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Hearing Disorders 1- Review/Case Hx
Terms in this set (62)
questions to ask pt when they first come in
-who are you
-what brings you in today
-what can you tell me (case hx) or can I find in Epic
-why: you think it happened, it's a problem, you came to me, who sent you
-where else have you looked for help
-how can I help you
physical observations of a pt to be aware of when they first come in
symptoms of ear pathology in case hx
-head noise (tinnitus)
ear pain (term)
ear discharge (term)
head noise (term)
if pt says they have HL during case hx, what should you ask?
if pt says they have otalgia during case hx, what should you ask?
unilateral or bilateral
if pt says they have otorrhea during case hx, what should you ask?
continuous or intermittant; acute or chronic
if pt says they have tinnitus during case hx, what should you ask?
associated with other symptoms/events
if pt says they have vertigo during case hx, what should you ask?
improve or deteriorate
what are some things to ask a pt during case hx if it's RELEVANT
-Chronic disease/Acute disease
-Illness: meningitis, measles, mumps, syphilis, high fever
-Drugs: chemotherapy, diuretics, aminogycosides, herbs, supplements, really weird things->Gcodes
-Hearing aid(s) or cochlear implant(s)?
-Hyperacusis, phonophobia etc
-Surgeries with anaesthesia
-Learning disabilities, speech, language
-Difficulty understanding speech
-Pregnancy and birth, milestones
explain referral to MD requirement
referral to MD for certain conditions used to be FDA for HA fitting, but now it's only in place for children
when should you refer a pt out to an MD
-congenital/traumatic deformity of ear
-active drainage within previous 90 days
-unilateral HL of sudden/recent onset within previous 90 days
-ABG of 15 @ 500, 1000, & 2000 Hz
-significant impaction or foreign body
based on behavioral responses (term)
are pure-tone audiometry and speech audiometry examples of subjective or objective measures
do not rely on behavioral responses (term)
are OAEs, tympanometry, and ABRs examples of subjective or objective measures
do objective procedures measure hearing?
is the average hearing level of a group of young adults with no otologic/pathology or history of noise exposure (term)
0 dB HL
frequencies for testing extended high-frequencies
intensity at which pt will respond 50% of the time (term)
hearing level (HL)
normal hearing range
slight hearing range
mild hearing range
moderate hearing range
moderately-severe hearing range
severe hearing range
profound hearing range
hearing loss with normal/near-normal BC thresholds in presence of elevated AC thresholds (term)
hearing loss where BC and AC thresholds equally elevated (term)
hearing loss where BC and AC thresholds both elevated, but AC poorer than BC (term)
-uses spondee words
-is adaptive (threshold test)
-expected to agree with PTA
speech reception threshold (SRT)
-uses monosyllables, phonetically balanced (PB)
-done at a fixed level (~40 dB above SRT)
-is not sensitive measures of auditory disorders
speech discrimination/word recognition
what tests (3) make up the acoustic immittance test battery?
what frequency is the signal for acoustic immittance presented at?
what test measures reflected sound energy in the ear canal?
acoustic immittance involves what 2 realms?
what tests measures change in admittance of probe tone as function of relative pressure in ear canal
what are the units for peak pressure (tymp)? what is the highest static admittance?
daPA; -50 to +150 daPa
what are the units for static admittance (tymp)? what is the height of peak relative to tail?
mmho; 0.3 to 1.0
what age group uses multifrequency tympanometry & wideband reflectance? what curves are seen?
newborns; B & G
name 2 wideband tymp machines
test where there is a contraction of the stapedius muscle in response to a high-intensity sound
acoustic reflex threshold (ART)
what is the typical range for the ART using pure tones
70-100 dB HL
why would you see a reversed ART?
-not due to stapedius contraction
-associated with something going on in ME in some cases
test where low-level sounds generated by the outer hair cells & the vibration of the TM
otoacoustic emissions (OAEs)
test that is an epiphenomenon of the cochlea's active mechanism
does an OAE require a normal middle ear?
types of OAEs in clinical practice
-transient evoked OAEs
-distortion product OAEs
OAE in response to clicks that is dominated by mid frequencies
OAE in response to 2 pure tones that generate an intermodulation distortion product; what graph is it shown on?
what are OAEs useful for? (6)
-identifying sensory dysfunction
-monitoring cochlear health
-confirm audiometric configuration
-early indicator of subclinical damage (noise, ototoxicity, tinnitus, hyperacusis)
benefits of OAEs (3)
disadvantages of OAEs (4)
-little indication of degree of loss
-dependent ME status
-subject to ambient noise levels
test that is a measurement of the electric potentials generated by cochlear and neural structures
___ is enhanced through signal averaging (evoked potentials)
types of evoked potentials (3)
short, middle, and long latency
test that records electrical activity from cochlea in response to auditory stimuli
electrocochleography; happens <3 msec after stimulus presentation
equation for electrocochleography
ECochG = CM +SP
uses for electrocochleography (4)
-enhancement of wave I amplitude
tests for auditory processing (4)
-monaural (temporal processing)
-binaural (localization, fusion)
-hearing in noise (HINT, BKB-SIN, QuickSIN, WIN, WARM, etc)
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