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AUD Unit 3

Terms in this set (105)

Name two acoustic immittance tests.
Tympanometry measures middle ear pressure, ear canal volume and tympanic membrane mobility.

Acoustic reflex stapedius muscle will contract and make TM stiffen in response to loud sounds. recorded at a single air pressure
The sound used in acoustic immittance measurement is known as the _________ tone.
probe tone
A very high ear canal volume estimated during acoustic immittance measurement usually indicates a ____________________.
perforation / PE tube
A perforated tympanic membrane would result in a _____ type tympanogram.
B
The acoustic reflex involves contraction of the ________________muscle.
stapedius
The abbreviation ART stands for __________.
acoustic reflex threshold
The abbreviations TEOAE and DPOAE stand for ______ and ________, respectively.
Transient Evoked Otoacoustic Emissions
-click/tone burst
-80 dB SPL
-stimulus is short/loud

Distortion Product Otoacoustic Emissions
-combination of 2 tones
-55-65 dBSPL
-cochlea produces frequency specific response
OAEs presence is defined by amplitude that is at least _________ above the noise floor.
6 dB SPL
T/F: OAEs are always normal when pure tone audiometry is normal.
False
T/F: Acoustic immittance tests can be performed with the ear canal open.
True
What is the peak pressure for a type C tympanogram?
a. Beyond -150 daPa
b. Beyond -50 daPa
c. Beyond +200 d. daPa
d. Between ± 100 daPa
What does the peak pressure in a tympanogram represent?
a. The pressure at which the tympanic membrane is the most compliant

b. The pressure at which the tympanic membrane is the least compliant

c. The maximum pressure that the tympanic membrane can sustain without rupturing

d. The minimum pressure that the tympanic membrane can sustain without collapsing
What are the components of an immittance bridge?
a. Three microphones
b. A loudspeaker and two microphones
c. A microphone and two loudspeakers
d. A microphone, loudspeaker, and manometer
Which of the following statements is true?
a. Only the stapedius muscle is involved during the activation of the acoustic reflex.

b. Only the facial nerve is involved during the activation of the acoustic reflex.

c. Only the ossicles are involved during the activation of the acoustic reflex.

d. Many structures in the middle ear and the central auditory pathway are involved during the activation of the acoustic reflex.
What is an indicator of the activation of the acoustic reflex?
a. Contraction of the stapedius muscle.

b. Stiffening of the ossicular chain.

c. Reduced compliance of the middle ear structures

d. All of the above
Which of the following is the correct description of the measurement of a contralateral acoustic reflex in the right ear?
a. Stimulus in the left ear and reflex measured in the left ear

b. Stimulus in the left ear and reflex measured in the right ear

c. Stimulus in the right ear and reflex measured in the right ear

d. Stimulus in the right ear and reflex measured in the left ear
Name the different types of tympanograms commonly measured, with examples for when each may be found.
As

Ad

B

C
Describe two important advantages of electroacoustic auditory measures over behavioral tests like pure tone audiometry.
Differentiate between the sensory and neural components of sensorineural hearing loss
Describe where and how otoacoustic emissions are generated.
sounds that the cochlea makes, sound is inaudible as listeners. different that tinnitus

reflection of activity of Outer Hair Cells

stimulated with clicks/tone bursts (TEOAE) or combination of 2 tones (DPOAE)
List some applications of OAEs in clinical audiology.
...
T/F: Word recognition testing in quiet is an example of a diagnostic speech audiometry test.
False
The SRT is described in _______________, whereas word recognition scores are described in ___________________.
dB HL; percentage
In word recognition testing, the phrase "Say the word ..." is known as a _________________ phrase.
carrier
T/F: The maximum score in word recognition performance is always at a comfortable listening level.
False
T/F: Word recognition is more accurate with a fifty-word list than with a twenty-five-word list.
false
T/F: In the clinic, word recognition is never tested in background noise.
false
Name different types of stimuli used in speech audiometry.
nonsense syllables

words

sentences/phrases

paragraph
What is a spondee word?
bisyllabic word with equal amount of stress placed on both syllables
Name different patient response modes in word recognition testing.
oral, written, sign
What is difference between the SDT and the SRT and how are they related?
SAT/SDT
Lowest level that the patient can detect/is aware that speech is present

-Patient does not have to repeat back words
-Patient merely detects the presence of speech
-say yes/no, raise hand, localize

SRT
Lowest level at which a patient can recognize a set of familiar words (closed-set testing)

-point, repeat, write, sign
What is the relation between the SRT and the PTA?
PTA&SRT 7-8 dB HL
PTA&SAT 10 dB HL
List three disadvantages to relying on the MLV approach for measurement of word recognition
...
The term for an infection is the external ear canal is _________________.
otitis externa
The terms exostoses refer to ______________ growths in the external ear canal.
-Benign bone growths in the EAC
-Multiple, bilateral (clusters)
-Thought to be reactive condition secondary to cold water exposure
-"Surfer's ear"
Constriction or narrowing of the external ear canal is called _________________
stenosis
Fluid in the middle ear space is called otitis media with ________________.
effusion
A common surgical treatment of otitis media is insertion of _____________________ tubes into the tympanic membranes.
pressure equalizing
A common factor in the development of middle ear disorders in children is _________________ tube dysfunction.
Eustachian
A _________________ is a growth of skin, a cyst, in the middle ear space.
cholesteotoma
____________ is the term used to describe an infection in the middle ear space.
otitis media
A disease characterized by fixation of the ossicular chain is ________________.
otosclerosis
Disarticulation of the ossicular chain is usually caused by ________.
TM perforation
Gentamyin is an example of an _________________________ antibiotic.
ototoxic
A hearing that occurs suddenly without a known etiology is called ________.
presbycusis
Which of the following is NOT an example of a craniofacial abnormality?
a. Preauricular pit
b. Aural atresia
c. Microtia
d. Perforation of the tympanic membrane
Aural atresia in Treacher-Collins syndrome or Goldenhar syndrome is typically associated with:
a. Conductive hearing loss
b. Normal hearing
c. High-frequency sensory hearing loss
d. Severe sensory hearing loss
Which of the following is NOT a risk factor for the development of otitis media in children?
a. Time in daycare
b. Secondhand smoke
c. Bottle feeding
d. Good prenatal care
Which of the following diseases is associated with dual sensory impairment?
a. Usher's syndrome
b. Otitis media
c. Eustachian tube dysfunction
d. Meniere's disease
Which of the following are viral infections that can cause hearing impairment?
a. Herpes viruses
b. Cytomegalovirus
c. All of the above
Which of the following is NOT one of the four symptoms typically associated with Meniere's disease?
a. Fluctuation sensory hearing loss
b. Tinnitus
c.Vertigo
d. Schwartz sign
Which of the following are signs/symptoms of acute otitis media?
a. Fever
b. Pain
c. Ruptured tympanic membrane
d. All of the above
Which of the following is a risk factor for pseudohypacusis?
a. Seeking financial compensation
b. History of physical abuse in a child
c. Adolescent girl with unexplained hearing loss d. All of the above
T/F: Cancer is never found on the pinna of the ear.
False
T/F: Cisplatin is an ototoxic drug often used in chemotherapy to treat tumors.
true
T/F: Sensorineural hearing loss never fluctuates in severity.
False
T/F: Medical referral is never indicated in patients with idiopathic sudden sensorineural hearing loss.
False
Explain why audiologists should have knowledge about ear diseases and disorders.
...
Why is it important for audiologists to refer patients with ear disease to physicians like otolaryngologists?
Otolaryngologists are trained as surgeons. Thus, they can manage patients with operative procedures.
T/F: Acute and chronic otitis media are equally serious disease processes.
False
Provide two examples of craniofacial abnormalities.
. Aural atresia
c. Microtia
Explain briefly how Eustachian tube dysfunction can lead to hearing loss.
Eustachian tube dysfunction prevents a fresh supply of air from entering the middle ear space and air pressure begins to decrease.

Due to the effect of negative air pressure (as compared to atmospheric or ambient air pressure), fluid from the mucous membrane lining the middle ear begins to seep into the middle ear space. If the Eustachian tube dysfunction persists, the fluid in the warm enclosed middle ear space becomes an ideal environment for development of a bacterial infection.
Identify three specific causes for a perforation of the tympanic membrane.
Hand clapped over the ear, Explosion, Q-tip or hairpin
State two different treatment options for otitis media.
antibiotics, PE tubes
How are cholesteatomas managed?
surgery
What is otosclerosis and what are the treatment options for it?
Formation of spongy bony growth around the stapes footplate - spongy bone hardens - stapes footplate becomes fixed, cannot move ; Stapendectomy - ProsthesisHearing Aids
State three different medications that can cause hearing loss.
ototoxic
antibiotics
platinum based
Compare and contrast labyrinthitis and vestibular neuritis.
infected fluid from semicircular canals, with HL

Neuritis
affects the branch of 8th nerve associated with balance, resulting in dizziness or vertigo but no change in hearing.

The term neuronitis (damage to the sensory neurons of the vestibular ganglion) is also used.


Labyrinthitis (inflammation of the labyrinth ie the fluid filled tubes and sac) occurs when an infection affects both branches of the vestibulo-cochlear nerve, resulting in hearing changes as well as dizziness or vertigo
Describe the effects on excessive noise exposure on the inner ear.
damage to hair cells in cochlea, unable to move efficiently
How is Central Auditory Processing Disorder (CAPD) different from typical hearing loss?
-MUST have normal hearing
-Unable to process directions and understand spoken language in challenging situations
-disinterest to follow conversation
-FM system can be helpful
-Not an accepted diagnosis
Describe the characteristics of Benign Paroxysmal Positional Vertigo (BPPV)
Caused by otoconia that have slipped into one of the semicircular canals. (usually posterior)

Symptoms are not constant; occur in certain head positions: dizziness, vertigo and nystagmus
Describe the characteristics of EVAS.Enlarged Vestibular Aqueduct Syndrome (EVAS)
-Severe episodic vertigo (adults)
-Lack of coordination (children)
Compare and contrast ENG and VNG.
VNG and ENG both are used to record nystagmus.

VNG=video nystagmography; the patient is wearing goggles.

ENG=electronystagmography; the patient is wearing electrodes.
Compare and contrast perilymphatic fistula and superior canal dehiscence.
Perilymphatic Fistula
A tear or defect in the oval window or round window that allows perilymph to leak into middle ear ; Dehiscence (opening) in the bone overlying the superior semicircular canal of the inner ear.

Dehiscence (opening) in the bone overlying the superior semicircular canal of the inner ear.
-congenital
-change middle-ear or intracranial pressure(such as coughing, sneezing, or straining)
-loud noises
When the stimulus is heard in the non-test ear, _____ occurs.
cross over
Covering an ear during bone-conduction testing produces the __________.
occlusion effect

low-frequency sound in bone-conducted signals is enhanced as a result of TE covered during masked BC testing
The reduction in intensity when sound is transmitted from other ear to the other through or around the head is called ___________.
interaural attenuation
The interaural attenuation for bone-conduction testing is ______.
0 dB HL
T/F: Masking is almost never required in speech audiometry.
False
The goal in masking is to:
a. Verify accurate hearing test results

b. Ensure that the nontest ear is not contributing to the patient's response

c. Use an effective level of masking in the nontest ear

d. All of the above
Which of the following occurs when stimulus intensity in the test ear exceeds inter-aural attenuation:
a. Cross hearing
b. Cross masking
c. The occlusion effect
d. The Weber effect
If the amount of masking noise is insufficient to prevent cross-over, what type of masking would this be?
a. Sufficient masking
b. Undermasking
c. Overmasking
d. None of the above
While deciding to measure masked AC thresholds, which of the following should be considered?
a. Only the unmasked AC threshold/presentation level in the test ear
b. Only the amount of inter-aural attenuation
c. Only the BC threshold of the non-test ear
d. All of the above
The acronym ABR refers to _______________________________________.
Audiometric Brainstem Response
The three major waves or components of the ABR are: _____, ____, and ____.
I,III,V
The time difference between stimulus presentation and measurement of each peak in the ABR waveform is called
a. Absolute latency
b. Interpeak latency
c. Amplitude
d. Wave morphology
Minimum interaural attenuation for supra-aural earphones in air-conduction testing is:
a. 0 dB
b. 40 dB
c. 60 dB
d. 80 dB
T/F: The ABR can be used to estimate auditory thresholds at different frequencies.
True
Minimum inter-aural attenuation for insert earphones in air-conduction testing is:
a. 0 dB
b. 40 dB
c. 60 dB
d. 80 dB
T/F: The ABR is a complete test of hearing.
False
The most effective masking noise in pure tone hearing testing is:
a. Broadband noise (BBN)
b. White noise
c. Speech noise
d. Narrowband noise
Why is the ABR is important in pediatric hearing assessment?
is a technique used to record the electrical activity in the auditory nerve, the brainstem, and the cortical ease of the brain.
The most effective masking noise in speech audiometry is:
a.Broadband noise (BBN)
b. White noise
c. Speech noise
d. Narrowband noise
The process of screening all babies for hearing loss within the first three months of birth is called _________.
Early Hearing Detection Intervention
T/F: The ABR cannot be recorded from children who are sleeping or sedated.
False
The two objective techniques recommended for universal newborn hearing screening are ____ and _____.
TEOAE and A-ABR
Speech Audiometry Test Order
a. SAT/SDT and/or SRT. These tests determine the lowest intensity level a patient is aware of, or can detect speech (SAT/SDT) and the lowest intensity level a patient can recognize speech (SRT)

b. WRS. This test determines the number of words (or percentage) a patient is able to correctly understand or recognize. This test is performed ideally at 40 dB above the patient's SRT aka 40 dB SL. This test can be performed at other sensation level intensities (dB SL) as well.
Electrocochleography (ECoG)
measure electrical potentials (activity) in the cochlea, in response to auditory stimulation.

used to evaluate patients with Meniere's disease and is a part of the vestibular test battery.
The gold standard to determine a patient's hearing levels or thresholds is ____. But, the ABR test can be used to estimate hearing levels.
pure tone testing or behavioral testing
In ABR testing, as intensity decreases, latency _______________ and amplitude ________________.
increases; decreases
2 important statistical measurements to determine the efficacy of the a screening
sensitivity & specificity
EHDI 1-3-6
screened by 1mo, HL diagnosed by 3mo, hearing aids by 6mo
4 reasons why a baby may not pass newborn hearing screening
debris
small ear canal
too active/fussy
HL
what ages must school-aged children need a hearing screen in Texas
preK, kinder, 1st,3rd,5th,7th
OSHA standards for noise exposure
85 dBA for 8 hours - KEY RULE
For every 5dB increase in noise (over 85dBA), half the time is allowed
>22million Americans ages 20-69 have permanent NIHL
...
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