3 - Tuning Fork Tests

Question 1

True or False: Tuning forks produce a pure sound

Answer 1

True

Question 2

Why do we use a 512 Hz tuning fork?

Answer 2

• mid-speech frequency
• minimum overtones and undertones
• do not fade quickly

Question 3

Name one type of tuning fork test

Answer 3

• Weber test
• Rinne test
• Bing test
• Schwabach test

Question 4

During the Weber test, the tuning fork is placed on the top of the head. What does this test tell us?

Answer 4

Midline: symmetric sensitivity
- this can indicate normal hearing or bilateral hearing loss (perform Rinne test)
Lateralization: lateralized to one ear
- this indicates a hearing loss.
- lateralize to worse ear = conductive loss
- lateralize to better ear = SNHL (perform Rinne Test)

Question 5

Which Tuning Fork Test compares AC and BC?

Answer 5

The Rinne Test

Question 6

What is the main principle of the Rinne Test?

Answer 6

• hearing mechanism is more efficient by AC than BC

- sound transmission is louder for AC

Question 7

A positive Rinne Test (AC > BC) can mean which two things?

Answer 7

• normal hearing

- SNHL

Question 8

A negative Rinne Test is when AC is ______ ( > or < ) BC, and indicates a conductive hearing loss

Answer 8

AC < BC

Question 9

The ______ (Weber/Rinne) Test is conducted by placing the base of a tuning fork on the mastoid process until subject no longer hears it, then holding it in the air next to their ear

Answer 9

Rinne

Question 10

Normal or Bilateral SNHL would be indicated by _____ (symmetrical/lateralization) Weber Test results, and AC ( > or < ) BC Rinne Test results

Answer 10

Weber: Symmetrical
Rinne: AC > BC

Question 11

SNHL in one ear would be indicated by a louder sound in the _____ (normal/abnormal) ear for the Weber Test results, and AC ( > or < ) BC Rinne Test results

Answer 11

Weber: louder in Normal ear
Rinne: AC > BC

Question 12

Conduction deafness in one ear would be indicated by a louder sound in the _____ (normal/abnormal) ear for the Weber Test results, and AC ( > or < ) BC for the Rinne Test results

Answer 12

Weber: sound louder in Diseased Ear because masking effect of environmental noise is absent on that side
Rinne: AC < BC

Question 13

What is the probable “diagnosis” for someone with the following results:
Weber: lateralized
Rinne (on lateralized side): positive

Answer 13

SNHL on the non-lateralized side

Question 14

What is the probable “diagnosis” for someone with the following results:
Weber: lateralized
Rinne (on lateralized side): negative

Answer 14

Conductive hearing loss on the lateralized side

Question 15

What is the probable “diagnosis” for someone with the following results:
Weber: midline
Rinne (on both sides): positive

Answer 15

Bilateral symmetrical SNHL

Question 16

What is the probable “diagnosis” for someone with the following results:
Weber: midline
Rinne (on both sides): negative

Answer 16

Bilateral symmetrical conductive hearing loss

Question 17

What is the main principle behind the Bing Test?

Answer 17

• tuning fork should sound louder with closed ear canal

- occlusion effect

Question 18

What does a positive interpretation of the Bing test indicate?

Answer 18

Occlusion effect present

- normal or SNHL

Question 19

What does a negative interpretation of the Bing test indicate?

Answer 19

No occlusion effect

- conductive loss

Question 20

The Schwabach Test is almost never used, but how is it conducted?

Answer 20

A tuning fork is placed on patient’s mastoid until they stop hearing it, then this is repeated with the examiner. Normal hearing is indicated by the duration being the same for both. Diminished hearing (SNHL) is indicated by a shorter duration for the patient than for the examiner