Rinne's and Weber Test Flashcards
which tuning fork do you use
512 Hz
Rinnes test
compares bone conduction (BC) to air conduction (AC) unilaterally (on both sides)
outline how one would conduct a Rinnes test
- Place a vibrating 512 Hz tuning fork firmly on the mastoid process (apply pressure to the opposite side of the head to make sure the contact is firm). This tests bone conduction.
- Confirm the patient can hear the sound of the tuning fork and then ask them to tell you when they can no longer hear it.
- When the patient can no longer hear the sound, move the tuning fork in front of the external auditory meatus to test air conduction.
- Ask the patient if they can now hear the sound again. If they can hear the sound, it suggests air conduction is better than bone conduction, which is what would be expected in a healthy individual (this is often confusingly referred to as a “Rinne’s positive” result).
normal Rinnes result
air conduction > bone conduction (Rinne’s positive)
Sensorineural deafness Rinnes result:
air conduction > bone conduction (Rinne’s positive) – due to both air and bone conduction being reduced equally
Conductive deafness Rinnes result
bone conduction > air conduction (Rinne’s negative)
why is bone conduction louder in conductive deafness
2 theories
- impaired sound conduction is more sensitive to stimuli received by BC- sound perceived as louder
- trapped sound waves
conductive hearing loss occurs when
sound is unable to effectively transfer at any point between the outer ear, external auditory canal, tympanic membrane and middle ear (ossicles).
Causes of conductive hearing loss include
- excessive ear wax
- otitis externa
- otitis media
- perforated tympanic membrane
- otosclerosis.
outline how one would conduct Webers test
- Tap a 512Hz tuning fork and place in the midline of the forehead. The tuning fork should be set in motion by striking it on your knee (not the patient’s knee or a table).
- Ask the patient “Where do you hear the sound?”
These results should be assessed in context with the results of Rinne’s test before any diagnostic assumptions are made
what does Webers test test
compares bone conduction in both sides
outline how one would do Webers test
- Tap a 512Hz tuning fork and place in the midline of the forehead. The tuning fork should be set in motion by striking it on your knee (not the patient’s knee or a table).
- Ask the patient “Where do you hear the sound?”
These results should be assessed in context with the results of Rinne’s test before any diagnostic assumptions are made
normal Webers test result
sound is heard equally in both ears.
unilateral sensorineural deafness Weber result
sound is heard louder on the side of the intact ear. (lateralises to the unaffected ear)
unilateral conductive deafness:
