Case History
5 steps of taking a case history and explain a bit about each step
1. greet - identify yourself, patient and their companion.
2. build rapport -
3. active listening - undivided attention, empathy, watch for "feelings", paraphrase what you have understood
4. gathering information - chief complaint, medical, social history, present complaints, patient needs
5. Finish - any questions?, next steps: audiologic assessments
Explain what otoscopy is and its purpose
otoscopy is the physical assessment of the pinna, ear canal, tympanic membrane, and some of the middle ear.
Define what sound is and how it is produced.
Sound production requires a source, a force and a medium. In the medium of air, sound is change in air pressure. For instance, if you slam the door and it produces a sound - the force is your hand, the source is the door and the medium is air. When you slam the door, there is pressure differences in the air space around the door. The sound waves produced propagate spherically.
if the amplitude is 5 db, phase is at 90 degrees, and period is 600 ms, what is frequency?
1.7 Hz
you are facing a 40 db HL hearing loss at 4000 Hz. What is this in db SPL?
52 db SPL
what does oldcarts stand for? what is the purpose of the acronym?
To understand present complaints
O - onset
L - location
D - duration
C - characteristics
A - Aggrevating factors
R - Relieving factors
T - timing
S - severity
explain step by step the otoscopy procedures (include safety procedures)
Sanitize hands or put on gloves• Select correct size speculum• BRACE your hand against patient’shead!!• Insert speculum into entrance ofear canal BEFORE looking into viewfinder.• If infection or drainageà do NOTuse same speculum for the otherear!• Discard speculum
Explain how acoustics applies to clinical audiology.
knowing acoustic properties is important because we use different acoustic elements within clinical assessment:
Pure tones of different frequencies in Hz andlevels in dB. Used to measure auditory sensitivity.
“Noise”: A combination of frequencies (complex)with no harmonic structure. Used for masking or inspecial tests•
Speech: A combination of frequencies and levels(complex). Used for detection and understanding.
If the x axis is frequency and the y axis is amplitude, what graph is being showcased? Draw a complex signal of that waveform
spectrum, something with multiple frequency lines
An individual has a hearing threshold of -5 dB HL at 2000Hz. What is the amount of hearing loss in dB SPL
4 dB SPL
what are some communication strategies?
sit face-to-face in a well lit room, no distractions, work with an interpreter if there is a language barrier, speak more, utilize Amplification or Assistive Listening Device, Written communication
What ear is it? right or left? explain how you know
It's the right year. The umbo is leaning toward the right. and the cone of light is in the anterior inferior position on the right of the image.
define frequency, amplitude, period, phase, duration, sound pressure level. If applicable, what are their physical correlates
frequency - cycles/ sec - pitch
period - amount of time it takes to complete one cycle
amplitude - loudness, intensity
phase - the degree/ radian where the sine wave starts
duration - time for a sound
sound pressure level - Physical properties of the level of soundwaves
Your fridge is making an annoying loud sound of 80 db. What is this in micropascals?
200,000 micro pascals
A person has a hearing loss of 30 dB spl at 1000 hz. what is the hearing loss in DB HL?
22.5 dB HL
what is some etiquettes associated with working with an interpreter?
keep sentences concise, speak directly to patient, Allow time for clarification questions (by interpreter and patient), pause often for interpretation
What are some reasons you need to refer patients?
Cerumen occlusion, Signs of infection (Tenderness• Drainage or foul odor are present), Unevaluated Perforation
if we have avalue of 0 dB, does thismean NO SOUND?
No, it is a point on a scale and it means that themeasured pressure in μPa equals the referencepressure in μPa
You were right behind the niagra falls. you measured a sound level of 632,456 µPa. How much db spl is this?
90 db spl
The concert you are about to attend says the average sound level will be 90 db. You buy ear protectors that advertise to reduce sound pressure by 7 times. what will be the the sound after you were the earplugs in db spl?
73.10 dB SPL
why is case histories important?
1. Differential diagnosis - plan testing strategies, learn about specific complaints, observe behavior and speech skills, factors contributing to hearing impairment
2. Treatment - tailor to patient needs
3. Building rapport - build trust with patient
Point Grab: each correct definition gets 50 points
auriculur pits
ear tags
Microtia
Atresia
stenosis
ear melanoma
exostoses
osteoma
cholesteatoma
otitis media
external otitis
TM retraction
Tympanosclorosis
Tympanic Membrane Monomere
Tympanic Membrane Perforation
Cerumen Occlusion
refer to group knowledge or check slides while playing lol
why do we use logarithmic scale? explain the difference between a linear scale and a logarithmic scale.
20 (audible pressure) -200,000,000 μPa (damaging sound pressure) is a LARGE and DIFFICULT to work with
you were watching tv peacefully. To annoy you, your sibling snatched the tv remote and tripled the sound level of your environment. How much of an increase is this in DB?
9.54 db
periodic v aperiodic sound
period - repeating
aperiodic - no repeats of wave cycles