Audiology Review Flashcards

Vocabulary flashcards for audiology exam review.

Frequency-Following Responses (FFR) reflects what frequency and requires what?

Reflects the frequency of a tone below 1500 Hz and requires neural phase-locking

FFR Amplitude

Decreases as tone frequency increases.

Auditory Steady-State Response (ASSR)

A stable brain response to modulated, continuous stimuli, reflecting both cortical and subcortical activity.

ASSR Carrier Tones

Typically 500–4000 Hz, with strongest responses at 1000 and 2000 Hz.

Modulation

The controlled variation of sound properties like amplitude or frequency.

AM (Amplitude Modulation)

Changes loudness.

FM (Frequency Modulation)

Changes pitch.

ABR (Auditory Brainstem Response)

Uses brief clicks/tones and assesses brainstem function.

What is recommended for newborn screening?

Automated ABR and OAE.

OAE (Otoacoustic Emissions)

Reflects outer hair cell (OHC) function.

Vernix

In the ear canal may cause OAE failure; ABR is more robust in newborns.

VRA (Visual Reinforcement Audiometry)

A behavioral test for infants 6 months-2 years where the child turns towards a sound and is visually rewarded.

ECochG (Electrocochleography)

Shows promise in diagnosing Auditory Neuropathy Spectrum Disorder (ANSD).

What does FFR measure?

How accurately the brain encodes sound frequency and timing via phase-locking.

At what intensity is FFR typically recorded?

40 dB above threshold.

What disorders are associated with reduced FFR?

APD, ANSD, language impairments, concussion, amusia.

What modulation rate is used for ASSR in awake adults?

40 Hz (cortical response).

What modulation rate is best for infants or sleeping adults and under anesthesia patients in ASSR?

80 Hz (subcortical response).

How does ABR differ from ASSR?

ABR uses brief clicks and focuses on brainstem; ASSR uses longer, modulated tones and includes cortical activity.

What does ASSR detect?

The modulation envelope of the sound signal.

How can SNR be improved in auditory testing?

Averaging, filtering, artifact rejection, and differential amplification.

What is the preferred hearing screening method in NICU?

ABR, due to auditory neuropathy risk and robustness.

What is the probe tone for tympanometry in infants <7 months?

1000 Hz.

What virus is the most common non-genetic cause of pediatric SNHL?

Cytomegalovirus (CMV).

What is the goal of infant hearing screening?

Identify hearing loss ≥40 dB HL.

What behavioral test is used for 6–36 month-old children?

Visual Reinforcement Audiometry (VRA).

When does an FFR start?

Around wave V latency and continues for the duration of the sound.

What can FFR reproduce? What is it influenced by?

Speech and music patterns and is influenced by attention.

What is FFR recording challenged by?

Artifacts and cochlear microphonics.

T/F: ASSR is objective and automated.

True.

ASSR is less reliant on …?

visual waveform inspection.

T/F: ASSR does NOT allow simultaneous testing of multiple frequencies.

False. ASSR allows simultaneous testing of multiple frequencies.

What does mixed modulation combine?

AM and FM.

How does ASSR differ from FFR?

ASSR detects modulation envelope, while FFR detects the actual waveform.

What does FFR detect?

The actual waveform of auditory signals.

ASSR (Auditory Steady State Response)

ASSR uses modulated, longer tones and assesses up to the cortex.

Which test would you use to detect cochlear and retrocochlear pathologies?

ABR

What tests would you use to test multi-frequency threshold estimation?

ASSR.

What does averaging and weighted average help with?

Reducing noise

What does filtering do?

Isolates target freqeuncy bands.

What is artifact rehjection?

Removes segments with movement noise.

What does differential amplification do?

Reduced environmental noise.

What should the patient do to reduce myogenic noise?

Be still or asleep.

What is spectral display in ASSR?

Amplitude across frequency.

What is polar display in ASSR?

Phase coherence of responses.

40 Hz gives behavioral thresholds within..?

Typically 10 dB

80 Hz ASSR is better for?

High frequency (> 1000 Hz) testing and sleeping adults.

Infants ASSR thresholds are how many dB higher than adults due to immaturity?

10 - 15 dB

T/F: ASSR behavioral thresholds match closely with infants with hearing loss.

True.

When does ASSR become more consistent?

By 6 weeks of age.

Aided ASSR thresholds correlate well with…? and is useful for..?

Behavioral thresholds - useful for hearing aid validation in infants.

3 limitations of ASSR?

Unreliable high-intensity responses due to stimulus artifacts at high intensities (<1000 Hz).

Possible vestibular activation confusion at low frequencies.

Less reliable in mixed hearing loss.

What does ABR detect?

Neural hearing loss.

What does click ABR focus on? (frequency)

~ 3000 Hz

What does OAE test? (frequency)

> 1000 Hz

Can ABR and OAEs miss low-frequency losses?

Yes.

What does presence of a distinct peak mean?

Normal ME

What does a flat tymp indicate?

Effusion.

How many infants with hearing loss pass initial screening?

15%

Risk factors for missed diagnoses?

Family hx, NICU stay, and congenital CMV infection.

T/F: Some U.S. states do NOT require CMV testing if hearing screening is failed.

False, some U.S. states require CMV testing if hearing screening is failed.

What is OAE sensitive to?

ME status.

What does OAE and tympanometry improve?

Accuracy and follow-up.

What does a failed OAE and abnormal tymp suggest?

Referral to PCP.

T/F: Children with family hx of hearing loss need diagnostic testing even if screening is passed.

True

What is the screening protocol?

Otoscopic inspection

OAE screening (<30 sec/ear)

Failed OAE → tympanometry

Follow up based on tymp results and risk factors

Diagnostic approach for infants <6 months?

ABR (air + bone)

OAE

Tymps

Cochlear microphonics

What does JCIH recommend about ART and ASSR?

JCIH does not recommend ART and ASSR as stand-alone tools.

What are behavioral thresholds used for in infants < 6 months?

Cross-check objective findings.

What does behavioral thresholds guide in infants 6 - 36 months?

Configuration.

Is an ABR conducted for infants 6 - 36 months?

Yes, ABR is still required if not previously done.

Advantages of VRA?

Effective and non-invasive, but can be influenced by child’s state and attention.

What is the accuracy of VRA?

~ 10 - 15 dB from actual threshold.

What tests would you use for uncooperative individuals or results are unclear?

ABR, ASSR, and cortical responses.

Would you include IAE and tymps in a diagnostic battery for children and adults?

Yes.

What stimuli in ABR yield better synchrony and amplitude?

Chirp stimuli yield better synchrony and amplitude.

What does high-frequency tymp explain?

High-frequency tymp explains OAE failures.

What is speech-evoked AABR emerging to assess?

Central dysfunction and learning disabilities.