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26 Multiple choice questions

  1. -patient stops hearing before examiner
    -SNHL
  2. tests the pt's occlusion effect
  3. -behind ear is louder; BC is WNL & AC is abnormal
    -Conductive HL
  4. •Assuming that BC is WNL and AC is not normal
    •Want to know these results could be due to other ear responding

    •PERFORM WEBER: sound heard in 1 ear.
    •POSSIBLE RESULTS: unilateral SNHL
  5. -NORMAL HEARING: beside ear is louder; AC more effective = POSITIVE RINNE
    -SNHL: beside ear is louder; same degree of loss by both AC & BC = POSITIVE RINNE
    -CONDUCTIVE HL: behind ear is louder; BC is WNL & AC is abnormal = NEGATIVE RINNE
  6. -patient hears the occlusion effect = normal hearing

    or

    -patient hears the occlusion effect = SNHL
  7. -Set into vibration
    -Place fork on patient's forehead
    -Say "I want you to tell me where you hear this sound."
  8. -NORMAL HEARING: examiner and patient stop hearing tone at approximately the same time
    -SNHL: patient stops hearing before examiner = DIMINISHED SCHWABACH
    -CONDUCTIVE HL: patient hears as long or longer than examiner, patients hearing in low pitches may appear better than normal = PROLONGED SCHWABACH
  9. -Set into vibration
    -Place stem on patient's mastoid (behind ear)
    Patient indicates if tone is heard
    -When patient no longer hears the tone, examiner uses a watch to determine # of secs sound is audible after patient stops hearing it.
    -Examiner MUST have normal hearing!
  10. -Examiner must not suggest what patient's response should be
    -Difficulty determining which ear is being tested
    -If ears are asymmetrical
  11. -NORMAL HEARING: patient hears the occlusion effect = POSITIVE BING
    -SNHL: patient hears the occlusion effect = POSITIVE BING
    -CONDUCTIVE HL: no change in loudness is heard, no occlusion effect = NEGATIVE BING
  12. test of lateralization (where patient hears the tone: right ear, left ear, both, or midline); if they pick an ear, do Bing test to pick results.
  13. -2 tones identical except for loudness presented at the same time in both ears, only the louder tone will be perceived
    -If same tone presented to both ears, one of which has poorer BC sensitivity
    -Perception that tones are louder in ear with better sensitivity
    -Only louder tone (better BC sensitivity) will be heard; patient responds they only hear it in one ear
  14. -based on occlusion effect; stronger at lower freq., so use low freq. tuning fork
  15. -beside ear is louder; AC more effective = Normal Hearing

    or

    -beside ear is louder; same degree of loss by both AC & BC = SNHL
  16. -Equally loud in both ears, cannot tell a difference, tone originates in middle of forehead = normal hearing

    or

    -Equal amounts of the same type of hearing loss (conductive, SNHL, mixed)
  17. -no change in loudness is heard, no occlusion effect = Conductive HL
  18. -Set into vibration
    -Place on mastoid (behind ear) and then beside ear canal
    -Ask which is louder
  19. -NORMAL HEARING: equally loud in both ears, cannot tell a difference, tone originates in middle of forehead = MIDLINE SENSATION
    -Equal amounts of the same type of hearing loss (conductive, SNHL, mixed) = MIDLINE SENSATION
    -SNHL (in one ear): hear tone in better ear; possibly due to Stenger principle
    -CONDUCTIVE HL (in on ear): hearing tone in poorer ear; results poorly understood, possibly result of prolonged BC (see Schwabach test)
  20. Patient could have a long standing unilateral loss
  21. -Interpretation is difficult with mixed HL
    -Difficulty determining which ear is being tested
    -FALSE NORMAL SCHWABACH: if ears differ, patient's response will be related to the better ear
    -Deciding which fork to use; you must state which you used
  22. -Set into vibration
    -Place fork on mastoid
    -Push tragus in and out of ear
    -If it sounds like "wooo wooo woooo" then you created an occlusion effect , which signifies normal hearing
  23. -Can be used to verify diagnosis of Schwabach or Rinne

    -FALSE NORMAL SCHWABACH or FALSE NEGATIVE RINNE: both due to better ear responding rather than test ear
    -Weber can verify unilateral SNHL
  24. -patient hears as long or longer than examiner, patients hearing in low pitches may appear better than normal
    -Conductive HL
  25. -Difficulty determining which ear is being tested
    -Can't tell if there is an asymmetric loss
    -FALSE NEGATIVE RINNER: inner ear of NTE is responding, patient is comparing AC of one ear to BC of the other ear (improper diagnosis of conduction HL if non-test BC is better than TE)
  26. looks at performance at AC vs. BC