Basic Audiology Midterm

Audiology

Studies hearing, balance, and related disorders. Help with identification and assessment/non medical treatment with hearing disorders, prevention, identification, assessment, rehab, and education

AuD practice settings

Private practice, medical settings, military

SLP scope of practice

Provide intervention with people diagnosed with auditory processing disorders. Also help counseling people and help them make decisions about communication and swallowing

What SLP CANNOT do

Select, fit, and establish effective use of prosthtetic/adaptive devices for communication and swallowing.

3 components of evidence based practice

client perspectives, clinical experience, external/internal evidence

Interprofessional collaboration

Collaborating with other professionals, providing referrals and other information

Diagnostic audiometry

Type and severity of auditory disorder

Hearing screening

Separate from among healthy people and whom may have a disease or other condition and refer them to get appropriate diagnostic testing

Screening (sensitivity)

% labeled positive on a test that truly have the condition

Screening(specificity)

% labeled negative who truly do not have the condition being tested for

True positive

Have condition tested for and test positive- high test sensitivity

True negative

do not have the condition tested for and test negative- high test specificity

False positive

Test positive for condition but does not have it

False negative

Test negative for condition but truly has it

Deaf

Culturally deaf, too deaf to benefit from hearing aid

Hard of hearing

Mild to moderate loss- could benefit from hearing aid

Hearing impaired

Negative way to describe hearing loss

Behavioral measurements

Active participation- subjective

Non-behavioral measurements

No participation needed

Properties of simple harmonic motion

frequency, amplitude, period, phase

3 parts of the ear

Outer (acoustic), middle(mechanical),inner(fluid)

Outer ear anat.

Acoustic energy, Auricle(pinna),External auditory meatus(canal), TM(eardrum)

Auricle(pinna)

Collects sound and assists in sound localization

External auditory meatus (canal)

Protects middle/inner ear and amplifies high frequency sounds

Tympanic membrane (ear drum)

Separates outer and middle ear

Middle ear anatomy

Mechanical energy

Begins at inner layers of the TM

Middle air cavity is filled with AIR

Ossicles- Malleus, incus, stapes

Eustachian tube

Malleus

hammer, lateral most bone connected to ear drum

Incus

Anvil, center bone of chain

Stapes

Stirrup, medial most bone, rocks in and out of oval window

Eustachian tube

Equalizes air pressure between ME cavity and nasopharynx. Helps drain fluid which might accumulate in ME

Inner ear anatomy

Fluid energy

Auditory and vestibular labrynths

Osseous labyrinth

Channel in the bone

Membranous labyrinth

soft tissue

Auditory labyrinth

Cochlea, which is the sensory end organ of hearing

Vestibular labyrinth

Semicircular canals, which is the sensory end organ of balance

Cochlea

Fluid filled space with temporal bone, snail shaped and has three chambers

3 chambers of cochlea

Scala Vestibuli, scala media, scala tympani

Scala vestibuli

Upper portion with perylimph fluid

Scala media

Middle portion with endolymph fluid

Scala tympani

Lower portion with perylimph fluid

Basilar membrane

Separates from scala tympani

Organ of corti

Sits on basilar membrane and contains sensory cells for hearing

Cranial nerve VIII (8)

Vestibulocochlear

Type of dB that is equal to the number of dB above the threshold of audibility

dBSL- sensation level

Type of dB that is used to compare the intensity of a sound referenced to audiometric zero

dBHL- hearing level

Types of hearing loss

Conductive, sensorineural,mixed

Conductive hearing loss

Abnormal air conduction (outer and or middle ear dysfunction), normal bone conduction(normal inner ear function)

Sensorineural hearing loss

Abnormal air and bone conduction- equal in severity outside of normal within 10 dB of each other

Normal outer and middle ear function with abnormal inner ear function

Mixed hearing loss

Abnormal air and bone conduction- air is more severe than bone

Abnormal outer and middle ear function with more abnormal inner ear function

Primary function of the middle ear

Impedance matching transformer- compensates for loss of energy from air to fluid

Intensity and loudness vs frequency and pitch

Intensity and frequency are objective measures, pitch and loudness are perception

4 components of audiometers

Presentation dial, frequency dial, intensity control, output selector(transducer)

Procedures designed to help healthcare workers and patients alike, from a wide range of pathogens, are known as

Universal percussions

As an SLP, what is the minimal equipment you should have to preform hearing screenings

Audiometer, transducer, bone conduction oscillator

Where should you look for a calibration sticker? What information should be on the sticker?

Look for the sticker on the audiometer, calibration date and company name, ensure calibration was done in the past year

Can a diagnostic hearing evaluation be preformed outside a sound treated booth?

No, it won’t be reliable

Most common infectious diseases of childhood

Otitus media

Term that refers to age related changes in hearing

Prebycusis

Questions to ask patient regarding past/present hearing problems and family history

Patient history

2 different means of obtaining case history

Patient interview or informal observation (look, play, listen)

Informal observation

Studying a persons behavior and watching how they communicate

Case history questions clinicians should ask parents

-Anything unusual with the pregnancy

-Have they had a hearing screening

-Is another language spoken at home?

Differential diagnosis

Rule out what isn’t and rule in what it could be

Congenital HL

HL present at birth, can be genetic or acquired

50%-75% is genetic

25%-50% is acquired

Syndromic

Hearing loss involving other systems such as sight

Non-Syndromic

Mostly sensorineural , usually only hearing is affected

Environmental HL

Medication

Idiopathic HL

Unknown cause of HL

Prenatal

Before baby is born

Perinatal

During birth- cut off of O2

Postnatal

After baby is born

Prelingual

birth-2

Perilingual

3-5

Postlingual

5-6

Conditions with symptoms similar to hearing loss

ASD, language disorder,ADHD depression, dementia

Air conduction

How much loss there is

Normal means of sound transmission in day to day situations

Transducers- spura-aural, inserts, headphones

Puretone air conduction audiometry

Loudness or intensity threshold in dB at which a person just begins to hear sound

Bone conduction

What kind of loss there is

Place pure tone bone oscillator on either right or left mastoid and forehead

Better cochlea will always respond first

Bypasses the middle ear

Air conduction symbols and colors

Right- circle-red- unmasked (triangle-masked)

Left- X- blue- unmasked (square masked)

Bone conduction symbols and colors

Right-<-red ([ - masked)

Left->-blue(]- masked)

Air-bone gap

Difference of 10 dB or greater between AC and BC

Spondees

Two syllable words with equal emphasis on both

Used to retain SRT

Phonemically balanced

Monosyllabic words

Used to obtain WRS

20-50 word list

SAT/SDT- speech awareness/detection threshold

Indicates awareness but not understanding of sound

SRT- speech reception threshold

Lowest dBHL understood

WRS- word recognition score

Monosyllabic words presented at MCL

10,25,50 words per ear

Speech thresholds

0-25 Normal hearing

26-40 Mild hearing loss

41-70 Moderate hearing loss

71-90 Severe hearing loss

91-120 Profound hearing loss

MCL

Most comfortable level- 40 dB louder than SRT

UCL

Uncomfortable listening level- too loud

DR(dynamic range)

Between SRT and UCL