After the TM is perforated and surgery is done...
when it heals how many layers does it have?
***epithelium layer and the mucous layer
Can't make the fibrous layer again
A person with MHL has what type of air and bone conduction thresholds?
________ bone conduction + Air conduction but there is at least a _____ gap.
*****For example a patient may come in a first time and find out he has a sensorineural hearing loss due to presbycusis. Then maybe he perforates his tympanic membrane with a q-tip. Now the audiogram will show the difference.
Adult case history example
1.Do you ever have: Ringing? ___Dizziness?________ Drainage? _____ Full feeling? __ Ear pain________
2.Is there a family history of hearing loss? ________________________________________
Which family members?_______________________________________
3.Have you ever been exposed to loud noise? ______________________________________
When?____What Type?_________How Long_______
4.Have you ever had any of the following:
Meningitis_____, Scarlet Fever_____,Mumps_____, Measels_____, Diabetes_____
5.Did you have an illness or accident at the onset of your loss?____________________
If so, what?
Air bone conduction
We use both _____ and _____ __________ to together to find out what determines the nature/type of hearing loss one has. By reading an audiogram and comparing Bone v.s. Air conduction you can tell the type of hearing loss and its degree.
air born radiation
During a bone conduction test sound may come out and reach the inner ear Via the EAM. This is called _____ ______ _________
This is when masking is done.
* This scale evaluates newborns hearing
*By 10 minutes they need to have a score of 7 or better
* If the score is less than 7 they may have hearing loss
register hearing test by introducing pure tones & determine the minimal level a patient can hear a signal.
Air conduction Bone conduction
O Right ear < Right ear
X Left ear > Left ear
*When a signal is heard via bone.
sound bypasses the ear canal and goes directly to the inner ear via the bones of the skull (temporal and mastoid bone)
* We hear our own voice mainly through bone conduction.
Bone conduction device
transducer converts electic signals into sounds- Place device on either temporal bone or mastoid bone and send the signal. This can be in the form of a bone vibrator or a tuning fork.
Questions asked to get a better understanding of what may be wrong with the patient.
Questions on: background, history, family history
What is the first evaluation an audiologist should administer?
They should do a _________ _________
Why do you use a otoscope?
* Not to diagnose, but to see if there is a ________ _______ for hearing.
conductive hearing loss
*related to the damage, pathologies, or abnormalities of the external or middle ears, or both
*No permanent damage-mechanical problem-hearing will come back in most cases-medically manageable
What does an air conduction test tell us about hearing?*Tells us the _________ % of hearing loss
Why is it important to do a case history on a patient?
It helps make a better ___________.
hasn't been asked
What is an important question to ask when doing a case study?
Is there anything else you would like to mention that __________ _______ ________? (open set question)
5 major types of _________ _______
1. Sensorineural hearing loss
2. Conductive hearing loss
3. Mixed hearing loss
4. Central auditory dysfunction
5. Non-organic hearing loss (pseudohypacusis)
*loudness of sounds-dB hearing loss
** Unit is dBhl
*** Softer the sound the closer to zero
*** Louder the sound the closer to 100
what are the two scales of the audiogram?
1. __________ Line - db
2. _________ scale - Hz
What are some causes of CHL?
*wax in the ear canal
* perforation of the TM
*abnormalities in the middle ear
*_______ in the middle ear
*atresia (closure of the ear canal)
*___________perforation on the TM
perforation is on the side of pars tensa-harder to heal than center perforation
Central perforation of TM - In center, pars tensa. easier to heal after surgery.
Pars flaccida perforation: aka "atic perforation": very dangerous.
Total perforation: Complete perforation of TM. Not able to fix or heal. Not congenital. Can be caused by middle ear disease.
mixed hearing loss
What are some examples of __________ ____ _____?
*Person who has prebycusis and was cleaning ear out and happened to rupture the TM.
*A child with Rubella who develops a middle ear infection
What are some causes of sensorineural hearing loss?
* person who has had ________
* because of presbycusis
What does a bone conduction test tell us about?
* It determines the ______/______ of hearing loss or site of lesion.
A patient with CHL has what type of air and bone conduction thresholds?
*Inspection of the ear-look inside the ear canal using a tool called the otoscope
TM intact (Malleus? Cone of light? Umbo? coloration pearl-like?
In a case history study, what types of problems in the _____________ ____________ are it important to know about?
High Blood Pressure
All of which may cause hearing loss
* During birth or at birth (during the birthing process)
*Was there anoxia (lack of oxygen)?
*Was the child pale?
*Did the child have enough muscle tone?
*Was the Apgar scale low?
*low birth weight?
* After birth
* Has anyone smoked in the house while the child was in the room?
* Does the child have noisy toys?
*Was the child's birth weight less than 1500grams?
* Was the child in NICU?
*Was the child full term or premature?
*Was the child born naturally or c-section?
*Before birth, during pregnancy
*Did the mom have Rubella?
*Did the mom use drugs or alcohol?
*Was there an accident or some kind of trauma?
prenatally, perinatally, and postnatally
What are important questions to ask for a child's case history?
*ask the parents
* ask questions ____________ __________ ___________
rupture their TM
When using an otoscope on a child how should you hold their head? Why?
*parent should embrace child and put their hand on their child's head, so the child doesn't move and __________ _____ ____
A patient with SNHL has what type of air and bone conduction thresholds?
they are the ________ or similar
save their hearing
Sudden hearing loss V.S. gradual hearing loss
Sudden hearing loss can be managed if treated quickly-there is more of a chance to _______ ______ _______
*Sudden -just happened
____________ hearing loss
*the most common type of hearing loss
*due to the damage or the cochlea or hearing nerve-or beyond(inner ear or beyond)
*called this because it has both a sensory + neural component
*sometimes can be just sensory or neural
*But can also be both
threshold, hearing loss
The _________of bone and air conduction tells us the nature/type of ____________ ______. As well as the degree.
*A device the connects to the otoscope to look inside the ear-it can be seen on a screen-great for teaching.