Assessment Final Review

The gold standard of every audiolgoical evaluation is

Pure tones

What type of hearing loss is this?

Sensorineural

What are the critical frequencies for speech

300-3000

What type of hearing loss is this?

Mixed

What is the dB range for a slight hearing loss for a child?

16-25

What is the dB range for profound hearing loss in adults?

90+

What type of hearing loss is this?

Conductive

The patient responds when there is no sound

False positive

T or F: When doing bone you place the oscillator on the better ear

False

When doing ABR’s the most important wave for hearing is

Wave V

This type of OAE is more sensitive to hearing loss

Transient Evoked OAE

AC crossover occurs in inserts when there is a ____ dB difference between ears

60-70

AC crossover occurs in headphones when there is a ___ dB difference between ears

40-50

To achieve the plateau method you need to have __ consective increases of the masking noise

3

__ has a chromosomal abnormality of chromosome 21

Down syndrome

For age 6 to 24 months the most appropriate test method for testing would be

VRA

You will usually find wave(s) ___ to be distinct on ABR

Wave I, III, and V

One test that can be used for hyperacusis is the stenger test

False

How many hearing impaired children have multiple disabilities

1/3

Auditory neuropathy normally presents with present OAE’s and abnormal ABR

True

Which ear do we add masking to?

Non test ear

We must consider the occlusion effect when masking for

Bone thresholds

Tactile responses are likely to occur at the following frequency(s) for bone

250 and 500

For bone ANSI standards are based on __ placement

Mastoid

T or F: Spontaneous OAE’s are used clinically

False

T or F: OAE’s can be impacted by middle ear issues

True

Which of the following is NOT a common characteristic of Down syndrome

Downward slanting eyes

Who discovered the existence of Otoacoustic emissions

David Kemp

T or F: OAEs reflect the integrity of the IHC function

False

Spontaneous are absent in ___ of ears with normal hearing

50%

TEOAEs are most sensitive to the following frequency(s)

1000

DPOAEs are most sensitive to the following frequency(s)

4000-6000

When comparing the air and bone thresholds we can classify the ___ of hearing loss

Type

IA varies based on

Frequency

Skull thickness

Transducer used

Which stimuli can be used for masking noise

Narrowband noise

Broadband noise

Speech noise

For ages 2-5 years the most appropriate testing protocol is

Conditioned play

When testing a young child we are getting

Minimum response level

T or F: Children respond the best to pure tone stimuli

False

Infants begin to turn their head around

4-7 months

T or F: Infants in the age range of 25-30 months are the hardest to test

True

A non progressive disorder of motion and posture due to brain injury under the age of 3

Cerebral palsy

ADHD has __ subtypes

3

Pseudohypacusis is commonly seen in

10-12 year old females

Industrial settings

Children experiencing hardship in family life

T or F: Cross check principle is using multiple tests in order to get a better idea of what is going on and check booth results

True

T or F: Suprathreshold hyperacusis is having discomfort to sounds above 65 dB when they have normal hearing

True

ABR is recorded in this time frame

0-15 ms

T or F: When masking for air we must account for the occlusion effect

False

T or F: We should mask for 2k-8k air thresholds if using headphones

True

What would be our starting mask dB at 3k for air thresholds? (if we were using headphones)

40 dB mask in right ear

What would be starting mask threshold for 4k bone thresholds?

40 dB in the right ear

Explain the general procedure used in Evidence Based Practice

• Integration of the best research evidence with clinical expertise and patient values

• Involves a process by which the effectiveness of clincial practice is validated through study and analysis

• General procedures include:

  • Framing the clinical question

  • Finding the evidence

  • Assessing the evidence

  • Making the decision

Why do we use FM signals in the sound field

To avoid standing waves

Individuals with hearing loss that can identify enough of the distinguishing features of speech through hearing alone to permit at least partial recognition of spoken language

Hard of Hearing

Represents little or no static admittance in the system (most abnormal tymp)

Type B

Represents normal static admittance but abnormal negative pressure in the middle ear 

Type C

Which frequencies do you use to calculate PTA? Explain how to calculate PTA?

500 Hz, 1000 Hz, and 2000 Hz. You add up the thresholds for each ear at 500 Hz, 1000 Hz, and 2000 Hz and then divide by 3. This gives us the pure-tone average.

How many classical Bekesy patterns are there?

5

The intensity range from weakest to most intense phoneme is

30-65 dB

Limitation on function imposed by the hearing loss:

Hearing disability

The ease with which acoustic energy is transmitted

Admittance

Describe in detail the pathway otherwise known as the Acoustic Reflex Arc for both the ipsilateral side and the contralateral side.

Ipsilateral: The acoustic reflex arc begins as sound enters the ear and makes its way to the middle ear. The signal is sent to the inner ear at the cochlea, then to the cochlear nerve and up the the brainstem towards the superior olivary complex and VII nucleus. It makes its way back to the middle ear and sends the reflex signal back, hitting the stapedius muscle which contracts and in turn makes the ossicular chain stiffen.

Contralateral: For contralateral reflexes, the sound travels from one side (lefft or right) to the other. It begins by passing through the outer and middle ear and towards the inner ear and cochlea. The signal is sent to the cochelar nerve and up the brainstem towards the opposing ear. This is where sound “crosses” and travels to the opposite superior olivary complex and VII nucleus. Finally, the signal is sent back out to the other tympanic membrane as the stapedius muscle contracts and hit the ossicular chain.

The patient responds in the absence of the stimulus  

False positive

This tuning fork test assesses bone conduction via mastoid placement and alternative opening/closing of tragus

Bing

Name the 2 professional organizations that have developed the scope of practice statements for audiology. 

ASHA: American Speech-Language-Hearing Association

AAA: American Academy of Audiology

Why do we do daily listening checks?

To ensure that equipment is calibrated and functioning properply before testing patients. This ensures patients results are accurate and reliable.

This tuning fork test assesses bone conduction providing feedback about the location of sound via forehead placement of tuning fork

Weber

Acoustic Reflex Decay is assessed using which frequencies?

500 Hz, 1000 Hz

Explain rollover. What can this suggest? 

Rollover is intensity is increased, but speech recognition decreases. This can suggest retrocochlear pathologies, neuropathy, or middle ear dysfunction.

Used to measure the output of an electronic device 

Voltmeter 

Define descrimination

Patient detects a change in the acoustic stimulus

Define awareness

Patient indicates a sound was detected

Define comprehension

Patient attaches a meaning to a stimulus by answering questions

Define indentification/recogntion

Patient attaches a label to a stimulus

Write 4 configurations you may see in an audiogram 

Sloping: Low frequency thresholds are better then high frequencies. Thresholds are higher in the low frequencies and lower in the lower frequencies.

Rising: Low frequencies thresholds are worse than high frequencies. Thresholds are lower in the low frequencies and higher in the high frequencies.

Flat: Thresholds at all frequencies are equal.

Trough Shaped: Thresholds at mid frequencies are worse than low and high frequencies. Thresholds are better in the low and high frequencies and worse in the mid frequencies.

Name two types of audiometers, what are their purposes? 

Pure-tone audiometer: This is the standard audiometer that allows us to test patients thresholds up to 8000 Hz.

Extended high frequency audiometers: Presents tones greater than 8000 Hz. This allows us to test patients thresholds at extended high frequencies.

When an acoustic stimulus is delivered to the ear canal the ___ muscle contracts and creates the acoustic reflex

Stapedius

____ are the gold standard of every audiological evaluation

pure tones

A measure of the ability of a test to detect the disorder for which it was designed

Validity

When doing acoustic reflexes for the ipsilateral side the highest intensity you will go to is?

100 dB

The inverse of stiffness as it relates to the ease of acoustic energy transmission

Compliance

Which frequencies are critical for the perception of speech?

300-3000 Hz

When doing acoustic reflexes for the contralateral side the highest intensity you will go to is?

105 dB

Who makes the standards in which our audiometers, acoustic immittance instruments and environment should comply to? 

ANSI: American National Standards Institute

Accuracy in correctly rejecting patients without a disorder

Specificity

Write the degrees of hearing loss classification for children

Norm: 0-15 dB

Mild: 16-25 dB

Moderate: 26-30 dB

Moderate-Severe: 31-50 dB

Severe: 51-70 dB

Profound: 71+ dB

T or F: Middle ear measures assess hearing and provide objective information on the mechanical transfer of sound through the ear pathway.

False

Describe in detail the modified Hughson- Westlake Technique

When a patient responds to a sound presented, you decrease the dB level by 10. When a patient does not respond to a sound presented, you increase the dB level by 5. You can mark the patients threshold on the second time ascending. (Down 10 dB and up 5 dB)

The opposition to the flow of energy

Impedance

T or F: Threshold Tone Decay tests (TTD) provide differential diagnostic information regarding cochlear vs Retrocochlear pathology

True

Write the degrees of hearing loss classification for adults

Normal: 0-25 dB

Mild: 26-40 dB

Moderate: 41-55 dB

Moderate-Severe: 56-70 dB

Severe: 70-90 dB

Profound: 91+

Represents abnormally high static admittance 

Type Ad

Standardized devices used for measuring the output of transducers

Coupler

Accuracy in correctly identifying disordered subjects

Sensitivity

SRT scores are generally _____ than the SDT. 

10-12 dB greater

When running Tymps on babies age birth to 6 months we use which probe tone frequencies?

660-1000 Hz

Extended High frequency Audiometers use Circumaural headphones rather than supra-aural earphones

True

PTA should be within _____

5-10 dB