SPPA 461 - Basic Audiometry > Exam 1 > Flashcards

Exam 1 Flashcards

(56 cards)

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1
Q

What range of frequencies can humans hear?

A

20 - 20,000 Hz

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2
Q

1 Hertz = 1 ____ per _____

A

cycle/second

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3
Q

What range of intensity/pressure levels can humans hear?

A

0 - 120 dB

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4
Q

What is the period of a sound?

A

The time the wave takes to complete one cycle.

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5
Q

How are frequency and period relateed?

A

Indirectly

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6
Q

Pitch

A

Psychological correlate of frequency

  • Measured in mels
  • Directly related to frequency
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7
Q

Loudness

A

Psychological correlate of intensity/pressure

  • Measured in phons/sones
  • Directly related to intensity/pressure
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8
Q

Simple sounds

A

Frequency specific (only one frequency)

Ex: puretones

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9
Q

Complex sounds

A

Many frequencies

Ex: speech and noise

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10
Q

Complex periodic sounds

A

Has fundamental frequency

  • All other tones are harmonics of it
  • Ex: voiced speech sounds
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11
Q

Complex aperiodic sounds

A

No fundamental frequency or harmonics

  • Ex: voiceless speech sounds
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12
Q

What is the purpose of puretone audiometry?

A

To determine:

  1. degree and
  2. type

of hearing loss.

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13
Q

What are the two types of measurement in puretone audiometry?

A
  1. Air conduction threshold
  2. Bone conduction threshold
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14
Q

Conductive vs. sensorineural vs. hybrid hearing loss

A
  • Conductive: outer and/or middle ear
  • Sensorineural: inner - cochlea and/or nerve
  • Hybrid: both
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15
Q

What is the purpose of speech audiometry?

A

To validate puretone audiometry

  • More power/validity since we hear speech in real life

For accurate differential diagnosis

  • Where the problem is in the ear
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16
Q

What are the two measurements in speech audiometry?

A
  • Speech reception threshold

Speech discrimination score

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17
Q

What is the purpose of tympanometry?

A

To objectively (no patient participation) assess the middle ear function

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18
Q

Tympanogram

A

Graphical plot of the eardrum mobility at different air-pressure values

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19
Q

Behavioral Observation Audiometry (BOA)

A

Subjective assesment for ~6 mos - 3 yrs population

  • Sounds presented through speakers
  • Effective with visual reinforcement (must be able to turn their head)
  • Tests localization
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20
Q

Play audiometry

A

Subjective assessment for 3-5 population

  • For a/c and b/c threshold assessment
  • Play a game where child completes a task after each sound
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21
Q

Otoacoustic Emissions (OAEs)

A

Objectively evaluate the inner ear/cochlear (OHC) function

  • Very fast - <5 min/ear
  • Present clicking sounds, read echoes coming away from hair cells, look @ amplitude
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22
Q

Auditory Brainstem Response (ABR)

A

Objectively evaluates auditory nerve & brainstem function

  • Preceded OAEs
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23
Q

Immittance Audiometry

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A

Objective assessment that preceded ABR

  • Directly evaluates middle ear status
  • Indirectly evaluates inner ear status (stapedius function)
  • Includes tympanometry
24
Q

Audiogram

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A

Graphical plot of a/c & b/c thresholds across puretone frequencies

25
Audiometer
Electronic device for hearing assessment
26
Audiometry
Procedure for hearing assessment ## Footnote *Ex: speech or pure tone*
27
Hearing Threshold Level (HTL)
* Lowest level you can hear 50% of the time (2/4) OR * lowest level you can hear 3 out of 4 times OR * Lowest level you can hear 3 repeated times * Whichever comes first*
28
External/Middle ear function
Conducts sounds to the inner ear
29
Inner ear function
Sound analysis & discrimination * does complex Fourier analysis
30
Air Conduction Audiometry: device
Pure tone Audiometer
31
Air Conduction Audiometry: purpose
* Obtain a/c thresholds across audiometric frequencies * Compute pure tone average (PTA) * Compute degree/extent of hearing loss
32
Air Conduction Audiometry: procedure
* Frequency sequence: 1, 2, 4, 8, 0.25, 0.5, and 1 kHz * Initial intensity dial setting: 30 dB * Starting ear: better ear or right ear * Threshold level: 50% correct or 3 repeated responses
33
Air Conduction Audiometry: symbols for plotting a/c thresholds
34
The pure tone average (PTA) tells you the _____ of hearing loss.
degree
35
PTA (PTA1)
Average of a/c thresholds at 500, 1000 & 2000 Hz
36
PTA2
Average of a/c thresholds at 1000, 2000, and 4000 Hz
37
Two Frequency Average/Fletcher Average
Average of best a/c thresholds @ two frequencies between 500, 1000 and 2000 Hz
38
Hearing loss classifications for children 5 and under
0-15 dB HTL - Normal 16-30 dB HTL - Mild 31-50 dB HTL - Moderate 51-80 dB HTL - Severe \>81 dB HTL - Profound
39
Hearing loss classifications for children older than 5 & adults
0-25 dB HTL - Normal 26-40 dB HTL - Mild 41-55 dB HTL - Moderate 56-70 dB HTL - Moderate-Severe 71-90 dB HTL - Severe \>91 dB HTL - Profound
40
When do we test mid-octive frequencies?
When the difference between two octaves tested (e.g., 1,000 and 2,000 Hz) is ≥20 dB
41
What is the maximum acceptable difference between test-retest thresholds?
10 dB
42
Symbols for plotting bone conduction threshold levels
masked are brackets []
43
Procedure for audiometric threshold
Start @ 30 dB: * If correct, do down 10 up 5: * If correct, go down 10 * If that's incorrect, go up 5 * Continue until you reach threshold * If no response, go to 50 dB * Move up in 10 dB steps until you get a response * When you get a response, do down 10 up 5 procedure until you get threshold
44
What is the purpose of bone conduction audiometry?
* Evaluates the inner ear status * Helps us make a differential diagnosis of the site of pathology
45
Procedure for bone conduction audiometry
* Test at 1, 2, 4, .25 and .5 kHz (no retest) * Start at 30 dB * Placement: mastoid
46
Normal B/C thresholds
* 0-5 yrs: 0 to 15 dB across 250-4,000 Hz * 5+ yrs: 0 to 25 dB across 250-4,000 Hz
47
How will a/c and b/c thresholds differ for people with sensorineural, conductive, or mixed hearing loss?
* **Sensorineural**: a/c and b/c both abnormal, equally affected * **Conductive**: a/c normal, b/c abnormal * **Mixed**: a/c and b/c both abnormal, a/c worse (passes through two damaged areas)
48
What is Interaural Attenuation (IA)?
AKA cross hearing. Refers to loss of sound energy as test travels from the test ear to the nontest ear * for A/C, IA = 40 dB * for B/C, IA = 0 dB (no loss of energy)
49
When & how much masking: air conduction
Mask if: * unmasked AC threshold in the test ear - 40 dB (IA) ≥ the unmasked BC threshold in the non-test ear How much: * Minimum masking = unmasked AC threshold in the nontest ear
50
When & how much masking: bone conduction
Mask if: * Air-Bone gap in the test ear ≥ 10 dB How much: * Minimum masking = Unmasked AC threshold in the non-test ear + Occlusion Effect (freq. dependent)
51
When do we use the occlusion effect?
With **normal** or **sensorineural** loss.
52
Puretone audiometric criteria for **Normal Hearing**
* A/c & b/c within 15 or 25 dB (age dependent) * A/c = b/c * Air-bone difference ≤ 10 (clinically insignificant)
53
Puretone audiometric criteria for **Conductive Loss**
* B/c = normal * A/c = abnormal * A/c ≠ B/c * Air-bone difference \> 10 (clinically significant) Ex: otitis media
54
Puretone audiometric criteria for **Sensorineural Loss**
* A/c = abnormal * B/c = abnormal * A/c = B/c * Air bone difference ≤ 10 (clinically insignificant) Ex: Presbycusis (age-related sensorineural loss)
55
Puretone audiometric criteria for **Mixed Loss**
* A/c = abnormal * B/c = abnormal * A/c ≠ B/c * Air bone difference \> 10 (clinically significant) Ex: Presbycusis + otitis media
56
ASHA guidelines for hearing screening
* **1, 2,** and **4 kHz** at **20 dB** HL * Criteria: child fails if he/she fails to respond @ any frequency in either ear
SPPA 461 - Basic Audiometry
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