Hearing Tests & Measure Exam 1

History of Audiology

Military Hospitals

Parents of Audiology

SLP

Otology

Father of Audiology

Raymond Carhart

Association

American Academy of Audiology

How to become

doctorate

praxis

4th yr degree

Medical Audiology

Diagnosis hearing loss

newborn screenings

Dispensing/ Rehab

reduce negative impact of hearing loss

private practice

hearing aid fitting

Pediatric

Hearing loss in kids

minimize impact on language development

Educational

impact on school

hearing screenings

prevention

Industrial

Prevent hearing loss

identification

Outer Ear

Pinna

EAC

Tympanic Membrane

Middle Ear

Air filled

ossicles

Inner Ear

Fluid filled

hair cells

CANS

cortex

brainstem

Conductive

Outer

middle

Sensorioneural

Inner ear

CANS

Conductive Hearing Loss

Inner & Cans = normal

Air bone gap: AC poorer than BC

Sensorineural Hearing loss

Inner & CANS issue

AC = BC no air bone gap

Mixed Hearing Loss

Inner & Outer ear problem

Air bone gap: AC more than BC

Rinne Test

Tuning Fork on Mastoid

Positive Rinne

AC > BC

normal hearing

Negative Rinne Test

BC> AC: Conductive Hearing Loss

Bing Test

Occlusion Effect

Positive Bing

AC> BC: Normal hearing or SNHL

Negative Bing

No Change

CHL

Weber Test

Lateralization

tuning fork on forehead

Lateralization in 1 ear: Weber

CHL in THAT ear

or

SNHL in opposite ear

Midline Weber Test

Normal or symmetric loss, or no lateralization

Psychoacoustics

Auditory perception vs acoustics

Pitch

Frequency

influenced by intensity

Loudness

Intensity dB

Quiet

Loud phon scale

Interaural Intensity

Difference used for high frequnecies

Interaural Phase

Difference used for low frequency

HL to SPL

add themS

SPL - HL

Subtract them

ANI

s3.6=210

Pure tone generator

frequency selector switch

Attenuator

Controls intensity, dial

Interpreter swtich

on/off switch

Out put transducer

Ear phone

Air Conduction Audiogram

R = o , L = x

Bone conduction audiogram

R = <

L = >

Air conduction & bone conduction NO response

add an arrow to either the air conduction or the bone conduction

Air conduction masked

R = triangle

L = Square

Bone conduction masked

R = [

L = ]

Sound field

S

Alded

A

OE case history

helix

antihelix

antitragus

tragus

lobule

fossa

concha

Cartlaginous portion

1/3- ½

skin in part

cerumen glands

hair follicles

migratory

Bony portion

1/3-1/2

just skin in this part

Parts of TM

cone of light

annulus

manubrium of the malleus

short process of the manubrium

pars tesna pars flaccida

umbo

Pinna disorder

Anotia

microtia

trauma

cancer

EAC disorders

Atresia

stenosis

external otitis

exceessive cerumen

collapsing ear canal

pure tone audiometry

minimize background noise

Hughson-Westlake

correct go down 10 dB

no response go up 5 dB

2/3 correct

Better ear 1st or right

test steady tone or warble

Frequency tests AC

250, 500, 1k, 2k, 3k, 4k, 6k, 8k,

• test 750 & 1500 if there is more than a 20 dB gap between octaves

Frequency test BC

250, 500, 1k, 2k, 3k, 4k

Frequency starting point

start at 1k Hz

and 30 dB

PTA

Take AC 500 + 1k + 2k / 3 = PTA

BC Distortional

vibration distorts inner ear

Inertial

skull moves, ossicles lag behind cochlea, stapes to move in oval window

Osseotympanic

Column of air in ear canal vibrates

Bone Vibrator Mastoid

Stimulates both ears

Forehead Bone Vibrator

easier to place

less variables

Masking

Interference in perception of 1 stimulus caused by another

Cross over

presente to test ear, heard by NTE

always bone conduction

Clincial Masking

presenting narrow band to NTE during pure tone testing of test earC

Central Masking

Noise in one ear causes small threshold shift in other ear, no crossover

Inter Aural

40 dB Supra

60 dB Insert

0 dB BC

Rule #1

Supra: AC test - BC nte >/= 40 dB

Insert: AC test - BC nte >/= 60 dB

Rule #2

When AC between ears is greater than IA

Supra: AC test - AC nte > / = 40 dB

Insert AC test - AC nte >/= 60 dB

Bone Conduction Masking

Air bone gap > 10 in SAME ear

Initial Masking

AC: threshold of NTE + 15 dB

BC: Threshold of NTE + 15 + OE

Masking dilemma

size of air bone gap close to IA