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TASKS,PRINCIPLES,QUESTIONS
Hearing,Vestibularsystem,Stabilometry
Physiologicallyspeaking,HearingandVestibularsystemshaveverylittleincommon.Despitethis,both
aretestedinoneclass.
Requiredknowledge:
Soundpitchandintensity(typicalfrequenciesofsounds
Decibelandotherunits
Hearingthreshold
Soundconduction(airvsbone)
Conductionvsperceptiondefect
Tuningforkstests,audiometryprinciples
Overviewoftasks:
1. speechtest
2. tuningforkstests
3. audiometry
4. vestibularreflexes,nystagmus(Barranichair)
5. stabilometry
Speechtest
Aim:fastassessmentofhearingatdifferentfrequencies(speech,whisper)
Procedure:
Askpersonbeingtestedtostandincca5mawayandturned90`fromfacetofaceposition(in
ordertopreventreadinglips)andrepeatwordsyuosay
Startsayingwordswithhipitchandlopitchtones(cheese,see/root,boom)andwaitforeach
toberepeated.
Usebothloudvoiceandwhispering
Ifpersonbeingtestedcannothear,asktomovecloser
Recordtheresultasmax.distancefromwhichtestedsubjectcanrepeatw/ohesitation.
Tuningforktests
Aim:distinguishbetweenconductionandperception=typehearingdefect.Alsotoidentifywhichearis
affected.
Principle:boneandairconductionisevaluatedandcompared
Airconductionsoundpropagatesthrumiddleear.Typicalforlisteningtoexternalsounds.
Boneconductionsoundpropagatesthrubonesofscull.Typicaltolisteningtoownvoice.
Forexternalsounds,airconductionis(physiologically)substantiallymoresensitive
Tuningforkstestsoverview
Testname procedure
Whatistested
comment
Weber
Tuningforkattachedto Boneconduction.
Ifoneearhearslouderthancross
boneinthemidline
Ifbothearshearequally
lateralone,thisiscalled
Lateralizationandimpliespathology
Rinne
Forkattachedto
Boneconductionandair
Normalfinding:soundisperceived
mastoidprocessand
conduction(ofthesame
longerviaairconduction.Testis
oncehearingceases
ear)
negative
Pathologicalfinding:soundis
movedinfrontofthe
ifhearingthruair
perceivedlongerviabone
ear(same)
conductionislongerthan
conduction
inbonecond.
Schwabach Forattachedto
Comparebone(andair)
Normal:patientanddoctorcanhear
mastoid,oncehearing
conductionbetween
similarintensities
ceases,doctorattaches patientanddoctor
forktoher/hisown
mastoid
Tasks:
performalltuningforktests.(everybody,bilaterally,inquietroom)
performthetestsagainwhilesimulatingconductiondefect
Recordallresults
trytointerprettheresults
AUDIOMETRY
Aim:estimatehearingthresholdovertherangeoffrequencies.Requiresaudiometer(specific
device).Maytestbothairconduction(loudspeaker)andboneconduction(vibrator).Audiometer
inlabsonlyallowsfortestingairconduction.
Use:diagnosevariousdefectsincluding:professionaldamage,presbyacusis)
Task:performaudiometryandrecordresultsintoprovidedchart.
Procedure:
checkaudiometerandearphonesifproperlyconnected
workinsilentroom
explaintheproceduretothetestedperson
instructthepersontoindicatewhenhe/shestartshearingtestingsound
askthetestedpersontoputthephoneson
makesureloudnessissettominimum
turnonaudiometer
beforeeverynewtonebeingused,allowforbrieflisteningatlowintensity(togetacquainted
withthefrequency)
foreachfrequencyfindhearingthresholdofeachear.Note:whileslowlyincreasingthe
intensity,usebuttontoperiodicallyinterruptthetone(ca1xpersecond).
Plottheresultsintograph
Trytointerpretthefinding
Questions:
Whymorethanonetuningforktestisneededforproperdiagnosis?
Whytuningforktestsdonotrequiresoundproofroom?
Whyaudiometryusuallyrequiressoundproofroom?
Duringaudiometry,whydoesthetestedtoneneedtobeperiodicallyinterrupted?
VESTIBULARSYSTEM,STABILOMETRY