 factors that influence the amount of interaural attenuation

A

the patient, the transducer, and the frequency of the stimulus

49
Q

minimum IA values for BC

A

0 dB

50
Q

minimum IA values for supra-aurals

A

40 dB

51
Q

minimum IA values for circumaurals

A

40 dB

52
Q

minimum IA values for inserts

A

60 dB

53
Q

undermasking

A

not enough masking

54
Q

adequate masking

A

valid masked threshold obtained
-successfully raised and heard the tone 3x in a row

55
Q

overmasking

A

too much masking
-will have to increase the presentation tone

56
Q

plateau

A

the point of which the threshold in the test ear does not change with increases in the masking level
-if you increase the noise without changing the threshold, you are masking correctly

57
Q

effective masking level (dB EML)

A

the masking noise level that ensures there is a plateau when masking
-helps in making it harder to hear the tone in the NTE

58
Q

occlusion effect

A

happens when the ear canal is blocked (occurs with something in the canal) and what is occurring is that whatever is in the canal the sound will be bouncing off that item and basically a dying to whatever sound is already in there
-the difference between the one being occluded and the one that is not occluded

59
Q

when is masking needed for BC

A

if there is an ABG of 15 dB or greater
-ABG between unmasked BC to AC threshold

60
Q

when is masking needed for AC

A

when the unmasked TE threshold is:
-40 dB above NTE BC for supra’s
-60 dB above NTE BC for inserts

61
Q

what is the starting masking level for AC

A

NTE AC threshold + 10 dB safety factor

62
Q

what is the starting masking level for BC

A

NTE AC threshold + 10 dB safety factor + occlusion effect

63
Q

occlusion effect numbers

A

supra’s : 15 dB for 250 and 500 Hz, 10 dB for 1000 Hz
inserts : 10 dB for 250 and 500 Hz

64
Q

anytime masking is needed, what is the starting level of the TONE

A

unmasked threshold

65
Q

tone refers to the and the masking level refers to the

A

tone is what you present in the test ear and masking level is the noise you play into the NTE

AUDE 5240 (2 decks)

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