Audiology EXAM 1

Chapters 1-3

sound is a type of energy that occurs because of distrubed ___ and results from the ___ of a molecule in the medium it travels by.

pressure waves

compression

requirements for sound (2)

source of vibratory energy (vocal cords)

medium that has mass and is elastic

properties of sound (4)

1. intensity

2. amplitude/frequency

3. phase

4. spectrum

the the magnitude of a compression wave equals the ___intensity of the signal

higher

higher

intensity is measured in

decibels

decibles is measure in a ___ scale

lograithmic

spl stands for

sound pressure level

at what dB for slight discomfort

90 dB

at what dB for pain

140dB

frequency is measured in

hertz

frequency is the ___ of vibration: cycles per ___

speed of vibrations: cycles per second

human hearing range in Hz

20Hz - 20,000Hz

the higher the speed of vibration of compression wave is the ___ the frequency of the signal

higher

for pure tones, the periodic wave is called a

sinusoidal wave. it repeats itself at regualr intervals

normal speech sounds and nature sounds exhibit a ___ wave.

complex wave. For complex sounds ( like nature and speech) the interaction between intensity and frequency is called the sound spectrum.

where does physical processing occur:

outer, middle, and inner ear

where does neural processing occur

inner ear then 8th nerve then central auditiory nervous system

where does psychological processing occur

begins in brain stem then pons t

afferent

sensory

carries signal TO cns

responsible for sensing stimulus

efferent

motor

carries signals AWAY from cns

initiates action

describe sturctures in outer ear. functions of outer ear

auricle/pinna

ear canal/ or EAM

outer layer of tympanic membrane (TM)

Functions: collects, localizes, resonates sound

protects middle ear

auricle serves as a resonator. resonators are set into vibration by another vibtration. this enhances sound energy.

structures of tympanic membrane

made of several layers of skin

at the very end of EAM

includes: pars tensa- larger, stiff, inferior

pars flaccia- more flexible and smaller

{manubrium, umbo and light reflex} mentioned later

middle ear structure

air filled cavity

within the temporal bone

functions as an impedance matching device

bridge between airbone vibtration from TM and the fluid traveling waves in cochlea

ossicular chain

responsible for boost in sound

made up of 3 small bones suspended in air:

1. malleus (hammer)

2. incus (anvil)

3. stapes (footplate)

malleus rest on TM and stapes is on the oval window of the cochlea (specifically the scala vestibula in the cochlea)

what about the middle air cavity

filled with air.

air is kept pressurized by eustachian tube. e tube leads to the back of the throat.

swallowing helps open the tube if pressure isn`t equalized .

the e tube is a passageway from nasopharynx to anterior wall of middle ear

inner ear structures

contains auditory and vestibular labryinths’

vibrations in ossicles vibrates cochlea labyrinth and set of neural impulses generated by 8th cranial nerve that travel to auditory nerve

name the 3 ossciles bones (in order); along with where the manubrium is

The malleus consists of a long process called the manubrium that is attached to the tympanic membrane and a head that is attached to the body of the incus.

the malleus moves ___ than the stapes. This shows an example of impedance matching.

The auditory labyrinth is called the ____ and is the ____ of hearing.

cochlea

sensory end organ

the cochlea structure

within the temporal bone

2.5 turns

encircles a bony central core called the modiolus

the TOP of cochlea

apex; aka helicotrema

uncoiled cochlea: understand where scala tympani vs scala media vs scala vestibuli ( with their respective fluids).

where is organ or corti

  tympani/vesitubli - both contrain perilymph fluid

the scala media/cochlear duct - filled with endolymph fluid

organ of corti is in cochlear duct. top of Organ of Corti is temporal membrance (STIFF, oscillating) bottom of Organ of corti is basilar membrane (gelatinous, osicllating, has hair cells.

result of oscillating/bending hair cells

depolarization/hyperpolization

after organ of corti recieves vibration it ___ back to ___

circles back to round window

soft noises trigger specific spots in ____membrane and is reflected as background noise/ soft noise

basilar

describe impedance matching with oval window to cochlea

louder vibration is recieved from stapes at oval window to account for the fluid in cochlea. vs vibration in TM

what are the two types of sensory cells called in cochlea

stereo cillia

outer hair cells and inner hair cells

both are elongated in shape with small cilia attached on top

cilia is impeded in tectorial membrane

these hair cells are mostly outer efferent hair cells

inner hair cells are NOT in direct contact with tectorial membrane. these inner are mostly afferent

the traveing wave goes down the __ membrane

basilar

higher frequencies occurs closer to the __ ___ near the ___end of the cochlea

oval window

basal or bottom

lower frequencies are ____ from the oval window.

At the ___ of the cochlea.

farther from the oval window.

at the TOP or apical end of the cochlea.

tonotopic arrangement (in the basilar membrane) simply means

each frequency stimulates a different stop/place along the basilar membrane

outer and inner hair cells work __ to translate wave of motion

together

outer hair cells are embedded in ___ ___

which produces contracting/expanding forces that influence…

which allows the ___ ___ __ to be stimulated

tectorial membrane

the position of the tectorial membrane

inner hair cells

autiorty nervous system

primarily afferent but includes a efferent component that regulates outer hair cells and general inhibitory actions. (gen inhib actions lowers background noises when listening)

is functionally crossed.

list the steps of traveling sound once the nerve vibers form inner hair cells exit the organ of corti

1. the cochlear branch of the 8th cranial nerve exits the modiolus (thru tonotopic arrangement)

2. then joins the vesitbular branch of the 8th cranial nerve

3. leaves the cochlea thru internal auditiory canal of the temporal bone

intensity is coded as the ___ of nueral firing

frequency is coded as the ___ of neural firing

rate

place

nuclei involved in primary auditory pathway of the central auditory nervous system (CANS)

1. cochlear nucleus

2. superiod olivary complex (S.O.C)

3. lateral lemniscus

4. inferior colliculus

5. medial geniculate

6. auditory radiations

7. auditory cortex

interepting audiograms are in the scope of SLPs (T/F)

T

absolute senstivity

capacity of aud. system to detect faint/ soft sound

differential sensitivity

capacity of aud. system to detect changes in sound

hearing senstivity refers to absolute or differential sensitivity

absolute

hearing acuity refers to absolute or differential sensitivity

differenital

absolute threshold is the threshold of

audiobility

absoulute sensitivity of hearing is usually a sound that can be heard what precent of the times presented

50%

2 out of 4 times

our auditory system is most sensitve to pressure changes aorund what frequencies

speech frequences

0 dB is the threshold for ___hearing

normal hearing.

it does not mean the abscne of sound

right ear symbol on audiogram

red

round/circle

left ear symbol on audiogram

blue

x

air conduction measures two things

degree of hearing loss

configuration

bone conduction measures the

type of hearing loss

the diff between air and bone conduction is termed

the air-bone gap

loudness referes to

intensity

pitch refers to perception of

sound frequencies . these are directly proportionate

during hearing testing we always start:

with R ear at 1000Hz

normal, conductive, senso?

conductive

normal, conductive, senso?

normal

normal, conductive, senso?

senso

what is an audiologist

health care profession devoted to hearing

prevents/diagnosis hearing loss

treats communication disorders

evals need/ IMPACT hearing devices

requirements for audiology

masters degree, 4 year AuD (doctorate) the last yr of doctorate is the residency.

1870 clinical hours

pass PRAXIS

certifications: ASHA CCC-A, AAA Board

Licensure varies by state

Audiologist Roles

I.D (develops/oversees) of HL, Assessment, Diagnosis, Treatment (works w/ ENT doc), Education, Prevention, REsearch

Scope of Practice

HL prevention screening, newborn hearing screening (lots of progress here!), ear canal inspec.(AKA otoscopy), pedi/adult assessment, I.D hearing impairment (and if pt is eligible for disability), audiologic rehab (i.e school counseling), fitting of hearing devices, edu programming(IEP: individual education plan)

where to practice (as of 2016)

26% private practice

26% hospital/med centers

25% physicans practice

12% hearing/speech clinics

6% research

hearing instrumentation manufactures also need audiologist

what is a HIS

hearing instrument specialist.

HS diploma and 6 months of training

B.C HIS are board certified

audiologist is a ___ profession

autonomous meaning not having to rely on other professions to complete your own work.

audiologist can have intraprofessional collaboration: ENT, PCP, nonaudiologist hearing aid dispensers, geriatric specialist, pediatrician, etc

SLP traits

eval/treatment of com. disord and swallong

collab, counsel, prevention/wellness,screening, asses, treat, etc

ASHA v CCC v State Licensure

asha- national body that grants CCCs

ccc-a/ccc-slp - you must pay annually, certificate of clinical compentency for audiology. requires your masters, fellowship/clinical, praxis

state licensure - can get this w/o ccc but you need to keep all your transcripts and observation hours. varies by state, bare minimum.

what questions would an audiologist ask

does hearing loss exist

to what extent

is the dysfunction of the audiological system a SYMPTOM

is the HL causing comm. impairment

can impairment be overcome with equip.

what are the specific tech needs of the pt.

The portion of the hearing mechanism from the auditory nerve to the auditory cortex is called the

central auditory nervous system

The ___ is a biological system that, in conjunction with vision and proprioception, functions to maintain balance and equilibrium.

vestibular system

what is an auditory brainstem response (ABR)

is an electrophysiologic response to sound that represent the neural function of auditory brainstem pathways.

The ___ cranial nerve refers to the auditory and vestibular nerves.

The VIII-th (8th)

Otoacoustic emissions (OAEs) are:

measurable sounds emitted by the normal cochlea, which are related to the function of the outer hair cells.

high frequencies are associated with __ sounds of speech

consonant.

poor artifulation would make sense in this scenario

individual factors that affect comm disorder

degree of sensitivty loss

audiometric config

type of hl

degree/nature of speech perception

degree of loss chart

order?

normal, minimal, milk, moderate, moder. severe, severe, profound

0 db in an audiogram is ____.

NOT the absence of sound

in audiogram, if it falls on the line/border of two degrees of loss go with the:

lowest of the 2.

ex: between mild and moderate? go with mild.

what frequency is the most important for speech when looking at an audiogram

2000k

generally around1k-2k

what is air conduction primarily used for

degree of loss

configuration

what is bone conduction primarly used for

the type of HL

degree of hearing loss explained. When are these useful?

when needing to explain the effects/remaining hearing for a pt in THETA

why is the audiogram focused on 250-8000Hz?

it is focused on speech perception

what is the purpose of testing really high frequencies

to detect otoxicity.

on an audiogram what is 1500HZ an example of

a mid-octave

what is audiometric zero

the sound pressure level where audiobility occurs for the average listener

3 types of ways you can obtain information from an audiogram

pure tone audiometry

bone conduction testing’

soundfield testing

pure tone testing

earphones or headphones

aka air conduction testing

determines air conduction thresholds

BEHAVIORAL TEST: requires a response from the pt

sound travels thru the ear to cochlea

abbrev. for right ear and left ear

AD right ear

AS left ear

bone conduction testing

tight head band around head that vibrates and stimulates the cochlea directly.

tests the sensitivity of the cochlea

bone vibrator(oscillator) placed on the mastoid(bone right behind ear)

headband should never touch pinna

NOT ear specific, the better ear will always respond: masking helps ear specificity

right ear <

left year >

soundfield testing

test children and infants

large speakers emit sound. second screen shows image/video to reinforce sound.

records responses based off of head turns

visual reinforced audiology

tests hearing assisted devices too! this helps to compare w/ device and w/o

NOT EAR SPECIFIC!!!!!! profound hearing loss in ONE EAR will not show in soundfield testing. the better ear will always respond.