Hearing Loss Assessment and ICF Model

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Questions and Answers

What does the ICF model identify as a component related to hearing loss?

Personal factors including lifestyle choices

Community resources available for rehabilitation

Cultural influences on hearing impairment

Physiological aspects of hearing such as sensitivity (correct)

In the Weber tuning fork test, what does lateralization to the poorer ear indicate?

Conductive hearing loss (correct)

Mixed hearing loss

Sensorineural hearing loss

Normal hearing response

Which statement about Rinne's test is true for a negative result?

Suggests a mixed hearing loss condition

Indicates normal hearing in both ears

Bone conduction is greater than air conduction (correct)

Air conduction is greater than bone conduction

What is the significance of interaural attenuation in Pure Tone Audiometry?

It represents the reduction of sound energy crossing from one ear to another Signup and view all the answers

Which aspect does the ICF model emphasize regarding treatment for individuals with hearing loss?

A holistic assessment including functional and participatory aspects Signup and view all the answers

What is the typical latency for Wave I in adults during ABR testing?

~ 1.5ms Signup and view all the answers

Which wave is smaller in adults compared to children during ABR testing?

Wave I Signup and view all the answers

What is indicative of potential retrocochlear pathology in ABR results?

Latent shift of 0.4ms or greater Signup and view all the answers

How does conductive hearing loss affect interpeak latency in ABR results?

All latencies remain normal Signup and view all the answers

What is the expected latency for Wave V in pediatric ABR testing?

~ 6.5ms Signup and view all the answers

What shift is observed in the latency of wave V when comparing 40 dB nHL to 60 dB nHL intensity levels?

Latency shifts to the right at 40 dB nHL Signup and view all the answers

What is a key challenge in recording the Middle-Latency Response (MLR)?

Difficulty in identifying neural responses from muscle responses Signup and view all the answers

Which MLR peak occurs at approximately 18 milliseconds?

Na peak Signup and view all the answers

What does Electrocochleography (ECochG) primarily measure?

Electrical potentials generated within the cochlea Signup and view all the answers

What condition is indicated by an abnormal Summating Potential (SP) to Action Potential (AP) ratio?

Endolymphatic Hydrops Signup and view all the answers

In which clinical context is Electrocochleography (ECochG) most commonly used?

To monitor auditory nerve function during surgery Signup and view all the answers

What does the Auditory Steady State Response (ASSR) measure?

The brain's electrical responses to steady sounds Signup and view all the answers

What does an absent or abnormal Compound Action Potential (CAP) indicate?

Possible auditory nerve damage Signup and view all the answers

What occurs when there is a difference in the interaural attenuation (IA) between the presentation sound and the masking sound?

Overmasking Signup and view all the answers

What is the primary reason inserts are beneficial in cases of asymmetrical hearing loss?

They reduce the need for masking. Signup and view all the answers

Which tympanometry result indicates a normal middle ear function?

Type A Signup and view all the answers

What can occur if a stimulus is presented for too long?

Expectation bias or habituation Signup and view all the answers

What does central masking refer to in auditory assessments?

Threshold increase after masking Signup and view all the answers

What is the purpose of using a 1000Hz probe tone in tympanometry for infants?

To assess mass-dominated systems Signup and view all the answers

What is Naunton's Masking Dilemma?

A difficulty in obtaining masked thresholds Signup and view all the answers

What should be noted on an audiogram to provide clarity on test results?

Details on Naunton’s masking dilemma Signup and view all the answers

Which of the following describes a 'notched' hearing loss?

20dB or greater loss at one frequency with recovery at adjacent frequencies Signup and view all the answers

What effect can occur when masking for bone conduction (BC)?

Occlusion effect Signup and view all the answers

What is indicated by increased values greater than 1.7 mmho?

Deep compliance Signup and view all the answers

Which pattern is most common at a low probe tone frequency in a normal ear?

1B1G Signup and view all the answers

What does a 3B1G pattern suggest about the conditions of the middle ear?

Eardrum pathologies Signup and view all the answers

At which resonance frequency might a 5B3G pattern be obtained?

Above normal resonance Signup and view all the answers

Which compliance range indicates shallow compliance according to the provided classifications?

< 0.2 mmho Signup and view all the answers

What percentage of normal ears is likely to show a 5B3G pattern?

5% Signup and view all the answers

What type of ear system is indicated by a 1B1G pattern?

Stiffness dominated middle ear Signup and view all the answers

What is a potential complication of malignant otitis externa (MOE)?

Spread to the temporal bone Signup and view all the answers

Which condition is characterized by a dull or opaque tympanic membrane and no signs of pain or fever?

Otitis media with effusion (OME) Signup and view all the answers

What is a common consequence of untreated mastoiditis?

Meningitis Signup and view all the answers

Which of the following is true regarding tympanosclerosis?

It results in a bright white appearance of the tympanic membrane Signup and view all the answers

What type of hearing loss is commonly associated with otosclerosis?

Mild to moderate conductive hearing loss Signup and view all the answers

Which condition is commonly referred to as swimmer's ear?

Otitis externa Signup and view all the answers

What causes exostoses in the ear canal?

Repeated exposure to cold water or wind Signup and view all the answers

What is a characteristic feature of chronic suppurative otitis media (CSOM)?

Non-intact tympanic membrane with ear discharge Signup and view all the answers

What signs are indicative of acute otitis media (AOM)?

Redness of the tympanic membrane Signup and view all the answers

What is the typical time frame for healing of a perforated tympanic membrane?

4-12 weeks Signup and view all the answers

Study Notes

ICF Model for Hearing Loss

The ICF model considers physiological aspects of hearing, sensitivity, speech understanding, body structures (ear structures), activities (daily tasks), and participation (social and work).
Contextual factors include environmental factors (hearing aids, support services) and personal factors (coping skills, social support).
Holistic assessment focuses on both functional and participatory aspects of hearing loss to improve quality of life.

Tuning Fork Tests

Weber Test:
- Sensorineural hearing loss (SNHL) = lateralized to the better ear.
- Conductive hearing loss (CHL) = lateralized to the poorer ear.
- No significance between ears = midline.
- Mixed hearing loss = results are not accurate.
Rinne Test:
- Positive: Air conduction (AC) > Bone conduction (BC) = normal or SNHL.
- Negative: BC > AC = CHL (true), or severe unilateral SNHL/bilateral CHL (false negative).

Interaural Attenuation (IA)

IA is the reduction of sound energy as it crosses from one ear to the other.
40dB IA is used with headphones as more sound can cross over to the non-test ear.
60dB IA with inserts reduces more sound leakage to the non-test ear.

Tympanometry

Purpose: Measures middle ear function and the ability of sound to pass through the middle ear.
226Hz: Used to determine ECV (ear canal volume) in adults (6+ months).
1000Hz: Used for children 0-6 months (higher frequencies are a stiffer system).
Type A: Normal middle ear function,
Type As: Reduced peak,
Type Ad: Increased peak,
Type B: Flat,
Type C: Negative shifted.

Child Tympanometry Guideline

ECV (ear canal volume) range: 0.3 to 0.9cc.
Compliance/admittance range: 0.3ml to 1.4 mmho.
TPP (tympanometric peak pressure) range: -150 to +100 daPa.
Abnormal results can indicate middle ear pathologies or ossicular discontinuity.

Acoustic Reflexes

Reflex pathways involve the external ear, middle ear, inner ear, cranial nerve VIII, and facial nerve VII.
Ipsilateral (same side) or Contralateral (opposite side) reflexes provide detailed information about the auditory system.
Measuring reflex thresholds and decays can indicate issues, such as middle ear disorders, which can hinder accurate measurements.

Otoacoustic Emissions (OAEs)

TEOAEs (transient evoked otoacoustic emissions) provide an overview of cochlear function across a range of frequencies.
DPOAEs (distortion-product otoacoustic emissions) are frequency-specific and offer more detailed information about cochlear function.
OAEs are helpful for general screening and diagnosing cochlear function.

Speech Audiometry

Speech testing helps determine which ear should be fitted with a hearing aid and assess surgical effectiveness.
Gauges understanding of surgery needs.
Evaluating speech scores and associated masking criteria determine effective diagnoses. Scoring aids understanding of the degree and type of hearing loss present.

Auditory Brainstem Response (ABR)

Measures neural synchrony in the auditory system.
Useful for diagnosing and locating lesion sites and determining auditory function adequately.
Shows if the auditory system is functioning properly.
Measures latency norms for adults and children.

Electrocochleography (ECochG)

Measures electrical potentials generated within the cochlea in response to a sound.
Used to diagnose site of lesion and monitor cochlear/auditory nerve function.
Often a last resort due to related discomfort.

Vestibular Assessment

Includes various tests of the balance system, such as video head impulse tests (vHIT), to determine if there is a central or peripheral/unilateral/bilateral vestibular pathology.
These tests evaluate eye movement in response to head movement, which assesses the function of cranial nerves VIII (vestibulocochlear) and VII (facial nerve).
Evaluating the tests for abnormalities can provide diagnostic information.

Other Pathologies

Includes a wide range of hearing loss causes covering several conditions and causes of hearing changes.
These conditions can involve various aspects of the ear and hearing process.

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Description

This quiz covers the ICF model for assessing hearing loss, focusing on physiological aspects, contextual factors, and holistic assessments. It also delves into tuning fork tests like the Weber and Rinne tests to discern different types of hearing loss. Test your understanding of how these assessments impact the quality of life for individuals with hearing impairments.