Note 1 - These tests are inconclusive but are used to screen out patients and they help us understand a little bit of Biology.
Note 2 For better visualisation you may see some Youtube video and for the explanation read this.
The body cannot hear a vibration which is of very low intensity.
When sound travels through the ear following the proper pathway it gets amplified.
The vibration of tuning fork damps with time this is something that you have to keep in mind right now.
Hearing loss can be caused due to:
- Problem with Conduction pathway
- Problem actual nerves and receptors
Procedure
- We will take a Tuning fork of 512 Hz and hit it somewhere to make it Vibrate.
- We will keep it on the skin overlying the Mastoid process of the patient. (mastoid process - small bony prominence on the back of the Ear) the vibration will travel through the mastoid process into other bones we will call it Bony conduction.
- After some time when the patient is unable to hear the vibration of tuning force because the tuning fork is vibrating at a very low intensity we will make the patient hear the tuning fork by keeping it on the ear now the sound wave will travel through air and then follow the proper order flowing through the external ear canal and all, we will call it air conduction.
- A normal person should be able to hear the Vibration through the Ear even after the intensity is so low that he cannot hear it through bony conduction.
What happens is that Bony conduction is lesser than Air conduction because when sound travels through the ear following the proper pathway it gets amplified.
What can go wrong is that there can two problems.
Problem with Conduction pathway
Problem actual nerves and receptors
With problem with actual nerves and receptors both Bony conduction and Air conduction will get lowered so abnormal finding in Rinne' s test corresponds to Conduction Hearing loss.
For problems with actual nerves and receptors we can compare it with normal ears if a patient cannot hear the Tuning fork when a normal person can this corresponds to problems with actual nerves and receptors to do this when the patient is unable to hear the sound we will immediately check to see if a normal person can.
If there is a problem with Nerves and receptors it is obvious that in normal Ears more vibration will be felt by the patient.
What happens with Conductive hearing loss is interesting as more sound is heard in the ear with Conductive hearing loss as the patient can focus more on the sound that is travelling through the bone as he will not be able to hear ambient sound through air condition less is noise and more is the focus.
-Syed Moris
Click here to read my write-ups on Biology Note 2 For better visualisation you may see some Youtube video and for the explanation read this.
Rinne' s test
Background InformationThe body cannot hear a vibration which is of very low intensity.
When sound travels through the ear following the proper pathway it gets amplified.
The vibration of tuning fork damps with time this is something that you have to keep in mind right now.
Hearing loss can be caused due to:
- Problem with Conduction pathway
- Problem actual nerves and receptors
Procedure
- We will take a Tuning fork of 512 Hz and hit it somewhere to make it Vibrate.
- We will keep it on the skin overlying the Mastoid process of the patient. (mastoid process - small bony prominence on the back of the Ear) the vibration will travel through the mastoid process into other bones we will call it Bony conduction.
- After some time when the patient is unable to hear the vibration of tuning force because the tuning fork is vibrating at a very low intensity we will make the patient hear the tuning fork by keeping it on the ear now the sound wave will travel through air and then follow the proper order flowing through the external ear canal and all, we will call it air conduction.
- A normal person should be able to hear the Vibration through the Ear even after the intensity is so low that he cannot hear it through bony conduction.
What happens is that Bony conduction is lesser than Air conduction because when sound travels through the ear following the proper pathway it gets amplified.
What can go wrong is that there can two problems.
Problem with Conduction pathway
Problem actual nerves and receptors
With problem with actual nerves and receptors both Bony conduction and Air conduction will get lowered so abnormal finding in Rinne' s test corresponds to Conduction Hearing loss.
For problems with actual nerves and receptors we can compare it with normal ears if a patient cannot hear the Tuning fork when a normal person can this corresponds to problems with actual nerves and receptors to do this when the patient is unable to hear the sound we will immediately check to see if a normal person can.
Weber' s test
We hit the tuning fork to make it vibrate and keep it on the skin overying bone on head and on various positions each making sure that it is equidistant from both the ears.(for actual locations on the head see some other sources)If there is a problem with Nerves and receptors it is obvious that in normal Ears more vibration will be felt by the patient.
What happens with Conductive hearing loss is interesting as more sound is heard in the ear with Conductive hearing loss as the patient can focus more on the sound that is travelling through the bone as he will not be able to hear ambient sound through air condition less is noise and more is the focus.
-Syed Moris
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