ILE Subscription Test Prep/Class Test Prep with verified solutions

What are 4 ways to correct the occlusion effect? 1. Reduce the LOWS 2. make the fitting more "open" like RIC styles or thin tube BTE's coupled to the ear with open domes. Custom styles like CICs and IICs offer fewer venting options due to small shell sizes. 3. Increase vent size 4. SAV, is always a safe bet because its always easier to reduce the vent size than increase it Occlussion effect can sometimes be described by the wearer as their voice sounding like an "echo" or "down in a barrel." This is due to their ear being closed off and an increased amplification due to bone conduction. Patient's work environment includes both noisy and quiet areas. This requires the patient to make constant adjustments to the hearing instruments volume controls. Which specific measurement will be most important to obtain during the patient's hearing evaluation? MCL or UCL? UCL, because (pg. 115-118) of the constant adjusting. They're dynamic range needs to fit their work environment. 36 year old female restaurant worker with a family history of hearing loss reports that she is unable to hear as well as she did two years ago. Testing reveals a moderate conductive hearing loss. What is the likely cause of the patient's change in hearing? Meniere's Disease or Otosclerosis Otosclerosis pg. Pg. 43-46 disorders of the middle ear Otosclerosis is more common in women, and may be triggered by the hormonal changes of pregnancy. Otosclerosis is more of a progressive hearing loss. Meniere's Disease is classified as a SNHL. What is a Carhart's notch? It's an audiometric feature that shows a dip at 2000 Hz when people likely have otosclerosis that results in stapedial fixation. Named for Dr. Raymond Carhart. Patient has moderate to severe SNHL bilaterally. Patient was fit with slim tube BTE instruments. During the initial follow-up, the hearing healthcare professional performed probe tube measurements, which fell below targets in the high frequency range. Patient's validation results reveal low satisfaction with the fitting. What fitting option should the hearing healthcare professional recommend? Change to mini-BTE's with open domes Change to RIC's with custom earmolds and medium vents What are mini-BTE's? Change to mini-BTE's with open domes. This doesn't make sense because they already have BTE's and they aren't meeting high frequency range targets. Change to RIC's with custom earmolds and medium vents pg. 195-206. The medium vents may be able to increase high frequency sounds due to horn theory. What's horn theory? An acoustic horn is a change in diameter of the sound channel from smaller to larger. This response increases the high frequencies. This theory is used for a Libby Horn/Horn Tube, or modified canal bore belled/hollowed on earmold for BTE fittings when programming adjustments for high frequency enhancement cause distortion and unnatural sound. Patient with digital BTE's with dual microphones reports difficulty hearing in noisy environments. Which parameter should the hearing healthcare professional adjust when reprogramming the HA's? Compression or Directionality Directionality (pg. 171-182) because the noisy environments have noises coming from different directions, and they help with understanding speech in background noise. This makes the signal to noise ratio more favorable or the listener. Sound coming from the front will be louder than sound coming from the back. Compression doesn't make sense because it varies gain as the input changes. The compression kneepoint, or CK is when the intensity of amplification changes from linear to non-linear. Patient's assessment shows type A tympanometry values and unremarkable otoscopy with the tympanic membrane viewed while holding the pinna up and back. Audiometric findings using TDH-39 circumaural headphones show an air/bone gap of 15 dB at 1000 Hz to 4000 Hz. What should the findings indicate to the hearing healthcare professional? Ossicular disarticulation or Collapsed ear canal pg. 35-38 disorders of the outer ear Collapsed ear canal, because you already know that Type A tympanometry is classified with normal middle ear function and no conductive components. So the ossicular disarticulation wouldn't make sense. What does a Tymp A show? -normal middle ear compliance, peak pressure and TW -no conductive components -once exception is patients with otosclerosis who have a conductive or mixed hearing loss with normal ME measured by tympanometry To reduce occlussion effect should the fitting be deeper into the bony portion of the ear canal, or farther from the Tympanic Membrane? closer to TM means less occlusion effect because of shorter distance How is binaural interference characterized? Binaural word recognition can determine if binaural interference or degradation is present. Patients typically show improved speech rec scores binaurally, but when degredation or happens binaurally which speech recognition this is interference. More common with patients with significantly asymmetric word recognition scores. Patient with binaural dual microphone HA's reports difficulty understanding passengers in the rear seat of the car when driving. What should the hearing healthcare professional recommend? Using cardoid directional setting on both instruments Using omni-directional setting on both instruments pg. 231-276 Omni-Directional setting makes sense because they need to hear passengers behind them. pg. 231-276 Cardoid directional setting does not make sense because it's sound coming in directly in front of the microphone and none behind. A 65 year old patient states that during previous otoscopic inspections their ear was scratched, which caused bleeding. The patient has prolapsed canals. How should a hearing healthcare professional evaluate the ear? Use an earlight Brace against the head Use an earlight Brace against the head pg. 183-210 it is something we ALWAYS do to prevent scratching or injury An elderly patient reports having had a mastoidectomy performed in the past. No chronic infection is reported. The information provided by the patient is supported by otoscopic inspection. How should the hearing healthcare professional proceed? Use a non-occluding otoblock when taking the ear impression Use multiple otoblocks when taking the ear impression Use a non-occluding otoblock when taking the ear impression Use multiple otoblocks when taking the ear impression pg. 187-194 Air conduction audiometric test results indicate sloping mild to moderate hearing loss while bone conduction thresholds indicate normal hearing. How should the hearing healthcare professional proceed? Perform speech audiometry Mask for bone conduction pg. 93-98 ... What impact does the upward spread of masking have on intelligibility? Consonants overpower vowels Low frequencies interfere with high frequencies pg. 99-104 ... While taking an impression, the otoblock should be closest to which anatomical feature? Annular ligament Tympanic membrane pg. 183-210 The annular (stapedial) ligament (also called the stapediovestibular joint) is a ring of fibrous tissue that connects stapes to the oval window. Calcification and hardening of the annular ligament of the stapes (Otosclerosis) is a common cause of adult deafness. A patient brings a hearing instrument for cleaning, but the staff member does NOT have gloves immediately available. How should the hearing instrument be submitted? place the instrument in a tissue A patient comes into the office to have his hearing instruments cleaned and checked. The patient removes his hearing instruments and sets them on the front counter of the reception desk. To what could this expose the office staff and other patients? indirect contact transmission