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  1. Determind ability to discriminate pitches from stumulation of basal to apical electrodes (two electrodes are stimulated, one after the other, patient says which is higher)
  2. Type of stimulus unit- training emphasized recognition of individual speech sounds or syllables
  3. Nasal and voice
  4. Change in status in hearing due to
    -Ototoxic drugs
  5. Same sound may look different when spoken by a different person
  6. Currier in NY
    Gillespie in Nebraska
  7. Occurs when information form the auditory and visual signal combine to form a unified perception
  8. Consonants with lip closure
    Consonants with tongue towards front of mouth
  9. Words that look identical on the lips 47-56% of words in Enlish are homophenes
  10. Transient or impulse
    Continuous noises- constant for at least .2 seconds (more damaging)
  11. Maximum comfort level
    Maximum level sound can be listened at comfortably for a long period of time
  12. 3-5 days or 9-17 hours (rechargable)
  13. Fricative- air through constricted mouth 'hsssss'
    Affricates- fricative + stop "ch"
  14. 1. placement
    2. goals
    3. objectives
  15. Auditory training designed to contrast the features of articulation 1)Place 2)Voicing 3)Manner
  16. +6 DB
  17. - Recognize and interpret speech
    - Use residual hearing to maximum capability
    -Will not change hearing but will enhance ability to utilize sound
  18. -Prelingually defeaned
    -Post lingually deafened
  19. Same phoneme may look different when spoken in combination with another, influenced by vowel following consontant
  20. For each 5b increase in intensity permissible noise exposure is halved
  21. Ability to distinguish between words or phrases that differ in number of syllables
  22. 1. Evaluation
    2. Assesment of hearing
    3. Assesment of Otologic and general health
    4. Assesment Physchological status
  23. Time-weighted average- equates a sound level of 8 hours
  24. Programming the speech processor so stimulation follows contour of imcoming speech level (if not balanced popping sounds are heard, or no speech info)
  25. Electronic threshold of CI- just aware of sound
  26. Prelingually deaf:
    -Must learn to 'attend to' sound
    -Have no memory of sound or knowledge how it works
    Postlingually deaf
    -Can start with more difficult taks
    -Normally initially able to better deduce meaning from sound
  27. Bilateral, SNHL
    50% less sentence rec in ear to be implated
    60% or less in better ear
  28. The cochlea is oranized tonotopical with low frequecies at apex (center) and high frequencies on basal end (part near round window)
  29. ...
  30. Speech sounds that appear idential on the lips
  31. Cochlear Corp- 1st mult channel device
    Advanced Bionic
  32. DB of sound interest
    - DB of background noise
  33. TTS- muffled hearing, fullness or pressure in ear, tinnitus
    NIHL- loss in HF sounds
    Decreased speech discrimintation
  34. -designed to contrast vowels with different formants
    1) vowel awarness 2)distinguish between sounds 3)identitify
  35. Determine threshold (T level)
    Maximum comfort level- C level
    Loudness Balancing
  36. Asses child attention/vigilance
  37. Post op management
    Realistic espectations
  38. ...
  39. Evalautes binaural intergration skills
    -relies on ability of two brain hemispheres to communicate with each other
    -Student's ability to process mult stimuli
  40. -Bypasses hair cells in choclea (damaged by SNHL),
    -Stimulates auditory nerve directly
    -Neural impulses are sent to the brain as if the chochlea had been stimulated via acoustic input

  41. Speech Processor
  42. Child (6-11) listens to words and raises thumb every time hears 'dog'
    15 minutes
    20 monosyllabic words are repeated and arragned to form 96 word list
  43. Tiny exposed balls or rings on electrode array wire comprised of positive and negative polarity contacts
    + + ++ + +
    { { { { { {
    - - - - - -
  44. Listener able to label auditory stimuli
  45. Variations in pitch, rate, intensity, prosody (rythm) and duration imposed on segmentals (words and phonemes)
  46. Most basic auditory skill level- awareness of when a sound is present and when it is not
  47. Listener able to understand meaning of spoken message
  48. Damage occures in 3-6kHX region of cochlea
  49. Educate individuals on how to preserve and protect residual hearing
  50. Place
  51. Intergrates 3 dimensions of attention
    -Alertness- readiness to recieve stimulus
    -Selection- perceiving stimuli as being different and requiring a specific response
    -Effort- effect invest in test
  52. Acoustic trauma- permanent
    Temporary Threshold Shift- TSS (may case permanent threshold shift after time- PTS)
  53. Resonances in the vocal tract cause some frequences to have more energy than others
    1st and 2 formants distinguish vowels from one another
  54. Common with mengitius
    Electrode may be partially inserted
  55. 150 to 250 words per minute

  56. Part of brain that processes auditory info
  57. +30 million Americans are exposed to hazardous sound levels on daily basis
    -Excessive noise is most commone cause of hearing loss
    -10 million Americans have experianced loss b/c of this
  58. What we hear influences what we see and vice versa (visual intergration)
  59. Advanced form of babbling, 10 months
  60. Loss of residual hearing
    Fluid accumulation under incision site
    Irration over site
    Facila Nerve Paralysis
    Post-op middle ear infection
    Pain in implant site
    Facial nerve stimulation during programing
    Risk of anesthesia and surgery
    Leakage in cochlear fuilds
    Risk of menigitis
  61. -Emotion
    -Social Etiquette
    -Articulation style

  62. Reciever
    Electrode array (composed of electrode pairs)
  63. No, not associated with distinct mouth movements but are more acoustically salient to people with HL

  64. Auditory Skill
  65. 1790- Volta put eletrode in ear
    1950- Djourno developed electrical auditory prothesis
    1960-1970- Dr. William House and Dr. Graham Clare research wearable device
    1957- Eyries put this in an ear
    1980- C.I widely used
    1990- FDA approves C.I for children
  66. C.I (sound) processing stragety- trains of pulses are delivered across electrodes in non simulatenous fashion
    (pew pew pew pew pew)
  67. "Awareness plus the three 'ions'"
  68. Bilabial- lip to lip "man"
    Labiodental- teeth to lip "van"
    Linguadental- tongue to lip "thumb"
    Palatal- tongue to palat (roof of mouth) "ship"
    Velar- tongue to back of mouth "glove"
  69. ...
  70. Tests temporal processing
    Assesses how CANS processes degrade acoustic stimuli over time
    "Say the word ___"
  71. The "father of audiology," developed programs to help soldiers with hearing loss from WWII
  72. Ability to tell if two sounds or different or the same
  73. Formal takes place in a set, structured setting
    Informal intergrates training into everyday life
  74. Visual word decoding
    working memory
    lexical identification speed
    phonological processing
    verbal inference making
  75. Fatigue, anexiety, social withdrawl, depression, hypertension, stress, sleep disturbances
  76. Type of stimulus unit- training emphasizes meaning and context but not each word
  77. ...