1. Which of the frequencies listed is an inter-octave frequency?
B. 3k Hz
2. Human hearing sensitivity measured in dB HL is ______________, because the reference for dB HL is ____________________.
A. equal across all frequencies, normal human thresholds
3. Which transducer is used to test for high frequency thresholds (above 8,000 Hz)?
C. circumaural earphones
4. Which transducer cannot be used to obtain ear specific thresholds?
C. speakers (soundfield)
5. Which stimulus is typically used to obtain pure tone thresholds in children?
B. Warble tone
6. The air conduction threshold for the right ear at 250 Hz is ______ dB HL.
C. 40
7. The air conduction threshold for the left ear at 250 Hz is ______ dB HL.
D. 10
8. The above audiogram represents:
E. unilateral sensorineural hearing loss in the right ear
All of the thresholds for the left ear are normal (below 25 dB). The
right ear thresholds are above 25 dB, so there is a hearing loss.
Because there is no air-bone gap (difference between the bone conduction
and air conduction scores are less than 15 dB) this is a sensorineural
hearing loss.
9. The masked air conduction threshold for the right ear at 250 Hz is ______ dB HL.
A. 50
10. The bone conduction threshold for the right ear at 250 Hz is ______ dB HL.
A. 10
11. The above audiogram represents:
E. a sensorineural hearing loss in the right ear
All of the thresholds for the left ear are normal (below 25 dB). The right ear thresholds are above 25 dB, so there is a hearing loss.
• There is a conductive component because bone conduction and air conduction scores differ by 15 dB or more.
• This is a conductive hearing loss because the bone conduction scores are normal
o This lets us infer that the cochlea is functioning normally; The only problem is getting sound down into the cochlea (conductive)
12. The above audiogram represents:
D. 40
• There is a conductive component because bone conduction and air conduction scores differ by 15 dB or more
• The bone conductions scores are also elevated (above 25 dB). Since the bone conduction represents how well the cochlea alone is doing, this means that there is a sensorineural component.
• This is a mixed hearing loss, because there is a conductive component (air bone gap), and a sensorineural component (bone conduction thresholds that are not within normal limits).
13. Hearing is considered to be within normal limits as long as thresholds are not higher than _______ dB HL
C. 25
14. The main problem in a conductive hearing loss is ________________.
B. attenuation of the sound
15. Uses monosyllabic words
C. Word recognition score (WRS)
16. Uses spondee (spondaic) words
C. Speech recognition threshold (SRT)
17. Calculated as percent correct
B. Word recognition score (WRS)
18. Evaluates the lowest intensity at which words can be correctly identified
C. Speech recognition threshold (SRT)
19. Evaluates the lowest intensity at which speech sounds become audible.
B. Speech awareness threshold (SAT)
20. Estimates an individual’s maximum (best) ability to understand speech.
C. Word recognition score (WRS)
Word recognition score represents the patient’s best ability to understand speech. It is a percentage score, not a single loudness value (like SRT or MCL).
Remember, the loudness level of WRS testing is based upon the patient’s SRT. If we present the sound at 40 dB above the SRT (the most common value used), it should be loud enough for the patient to hear well, because that is 40 dB above the level at which they are first able to identify words.
E.G. Mr. Smith, you do have a hearing loss. However, we know based on the test we did when the words were loud enough for you that you got 100 % of them right. This means that if we can turn sounds up for you, with something like a hearing aid, you will probably do quite well.
21. A patient’s SRT is 30 dB, and his uncomfortable loudness level is 90 dB. What is the patient’s dynamic range for speech?
D. 60 dB
Dynamic range = SRT – UCL
Dynamic range = 90 – 30
Dynamic range = 60 db
22. Speech recognition threshold (SRT) and the pure tone average (PTA) should be within ____dB of each other.
D. 8
23. PB rollover is associated with:
B. Retrocochlear hearing loss
24. An air tight seal:
C. Hermetic
25. Tympanometry measures:
B. mobility of the middle ear system
26. A normal middle ear system:
a. Type A
b. Type B
c. Type C
d. Type Ad
e. Type As
Type A
Negative pressure in the middle ear space
a. Type A
b. Type B
c. Type C
d. Type Ad
e. Type As
Type C
No area of peak pressure is observed, due to an overly stiff middle ear system
a. Type A
b. Type B
c. Type C
d. Type Ad
e. Type As
Type B
29. The area of peak pressure is normal, but the system shows an abnormally high compliance
a. Type A
b. Type B
c. Type C
d. Type Ad
e. Type As
Type Ad
30. The area of peak pressure is normal, but the system shows an abnormally low compliance
a. Type A
b. Type B
c. Type C
d. Type Ad
e. Type As
Type As
Associated with eustachian tube dysfunction
a. Type A
b. Type B
c. Type C
d. Type Ad
e. Type As
Type C
32. A type B tympanogram with an abnormally large estimated ear canal volume would indicate:
D. an eardrum perforation or P.E. tube
33. In tympanometry, an abnormally large gradient (width) is associated with
B. otitis media
34. When testing the right ipsilateral acoustic reflex:
A. the probe and stimulus tones are both presented to the right ear
35. When testing the right contralateral acoustic reflex:
D. the probe tone is measured in the left ear, and the loud sound is presented to the right ear
36. If there is a conductive pathology in the right ear and the left ear is normal:
A. Right ipsilateral and left contralateral reflexes will be absent
A reflex will be absent if the probe is in an ear that has a conductive pathology, because the disorder prevents us from measuring the contraction of the stapedius muscle.The probe will be in the right ear in the right ipsilateral and left contralateral conditions.
37. In acoustic reflex decay testing, a loud sound is played for 10 seconds. If a reflex in the right ear “decays” within those 10 seconds:
C. A retrocochlear pathology may be present
38. Occurs when the sound presented to the test ear is heard by the non-test ear
C. cross hearing
39. What type of noise is used to mask pure tone stimuli?
A. narrow band noise
40. Supra-Aural Headphones (TDH-39)
a. 0 dB
b. 20 dB
c. 40 dB
d. 60 dB
40 dB
41. Insert Earphones (ER-3A)
a. 0 dB
b. 20 dB
c. 40 dB
d. 60 dB
60 dB
42. Bone Conduction
a. 0 dB
b. 20 dB
c. 40 dB
d. 60 dB
0 dB
43. The masked bone conduction threshold at 4k Hz is:
a. 60 dB
b. 80 dB
c. 100 dB
d. No Response
44. The above audiogram most likely represents:
a. Normal hearing
b. Conductive hearing loss
c. Sensorineural hearing loss
d. Mixed hearing loss.
43. d. No Response
44. c. Sensorineural hearing loss
• We discussed this one twice in class.
• This set of results is common in patients with a profound sensorineural loss
• Due to equipments limitations, bone conduction testing cannot be performed at very high intensities
• The arrows beside the symbols mean that even though a loud sound was presented at that level, there was no response.
o This does not mean that there is an air-bone gap, it just means that the patient’s threshold is louder than we could deliver the bone conduction stimulus
o While it is possible that there is an air-bone gap, this type of audiogram is most commonly found in individuals with a profound sensorineural hearing loss