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2. Shoulder
3. Stem or handle 4. Base or footplate
Tuning Forks
Frequencies used in E.N.T.: 256, 512, 1024 Hz
Striking Surfaces
Hard: Olecranon, radial styloid process, patella Soft: Thenar & hypothenar eminences, thick rubber strip Tuning fork is allowed to fall by its own weight
Rinne Test
Rinne Test
Duration comparison technique:
Rinne Test
Loudness comparison technique (better): Vibrating tuning fork kept on pt's mastoid Pt signals if sound is heard Move vibrating tuning fork immediately over opening of ear canal If sound is heard patient asked which sound is louder
Conductive deafness
Rinne Negative
1024 Hz = 46 - 60 dB HL
= severe conductive deafness
Weber Test
Procedure: Vibrating 512 Hz tuning fork placed in midline of pts skull at
forehead / vertex /
central incisor
Conductive deafness
Sensorineural deafness
Pt's B.C. compared vs. examiner's normal B.C. Vibrating tuning fork kept on pt's mastoid with pts E.A.C. occluded (to prevent A.C.) pt signals when sound ceases vibrating tuning
sensorineural deafness
Schwabach Test
Schwabach Test
Same as A.B.C. but E.A.C. is not occluded Pt stops hearing before examiner:
sensorineural deafness
normal hearing
conductive deafness
Etiology: U/L severe Sensorineural deafness Detection: Rinne negative, Weber lateralized to better hearing ear
Gelle Test
Vibrating tuning fork placed on pt's mastoid & examiner increases pt's E.A.C. pressure with Siegel's speculum
Softer sound:
No change in sound:
conductive deafness
Bing Test
Vibrating tuning fork placed on pt's mastoid & examiner blocks pt's E.A.C.
Louder sound:
No change in sound:
conductive deafness
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