Hearing Measurement Lect.02 Pure-Tone Audiometry
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Questions and Answers

What does a positive Rinne test indicate?

  • Greater SNHL in one ear
  • Normal hearing or symmetrical SNHL (correct)
  • Mixed loss in the ear
  • Conductive loss in the ear

    • In the Weber test, what does it suggest if the sound is heard louder in one ear?

  • Fluctuating hearing loss
  • Sensorineural hearing loss in the louder ear (correct)
  • Normal hearing in both ears
  • Conductive loss in the quieter ear

    • What does a negative Bing test suggest?

  • Conductive loss (correct)
  • Fluctuating hearing ability
  • Normal hearing in both ears
  • Some level of sensorineural hearing loss

    • What does a negative Rinne test on the right ear indicate?

    <p>Mixed loss in the right ear</p> Signup and view all the answers

    During the Bing test, what should happen if there is no conductive loss?

    <p>Sound should get louder when the ear is plugged</p> Signup and view all the answers

    What is the correct procedure to begin obtaining an AC audiogram?

    <p>Begin at 40 – 60 dB HL for 1000 Hz</p> Signup and view all the answers

    What does the 'down 10 up 5' rule help determine during an audiometric testing?

    <p>The threshold for perceptive hearing</p> Signup and view all the answers

    What is a false negative response in behavioral audiometry?

    <p>Failing to respond to a tone even when it is audible</p> Signup and view all the answers

    Which of the following defines 'permanent' hearing loss?

    <p>Hearing loss that is irreversible and long-lasting</p> Signup and view all the answers

    What should a clinician do immediately if a patient is responding rhythmically to stimuli?

    <p>Stop immediately and correct the situation</p> Signup and view all the answers

    What is meant by the term 'threshold' in the context of pure-tone audiometry?

    <p>The level at which a person hears a tone 50% of the time.</p> Signup and view all the answers

    What role do frequency-specific tones play in place specificity of hearing?

    <p>They are crucial for enabling place specificity at low sound pressure levels.</p> Signup and view all the answers

    What does RETSPL stand for in audiometry?

    <p>Reference equivalent threshold sound pressure level.</p> Signup and view all the answers

    Which component is NOT part of a clinical audiometer?

    <p>Tuner</p> Signup and view all the answers

    Which factor is critical in determining a person's performance in real-life hearing situations?

    <p>The audiogram result.</p> Signup and view all the answers

    What is a key feature of air conduction audiometry?

    <p>It allows sound to be delivered directly via air into the ear.</p> Signup and view all the answers

    What is the primary function of an audiometer's talk forward button?

    <p>To control the volume of the audiologist's voice to the patient.</p> Signup and view all the answers

    Why are low sound pressure levels important in audiometric testing?

    <p>They enable detection of subtle auditory thresholds.</p> Signup and view all the answers

    What is the primary purpose of KEMAR's dummy with huge ears?

    <p>To conduct hearing tests with variations in ear size.</p> Signup and view all the answers

    What is the main principle behind cochlear fluid inertial stimulation?

    <p>Bone vibrations causing fluid inertia in the perilymph.</p> Signup and view all the answers

    In the context of hearing loss, what does a positive Air-Bone Gap (ABG) indicate?

    <p>Conductive hearing loss is likely present.</p> Signup and view all the answers

    How is the percentage of impairment calculated according to the guidelines provided?

    <p>Using the formula: avg (.5,1,2,3 kHz) - 25 dB x 1.5.</p> Signup and view all the answers

    Which audiogram symbol is used to represent the left ear?

    <p>X</p> Signup and view all the answers

    Which statement best describes sensorineural hearing loss?

    <p>It results from damage to the inner ear or auditory nerve.</p> Signup and view all the answers

    What is a key distinguishing feature between conductive and sensorineural hearing loss?

    <p>Conductive loss typically has no Air-Bone Gap.</p> Signup and view all the answers

    Which average is used to determine the Pure Tone Average for hearing loss?

    <p>The average of 500, 1000, and 2000 Hz.</p> Signup and view all the answers

    Study Notes

    Hearing Measurement Lecture Notes

    • The lecture covered pure-tone audiometry, focusing on why measuring thresholds is important.
    • Measuring thresholds helps determine the extent of hearing loss.
    • The strange nature of speech perception was discussed, noting that speech has a complex spectrum.
    • Detailed and coarse speech spectra were presented, illuminating the frequency components of speech.
    • The role of detail in speech perception was highlighted.
    • The presentation questioned if measuring thresholds was too focused or too soft. 
    • An image of a cochlea, with different parts labeled, supplemented the discussion.
    • A graph related loudness, sones, phons, and loudness level.

    Frequency-Specificity and Place-Specificity

    • Place specificity is achievable only with frequency-specific tones at low sound levels.

    Importance of Audiometry

    • Audiometry is crucial for a variety of reasons, including assessing hearing function.
    • Various methods and tools for performing audiometry, images of the equipment (headphones, audiogram, etc.) were shown.
    • Types of audiometric data recorded were discussed, like air conduction, bone conduction, etc.

    What Affects Performance in Real Life?

    • Various factors in real-life, including social situations and distractions, may affect hearing.
    • The importance of using appropriate and controlled test conditions.

    The Audiogram

    • This graph shows hearing thresholds on the vertical axis and frequency on the horizontal axis.
    • Shows how audiometric data could appear on a visual graph.

    Audiogram of Familiar Sounds

    • This graph visualises the sound pressure levels of different everyday sounds at specific frequencies.

    Role of Outer and Middle Ear in Hearing

    • The outer and middle ear play essential roles in amplifying sound and channeling sound to the inner ear.

    Human Hearing

    • A graph showing the relationship between sound pressure level and loudness.
    • Includes the normal binaural minimum audible field (MAF) and other important auditory thresholds.
    • The graphic highlights the approximate pain threshold and loudness discomfort levels, alongside the conversational speech levels.

    dB SPL to dB HL Transform

    • This illustrates the transformation of sound pressure level (SPL) to hearing level (HL)
    • A reference level for hearing is demonstrated.

    What is a Threshold?

    • Threshold is a hearing level at which a person can perceive a tone 50% of the time.
    • Measurements should include hit and miss rates.

    The Role of the Criterion

    • The likelihood of a response is linked to the sensory input level.
    • The criterion plays a role in the test results.

    The Audiogram (Audiogram examples)

    • Demonstrates an audiogram showing the hearing thresholds for both ears across different frequencies.

    The Audiometer (Description)

    • The different sections/components of a standard or advanced clinical audiometer system.
    • Examples of specific audiometer models (e.g Madsen Astera, GSI AudioStar).
    • Practical details on using the audiometer were not shown, the models displayed were not explained in the specifics.

    GSI Audiostar

    • A specific example of an audiometer, featuring a screen display.

    Automated Testing

    • Automated testing for hearing, an example shown.

    The Screening Audiometer (Description)

    • An example of a screening audiometer, highlighting its features.

    First Things First: Control

    • Importance of control conditions (sound booth) for accurate hearing tests.
    • Examples of equipment used for controlling and monitoring audio conditions.

    Ambient Noise

    • This discusses the sound levels that are permitted for audiological testing.
    • Tables show the maximum permissible ambient noise levels for both supra-aural and insert earphones, at different frequencies.

    Air Conduction Audiometry (Description)

    • Discussion on air conduction audiometry and the types of equipment used.

    Transducer Choice: Pros and Cons

    • Audiometry equipment options (types of headphones/inserts) were displayed and discussed.

    Reference Equivalent Threshold Sound Pressure Levels

    • Table showing the reference equivalent threshold sound pressure levels for a variety of audiometric situations.

    dB SPL to dB HL Transform

    • The notes include a diagram showing the conversion from one to the other.

    Describing Hearing Loss: Percentages (AMA)

    • Shows a graph demonstrating different categories of hearing loss at different percentages.

    Describing Loss: The Pure Tone Average

    • The average of the hearing levels of 500, 1000, and 2000 hertz is useful in evaluating overall hearing ability.
    • The Fletcher average is a concept used for calculating hearing loss.

    Degree of Hearing Loss

    • The data shows a visual representation of the different severity degrees of hearing loss from mild to profound hearing loss.

    Configurations of Hearing Loss (Rules of 20)

    • Various configurations of hearing loss based on an audiogram of a test. Many examples of different forms were shown/discussed, the diagrams used to explain.

    Audiometric Procedures

    • Steps/principles associated with audiometric testing procedures

    Audiogram Symbols

    • Explains how audiograms are read and interpreted: the different symbols, their meanings in the context of the audiogram, including types of testing.

    Drawing an Audiogram

    • Example of how an audiogram is drawn to visualize hearing loss patterns. Specific symbols used to describe different aspects of the hearing assessment were also covered.

    Arrangement: Screening and Diagnostic

    • Diagrams illustrate different arrangements for conducting hearing tests in screening and diagnostic settings. 

    Transducer Placement

    • Highlights important considerations for who conducts the tests, and what instruments should be used in the different situations, e.g. Bone oscillator, inserts. 

    The 'Button'

    • Identifies a critical component of an audiometer.

    Obtaining AC Audiogram ANSI S3.21 (1978)

    • Procedures for obtaining air conduction (AC) audiograms. This section outlined the protocols to follow for a comprehensive assessment.

    False Responses and Patient Responses

    • Discussion of common errors, such as false responses.
    • How these may occur and what to do to minimize issues or prevent inaccuracies in interpreting results, and how to correct for errors.

    Examples of Audiograms

    • Examples of audiograms, illustrating various degrees and types of hearing loss, and how to interpret them. 

    Sensorineural Hearing Loss, Conductive Hearing Loss, Mixed Hearing Loss

    • Visual representations of audiogram profiles for these categories.

    Appendix (Notes)

    • Supplementing notes or additional details on the topics covered in the main body of the lecture.

    Onset

    • Different type (e.g. congenital, acquired, adventitious).

    Time Course

    • Overviewing the various time-based classifications of loss (e.g. chronic, acute, gradual).

    Tuning Fork Tests: Weber, Rinne, Bing

    • Description, and procedures of the Tuning Fork tests.

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