dasar dasar audiometri,lumayan penting.ppt

Marine Mammal Bioacoustics: Audiology / Vocal PathologyPeter M. Scheifele MDr, PhD, LCDR USN (Ret.)University of CincinnatiCommunication Sciences and Disorders, Neuroaudiology Dept.University Medical [email protected]

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VocabularyAudiogram - A record of a persons pure-tone hearing threshold levels Threshold A level of sound that a person can detect 50% of the time or moreAudiometric Zero sensitivity of normal, young adults

Graphical Hearing DescriptorsAudiogramHearing Threshold Curve

The Hearing Threshold CurveFrom: Yost

Beluga Whale Hearing Threshold Curve

Marine Mammal Hearing Thresholds

*Audiometric Zero (Ref ANSI S3.6 1996, TDH-39 earphones)

0 dB Hearing Level at 1000 Hz = 7 dB SPL

Audiometric Zero

Sheet1

Audiometric Zero

12545

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50011.5

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1007

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800013

Sheet2

Sheet3

Audiometric Zero

45

25.5

11.5

8

7

6.5

9

10

9.5

15.5

13

Frequency (Hz)

Loudness (dB)

Sheet1

Audiometric Zero

12545

25025.5

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10007

15006.5

20009

300010

40009.5

600015.5

800013

Sheet2

Sheet3

*Graphic AudiogramsProvides a pictorial representation of hearing thresholds as a function of frequency and intensityUses symbols and/or colors to represent right ear, left ear, bone conduction hearing and masking levels

*Graphic Audiograms

Audiometric Zero

Audiometric Zero

12545

25025.5

50011.5

7508

1007

15006.5

20009

300010

40009.5

600015.5

800013

cht-Audiometric Zero

Frequency (Hz)

Loudness (dB)

cht-Graphic Audiogram

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Left Ear

Right Ear

Frequency (Hz)

dB Hearing Level

Graphic Audiogram

Left EarRight EarPost-Audio Left EarPost-Audio Right Ear

50010002000300040006000500100020003000400060005001000200030004000600050010002000300040006000Significant Threshold Shift (STS)

51025203525101010152010

cht-nihl

101520

152040

204060

305070

406075

305580

Mild Loss

Moderate Loss

Severe loss

Frequency (Hz)

dB HL

nihl

50010002000300040006000

101520304030Mild Loss

152040506055Moderate Loss

204060707580Severe loss

gundecking

Right Ear

50010002000300040006000

000000

Left Ear

50010002000300040006000

000000

Right Ear

000000

cht-pre&post audios

10.9375

5.9375

7.1875

10.625

13.4375

21.25

8.125

5.3125

5.3125

10.9375

9.6875

19.375

Pretest

Sound Pressure Level (SPL)The physical power in a sound as determined from a sound pressure measurementdB SPL = 20 log Px/PrefPref = 20 Pa

Sound Pressure Level (SPL)The amount of power needed for a normal hearing human to perceive a sound at threshold varies across frequencyThe amount of power needed also depends upon the transducerANSI 1996 standards

Hearing Level (HL)Hearing Level (dB HL) refers to the level in dB relative to the audiometric normNormalizes minimal audible pressure levels across frequency 0 dB HL = average threshold for a specific frequencyRange of normal hearing is from -10 dB HL to 20 dB HLUsed on audiometer dials and the audiogram to plot hearing levels

Converting dB SPL to dB HLIf the minimal audible pressure perceived by a human at 500 Hz is 11.5 dB SPL, what is it in dB HL?If audiometric zero is 45 dB SPL at 125 Hz, what level in dB HL is the same frequency sound when it is presented at 85 dB SPL?

Converting dB SPL to dB HLIf audiometric zero is 11 dB SPL at 2000 Hz, what level in dB HL is the same frequency sound when it is presented at 61 dB SPL?If the minimal audible pressure perceived by a human at 4000 Hz is 17 dB SPL, what is it in dB HL?

Sensation Level (SL)Sensation Level (dB SL) is the level in dB relative to an individuals own hearing thresholdsRegardless of hearing ability, a persons own threshold is set to 0 dB and the level of any particular sound is specified in terms of that threshold

Sensation Level (SL)A sound that is 30 dB more intense than the sound level at a persons threshold is described as 30 dB SLA sound that is 75 dB more intense than the sound level at a persons threshold is described as 75 dB SL

Sensation Level (SL)Sensation Level can be defined in terms of a persons threshold for: one frequencypure tone average (PTA)speech recognition threshold (SRT)Clinical speech testing- stimulus level is presented in dB SL re: PTA, or SRT50 dB SL, 70 dB SL

Converting dB HL to dB SLIf a persons threshold at 1000 Hz is 10 dB HL, what is the sensation level of a 1000 Hz tone presented at 60 dB HL?If a persons threshold at 2000 Hz is -5 dB HL, what is the intensity in dB HL of a 2000 Hz tone presented at 35 dB SL?

Converting dB HL to dB SLIf persons pure tone average is 5 dB HL and speech testing material is presented at 50 dB SL, at what dB HL is the word list presented?If a persons speech recognition threshold is measured to be 20 dB HL and speech testing material is presented at 70 dB HL, what is the sensation level?

*Degrees of Hearing LossNormal Hearing-10 - 25 dB HL Mild Hearing Loss 30 - 45 dB HLModerate Hearing Loss 50 - 65 dB HL Severe Hearing Loss 70 - 85 dB HLProfound Hearing Loss > 90 dB HL

*Hearing Loss Zones

*dBHz250 500 1000 2000 3000 4000 6000 8000shfthschp h

kSpeech Sounds

*Cross-overOne ear hears much better than the other

The sound presented to the test ear crosses through the skull and stimulates the hair cells of the cochlea of the non-test ear

The non-test ear is the one actually responding to the tone

Differences of > 40 dB at the same frequency between ears are suspicious

*Cross-over

Audiometric Zero

Audiometric Zero

12545

25025.5

50011.5

7508

1007

15006.5

20009

300010

40009.5

600015.5

800013


45

25.5

11.5

8

7

6.5

9

10

9.5

15.5

13

Frequency (Hz)

Loudness (dB)

Serial Audiogram

Left Ear

50010002000300040006000

Baseline6/1/8351025203525

Annual7/24/99101015201535

Right Ear

50010002000300040006000

Baseline6/1/83101010252510

Annual7/24/99101015201535

Mild high-frequency hearing loss at 6000 Hz bilaterally.


510

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Right Ear

Frequency (Hz)

dB Hearing Level

Graphic Audiogram



51025203525101010152010

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305070

406075

305580

Mild Loss

Moderate Loss

Severe loss

Frequency (Hz)

dB HL

nihl

50010002000300040006000

101520304030Mild Loss



gundecking

Right Ear

50010002000300040006000

000000

Left Ear

50010002000300040006000

000000

Right Ear

000000

background noise

Left Ear

50010002000300040006000

3050500

Right Ear

3005000

cht-cross-over

455

455

455

705

7010

7015

Left Ear

Right Ear

Frequency (Hz)

dB Hearing Level

cross-over



45454570707055551015

cht-pre&post audios

10.9375

5.9375

7.1875

10.625

13.4375

21.25

8.125

5.3125

5.3125

10.9375

9.6875

19.375

Pretest

*Making Diagnoses

Thresholds and Threshold ShiftsThreshold = JND at 50% detection ratePure-toneDifferentialDetection/hearing/of audibilityAcoustic reflexMasked/unmasked(speech) recognitionPainThreshold shiftTTSPTSTime-weighted average (TWA)

*Malingering (Pseudohypacusis) (Exaggerated Hearing Loss)Pretending to have a hearing loss by waiting until the sound is quite loud before pressing the response button

Hearing LossesMay be due to:Cochlear disordersAuditory nerve disordersCentral auditory pathologyConductive disorders (bone)Noise-inducedInherited disordersPresbycusis (age-related)May be congenital or Late-onset

Sensorineural versus ConductiveConductive Loss- Due to outer or middle ear blockage or loss of bone conduction via the skull.

Sensorineural Loss- Loss of inner ear functions of either hair cells or auditory nerve damage

Central Auditory Processing Disorders (CAPD)- Due to lesions or other brain pathologies

*Sensorineural Hearing Loss

Audiometric Zero

Audiometric Zero

12545

25025.5

50011.5

7508

1007

15006.5

20009

300010

40009.5

600015.5

800013


45

25.5

11.5

8

7

6.5

9

10

9.5

15.5

13

Frequency (Hz)

Loudness (dB)

Sheet4

Serial Audiogram

Left Ear

50010002000300040006000

Baseline6/1/8351025203525

Annual7/24/99101015201535

Right Ear

50010002000300040006000

Baseline6/1/83101010252510

Annual7/24/99101015201535



510

1010

2510

2015

3520

2510

Left Ear

Right Ear

Frequency (Hz)

dB Hearing Level

Graphic Audiogram



51025203525101010152010

cht-nihl

101520

152040

204060

305070

406075

305580

Mild Loss

Moderate Loss

Severe loss

Frequency (Hz)

dB HL

nihl

50010002000300040006000

101520304030Mild Loss



gundecking

Right Ear

50010002000300040006000

000000

Left Ear

50010002000300040006000

000000

Right Ear

000000

cht-pre&post audios

10.9375

5.9375

7.1875

10.625

13.4375

21.25

8.125

5.3125

5.3125

10.9375

9.6875

19.375

Pretest

cht-sensorineural

10105

10105

303525

5045

705060

8055

9075

Left Ear

Right Ear

BC Left Ear

Frequency (Hz)

dB Hearing Level

sensorineural



1010305070809010103545505575

552560

5

* Conductive Hearing Loss

Audiometric Zero

Audiometric Zero

12545

25025.5

50011.5

7508

1007

15006.5

20009

300010

40009.5

600015.5

800013


45

25.5

11.5

8

7

6.5

9

10

9.5

15.5

13

Frequency (Hz)

Loudness (dB)

Sheet4

Serial Audiogram

Left Ear

50010002000300040006000

Baseline6/1/8351025203525

Annual7/24/99101015201535

Right Ear

50010002000300040006000

Baseline6/1/83101010252510

Annual7/24/99101015201535



510

1010

2510

2015

3520

2510

Left Ear

Right Ear

Frequency (Hz)

dB Hearing Level

Graphic Audiogram



51025203525101010152010

cht-nihl

101520

152040

204060

305070

406075

305580

Mild Loss

Moderate Loss

Severe loss

Frequency (Hz)

dB HL

nihl

50010002000300040006000

101520304030Mild Loss



gundecking

Right Ear

50010002000300040006000

000000

Left Ear

50010002000300040006000

000000

Right Ear

000000

cht-pre&post audios

10.9375

5.9375

7.1875

10.625

13.4375

21.25

8.125

5.3125

5.3125

10.9375

9.6875

19.375

Pretest

cht-sensorineural

10105

10105

303525

5045

705060

8055

9075

Left Ear

Right Ear

BC Left Ear

Frequency (Hz)

dB Hearing Level

sensorineural



1010305070809010103545505575

552560

5

cht-bone conduction

25105

30155

55355

5545

55505

5555

5575

Left Ear

Right Ear

BC Left Ear

Frequency (Hz)

dB Hearing Level

bone conduction



1015354550557525305555555555

5555

5

Vocal Pathologies: Functional CorrelatesOverviewSound production issuesDysphoniaAphoniaMechanicalNeurologicalImage from: Nestle Nutrition and speechscreen.com/Vocal%20Palsy.html

Fini

***AUDIOGRAM- a graph expressing hearing loss (sensitivity) as a function of frequency.HEARING THRESHOLD CURVE- a graph expressing the level of intensity at which a sound is just audible to an individual*********************************

dasar dasar audiometri,lumayan penting.ppt

Documents

db relative

db hlused

db hlif audiometric

level of sound

hearing threshold curvefrom

normal hearing human

frequency sound

bone conduction hearing