Lecture Coverage

Audiology Basics • Discuss the Pathways and Physics of Sound

By: Joane R. Mata, MRS-SP
SP 104 Introduction to Audiology
Department of S peech Pathology
College of Allied Medical Professions UP-Manila
• Discuss Hearing Disorders in terms of
etiology, types and degrees, and signs and
symptoms
• Discuss effects of hearing impairment on
communication
• Define Audiology and its relation to Speech
Pathology

Physics of Sound Physics of Sound

• Sound - is the term to designate the • Psychological • Physical
stimuli, usually airbone which activate
the hearing mechanism • Pitch • Frequency
• Dimensions: • Loudness • Intensity
• Psychological - being experienced by an • Timbre • Complexity
individual; subjective to the listener
• Physical - objective and are determined
and measured only by the appropriate
instruments

Frequency and Pitch Frequency and Pitch

• Frequency
• Defined as the measure of the number of
times per second that a vibrating particle
executes a complete cycle
• The range of frequencies to which a man
can respond auditorily is from 20 to
20,000.
• It is measured in hertz (Hz)
• Frequency
• Band of frequencies to which human ear is
most sensitive is from 500 to 4,000cycles,
the range which is essential in hearing
speech.
• It is measured in octaves in an audiogram
• 250Hz-500Hz is one octave
• The sounds /s/ is one octave higher than
/sh/

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 Frequency and Pitch
• Frequency
• The female voices, are on average, an octave
higher than male voices.
• If an object vibrates 2x as fast as another, it will
produce a sound that is exactly an octave higher
• slow long waves = low pitch
• fast short waves = high pitch
Intensity and Loudness
• Intensity - is a physical attribute of sound
• It refers to the magnitude or the power of sound,
the energy of the sound waves
• The unit of measurement is decibel (dB)
• The human ear has an intensity tolerance range
from one to approximately 120 decibels.
• 120dB is usually considered the threshold of pain
Duration
• The length of sound (length of time a
sound takes to be made)
• duration of different sounds helps us to
identify them
• vowels tend to be longer than consonants
Frequency and Pitch
• Pitch
• Physical attribute of sound that varies also
on the basis of intensity
• Perceived as high or low
• For low tones, the pitch decreases with
intensity, but for high tones, the pitch
increases with intensity.
Intensity and Loudness
• Loudness - is the subjective evaluations
made by the individual as he receives
auditory sensations.
• The experience of loudness is not dependent
on the intensity of sounds; it also varies on
the basis of frequency
• E.g. a given sound is judged loudest if it falls
in the middle frequency range (vowel /a/)
The Anatomy and Physiology
of the Ear
The EAR – organ of hearing and balance
• Balance is critical to our movement
and our ability to stand upright
• Hearing is for oral and aural
communication and higher level of
language
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 The Ear Parts of the Ear

Bones of the
Hearing
Nerve • The human ear is
Middle Ear
divided into 3 parts:
Eardrum

•outer ear
Ear Canal •middle ear
Cochlea
•inner ear

THE OUTER EAR THE Pinna or Auricle

• is the protrusion at the side of the head

• Pinna or Auricle
• acts as a funnel gathering sound from the
environment and channeling it towards the
ear canal
• Ear Canal - helps with directionality (localization of sound)

The Ear Canal The Ear Canal

• It runs horizontally towards the center of • It acts to resonate the higher frequency
the head for a little less than an inch (2.5 sounds, amplifying these sounds and
cm) and there it ends at the ear drum helping to ensure that they are heard and
processed by the inner ear structure
• The skin of the outer portion of the canal
bears stiff hairs and secretes a dark,
bitter-tasting wax (cerumen) that as a rule
discourages the entry of insects and keeps
the skin of the canal and drum membrane
from drying out.

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 THE MIDDLE EAR The Tympanic Membrane

• It is the boundary between the ear canal

and the middle ear
• Tympanic Membrane (Ear Drum) • The TM vibrates when struck by sound waves.
The TM does not vibrate as a unit.
• It oscillates in segments and the pattern of
• The Ossicles vibration depends on the frequency and
the intensity of sound.
• Low pitched sounds produce fewer
vibrating segments, while higher
frequencies result in multiple areas of
discrete vibration.

The Ossicles
The Ossicles
• Malleus (hammer) - a tiny bone that
> Consists of 3 small bones passes vibrations from the eardrum to
the incus (anvil)

• Malleus (hammer) • Incus(anvil) - a tiny bone that passes

• Incus (anvil) vibrations from the malleus (hammer)
to the stapes (stirrup)
• Stapes (stirrup)

The Ossicles The Mastoid Process

• Stapes (stirrup)-a tiny, U-shaped bone that • Facial Nerve - has no importance for
passes vibrations from the incus (stirrup) to hearing, but may be endangered by
the cochlea. disease in the middle ear
• this is the smallest bone in the human body (it is
0.25 to 0.33 cm long).
• its footplate lie in the oval window
• 2 Muscles:
• Together with the middle ear, the - tensor tympani
ossicular chain help to translate and - stapedius muscle
conserve acoustic air vibrations so that
they may effectively stimulate the fluid-
filled inner ear.

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 The Mastoid Process
• 2 Muscles:
- tensor tympani
- stapedius muscle
• have no importance to hearing but cushions the
air pressure fluctuations that occur with
intermittent eustachian tube opening
• the mastoid as a unit serves as a resonator of
sound and sound can be transmitted through it by
bone conduction
The Eustachian Tube
• It runs from the middle ear to the
nasopharynx in a forward, slightly inward
and slightly downward direction
- its main function is to equalize the air
pressure on either side of the ear drum --
that is, the air pressure in the middle ear
and in the external auditory canal

MIDDLE EAR FUNCTIONS THE INNER EAR

• a conductor of sound
• an amplifier of sound • The inner ear is a bony labyrinth
• a transducer – for vibrations which consists of:
transmitted from one medium to
another (air – fluid)
• the semicircular canals
• a volume controL • and the cochlea
• a safety device

THE VESTIBULAR SYSTEM Semi Circular Canals

• the balance organs of the labyrinth • the three loops of fluid-filled tubes
are housed in the vestibule and the that are attached to the cochlea in the
semicircular canals inner ear.

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 Cochlea
• is the labyrinthine organ of hearing;
responsible for the processing of sound
• with its 2.5 turns and its decreasing width
from the base to the apex, thecochlea
looks vaguely like a seashell, hence its
name
• traveling waves caused by high frequencies
reach a maximum at the basal end of the
cochlea, and those caused by low
frequencies reach a maximum at the apical
end
Organ of Corti
• It contains an orderly array of hair cells
consisting of a single row of inner hair
cells and 3 rows of outer hair cells.
• It is the hair cells that, when stimulated,
converts the mechanical swirling of inner
ear fluids into electrical energy, the
language of the nervous system and the
brain.
• The overall combined action and results of
hair cell movements is relayed to higher
centers. The information relayed is how
we perceive sound.
Bone vs. Air Conduction
• Bone conduction is the conduction of sound
to the inner ear through the bones of the
skull.
• Bone conduction is the reason why a person's
voice sounds different to him/her when it is
recorded and played back.
• Bone conduction tends to amplify the lower
frequencies, and so most people perceive
their own voice as being of a lower pitch
than others hear it.
Organ of Corti
• Found in thecochlea contains which in turn
contains the auditory sensory cells.
• Its primary function is to convert the
mechanical pressure fluctuations of sound,
which have passed through the ear canal
and ME to the cochlea, into electro-
chemical neural impulses, which in turn
will pass up the cochlear portion of the 8th
nerve and be processed centrally .
Hair Cells
• Overall there are about 3000 IHC and
12000OHC in each cochlea of a young
person. As the years pass these
numbers decline at a regular rate.
AIR CONDUCTION
• In normal hearing, this is the path where
sound passes along our ear canal to the
eardrum making it vibrate.
•
• These vibrations are passed to three small
bones in the middle ear, the ossicles, a
process called air conduction. These in turn
pass the vibrations across the oval window to
the cochlea and the fluid it contains.
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 AIR CONDUCTION How do we hear?
• Movement in this fluid bends the tiny hair
cells along the length of the cochlea,
generating signals in the auditory nerve. Let’s trace
• the air
• The nerve signals pass to the brain, which
interprets them as sound. These amplified
conduction
sounds are then heard through air pathway…
conduction, in the normal way.

Types of Hearing Loss Conductive Hearing Loss

• Conductive • a problem in the outer or middle ear
• Middle or outer ear
• Persistent middle ear infections
• Fluctuating hearing levels
• Sensorineural
• Inner ear and beyond
• Cochlear hair cell dysfunction
• Filter and distort sound
• Mixed Hearing Loss

Causes Characteristics
Outer Middle • Sounds reaching the inner ear is
• Congenital • Trauma and reduced in intensity
malformations injuries
Ex: atresia, (closure – • Acute inflammation • Discrimination is barely affected
occlusion) of the middle ear • Patients tend to lower their voices
• Wax in the ear
• Otitis media
• Foreign body
• New growths of the
middle ear

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 Management
• Re-open closed channels
• Removal of obstructions in the
external auditory canal
• Unblocking the Eustachian Tube
• Irrigation of the nasopharynx
• Treatment of infections
Causes
• Maternal infection (rubella)
• Inherited conditions
• Anoxia
• Rh blood problems
• Meningitis
• Oxytoxic drugs
• Unknown causes
Management
• Cannot be corrected
• Needs hearing aids or cochlear
implant
Sensorineural Hearing Loss
• Occurs in the inner (cochlea) ear or
along the VII nerve (auditory
pathway)
Characteristics
• Discrimination is reduced
• Hears less well in noise
• Hearing loss is greater for high tones
than for low tones
• Patients tend to raise their voices
Mixed Hearing Loss
• hearing loss arising from the
outer/middle ear as well as the inner
ear
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 The Effects of Hearing
Impairment
• Primary Effect – filters sound in such a way
that the auditory detection of speech is
either partially or totally excluded
• Secondary Effect – restricts both verbal
and non-verbal aspects of functioning,
particularly the acquisition and/or use of
spoken language in communication
Two Groups of Children with
Hearing Impairment
• those who became hearing impaired
prelingually (before language is
acquired)
• those who became hearing impaired
postlingually (after language skills
are established)
ETIOLOGY OF HEARING
DISORDERS
• The causes are classified based on
the time at which the disease
process started
1. HEREDITARY GROUP
2. PREGNANCY GROUP
3. BIRTH GROUP
The Effects of Hearing
Impairment
• Tertiary Effect – prevents optimal
educational attainment which results
into restricted employment options,
limited income, and circumscribed
leisure activities
• limits social interaction
• affects subtle aspects of personality
Two Groups of Children with
Hearing Impairment
• Other children and adults who suffer
from hearing impairment can usually
manage much more efficiently than
children who became hearing
impaired at an early age because
they have the linguistic experience
and social skills that permit them to
fill in missing information
Hereditary Group
• has something to do with the passing on
from one generation to the next of a
defective gene
A. Hereditary Agenesis – structural
deformities of either the outer, middle or
inner ear
• outer and middle ear deformities:
• Pinna is often small, misshapen and low set
(microtia)
• External ear canal severely narrowed and
tortuous;
• in some children there may be no canal
(atresia)
• The ossicles in the middle ear are usually
deformed
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 Hereditary Group
• inner ear deformities:
• Usually involves the cochlea or the
semicircular canals
• Extreme examples:
• no inner ear and auditory nerve
• partial development of the cochlea, with 1
1/2 turns instead of the normal 2
Hereditary Group
• B. Familial Deafness
• C. Otosclerosis – formation of spongy bone
affecting the middle ear capsule, around
the stapes and oval window
• D. Atresia – an abnormally small pinna;
may be accompanied by occluded canals
(or absence) and/or anomalies of the
middle ear

Pregnancy Group Birth Group

• Rubella • Anoxia – lack of oxygen
• RH incompatibility
• Congenital Syphilis
• Toxemia
• Drugs – ex: Thalidomide,
Aminoglycoside antibiotics, diuretics

Physical Symptoms
SIGNS AND SYMPTOMS OF • Frequent earaches
HEARING IMPAIRMENT • Discharge from ears
IN THE SCHOOL AGE CHILD • Faulty equilibrium
• Complaints of noises

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 Behavior Reactions in the
Speech/Voice Symptoms
Classroom
• Omission of certain sounds • Frequent requests for repetitions
• Mispronunciation of common words • Turning one side of the head toward
the speaker
• Habitually speaking too loudly or
softly • Inattention during class discussions
• Habitually watches the speaker’s
face/lips
• Straining in an attempt to hear

Behavior Reactions in the

Audiology
Classroom
• Frequent mistakes in following directions • the study of hearing disorders and the
• Appears unaware when spoken to if not rehabilitation of people with hearing
watching the speaker
impairments. (The American Heritage® Medical
• Inappropriate or irrelevant answers to
Dictionary)
questions
• Frequently watches others before • a field of research and clinical practice
beginning a task devoted to the study of hearing disorders,
assessment of hearing, hearing conservation,
• Poor learning skills and aural rehabilitation.(Mosby's Medical Dictionary)

Audiology Audiology
• the science concerned with the sense of
hearing, especially in the evaluation and • The study of hearing (McGraw-Hill Concise
measurement of hearing loss and the Dictionary of Modern Medicine)
rehabilitation of those with impaired
hearing. (Miller-Keane Encyclopedia and Dictionary of Medicine,
Nursing, and Allied Health, 7th Ed.)
• the study of the entire field of hearing,
including the anatomy and function of the
ear; impairment of hearing; and evaluation,
education or reeducation, and treatment of
persons with hearing loss. (Mosby's Dental
Dictionary, 2nd edition. © 2008 Elsevier, Inc.)

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 What’s the relationship?

Thank you for your

• Audiology and attention and listening
Speech and Language
Pathology

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