Audiology quiz 3

  1. Type of hearing loss: hearing thresholds are the same by air and bone conduction
    normal or sensorineural loss
  2. Type of hearing loss: hearing thresholds by bone conduction are within normal limits. air conduction thresholds show hearing loss
    conductive loss
  3. Type of hearing loss: hearing thresholds show loss by both air and bone conduction thresholds. bone conduction thresholds are better than air conduction thresholds
    mixed loss
  4. Type of hearing loss: hearing thresholds show hearing loss for both air and bone conduction thresholds. hearing loss is the same for both air and bone conduction thresholds
    sensorineural loss
  5. Type of hearing loss: hearing thresholds are better for bone conduction than air conduction
    conductive or mixed loss
  6. Type of hearing loss: hearing thresholds are within normal limits and are the same by both air conduction and bone conduction
    normal hearing
  7. Why is masking used?
    • it is used to eliminate the non-test ear from participation in the measurement of hearing thresholds in the test ear
    • it is used both for air conduction and bone conduction testing
  8. Why is a narrow band masking noise usually used?
    • it is more comfortable for the patient
    • broad band "white" noise is louder and more uncomfortable
  9. How is hearing testing conducted on infants and young children?
    look for behavioral response to sounds (eyes widening, arousal from sleep, cessation of activity, head turn)
  10. How is hearing testing conducted on children ages 2-5 years?
    can get conditioned responses through play, head turn, raised hand (conventional audiometry) and/or speech results
  11. Components of a tympanometer
    • pure tone generator
    • air pump
    • manometer
    • measuring device
  12. Pure tone generator (loudspeaker)
    pure tone is introduced into the ear canal
  13. air pump
    changes the air pressure in the ear canal
  14. Manometer
    measures the pressure changes
  15. Measuring device (microphone)
    measures the amount of sound that is reflected back from the tympanic membrane in response to air pressure changes
  16. Tympanogram
    • measures the mobility of the tympanic membrane and air pressure in the middle ear from +200 to -400 daPa
    • measures immittance (general term for impedance or admittance) of the TIM
  17. What suggests malfunction of the middle ear in a tympanogram?
    peak at less than or equal to -150 daPa suggest malfunction of the middle ear pressure equalizing system (eustachian tube)
  18. Pure tone hearing thresholds
    • the lowest level at which the client responds correctly 50% of the time
    • PTAs and SRTs should be roughly equal
  19. Speech recognition thresholds (SRTs)
    • lowest level at which the client can correctly repeat the words 50% of the time
    • spondaic words are used to measure this (football, playground), 2 syllable words are used
  20. Standard starting level for pure tone audiometry
    30 dB HL
  21. Standard procedure for finding threshold
    down 10 dB, up in steps of 5 dB
  22. Devices used for air and bone conduction
    • air conduction- headphones
    • bone conduction- vibrator
  23. ABR
    • auditory brainstem response
    • primary waveforms are I, II, III, IV and V
  24. Most common application of ABR testing
    • to predict hearing sensitivity in young infants, or in children or adults who are difficult to test
    • primary waveform is wave V which arises from the inferior colliculus
  25. Most common clinical application of OAEs
    universal screening of newborn hearing
  26. Phonetically balanced (PB) word lists
    • used in speech testing for suprathreshold speech recognition scores
    • this means that the phonetic composition of all lists is equivalent and are representative of everyday English speech (these are single syllable words)
  27. Closed set lists
    • multiple choice
    • the phonetically balanced choices vary by only one speech sound (rain-pain or car-tar or him-hit)
  28. Air-bone gap
    a 10 dB air-bone gap at two or more frequencies indicates a conductive loss, even if hearing thresholds are in the normal range, and requires a medical referral
  29. Standard audiometric test battery
    • pure tone air and bone conduction testing
    • speech audiometry
    • immitance testing (tympanometry)
    • in the measurement of auditory function, a test battery approach is essential
  30. Auditory processing disorder (APD)
    refers to dysfunction in the auditory portions of the CNS
  31. Personnel designated to conduct screening tests
    • nurses
    • audiologists
    • speech-language pathologists
    • graduate students in speech and hearing
    • volunteers and secretaries
  32. The newborn hearing screenings most commonly used in the USA
    OAEs and ABRs
  33. Why do we screen newborns for hearing loss?
    children who receive early intervention from the age of 3 years or younger show significantly better speech and language outcomes later in life
  34. ASHA recommendations for screening for middle ear disease
    • case history
    • visual inspection of the ear canal and eardrum
    • tympanometry with a low frequency probe tone
  35. ASHA guidelines for screening the hearing of school aged children
    • screening annually from preschool through grade 3 and then in 3-4 year intervals (except for at-risk individuals)
    • test in a quiet room (does not need to be sound treated)
    • test at 20 dB HL at 1000, 2000, and 4000 Hz
    • rescreen all failures
  36. At risk school aged children
    • require more attention than routine hearing screenings
    • children with delayed or defective speech
    • children who are having academic difficulties
    • children who suddenly begin failing academically
    • children with frequent colds and ear infections
  37. Screening
    a common healthcare practice that contributes to the high cost of health care in the US
  38. Reliability
    • consistent results
    • if you retest the same person, you get the same results
  39. Validity
    • are we measuring what we tink we are measuring?
    • a test must have high sensitivity and high specificity
    • validity and reliability do not necessarily go hand in hand (a test may be reliable but not valid and vice-versa)
  40. Prevalence of a disorder
    • how frequently it occurs in a population
    • sensitivity and specificity of a test are not affected by the prevalence of a disorder
  41. True positive
    has hearing loss and failed the screening
  42. False positive
    has normal hearing but failed the screening
  43. False negative
    has hearing loss and passed the screening
  44. True negative
    has normal hearing and passed the screening
  45. Sensitivity
    identifies the abnormal; those with the disorder; true positives (group A); has hearing loss and failed the screening
  46. Specificity
    identifies the normal; those without the disorderl true negatives (group D); has normal hearing and passed the screening
  47. An acceptable screening test for a disorder should be:
    • reliable
    • valid
    • cost effective
    • easy to administer
    • safe
  48. Follow-up
    • screening is of little value if follow-up is not provided for children who fail the screening
    • children who fail the screen need comprehensive audiologic evaluation as soon as possible
    • parent counseling is necessary
    • referral to educational services for planning and placement is necessary
  49. Adult screening
    • other than the military, there is no national program for the screening of adults
    • the prevalence of hearing loss increases with age, but there are no coordinated screening programs for the elderly in the US
    • new studies show that 1 in 5 people over the age of 12 in the US have significant hearing loss (this translates to 48 million people in the US with hearing loss)
Card Set
Audiology quiz 3