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AUDE 5450 AMP 1 > Practical > Flashcards

Practical Flashcards

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1
Q

what are the goals of earmold impression

A

go 2mm beyond bend
stretch aperature

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2
Q

what should you do first for earmold impressions

A

wash hands

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3
Q

what is important before starting impressions

A

case history

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4
Q

what should you ask for case hx

A

have they had surgery on their ears? if so what?

are they taking any blood thinners?

are they diabetic or immunocompromised?

do they have any allergies

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5
Q

should you stand for otoscopy

A

no sit

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6
Q

foam block

A

slightly larger than EAC entrance

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7
Q

cotton block

A

same size as EAC entrance

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8
Q

what are you looking for on otoscopy after inserting the otoblock

A

Ensure block is tight in canal with no gaps - foam blocks should be compressed
Ensure removal string is in the center of the block not at an angle

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9
Q

what are otoblock precautions

A

Perf
Ensure NO GAPS present bw canal wall and block
PE Tube
Aggressive block depth may cause pain/damage
Mastoidectomy/Widening Canal
Might require more than one block to fill canal
If insertion beyond the isthmus suddenly becomes easier it is a clear sign of a widening canal

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10
Q

can you use gloves to mix earmold material

A

no

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11
Q

how to do a single open jaw impression

A

place in mouth horizontally on side of impression

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12
Q

how do you do a bilateral open jaw impression

A

place vertically in center of mouth

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13
Q

why do we do open jaw impressions

A

Increase size of aperture for a snugger fit - condyle of mandible moves forward and pulls the anterior canal wall

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14
Q

what are you looking for on earmold impression after removal

A

Are concentric circles present?
Is the valley filled?
Is the Concha cymba filled?
Is the Concha cavum filled?
Does material reach the otoblock?
*Does the canal length meet requirement/ patient’s needs

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15
Q

for earmold modifications what is the blue stone for

A

Course
Used to modify silicone
Need to use at least 25k to 20k RPM for best results

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16
Q

what is the white stone for for eaermold modifications

A

For grinding acrylic or vinyl
Smaller one is for smaller areas

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17
Q

low grit

A

removes a lot fast

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18
Q

medium grit

A

less material & smoother finish

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19
Q

fine grit

A

smooths & restores shine
only used w/ lucite/acrylic

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20
Q

Factors to Consider When Selecting a HA Style

A

Fitting range- can the style supply sufficient output?
Pinna effect- will the microphone placement enhance or reduce spectral cues?
Likelihood that the style will cause feedback or occlusion?
Wind noise-will the wind to produce turbulence inside the microphone?
Will the size of the patient’s ear canal limit the output or size of controls?
Will perspiration, cerumen, and humidity impact device function?

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21
Q

Realistic fitting ranges are impacted by

A

Proximity of microphone to receiver
smaller devices produce less output
Size of receiver
larger receivers produce greater output
Physical properties of sound bore (length, diameter)
Vent size
Microphone location
Proximity to tympanic membrane

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22
Q

Near normal low frequency hearing typically doesn’t require an amplified signal because the intensity of a “direct signal” is audible without amplification

A

true

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23
Q

what vent size should match 50-60 dB loss @ 500 Hz

A

.5 to no

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24
Q

what vent size should match 40-49 dB loss @ 500 Hz

A

1-2mm

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25
what vent size should match 30-39 dB loss @ 500 Hz
2-3mm or power
26
what vent size should match 20-29 dB loss @ 500 Hz
3-3.5 mm or closed
27
what vent size should match
open dome
28
what is the OE
Increased perception of ones own voice when there is something blocking the ear canal
29
what causes the OE
Dome closing off the ear Mold with a vent that isn’t large enough
30
what is feedback
too much amplified sound that leaks back out
31
what causes feedback
Too large of a vent = sound escaping and recycles back into the microphone Creates a cycle/loop Makes a squealing sound Need tighter earmold or vent
32
As receiver gets closer to the mic -
less output = smaller devices because it drives feedback
33
what is the pinna affect
Pinna adds natural gain & spatial awareness cues & decreases wind noise Effets boosts of HF signals by ~7 dB SPL The deeper the microphone is in the ear canal the greater the effect
34
what type of HA gives the pinna effect
CIC/IIC
35
Combination of deep mic placement & deep fit device increase output by
~13 dB SPL
36
When volume b/w ™ & receiver reduces the output increases by
~6 dB SPL
37
what increases the devices output
sound bore proximity to the TM
38
what does an IP68 mean
IP68 Dust light Protects against long periods of liquid immersion
39
-10 to 15 dB
nornal
40
15-25
slight hl
41
25-40
mild hl
42
40-55
moderate hl
43
50-70
mod severe hl
44
70-90
severe hl
45
>90
profound hl
46
what degree of hearing does BTE fit
all -10 to profound
47
what degree of hearing does slim tube fit
mild to mod hl -10 to 55
48
what degree of hearing does ric fit
min to severe hl -10 to 90
49
what degree of hearing does ITE full shell fit
normal LF to mod sev hl -10 to 70
50
what degree of hearing does ITC fit
slight lf to mod sev hl 20-70
51
what degree of hearing does CIC fit
mild to mod sev hl 25-70
52
what degree of hearing does IIC fit
mild to mod severe 30-70
53
what is a cros HA
Contralateral routing of sound Single sided deafness - one ear is normal and poorer ear is unaidable One good ear and one bad
54
what is bicros
Bilateral contralateral routing of sound Bilateral asymmetric HL - one ear has threshold loss & poorer ear is unaidable Both ears are bad, asymmetry HL
55
for bicros or cros when the PT wears the devices will they get binaural hearing?
No because they still only have one ear and will not have spatial awareness
56
what is ampcros
For asymmetric HL bad and better ear bad ear is not good for hearing aids (poor discrimination etc.) but not unaidable fits two HA’s on the PT’s ear but in the two is a transmitter so you amplify both ears but then also routing the poor ear over to the other ear for extra boost of understanding when you fit HA’s to both ears but they also transmit a signal to the opposite ear
57
what loss is full shell for
challenging to insert max retention severe/profound - 70-90 high gain aids
58
skeleton mold
popular easy to insert & discrete max retention mild to severe - 25-90
59
canal mold
easy insertion cosmetically nice retention needs 2mm beyond 2nd bend mild to sev - 25-90
60
canal lock
easy insertion cosmetics w/ retention mild to severe - 25-90
61
half shell
easy insertion easy retention mild to severe - 25-90
62
all shells are mild to severe fitting except
full shell fits to profound
63
when can an open dome be used
normal hearing to 1500 w/ HF loss
64
when can a closed/tulip coupler be used
thresholds
65
when can a power dome be used
thresholds
66
If HL 50dB or more in low frequencies you have to have
mold
67
what is an alternative to stock open dome couplers
custom open mold
68
who is vinyl good for
infants those w/ dexterity issues high gain devices
69
who is silicone good for
peds high gain devices allergiesw
70
who is lucite good for
adults mild-severe loss soft pinnas
71
advantages of vinyl
snug fit needed for high gain devices cemented tube needs less canal space easily modified
72
disadvantages of vinyl
shrinks hardens discolors replace every 6-12 mos
73
advantages of silicone
durable doesn't shrink hypoallergenic snug fit for high gain
74
disadvantages for silicone
sticky material can cause discomfort hard to modify cannot glue tubing more expensive
75
adv of acrylic
durable no shrinking easy insertion & removal
76
disadv of acrylic
cannot move w/ ear canal turns & narrowing increased feedback w/ movement physical injury if hit
77
common use of acrylic
adults floppy soft pinnas
78
common use for vinyl
pediatric firm ear texture
79
common use for silicone
high gain aids allergies facial flex issues
80
A change to the internal diameter will change the device output and frequency response
true
81
what is the diff bw 12 & 13 inner diameter?
12 is thicker and bigger opening 13 has a smaller opening
82
smaller diameter of inner tube =
more attenuation there is in high frequency signals
83
what is a tube lock
Used w/ silicone Grommet used to increase friction fit into the mold
84
waht is a libby horn
gives a boost in the high frequencies
85
what is a continuous flow adapter
Small canals that can’t fit standard tube size Keeps internal diameter of sound bore bw BTE & earmold to provide a continuous inner diameter & unimpeded flow of amplified signal
86
what is dry tubing and why is it used
Reduces moisture buildup problems in tubing in humid environments or those who perspire a lot
87
thin/heavy cement
lucite acrylic
88
uses vinyl cement
vinyl
89
walk through silicone retubing
Cut the tube where it enters the earmold as close as possible Take the screwdriver tool and push the tubing out of the mold Push the threader through the sound bore side Feed the new tube through the needle with the quail side up & pull through the sound bore side Make sure the new tubing has the grommet Pull until the grommet meets the wall of the mold. DO NOT PULL FULLY THROUGH Use tool to push and lock it in the sound bore correctly Use the depth line on the tool for reference and push grommet in until it reaches that line Cut the tube at the sound bore as close to the mold as possible without cutting the mold Use the exacto knife
90
walk through retubbing of vinyl & acrylic
Take pliers and try to pull the tube out in one try Use the reemer to push through the sound bore to make sure all pieces are out Size the tubing Once you find the right tube size, find the right cement Lucite/Acrylic uses thin cement Vinyl uses vinyl cement Use a pipe cleaner and dip into the correct cementTake the needle threader and push through the sound bore side. Then take the quail side of the tube through the threader and pull through Make sure the tubing is facing the correct angle Drop a little cement as a final seal on the outside on the base side Use the exacto knife to cut the sound bore tubing without cutting the mold. Check it doesn’t snag
91
Measurement mic that is sealed into the coupler and collects output data from the HA
coupler mic
92
Simulates ITE & ITC products
ha 1 coupler
93
BTE w/ hooks
ha 2 coupler
94
what is the OSPL 90- Output SPL @ 90 dB measured during ansi
This shows output for a 90dB SPL input signal (MPO) Loudest possible output point device can produce for a 90 dB input signal & represents a single frequency
95
what is HFA OSPL 90- HF Avg output SPL @ 90dB measured in ansi
Calculates the average OSPL 90 output for 1, 1.6 and 2.5 kHz *3 triangles at the bottom
96
what is HFA FOG - HF avg full-on gain measured on ansi
Shows avg gain for 1, 1.6, 2.5 for a 50 dB signal Estimates the max gain available at different frequencies when an avg input signal is amplified
97
what is equivalent input noise (EIN)
Measures the internal noise of the HA Noise coming from mic, amplifiers, DSP circuit, receiver etc. Typically 25- 30 dB SPL is acceptable
98
what is total harmonic distortion
Measures signal distortion Determines if output signal contains harmonic frequencies that were not present in the input signal
99
what is % total harmonic distortion
Should be below 5-10% High DL are indicators the device is close to failing (most likely the receiver) & needs sent in for a repair
100
step one: look at manufacturer value on spec sheet step two: look at summary of tolerances step 3: look at data point; is it in or out of spec
true
101
what are the steps for looking at specs
step one: look at manufacturer value on spec sheet step two: look at summary of tolerances step 3: look at data point; is it in or out of spec
102
what is directional mic front to back ratio (FBR)
Compares output of an input signal coming from 0-deg azimuth to the input signal coming from 180-deg azimuth
103
what does directional mic test show
Heavy line - front mic output Light line - back output at the null
104
what is digital noise reduction attenuation ansi
it acts on steady signals (fast modulation rates and low modulation depths) Kicks in for signals that are louder than the first TK Because it looks at the timing elements of the noise (fast mod rate & low mod depths)
105
what is SPLITS
shows output of tcoil in horizontal
106
what is RSETS
difference bw the mic and the tcoil output in horizontal
107
which measures telephone tcoil
horizontal magnetic field SPLITS & RSETS
108
which measures looped t coil
vertical magnetic field SPLIV & RTLS
109
SPLIV
output of tcoil (in vertical)
110
RTLS
difference bw mic and tcoil in verticle
111
horizontal t coil is best for
telephone
112
vertical t coil is best for
loop environment
113
what is the point in the TMFS test
This verifies output from the two transducers is the same & identifies which position the telecoils sensitivity is greatest
114
what is a +RSET
telecoil output it louder than the mic output PT will turn HA down when telecoil is on
115
what is a - RSETS
telecoil ouput is softer than the mic output PT will turn HA up when telecoil is on
116
T indicates mic is off & output is only from tcoil
open dome device
117
mT indicates tcoil & mic output is combined but mic output is softer
severe thresholds
118
MT indicates devices combines tcoil & mic output
equally
119
what is the largest battery size
675 (blue
120
what is the smallest ha size
10 (yellow)
121
what is the most comon size battery
312 brown
122
what is the purpose of a listening chekc
subjective eval of HA, will only pick up significant device malfunction, should perform electroacoustic measure to compare to manufacturer specifications Listening for unusual distorted bad sounds Is it linear or nonlinear Is it directional or omn
123
what are the ling sounds
“ah”, “ee”, “oo”, “sh”, “ss”, “mm
124
why are ling sounds used
tests across the frequency range
125
what is linear on a ha
If there is no change in amplitude from soft to loud
126
what is nonlinear in a ha
Amplitude is louder for soft and softer for loud
127
how do you know its a directional mic
If you turn HA 360 deg and sound attenuates behind HA
128
how do you know its an omnidirectional mic
If you turn HA 360 deg and it doesn’t attenuate from behind
129
what is expansion used for
to lower the output of very soft sounds CR <.9:1
130
what is WDRC used for
needed to get soft sounds louder & expand dynamic range restores loudness perception More sound added to soft signals for audibility, less to moderate signals and minimal to intense sounds so they are perceived as loud without causing discomfort CR 1.1:1 TO 4:1
131
when is output limiting compression used
-need this to protect the ear from loud sounds CR >/= 5:1

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