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SHS 450 Final Exam Practice Questions

Terms in this set (99)

Pathology of the inner ear or auditory nerve (with normal outer and middle ear function) would indicate a __________ hearing loss.
Sensorineural
Eustachian Tube dysfunction suggests what possible type of hearing loss?
Conductive
Otitis media with fluid in the middle ear suggests what type of hearing loss?
Conductive
To increase the interaural attenuation to around 80dB, when testing by air conduction, one should use what type of earphone?
Insert earphones
The purpose of hearing screening is what?
Screening is designed to assess hearing sensitivity of large numbers rapidly. Find who is 'at-risk' for hearing impairment. Whose undetected impairment could have a negative effect on communication ability
What is the interaural attenuation for supra-aural earphones?
If the patient's interaural attenuation is not known, its likely to be as little as 40 dB.
35-50 db
Contralateral masking is defined by ______________.
Playing sound into the NTE to raise its threshold so it doesn't participate in our threshold measurement of the TE
What is the occlusion effect and which frequencies are affected the most?
Occlusion effect: covering the ear (e.g. supra-aural earphone) increases the level of sound heard via bone conduction due to the osseo-tympanic path of BC.
Frequencies affected the most: Below 1000 Hz; 250 Hz affected the most (about 30dB)
Which three frequencies are typically used to calculate a patient's PTA?
500, 1000, 2000 Hz
How would a healthy TM appear when viewed with an otoscope?
TM should be pearly white, semitransparent, slightly retracted, not bulging
The supra-threshold (40 dB SL) word recognition score expected of a patient with a conductive hearing loss is about ________%.
100
Where is pathology in a conductive hearing loss?
Outer and/or middle ear
Masking will give actual threshold values that may be ______ compared to the unmasked thresholds.
Higher
When should masking be used?
-Mask when when the AC threshold differs from the non test AC and BC threshold by more than 40 dB
-For BC testing, if there is an air-bone gap of 10 dB or more , masking will be needed at that level
If 20 dB HL is threshold at 2,000Hz, then at 70 dB SL the sound level is ____dB HL?
90 dB HL (70 + 20 = 90)
What range of hearing thresholds is considered normal on the audiogram?
>25
What is a vibrotactile response?
It is considered a false response. A response to the perception of vibration through feeling rather than true hearing.
A conductive hearing loss would do what to word recognition scores?
Nothing, because speech testing is performed at suprathreshold levels and conductive hearing loss does not cause distortion
The SRT should agree with PTA within how many decibels?
5-6
In ___________ word list, the /t/ in "battle", "table", and "dart" would be considered as three different elements that would contribute to the development of the word list.
Phonetically balanced
The California Consonant Test and Word Intelligibility by Picture ID test use _______ set of words?
Closed
What is speech detection threshold?
Lowest level you can detect presence of speech
What are open set speech tests?
When the client does NOT know which words will be used on the test
Which type of speech testing makes use of spondees?
Speech Recognition Testing (SRT)
How is speech recognition testing different from speech detection testing?
Speech rec: Can understand the words. Lowest intensity at which at least 50% of a list of spondees can be identified correctly
Speech det: Can hear that there is a sound but can not distinguish
Which speech test can reveal a retrocochlear loss?
WRT, this is seen through the PI function
A retrocochlear site of lesion includes?
Auditory Nerve
When a person listens to a sustained signal at low sensation levels, there is a certain amount of threshold shift even in normal ears, what is this called?
Auditory Adaption
For an ear with hearing loss, equal loudness at equal hearing levels (dB HL) suggests:
Bilateral hearing loss
What is the test stimulus in tone decay tests?
A tone presented for 60 seconds
Specificity is:
Reject incorrect diagnosis, true negative
Otitis media with fluid in the middle ear suggests what type of tympanogram?
Type B
Which type of tympanogram would be present in a patient that has a hole in the tympanic membrane?
Type A Deep
An 8th nerve hearing loss is often identified by at least ______ dB or significant (marked) tone decay.
20 dB
Eustachian Tube dysfunction suggests what type of tympanogram?
Type C
What type of tympanogram is generally seen in an individual with otosclerosis?
Type As
Which muscles get contracted during acoustic reflexes?
Middle ear: tensor tympani, stapedius muscle
If acoustic reflexes decay, what site of lesion is indicated?
Auditory Nerve
Identify three ways to assess effectiveness of tests?
Sensitivity: correct diagnosis: true positive
Specificity: reject incorrect diagnosis: true negative
An immittance meter probe contains which components?
Microphone, loudspeaker, and an air pump
Low static compliance is due to either:
Stiff middle ear: stapes immobilization, break in ossicular chain
Tone decay tests are associated with:
Sensorineural pathology, auditory nerve site of lesion
Ears with cochlear hearing loss show which type of tympanogram?
Type A
Why is a continuous sound used for testing adaptation?
When listening to a sustained signal at low SLs, there is a certain amount of threshold shift even in normal ears
The percentage with which a test correctly identifies a site of lesion is called?
Sensitivity-true positive
What is the equation for static acoustic compliance of the ME?
C2-C1=SAC ME C2-EAC+ME C1=EAC
Acoustic reflex thresholds with mild-moderate hearing loss occur at normal dB HL and ___________ dB SL.
60-90
The tympanic membrane is made up of what three layers?
Outer epithelial layer, Inner mucosal layer, middle fibrous layer
A ______ notch occurs with noise induced hearing loss at about ______ kHz.
Noise notch, 4
What is the difference between the Eustachian tube of an adult and of a baby less than 6 mos. of age?
Longer, greater angle in adults while an infants is shorter, wider, and more horizontal the orifice of the eustachian tube in the nasopharynx tends to remain open in infants until the age of about 6 months
What are the possible causes of Eustachian tube dysfunction?
Two of the most common causes are edema of the eustachian tube secondary to infection or allergy and blockage of the orifice of the tube by hypertrophied (overgrown) adenoids. structural abnormalities of the mechanisms responsible for opening to tube are sometimes also present.
A form of otitis media characterized by pain, infected middle ear fluid, inflammation is
Myringitis
A patient is experiencing facial paralysis. There is a problem with which cranial nerve?
CN VII
A pseudotumor in the middle ear composed of skin and fatty tissue is called ____________.
Cholesteatoma
Carhart's notch is a symptom of __________ and most often occurs at _________ kHz for ________ conduction threshold measures.
Otosclerosis, 2000, bone
A permanent threshold shift should last longer than _______ hours.
24
Why are noise-induced temporary threshold shifts a problem for pure tone testing?
Inaccurate thresholds
The impedance matching process of the middle ear system provides amplification in the amount of approximately:
30 dB
Ototoxins attack which part of the auditory system?
The cochlea (outer hair cells)
Hearing loss resulting from ototoxins is best revealed by testing thresholds at _________ frequencies.
Higher
The portion of the auricle just lateral to the external auditory meatus is called the ____________ because of its bowl-like shape.
Cavum Concha
What is an acoustic neuroma?
Benign tumor on auditory nerve VII
Otitis externa or swimmer's ear causes _____________ of the outer ear canal.
Bacterial or fungal infection (or dermatitis)
Anotia and microtia are present at birth and therefore are ____________ outer ear disorders.
Congenital
The experience of a hissing or ringing in one or both ears is called __________.
Tinnitus
A treatment for otosclerosis often removes all or part of the stapes (____________ and __________) and uses a ___________ to replace the function of ossicles.
Stapendectomy and prothesis, prosthetic
Noise-induced sensorineural hearing loss often shows distinctly poorer thresholds at _________ kHz.
4000
The general classification of surgical procedures for repairing middle ear damage is __________.
Myringoplasty
Otosclerosis most often has effects at which middle ear ossicle?
Stapes footplate
The term myringitis refers to ______________.
Infected middle ear with inflammation
Middle ear fluid or effusion that is purulent or suppurative indicates that the fluid is _____________.
Infected
What is an event-related potential?
measures electrical changes in brain activity current
What is the source of wave V in an ABR test?
lateral lemniscus fibers near the contralateral inferior colliculus
When is an ABR considered neurologically abnormal? What measures of the waveform are used?
Inter-peak latency
Evoked otoacoustic emissions (EOAEs) test to see if what part of the ear is healthy?
Outer hair cells
When is threshold ABR used?
For newborn infants and adults who are unable to participate in the behavioral test
What pathology is indicated when an evoked otoacoustic emission is abnormal without any conductive loss?
Sensorineural
Which evoked otoacoustic emission can most likely be measured with a moderate hearing loss?
Distortion Product Otoacoustic Emission (DPAOE)
Ototoxic drugs cause what type of hearing loss?
high frequency hearing loss
When giving a test for distortion product otoacoustic emissions with F1 being ______kHz and F2 being ________ kHz, using the most common formula what would the distortion product be?
2F1-F2
On an ABR what site of lesion would be indicated by an absence or delay of wave I with all the waves following it altered too?
Distal VIII Nerve
The rapid movements of the eye associated with the vestibule-ocular reflex are called
Nystagmus
Benign Paroxysmal Positioning Vertigo (BPPV) is produced by aberrant stimulation of hair cells in the semicircular canals. The source of stimulation is __________.
otoconia (loose crystals in semicircular canals)
What observations are essential to consider when testing children?
Flexibility, alertness, and time
What does behavioral observation audiometry BOA use to evaluate hearing status?
Use a childs attempt to find the sound as a response to the sound
For auditory responses, small children will often try to localize sound sources. How can this be used during hearing tests and why can't we rely on accurate localization of sounds to indicate ear specific hearing evaluation in sound field?
The thresholds measured are not ear specific
Hardy (1962) suggested that children don't really localize sounds until _________ of age.
8 months
What do low APGAR scores indicate with respect to hearing health?
Indicate risk for SNHL
The minimum response level (MRL) is assumed to be the response of a child during an auditory test. This response is actually _______ their threshold.
Above
Visual Reinforcement Audiometry (VRA) tests hearing of very young children using a pair of loudspeakers. Which ear is evaluated?
Both, not wearing headphones, sound is through speaker in a room
APGAR scores are indicators for _________.
The normalcy of respiratory effort, muscle tone, heart rate, color, and reflex irritability for newborns in the hospital. The scores helps determine whether the child requires additional oxygen and whether there is a likelihood of CNS damage
When presenting sound from a loudspeaker, visually reinforced audiometry (VRA) estimates hearing threshold of infants for the ____________ ear.
Both
Define appropriate and inappropriate labels for pseudohypacusis.
appropriate labels: non-organic hearing loss, functional hearing loss
inappropriate labels: malingering, feigning, simulated hearing loss, hysterical hearing loss, psychogenic hearing loss
What goal of audiometric evaluation is especially important in the case of pseudohypacusis?
goal is get accurate results by increasing the cooperation of the patient
How are case histories an important tool for evaluation with pseudohypacusis?
Certain details can stand out such as: long standing hearing loss but normal voice quality; only uses speech reading, stare intently at face - covers mouth speaks quietly; no eye contact but understands quiet voice, speaks excessively loud and/or cups ear, excessive detail about hearing loss
What differences might be expected when comparing PTA and SRT with pseudohypacusis?
SRT is often better than PTA
What are the roles of ABR, evoked OAE, and acoustic reflex thresholds in evaluating for pseudohypacusis?
A person who is faking hearing loss will not be able to manipulate the test because it is a reflex
How can the Lombard voice reflex be used to evaluate for pseudohypacusis?
It is based on the phenomenon that people increase their vocal levels when they speak in a background of noise. Therefore, if a noise is presented to the ears of someone who cannot hear that noise, their voice loudness will not change. However, if the person can hear the sound, he or she will usually talk louder. Shows that a person who does not have TRUE hearing loss is faking it.
The purpose of the eustachian tube is to match the pressure of the middle ear to that of the ________.
Outer ear
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