History and examination of ear, balance + facial palsy

Question 1

Describe Rinne test in basic terms

Answer 1

tuning fork on mastoid bone, tuning fork in front of ear
tests conduction
normal hearing = air>bone

Question 2

Describe Weber test in basic terms

Answer 2

Tuning fork on top of forehead
localises hearing loss
normal = loudest at midline (does not localise to one ear)

Question 3

How would sensorineural hearing loss show in Rinne test?

Answer 3

air>bone (would present as normal)

Question 4

How would sensorineural hearing loss show in Weber test?

Answer 4

sound localises to normal ear

Question 5

How would conductive hearing loss show in Rinne test?

Answer 5

bone>air

Question 6

How would conductive hearing loss show in Weber test?

Answer 6

sound localises to affected ear

Question 7

5 branches of the facial nerve

Answer 7

temporal branches
zygomatic branches
buccal branches
marginal mandibular branches
cervical branches

Question 8

Why does UMN lesion have forehead sparing?

Answer 8

lesion allows ipsilateral input for the temporal branch of the facial nerve

Question 9

Why does LMN lesion not have forehead sparing?

Answer 9

lesion blocks all branches of the facial nerve

Question 10

What is Romberg test a tes of?

Answer 10

proprioception
(tests balance/coordination)
tests a patient’s ability to stand with feet parallel and together with eyes open and then closed for 30secs

Question 11

What does BPPV stand for?

Answer 11

benign paroxysmal positional vertigo

Question 12

What test diagnoses BPPV?

Answer 12

Hallpike test
rotating nystagmus

Question 13

What manoeuvre treats BPPV?

Answer 13

Epley