Overview
This lecture covers the Weber and Rinne (Rini) tests, which are used to distinguish between conductive and sensorineural hearing loss.
The Hearing System Basics
- Hearing involves two ears, ear canals, ossicles, and cochleae.
- Sound can be conducted via air conduction (through the ear canal) or bone conduction (through the skull).
- Normally, air conduction is greater than bone conduction.
Rinne (Rini) Test
- The Rinne test compares air conduction to bone conduction by placing a tuning fork on the mastoid process and then next to the ear.
- "Rini under the penny" mnemonic helps remember that the test begins under the ear (the pinna).
- A normal Rinne test: patient hears better by air conduction than bone conduction.
- Conductive hearing loss: patient hears better by bone conduction (on the mastoid).
Weber Test
- The Weber test involves striking a tuning fork and placing it on top of the patient's head.
- The Weber test helps localize which ear is affected ("Weber it's the right or left ear").
- Normally, sound is heard equally in both ears.
- In sensorineural hearing loss, sound localizes to the healthy ear.
- In conductive hearing loss, sound localizes to the affected ear.
Example Scenario
- Rinne test: patient hears tuning fork better in air (normal).
- Weber test: patient hears tuning fork better in the right ear.
- Diagnosis: left ear has sensorineural hearing loss.
Summary & High-Yield Points
- Rinne test: tests for conductive hearing loss ("Rini under the penny" = mastoid, then air).
- Weber test: detects sensorineural hearing loss; localizes to the ear without loss.
Key Terms & Definitions
- Air Conduction — Sound passing through the air into the ear canal to the cochlea.
- Bone Conduction — Sound transmitted through the bones of the skull to the cochlea.
- Conductive Hearing Loss — Impaired sound transmission in the middle or external ear.
- Sensorineural Hearing Loss — Impaired sound transmission in the inner ear or cranial nerve VIII.
- Rinne (Rini) Test — Compares air to bone conduction to detect conductive loss.
- Weber Test — Uses bone conduction on skull to localize sensorineural hearing loss.
Action Items / Next Steps
- Review this material and repeat the explanation for mastery.
- Practice interpreting Rinne and Weber test results for different types of hearing loss.
- Consider watching the lecture video again for reinforcement.