CMD361: MIDTERM

pediatric questions for a case history

- Developmental Issues or Concerns - language development (when did they start talking? Is he/she intelligible) - Status of Siblings - Birth Issues - premature, NICU stay - Information from Pediatrician, Health Professionals, Teachers

conductive questions for a case history

- History of Infection - Drainage/Discharge - Excessive Cerumen - Upper Respiratory Infection - Swimming - Are the symptoms associated with an event or disorder

congenital disorder questions for a case history

- Inherited - other family members having similar problems ? - Acquired - maternal illness/ototoxicity, accident/trauma - Family History

rational for calibration of equipment

- Norms are conceived on the audiometer meeting standards - To apply the norms, the standards must be met - Equipment inaccuracy leads to misdiagnosis

central disorder questions for a case history

- Processing Problems - Hearing vs. listening vs. understanding - Other central manifestations - Multiple sclerosis

sensorineural questions for a case history

- Speech Understanding - Noise Exposure - Onset of Loss - Vascular Disorder - diabetes, high blood pressure - Neural Signs - symptoms suggesting schwannoma - Medication History ototoxicity

adaptation

- follows the on effect - a reduction in responsiveness

method of limits

- hearing test method in which the examiner manipulates the intensity of the signal - Patient identifies when it is just audible

weber test

- test where tuning fork is set to the center of the frontal bone - the patient is asked where he/she hears the sound

sound treated booth

- what's happening on the inside of the booth, surfaces in the booth are meant to absorb and diffuse sounds - helps to make sure there isn't a lot of reflection of sound because it gets distorted if it is reflected a lot

electroacoustic procedure, assessment of all parameters using a known normal for comparison

2 ways to calibrate equipment

supra aural headphones

Air conduction transducer: - Less time to prep patient - Work for most patients - May cause collapsed canals - Best for atresia or draining ears - Less costly

pure tone average

Average of 500Hz, 1000Hz, and 2000Hz

sensorineural loss

If AC and BC is depressed equally

mixed loss

If AC is depressed and BC is depressed but better than AC

conductive loss

If BC is normal and AC is depressed

air conduction, bone conduction

_______ can never be better than _______

it gives a chronology of events and is a legal and official document, the answers guide your testing

a case history is rationalized in that it is a professional record, meaning ___________, and a diagnostic tool, meaning __________

intensity is inversely proportional to distance from the source

according to the inverse square law,

60 dbhl

air bone gap maximum is

vibro-tactile response

air conduction can cause bone conduction stimulation by triggering a

entire auditory system

air conduction represents the

insert earphones

air conduction transducer: - Takes more time to place Avoid collapsing canals - Less masking required (because the sound is coming from inside the ear canal) - More costly - new one every single time

fletcher's average

average of the best of 500Hz, 1000Hz, 2000Hz

cochlear function

bone conduction measures

sound poof booth

booth that keeps outside sounds from coming in

normal or sensorineural hearing loss

during a rinne test, if the individual being testing hears the tone louder or longer by air, it suggests

conductive loss

during a rinne test, if the individual being testing hears the tone louder or longer by bone, it suggests

twice as long

during a rinne test, the tone should be ________ by air conduction

when the sounds no longer audible

during a rinne test, when do you move the tuning form from the mastoid toward the ear?

side with a conductive hearing loss or better bone conduction

during a weber test, the tone will lateralize to the

poorer ear

during a weber test, where will someone with a conductive hearing loss say they heard the tone?

better ear

during a weber test, where will someone with asymmetric sensorineural hearing loss say they heard the tone?

in the middle

during a weber test, where will someone with normal or symmetric sensorineural hearing loss say they heard the tone?

ascend 5db

during air conduction testing, each time the patient does not respond to a signal, you

descend 10dB

during air conduction testing, each time the patient responds to the signal, you

electroacoustic procedure

equipment calibration technique that is performed annually

steeply sloping

fletcher's average is usually used for what type of slope on an audiogram?

not calibrated, not reliable, of limited value

gross tests of hearing are

severe and minimal loss

gross tests of hearing may distinguish between

conversational speech, whisper, or watch ticking

gross tests of hearing may use

method of adjustment

hearing test method in which the patient manipulates the stimulus

with an oscilloscope

how is frequency measured during an electroacoustic procedure for testing calibration?

sound level meter and artificial ear

how is intensity measured during an electroacoustic procedure for testing calibration?

phase and rise are measured with an oscilloscope

how is time measured during an electroacoustic procedure for testing calibration?

4

how many times is threshold presented before determined?

general (why are you here, age, health, employment) to specific questions (symptoms, if one ear is better than the other, type of HL questions)

how you want to question someone for a case history

bone conduction is normal

if air conduction is normal,

inverse square law

intensity is inversely proportional to the distance from the source

125Hz-8000Hz

parameters of frequency on an audiometer

-10dB to 110dB

parameters of intensity on an audiometer

frequency, intensity, interrupter, mode selection

parameters of the audiometer

intensity, frequency, time

parameters tested during the electroacoustic procedure

interrupter

part of an audiometer that delivers the stimulus

mode selection

part of an audiometer that delivers which ear, air/bone, speech, sound field, MLV or CD

check equipment, review patient folder, size up patient, establish a rapport

pre hearing test activity

flat or gradually sloping

pure tone average is usually used for what type of slope on an audiogram?

inspect ear canal and ear drum status

purpose of an otoscope

the on effect

quantum leap in the neural system after sustained tone presentation of 1-2 seconds

the on effect, adaptation

testing protocol

test booth, otoscope, air conduction transducers

testing protocol equipment

threshold

the quietest level of sound that can be heard 50% of the time

severity, slope, site

threshold is measured at several frequencies in each ear and help to determine

rinne test

tuning fork test that compares air conduction to bone conduction by placing it on the mastoid and moving it in front of the ear when it is no longer audible

method of limits, method of adjustment

two main methods for testing hearing

rinne and weber

two types of tuning fork tests

severity of loss

what can a tuning fork test NOT tell us?

lateralization

what kind of test is a weber test?

1000hz at 30dbhl for 1-2 seconds

when testing air conduction, one presents a tone at

mastoid

when testing for bone during a rinne test, the tuning fork should be placed on the

mastoid or forehead

where do you place a bone oscillator?

right ear or better ear

which ear does one begin testing in?

red right, blue left

which ear goes which which color when testing air conduction with headphones

the tone will lateralize (or be longer) to the conductive side

why is the weber test a lateralization test?