Audiology Midterm Study Guide

an outline of the parameters of each profession

Scope of Practice

An audiologist cannot diagnose what?

communication disorders, swallowing disorders, voice disorders

An SLP can perform hearing evaluations

False

1 multiple choice option

An SLP can perform hearing screenings

True

1 multiple choice option

Audiologists are responsible for diagnosing and managing what disorders?

Hearing and vestibular/balance disorders

Sound is measured in a logarithmic scale

True

1 multiple choice option

Audiometers are calibrated in dB HL whereas sound meters are calibrated in dB _____?

SPL

Electroacoustic calibration

All audiology equipment has to be calibrated on an annual basis

daily biological calibration/listening checks

daily functional inspections conducted to verify the equipment performance before use

Preferred practice patterns

the informational base for providing quality patient/client care and a focus for professional preparation, continuing education, and research

Position statements

public statements of ASHA's official stand on various issues

Technical Reports

supporting documentation and research for an ASHA position statement

Disorder

any abnormal function or condition (any diagnostic code)

Impairment

measurable loss or abnormality (threshold outside of normal range)

Disability

Functional limitations due to impairment (difficulty hearing conversations)

Handicap

Social disadvantage due to a disability (inability to perform job duties)

Principles of screening

availability of assessment and treatment

Sensitivity

ability of a test to correctly identify individuals have the condition (true positives)

Specificity

ability of a test to correctly identify individuals who do NOT have the condition

10-20 dB is considered normal

True

1 multiple choice option

Sound

A physical phenomenon that describes a movement or vibration of an elastic medium without permanent displacement of the particles

3 prerequisites of sound:

1. a source of energy such as force

2. a vibrating object that creates a sound pressure wave

3. a medium of transmission (like air)

Mass

Quantity of matter present in an object

Are mass and weight the same thing?

No, weight is affected by gravity, mass is not

Force

A push or a pull on an object

Heavier objects will vibrate more slowly, producing lower frequency sounds

True

1 multiple choice option

Elasticity

tendency of an objects resistance to deformity and its return to the rest position

Inertia

tendency to resist change in motion (the greater the objects mass, the greater the inertia)

Condensation

increased pressure and density of air molecules

Rarefaction

thinning of air molecules that creates areas of decreased air pressure and density

Pure tones are very rare in nature

True

1 multiple choice option

Pure tone

undistorted sound wave (sine wave) if areas of alternating condensation and rarefaction occur at the same time

Frequency

the number of complete vibratory cycles per unit time, measured in Hz

The higher the frequency, the higher the pitch

True

1 multiple choice option

Amplitude

describes an objects distance from rest to maximal displacement

The higher the amplitude, the louder the sound

True

1 multiple choice option

Period

Amount of time needed to complete one cycle of vibration, measured in units of time (the time it takes for a vibrating object to return to its starting position and begin its repeating motion)

Phase

describes the relative timing of compressions and rarefactions of waves (describes the position of a point in time on a wave cycle, relative to the start of the cycle)

4 properties of simple harmonic motion

Frequency, amplitude, period, phase

Linear scale

a scale where equal increments correspond to equal changes in the quantity being measured

Is the linear scale practical for measuring sounds as we hear them?

No, the human ear does not perceive changes in sound intensity in a linear way (a sound that is 10 times more intense does not seem 10 times louder to us)

Logarithmic scale

each increment represents a tenfold change in the quantity being measured (more aligned with how humans perceive sound)

Intensity

the power of the sound in watts divided by the area the sound covers in sq meters

Loudness

related to the intensity of any given sound to the intensity at the threshold of hearing

Sound Pressure Level (SPL)

Sound meters are calibrated in dB SPL (ex: loudness meter at a football game)

Hearing Level (dB HL)

Audiometers are calibrated in dB HL (normal/perfect hearing is considered a straight line across the top of an audiogram at 0 dB HL)

3 parts of the human ear

1. outer (acoustic energy)

2. middle (mechanical energy)

3. inner (fluid energy)

Ossicles

bones of the middle ear that carry sound vibrations

Malleus

(aka hammer) lateral-most bone of the chain; connected to the eardrum

Incus

(aka anvil) center bone of the chain

Stapes

(aka stirrup) medial-most bone, rocks in and out of the oval window

Eustachian tube

equalizes air pressure between the middle ear cavity and nasopharynx

2 muscles of the eustachian tube

1. stapedius

2. tensor tympani

Cochlea

Fluid-filled space within temporal bone

Outer Hair Cells (OHC)

tuned to sound intensity

Inner hair cells (IHC)

tuned to sound clarity

Case history form

Commercially Available, made on site, discipline specific, age specific

There is a weak correlation between cognitive rate of decline and severity of hearing loss

False

1 multiple choice option

Any additional sound can affect the results of a hearing test

True

1 multiple choice option

Audiometer

the device that delivers the tone and words for a hearing examination

Air conduction audiometry

The normal means of sound transmission in day to day situations (results represent degree of sensitivity of entire audiometry system)

Pure tone air conduction audiometry

determines how quiet someone can hear a sound in dB

Findings of air conduction audiometry cannot localize the etiology/site of damage

True

1 multiple choice option

Headphones are not as accurate as other technology

True

1 multiple choice option

Bone conduction will tell you the etiology of a hearing loss

True

1 multiple choice option

Normal degree of hearing

-10 to 20 dB

Mild degree of hearing loss

25-40 dB HL

Moderate degree of hearing loss

41 to 55 dB HL

moderately severe degree of hearing loss

56-70 dB HL

severe degree of hearing loss

71-90 dB HL

profound hearing loss

91+ dB

Bone conduction audiometry

tells us the etiology of hearing loss (bypasses the middle ear)

Results of bone conduction audiometry differentiate between conductive hearing loss and sensorineural hearing loss

True

1 multiple choice option

Masking

keeps the non-test ear busy while establishing results (threshold) for the test ear

Masking is necessary when there is a difference of __ dB between ears using headphones and __ dB between ears using insert earphones

40 dB, 60 dB

Sound field testing

2 speakers on either side of the booth (great for testing young children)

Behavioral observation audiometry (BOA)

audiologist presents a stimulus through a loudspeaker and observes a child's reaction

(used for a child with a developmental age of 6-7 months)

Behavioral Observation Audiometry should be used in conjunction with another methos as it is not 100% accurate

True

1 multiple choice option

Visual Reinforcement Audiometry (VRA)

Audiometry test appropriate for children 6-24 months - The child is rewarded with visual reinforcement such as moving toy or light, when looking toward a sound source

Conditioned Play Audiometry

used for children 2 1/2 to 5 years of age - makes pure tone audiometry (air and bone conduction) into a game

Speech Recognition Threshold (SRT)

Uses spondees (multisyllabic words) such as baseball, toothbrush, and cowboy

Pure Tone Average (PTA)

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

SRT tests the ears individually

True

1 multiple choice option

In an SRT, you drop the frequency each time and always use the same words recorded on a CD

True

1 multiple choice option

SRT and PTA should always be in good agreement with one another

True

1 multiple choice option

Good agreement of SRT and PTA

anything from 0-5 dB apart

Fair agreement of SRT and PTA

anything from 6-10 dB apart

Poor agreement of SRT and PTA

anything over 10 dB apart

Why is it important for SRT and PTA to be in good agreement with one another?

it proves the validity of the test results and indicates that each of these are consistent

If a patient's SRT is much poorer (louder than) than expected compared to their PTA, what might this suggest?

this might suggest that the client has poor cognitive or language processing abilities, there is poor test reliability, or the client misunderstood the instructions given

Speech Detection Threshold (SDT) / Speech Awareness Threshold (SAT)

Detecting something is there but not quite being able to make it out (SDT/SAT should also be in good agreement with PTA)

Most Comfortable Listening Level (MCL)

when the voice is "just right" level at which you like to listen to television (inter-test reliability: ideally should be 40 dB above the SRT)

MCL is the reference for word level recognition and discrimination testing

True

1 multiple choice option

Uncomfortable Listening Level (UCL)

Limit at which the patient would find sound to be unacceptably loud, or painful to listen to

Dynamic range

the range of volume that a patient can comfortably listen to sound

Word Discrimination Testing (WDT)

Repetition of the last word heard in a sentence (the only result of a test recorded in a percentage)

Is the gold standard for WDT typically recorded voice or live voice?

recorded voice

MCL and UCL will never be the same

True

1 multiple choice option

DNT

did not test

Keloids can continue to grow throughout life even after removed

True