you got a no the Weber Hearst Renee test I don't know if it's pronounced Renee or Renny but for now on we're calling it the Renny test the Weber in the Rini test are both high yield the difference between sensory neural hearing loss and conductive hearing loss is also high yield if you look in first aid this only gets a little table in first aid but many students report that this does show up a lot so it's important to know here is a really simplified drawing of the hearing system you have two ears in this case they look like little Mickey Mouse ears then you have a blue ear canal some red ossicles and a green cochlea I've labeled that for you here by colors just so we can keep this really simple there are two types of ways that we conduct impulses to be able to process them through cranial nerve eight one is through air conduction if something is held right in front of your ear it moves through the air into your ear and is conducted on its way towards the brain the other is bone conduction if something is held against the bony process of the skull sound waves move through the bones and go directly to the cochlea under normal circumstances air conduction is greater than bone conduction this makes sense if something is held right next to your ear it's gonna be louder and more audible than if it was held against your skull now let's say that we place a tuning fork on the mastoid process you need to know whether this is the Weber test or the Rini test the mnemonics remember this is that the Rini is under the penny so if you know that the out the outside of the ear is called the pinna or the penny ready under the penny so anything that's under the ear it's there ready because your Rini is under the penny so what you do is you strike the tuning fork and you put it under the penny or on the mastoid process and then you ask the patient to tell you when they can hear it they tell you that they can hear it and then you move it right outside the ear so what you've done at first is you've tested bone conduction with Rini under the penny and then you've moved it right outside the ear to test air conduction again under normal circumstances air conduction should be greater than bone conduction if they have conductive hearing loss they'll be able to hear it better when it's held against the bone when it's under the penny on the mastoid process but our mnemonic to remember the rainy test is Rini under the penny there's another test that you have to know if you place the tuning for if you strike the tuning fork and place it on the top of the patients head this is the Weber test the Weber test localizes ears the Weber test tells you Weber it's the right or left ear see what I did there I replace the word weather with Weber so the Weber test tells you Weber it's the right or the left ear when you strike a tuning fork and place it on their head during the Weber test the sound moves to both ears so this is for localization under normal circumstances the patient should be able to hear the sound equally in both ears but if they have sensory neural hearing loss they're not going to hear it in the ear that has sensory neural hearing loss which means it localizes to the good ear in other words if I strike a tuning fork and do the Weber test and place it on your head and you only hear it in your left ear that means that your right ear has sensory neural hearing loss so Rini under the penny and a Weber tells you whether it's the right or the left so that's a lot of information in a very short amount of time so why don't we do an example if a tuning fork is placed on the mastoid and then moved outside the right and left ears the patient says that they're able to hear the tuning fork better when it's held in the air next to both ears the physician then strikes the tuning fork and places it on the patient's head the patient says that they hear the tuning fork better in their right ear what is the diagnosis so I'm asking you what type of hearing loss is present if at all so let's dissect this step by step the first thing that the physician did was strike the tuning fork place it on the mastoid and then move it outside both ears he started with the mastoid that's Rini under the penny so he did Rini under the penny and the patient said that they were able to hear the tuning fork better when it was held in the air that's a normal response because again air conduction should be greater than bone conduction so we have a normal for any test then the physician strike the tuning fork and placed it on the patient's head what test is that well that's the Weber test it told you Weber it was the right side of the left side when the physician did this the patient said that they were able to hear the tuning fork better in their right ear the question is which ear has sensory neural hearing loss and that is the left because the patient heard it better on the right side so here that was just a really easy example but it goes to show you how simple these tests are if you know what the tests are testing for in a nutshell if I'm gonna summarize all this for you I would say that the Rini test is really under the penny you put it on the mastoid just below the pin of the ear and you're testing for conductive hearing loss the Weber test is testing for sensory neural hearing loss it tells you Weber it's the right side or left side that has sensory neural hearing loss these are very high yield and I suggest that you go through this video once or twice to get it down it should only take you five minutes but it will be free points on test day if you dedicate the necessary amount of time good luck guys