CSD 4301 Final Exam

relay stations ; processed

8CSLIMA is an acronym to remember the _____ in which auditory information is ______ as it travels beyond the cochlea to the auditory cortex

cochlear nucleus ; superior olivary complex

a crossover point (decussation) occurs after the ____ so that the ____ is the first point at which information from both ears is available

speech pathology ; otology ; WW2

audiology developed from the profession of ____ and ____ to help soldiers overcome challenges of hearing loss noticed when returning to civilian life after ____.

AuD

the entry level degree for the profession of audiology is the ____.

frequency and intensity are ____ measurements of sound.

frequency

the ____ of a sine wave is determined by the number of cycles completed in one second.

recruitment

large increase in the perceived loudness of a signal produced by relatively small increases in intensity above threshold. phenomena that occurs with damage to the cochlea.

hyperacusis

reduced loudness tolerance. can interfere with activities of daily living such as attending birthday parties or church with organ music

mixed loss

abnormal bone conduction with an even greater hearing loss by air conduction signifies _____.

the inner ear or 8th nerve and beyond

an audiogram indicating a sensorineural loss means that the hearing loss is a result of an issue in ___.

AC: 30 dBHL ; BC 15 dBHL

which of the following is indicative of an ABG?

- AC: 15 dBHL ; BC 5 dBHL

- AC: 45 dBHL ; BC: 40 dBHL

- AC: 60 dBHL ; BC: 60 dBHL

- AC: 30 dBHL ; BC: 15 dBHL

an issue with a conductive mechanism

if AC shows a loss and BC is normal and ABG are present, the diagnosis is ___.

damage to the IHC of the cochlea from taking ototoxic medication

pick the best answer from the choices below.

if AC shows a loss and BC shows a loss and no ABG are present, a possible cause of this hearing loss is ____.

- damage to the IHC of the cochlea from taking ototoxic medication

- something blocking the sounds from reaching the cochlea in the inner ear

- a middle ear that is filled with infection

conductive

eroded ossicles would result in what type of loss?

true

t/f: sensorineural hearing losses often need to be fit with hearing aids to improve access to sounds

OE, ME, IE, 8CSLIMA

which of the following is the aid conduction pathway?

- OE, ME, IE, 8CSLIMA

- OE, IE, 8CSLIMA

- IE, 8CSLIMA

- ME, IE, 8CSLIMA

yes ; no

if someone has impacted cerumen in their ear canal, would you expect this to affect AC findings? would you expect impacted wax to affect BC findings?

yes ; yes

if someone has a history of noise exposure that has resulted in damage to the hair cells in the cochlea, would you expect this to affect AC findings? would you expect this damage to the hair cells to affect BC findings?

<

the symbol for right unmasked bone conduction is

O

the symbol for right unmasked AC is

]

the symbol for left masked bone conduction is

X

the symbol for left unmasked air conduction

x ; Hz

the _____ axis on the audiogram is frequency and the unit of measurement is ____

the patient has a hearing loss in both ears

from an audiogram with only S's on it at 40 dB and below we can tell....

you add up all of the dots underneath the line drawn and the patient has access to about ___ (insert the number of dots counted)% of the speech spectrum

how do you read a count the dot audiogram?

threshold

____ is the level at which a tone is barely audible. it is so soft that a patient may only respond to it 50% of the time

80 dBSPL

you are at a basketball game and you want to measure the sound levels in the gym. you use a sound level meter app on your phone to make a measurement ... what is the likely finding

- 40 dBHL

- 30 dBSL

- 70 dBHL

- 80 dBSPL

1000 to 4000 Hz

the human ear is most sensitive to what frequency range?

dynamic range

the range from the softest sound you can detect to your uncomfortable loudness levels (UCL) is your ____

auricle, cartilage, high, localization

the ____ gathers sound waves from the environment, is made of ___, emphasizes ____ frequencies and helps with _____.

in the outer portion of the EAC

cerumen is produced by the sebaceous glands...

- in the inner portion of the EAC

- throughout the length of the EAC

- in the outer portion of the EAC

- in the internal auditory canal

has a steeper downward slope than it does in the adult requiring the ear to be pulled up and back when inspecting the canal

in infants and small children the EAC...

- has a steeper downward slope than it does in the adult requiring the ear to be pulled up and back when inspecting the canal

- angles in a greater upward direction than it does in adults requiring the ear to be pulled up and back when inspecting the canal

- has the same slope as in adults

- is generally parallel with the floor when seated and has no slope

S ; one inch

the external auditory canal in an adult is shaped like the letter ___ and its typically about this long ___.

annulus

the tympanic membrane is held in position at the end of the external auditory canal by a ring of tissue/ligament called the ____.

cerumen is most easily cleared with judicious use of cotton swabs

which of the following is not true about cerumen?

- cerumen becomes darker in color and harder in consistency the longer it stays in the ear canal

- cerumen is a natural byproduct of a healthy ear

- cerumen is most easily cleared with judicious use of cotton swabs

- cerumen is a bug repellent and barrier for dirt

eustachian tube

middle ear air pressure is regulated through the ___.

malleus

the middle ear ossicle embedded in the fibrous portion of the tympanic membrane is the ...

- incus

- malleus

- tragus

- stapes

stapes

the smallest of the middle ear bones is the ...

- malleus

- incus

- stapes

- anvil

stapes

the middle ear ossicle that rocks in the oval window to transmit the mechanical vibrations of the ossicles to the fluids of the cochlea is the ...

- stapes

- malleus

- anvil

incus

middle ear impedance matcher

the size difference between the tympanic membrane and the oval window, along with the leverage action created by the ossicles compromise what is known as the ___.

tensor tympani muscle

the muscle in the middle ear stiffens the ossicle attached to the membrane in the oval window when it contracts in response to loud sounds is the ...

- superior oblique muscle

- stapedius muscle

- tensor veli palantini muscle

- tensor tympani muscle

scala media

endolymph is found in the...

- scala vestibuli and scala tympani

- scala media

- spiral ganglion

tectorial membrane

in the inner ear, the tips (stereocilia) of the hair cells are embedded in ...

- reissner's membrane

- basilar membrane

- tectorial membrane

- stria vascularis

helicotrema

small opening allowing passage of fluid from scala vestibuli to scala tympani

2 1/2

the number of turns of the cochlea is

modiolus

the central core around which the cochlea winds

semicircular canals

portion of the inner ear that responds to angular acceleration

low frequency hearing loss

damage to the apical portion of the cochlea would result in...

- middle ear infection

- high frequency hearing loss

- low frequency hearing loss

- oxygen and nutrients not reaching the cochlea

vestibulo-occular reflex

when you stare at your finger in front of your face and move your head back and forth, you are testing your

- vestibulo-occular reflex

- eye hand coordination

- fine motor skills related to the semicircular canals

- vision balance ratio

movement of the footplate of the stapes

the ____ transforms mechanical energy into hydraulic energy

basilar membrane

when dong a visual inspection of the ear you should check all of the following EXCEPT

- basilar membrane

- mastoid process

- cartilaginous EAC

- pre-auricular area

the pressure in the middle ear is equal to the pressure in the outer ear

the tympanic membrane vibrates most efficiently when...

- the pressure in the middle ear is equal to the pressure in the outer ear

- the pressure in the middle ear is negative compared to the pressure in the outer ear

- the pressure in the middle ear is positive compared to the pressure in the outer ear

cerebellum ; proprioceptive

the maintenance of balance depends on input to the ___ from the vestibular system along with the inputs from the visual and ____ systems

if hair cells int he apex of the cochlea are damaged it will result in a high frequency hearing loss

which statement is not true regarding hair cells in the cochlea:

- normally functioning hair cells have sharp tuning curves and only activate to a specific frequency

- severely damaged hair cells result in a distorted signal reaching the brain

- the hair cells in the first bend of the cochlea are most vulnerable to damage from loud sounds

- if hair cells int he apex of the cochlea are damaged it will result in a high frequency hearing loss

asking the family member to clarify

during the video we watched in class of the case history intake by the graduate student, all of the following behaviors were seen except:

- giving adequate time for patient response

- asking the family member to clarify

- paraphrasing

- active listening

false

t/f: when taking a case history for an adult, noise exposure which occurred more than 10 years ago is considered unremarkable

right

your patient tells you that they have more difficulty hearing with the left ear than the right ear. which ear do you begin testing first?

1, 2, 3, 4, 6, 8, .5, .25 kHz

which is the correct frequency order when performing AC pure-tone testing?

- .25, .5, 1, 2, 3, 4, 6, 8 kHz

- 1, 2, 3, 4, 6, 8, .5, .25 kHz

- 1, 2, 3, 4, 6, 8, .25, .5 kHz

- .5, .25, 1, 2, 3, 4, 6, 8, kHz

present a tone at 50 dbHL

if a patient does not respond to the intitial tone that you present at 4 kHz, what do you do?

respond every time they hear a tone even if the tone is so soft they can barely hear it

when giving instructions for pure-tone testing, it is important that the patient understand that they should..

drop 10 dB

if your patient responds to the first tone you present at .25 kHz in the right ear via air conduction, what is your next step?

air conduction findings only

to determine degree of loss you look at ___.

type, degree, and configuration

when describing a hearing loss you should classify the

determine the type of loss

what is the purpose of measuring hearing by bone conduction?

1, 2, 4, .5 kHz

which frequencies are tested for bone conduction and what is the frequency order for testing

false

t/f: when testing BC you can isolate results from the right ear by placing the oscillator behind the right ear and results from the left ear are obtained b placing the oscillator behind the left ear

none of the above

you are testing a ten month old child. you obtain thresholds between 50-60 dBHL in the soundfield. you can state:

- the child will need hearing aids

- the child's hearing loss can likely be remedied by medical intervention

- the child has normal hearing in at least one ear

- none of the above

1 kHz, 30 dBHL, drop 10 db

when testing bone conduction you should start at what frequency and at what level? if there is a response at the initial level, what do you do next?

mid frequency

with a reverse cookie bite configuration the best thresholds are

- low frequency

- mid frequency

- high frequency

minimal response level

the state of the child can affect some test results. ____ is the lowest level at which a small child might respond to a stimuli...it may be above their threshold.

- minimal response level

- habituation level

- SAT

- conditioned level

false

t/f: it is safe to say that if a child responds to sounds appropriately in his/her home environment (bobbing head to music, being startled by a door slamming), the child most likely has normal hearing

all of the above

you are seeing a 2 year old for a hearing evaluation. case history indicates that he passed his newborn hearing screening. his parents have concerns about his speech. why is it necessary to test his hearing if he has previously passed a hearing screening?

- he could have late onset or progressive sensorineural hearing loss

- he could have a conductive loss due to er infections

- it is possible that hearing loss is affecting speech and language development

- all of the above

- non of the above - further testing not warranted if they passed newborn hearing screening

none of the above

when working with a 15 month old pediatric patient you should

- tell the parent that a reliable hearing test cannot be obtained until about age 3

- enlist the parent to discipline the child if he/she is not responding to the stimuli

- none of the above

there are syndromes that affect both hearing and kidneys

why do we ask if a child has any kidney issues during a case history for an audiological evaluation?

all of the above

interprofessional collaboration is necessary for audiological patients. specifically a child with a newly diagnosed sensorineural loss should be referred to

- ENT

- SLP

- genetic counselor

- all of the above

be flexible

for a successful pediatric hearing evaluation you should

noise exposure

which of the following is not a reason we typically receive a referral for a pediatric hearing evaluation?

- speech and language delay

- noise exposure

- failed newborn hearing screening

- recurrent ear infections

habituation

when a baby stops responding to an audible stimuli after a few presentations this is called

false

t/f: a thorough case history should be taken PRIOR to to testing a young pediatric patient

false

t/f: if a patient states that their child responds to environmental sounds such as the vacuum or a dog barking, your prediction would be normal hearing results from the hearing evaluation.

do the grandparents have vision problems

which of the following is not a question typically asked in a young pediatric case history?

- how have ear infection been treated

- how do you feel about you child's hearing

- do the grandparents have vision problems

- was there anything unusual about the birth

true

t/f: during a pediatric case history it is appropriate to ask "how do you feel about your child's hearing" and let the parent express their reasons for seeking out the services of the audiologist

false

t/f: hearing tests such as presenting cold running speech in the sound field measure hearing itself and are not affected by the child's ability or willingness to respond to stimuli

OAE

which test is measuring the presence of "echoes" from the outer hair cells of the cochlea?

based on OAE findings both cochleas appear to be functioning normally

when testing a 15 mo old soundfield results show normal hearing in the better hearing ear. otoscopy is within normal limits. the child passes an OAE with both ears. which of the following is true?

- based on OAE findings both cochleas appear to be functioning normally

- based on pure tone the child has normal hearing in both ears

- the child most likely has an ear infection in at least one ear

- the child most likely has wax occluding at least one earcanal

tone bursts

in order to get frequency specific findings during an ABR you need to use ____ as your stimuli

TYMP

which of the diagnostic tests that we have discussed is not a hearing test but a test to tell you about the integrity of the tympanic membrane and the function of the middle ear?

- OAE

- ABR

- TYMP

- latency/ intensity function

ABR

it is necessary to prep the skin to ensure good impedance when placing electrodes for which objective diagnostic test?

- OAE

- ABR

- acoustic reflexes

- tymps

auditory pathway disorder

______ is diagnosed when ABR findings show normal hearing sensitivity yet the absolute and interwave latencies of the ABR are prolonged

false

t/f: a Type A sub d tympanogram is found when a ear infection is coming on or clearing up

pass OAE for both ears

addison has normal hearing in both ears. which of the following results would you expect for addison?

- pass OAE for both ears

- SRT of 25 dBHL

- type B tymp with normal ear canal volume

- none of the above

she does not have patent (open) tubes in her ears

findings for 3 year old: otoscopy is WNL. ABR testing for tone bursts are as follows: wave V thresholds obtained at 500 Hz - 40 dBHL, 2000 Hz - 60 dHL, tympanometry yields Type A tympanogram. which of the following is true?

- it is probable that she has bilateral ear infections

- she does not have patent (open) tubes

- she has normal hearing

- she would pass an OAE

you would expect an SAT between 0-15 dBHL

findings for 18 month old: otoscopy revelaed bilateral tubes, he passed his OAES with both ears, his tone burst BAR revealed Wave V's down to 20 dB for both ears at 500-4000 Hz. which is true?

- you would expect type c tympanogram

you would expect an sat between 0-15 dBHL

- you would expect an abr click threshold at approx. 50 dBHL

- you would expect him to be able to perform play audiometry

you would expect a REFER reading for OAEs

6 year old has air conduction and bone conduction thresholds between 40 - 45 dBHL at .25-8 kHz in both ears. there are no air bone gaps. what is true for him?

roxy is not responding to the stimuli as expected and objective diagnostic hearing testing is needed

has severe autism and cannot be tested like a typical 10 year old. will not tolerate headphone or insert earphones. soundfield yield mild to moderate range for better hearing ear. will not tolerate otoscopy or tympanometry. no other testing can be done during this session. what do you tell the parent?

TYMP

all of the following tests provide info about the degree of hearing loss except:

- TYMP

- ASSR

- ABR

- play audiometry using insert earphones

type A

has a sensorineural hearing loss and normal otoscopy. what type of tympanogram would you expect?

type B normal ear canal volume

you performa tympanometry. there is not a perforation but it is red and bulging. what tympanogram would you expect?

probable otitis media

a normal ear canal volume with a type B tympanogram is indicative of ___

stiffness of the middle ear system, reduced compliance of TM

tympanogram should peak below the box (lower and flater)