Puretone Audiometry Flashcards by Hilmarie Tran

What is the range of frequencies that human ears can hear?

20 - 20000 Hz

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Describe different sounds

Tones, Noise, Speech

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Describe perceptions of sound

Pitch is the perception of frequency
Loudness is the perception of amplitude or intensity

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What is psychoacoustics?

Science that deals with the perception of sound

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What is the difference between frequency and pitch?

Frequency is the number of cycles per second while pitch is the perception of frequency

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What are octaves?

A frequency ratio, 2:1
Doubling of frequency

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What is the difference between intensity and loudness?

Intensity is the amount of energy transmitted per second over an area of one square meter (MKS) while loudness is the perception of intensity

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Why do we do puretone audiometry testing?

Provides information on the type of hearing loss and also quantifies frequency-specific threshold elevations due to damage in the auditory system. In this way, the amount of loss can be measured separately between the cochlea and the outer/middle ear, provide information on how well the systems are functioning and narrow down which frequencies are affected

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Define “hearing”

Ability to perceive acoustic signals/sounds

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What are the interoctave rules?

Frequencies between octaves

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What are the four threshold testing methods?

Ascending vs Descending
Method of Limits
Method of Constant Stimuli
Hughson-Westlake

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Describe the Hughson-Westlake method

Described by Carhart and Jerger, 1959
Variation of method of limits
Often call “down 10 up 5”

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Describe the Method of Limits

Tones are presented one at a time, patient responds yes/no after each presentation. Tester controls the level of the stimulus and changes it in fixed steps (ascending or descending).

Ascending runs begin below the subject’s threshold. Descending run begins above the subject’s expected threshold.

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Describe the Method of Constant Stimuli

Uses equal number of stimuli at each of several predetermined levels, presented in random order. Yes/No responses are tallied for each level used. Threshold is obtained by calculating the level that corresponds to 50%.

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What are false responses?

False-positive means the patient responds when they should not have. Caused by tactile stimulation, confusion between test tones, tinnitus, often behavioral due to misunderstood instructions or tester may inadvertently encourage false positives by presenting tones rhythmically.

False-negative means the patient failed to respond when they should have due to equipment problems or tester errors, tinnitus, or misunderstood instructions, collapsed ear canals or standing waves.

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Why do we start with better ear, if known?

Easier to know when to mask

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What is the normal range of hearing?

Humans can hear 20-20000 Hz

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What is test-retest reliability?

Degree to which test scores remain unchanged when measuring a stable individual characteristic on different occasions.

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What is an audiometer?

Electronic instrument used by audiologists to measure hearing function designed to present auditory stimuli.

Audiologists can select the type of signals; characteristics of the sound such as frequency and intensity and transducer through which the signal is routed.

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What is an air bone gap?

The difference between AC threshold and BC thresholds

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What are the types of hearing loss?

Conductive
Sensorineural
Mixed

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Explain high frequency testing

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Describe TDH 49

Supra aural headphones
Easy and affordable
Most appropriate to test ears with TM perforation

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Describe ER-3As

Insert earphones
Greatest interaural attenuation
Avoid collapsing canals
Lower test-retest variability
Prone to impacts of TM perforation

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Describe HDA200

Circumaural headphones Needed for extended high frequency testing (8-20 Hz) Cushions sit around the pinna

Describe Radioear B-72

Limited max output

Describe speakers

Patient positioning in the room is critical Ear-specific information cannot be obtained

For each headphone the __________________ should be centered over the ear canal and the headband should be tightened to make the headphones ________________ to the floor when the patient is sitting upright.

diaphragm perpendicular

The two most common placements of a bone oscillator are _________________ and ________________.

Mastoid process Forehead

How is the PTA typically yielded?

Calculated by averaging the thresholds at 500, 1000, and 2000 Hz

What is hearing sensitivity within normal limits?

-10 - 20 dB HL

What is considered mild hearing loss?

21 - 40 dB HL

What is considered moderate hearing loss?

41 - 55 db HL

What is considered moderate-severe hearing loss?

56 - 70 db HL

What is considered severe hearing loss?

71 - 90 dB HL

What is considered profound hearing loss?

Great than 90 dB HL

Which of the following can be a cause of poorer speech understanding ability than is predicted by the degree of hearing loss?

Meniere's disease Acoustic tumor Dead regions

Describe the limitations of using severity qualifiers (mild, mod severe, profound..) in predicting the degree of handicap associated with the hearing loss

1. Handicap is depended on many factors related to individual's needs and abilities 2. Only some speech frequencies are assessed using three-frequency average so identical amounts of hearing loss sometimes result in large differences in the ability to understand speech and as a consequence, the degree of disability associated with the loss.

What type of hearing loss? AC = 15 dB HL BC = 10 dB HL

Normal hearing

What type of hearing loss? AC = 30 dB HL BC = 10 dB HL

Conductive

What type of hearing loss? AC = 50 dB HL BC = 30 dB HL

Mixed

What type of hearing loss? AC = 50 dB HL BC = 40 dB HL

Sensorineural

What type of hearing loss affects the auditory nerve?

Sensorineural

What type of hearing loss affects the optic nerve?

Normal hearing

What type of hearing loss is caused by a TM perforation?

Conductive

What is considered gradually falling configuration?

5-12 dB increase per octave

What is considered sharply falling configuration?

15-20 dB increase per octave

What is considered precipitously falling configuration?

Threshold increasing at 25 dB or more per octave

What is considered flat configuration?

< 5 dB rise or fall per octave

What is considered rising configuration?

> 5 dB decrease in threshold per octave

What is considered a trough configuration?

Loss in the mid-frequencies; less loss or no loss in the low/high

What is considered peaked or saucer configuration?

Loss at lows and highs; no loss or less loss in the mid-frequncies

What is considered notched configuration?

Loss at one frequency; complete or near recovery at adjacent octave frequencies

What are the symbols for unmasked air conduction thresholds?

O, right X, left

What are the symbols for masked air conduction thresholds?

Triangle, right Square, left

What are the symbols for unmasked bone thresholds?

<, right >, left

What are the symbols for masked bone thresholds?

], left [, right

What is considered a significant change in hearing thresholds?

15 dB or more

T/F: Ear related medical problems can still exist even if all thresholds fell below 15 dBHL

True

What does the interruptor do?

Press to present the signal

What does continuously-on mean?

Signal is on uninterrupted; used most often during speech audiometry and clinical masking

What does talk-forward do?

Used to give instructions during/between testing. Clinician can talk to the patient at a predetermined level regardless of the current audiometer setting

What does monitor control do?

Allows clinician to listen to what is being presented at a specified intensity set by the clinician

Which button controls frequency?

Two buttons positioned horizontally; right increases and the left decreases

Which button controls intensity?

Usually a dial, turns the presentation level up or down

What does the VU meter and control do?

Allows clinician to monitor the intensity level of the input (into the audiometer) whether from the mic or external audio device

What are transducers?

Inserts, Bone, Heaphones

Human ears are most sensitive to frequencies in what range?

500 - 8000 Hz

What is the unit for amplitude?

decible (dB)

What is the difference between dB HL and dB SPL?

The reference point! The reference point for dB SPL is 20 microPa The reference point for dB HL is dependent on the frequency

Puretone Audiometry Flashcards

(70 cards)