Q2 Study Guide

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University of St. Augustine for Health Sciences *

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Biology

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Feb 20, 2024

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Quiz 2 Study Guide Be familiar with: 1. Types of audiology equipment and (in general) what each piece of equipment is used for. Otoscope – Allows audiologist to visualize the ear canal and tympanic membrane. Used to observe if there are abnormalities in outer or middle ear. Also used to determine success of treatment such as tubes. Audiometer – Can be pure tone air or bone conduction audiometry. It can be masked or unmasked. Tympanometer - Used to assess the tympanic membrane and middle ear health. It can detect TM perforations, middle ear fluid, eustachian tube dysfunction, and ossicular discontinuity. It is also used to test ipsilateral and contralateral middle ear reflex. Otoacoustic Emissions Analyzer – Used to assess outer hair cell health. It is sensitive to outer hair cell damage and middle ear disease. Auditory Evoked Potentials Analyzer – Used to assess neural responses to sound. Specifically in from the brainstem. Sensitive to hearing loss occurring in outer, middle, or inner ears. As well as the brainstem. Vestibular Equipment –  Videonystagmography: Assesses the health of 2 semicircular canals.  Video head impulse testing – Assesses the health of all 6 semicircular canals.  Rotary Chair testing – Assesses the health of 2 semicircular canals using natural movements.  There is knobs and buttons on an audiometer. The biggest difference now is that it now has a digital interface. We can now see information about the frequency we are presenting. New audiometers now have a visual display that you can plot an audiogram digitally on a screen. There is both pure tone air and bone conduction audiometry. It can be masked or unmasked. 2. Components of an audiometer. There is a power switch. There is a stimulus option button. You can choose between a tone or a speech signal to a listener. If we are using a tone we can decide whether or not we would like that tone to be pulsed, continuous, or warbled. Generally pulsed tones are used for audiometry. We usually present three pulses for every presentation. Pulsed and warbled tones are more commonly used. They are more interesting to engage the listener. You also have the ability to add masking noise. Masking noise basically knocks out the opposite ear from trying to participate in the hearing test.

3. Different transducer types for conducting audiometry and pros/cons of each. Audiometer Transducers  Insert Earphones – The most commonly used. The boxes click to the shoulder of the patient. The foal ear tips go directly into the ear. The foam can form fit to each patient’s ear and are normally pretty comfortable for them. The foam also allows for structure inside of the ear canal for those that are older and may not have as much cartilage.  Supra – aural headphones – These headphones go over the ears. Red is for right and blue is for left. They are useful in the way that it can be used over and over again and there is nothing disposable about it. Just need to be wiped down and they are ready to go for the next patient. Disadvantage is that these headphones are not as good for older patients since it is blocking the ear canal and they may not have a lot of cartilage. It requires for you to mask more often.  Bone conductor – It goes behind the ear and directly on the mastoid portion of your temporal bone. The hard part on the pina. The black hard part vibrates. The vibration is passed on the temporal bone directly. It bypasses the air conduction pathway, middle ear, and outer ear. It can directly stimulate the cochlea.  Circumaural – These go all the way on the ears. They are like cups that surround the pina. It kind of smashes down on the pinna. Used in noisy test environments. 4. Goals of audiologic evaluation.  Determine the hearing status of a patient an describe the hearing loss ( if present).  Estimate “site of lesion” producing hearing loss and assist in diagnosis.  Estimate function effects of impairments.  Determine the clients habilitative/rehabilitative needs. 5. Purpose and important questions of case history. To understand the patients complaints and note signs/symptoms of possible disease.  How long has hearing or balance issue been a problem?  Was onset sudden/ or related to an acute event or insidious?  If there is a hearing issue does it impact both ears equally  Pain or discharge from ears? History of ear infections?  Tinnitus? Dizziness or vertigo?

Also any other significant medical history or medications. 6. Purpose of otoscopy and some examples of abnormal findings. The purpose of an otoscope is to visualize the ear canal and tympanic membrane. It is used to determine if the middle and outer ear appear normal or abnormal. Also used to determine the success of treatment or the status of current treatment. An example would be if PE tubes were placed inside of the ear. Tubes are placed inside of the ear if there is a middle ear infection or fluid behind the ear drum. It allows fluid to leak out and air to come in so it can be aerated. They would want to see if it is still open, if it has fallen out, or if it is still in place. 7. The audiogram. Specifically, what does each axis represent and what do different symbols mean? X – axis frequency in Hz “Pitch” Y – axis sound level in dB HL “Volume” X – left ear. Blue O – right ear. Red 8. The “origin” of the audiogram. Why do we plot thresholds in dB HL instead of dB SPL? We use dB HL instead to make it more cumbersome and use on a more normalized scale. It visually and intuitively makes more sense. Thresholds that are within the normal range will be plotted at the top of the graph and if you have hearing loss then it would be plotted more lower on the graph. 9. The speech banana. Why is it useful? It is a shaded region on the audiogram in where different consonants fall. It is the frequency range of where normal speech falls. It is useful because it helps show patients which speech sounds are higher in frequency and which ones are lower in frequency. They can discuss how their hearing loss is cutting off different aspects of this speech banana. It tends to be the higher frequency sounds that are lost first and lower frequency sounds (voiced) tend to be spared. Hearing loss can chop up the speech banana.

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