If anyone would like to know why air conduction is longer than bone conduction in the first place. Remember the mastoid process is full of air pockets, IT IS NOT 100% SOLID. And sound travels slower and tends to be dampened more in air than in a solid. You may ask how does that make sense if sound is traveling only through the air when we remove the tuning fork from the mastoid. The reason is that the malleus, incus, and stapes are designed in such a way as to AMPLIFY sound coming from the air and that increases the ability of the neurons in the cochlea to sense sound from the moving lymph. Because the sound is being amplified from the air, it lasts longer than if sound was moving through the mastoid process which is full of air cells. Maybe someone is curious and it's the least I can do for this helpful video. I hope it helps someone.
Thank you, Amazing easy explanation. I think that one thing is missing: when there is conductive hearing loss 1. yes in Rinne test BC > AC in the affected ear, plus 2. in Weber test (same patient, same conductive defect) sound will be more audible on affected side. so I'm saying that in the conductive hearing loss both Rinne and Weber tests are abnormal.
S M this actually came up on my exam. One way to make this easier, is to add arrow heads to the tips of the letters; S for sensorineural and C for conductive. This can tell you the direction of the Webber test. Sensorineural: arrows point in opposite directions, indicating the opposite ear is affected vs. the one that sound was conducted to. Conductive: arrows are on the same side, indicating that the ear the sound was localized to was the one with the defect.
Patient with hearing issues: Step 1: Rinne Rinne (BC>AC) = Conductive hearing loss in that ear --> Done Rinne (AC>BC) = Not conductive hearing loss --> use Weber to localize sensiorneural hearing loss Step 2: if Rinne (AC>BC) --> Weber for SNHL Weber Louder ear is good ear--right if they can hear it, ear is working Weber softer ear is bad ear --> SNHL Great video !
i would say do Weber first because it tests both sensorineural and conduction issue. If abnormal, you confirm with Rinne if it's conduction. If not, it must be sensorineural.
I have always struggled to remember the tests but to simplify things, try imagining yourself with complete conductive hearing loss or sensorineural hearing loss: First, perform Rinne: 1. We know Rinne test mainly tests for conductive hearing loss. If Rinne test is negative (abnormal) on one side, that means your air conduction is not working, i.e. bone conduction works better than air conduction. This happens when you have a blockage in the outer ear, so the sound doesnt get transmitted through the chain of ossicles to the cochlear. = Conductive hearing loss Then, perform Weber: 2. If Weber test makes you hear louder on that same side of the ear, that confirms the conductive hearing loss. (try shutting your ear with your hand in a quiet room and say something) you always hear louder with conductive hearing loss, softer with sensorineural loss. 3. If Weber test makes you hear louder on the other side, it could indicate sensorineural hearing loss on the first side of the ear. Because you pretty much can't hear anything on the ear you just tested, maybe the cochlear/nerve is dead, so only the other ear can hear something. Tricky part is, there could also be conductive hearing loss on this other ear (remember you hear louder when your ear is blocked), therefore it's hard to distinguish when this happens, best to perform audiogram to confirm. I think there are many variations and possibilities to this but hopefully this simple idea/concept help you pass your exams XD, in practice you will end up asking them to do audiogram or refer to ENT if concerning anyway
Since R comes before We Do Rinne before Weber. Bone conduction > Air conduction, why? When sound passes through ear canal through Malleus Incus and Stapes it gets amplified therefore Bone conduction > Air Conduction. First we do Rinne Test if there is a problem in that ear we know that there is a problem but to ascertain if it is Conductive or Sensoneural we do Weber - if Sound is heard more in the ear which is normal it is Sensoneural problem this makes sense but in conductive hearing loss the sound is heard more in damaged ear this is quite counterintuitive - this happens because in damaged ear there is less noise coming from outside through ear canal and also there is less of sound waves leaving through ear canal as the ear canal is damaged - the reasoning is good but it can be confusing so the mnemonic used here is Sensoneural makes sense.
This is by far the BEST explanation EVER!!! I’ve been avoiding delving into this seemingly confusing topic since I was in med school. Thank you much!!!
Thank you so much, I have no idea why the so-called expert professors at my med school can't explain this concept in an easy-to-follow way like you just did.
Wow! I am clutching this high yield concept with 3 days left as I take the Philippine National Licensure Examination (PNLE). Very helpful. I will comeback to this once I passed my exam! :)
😅I had to keep reviewing the topic a few times after this video... But the video is brilliant and it's a shame I forgot I even watched it. I would've watched it over and over again.
Wow just wow literally you made a topic of number of pages into a simple one page concept so... good I mean my professor was explaining this thing since 1 hour still i was confused and you are a genius ♥️
I have been trying to understand it since first year of my medschool, but I never understand. And this guy fixed it in my mind within 2 minutes ! Thanks man... I really appreciate it 👍🏻
Thank you, this is an awesome video. You do an excellent job breaking the concepts down in a way that fosters rapid recall of the information. I love your videos!
Thank you for this easy to understand/concise explanation of this difficult concept! I found it very helpful that you gave the example as a follow up, thank you! :)
Thank you for this video! I have been procrastinating to truly learn this for the longest time. I have my PANCE licensing exam soon and your video helped to clarify this concept that they too also often test.
Thank you very much for this video! I have watched other videos and read some material to help me distinguish between the Weber and Rinne, and yours, is very helpful.
This video is very informative.I want to ask if you could organize your videos categorically under the playlist section so that navigating will be easier for us. Thanks!
Which of the following is a risk factor for inflammation of the outer ear? 1) Installing headphones or hearing aids Eustachian Tube Dysfunction (2 3) Older age (compared to children at a younger age) 4) A child who does not follow the frequent use of ear sticks
Since R comes before We Do Rinne before Weber. Bone conduction > Air conduction, why? When sound passes through ear canal through Malleus Incus and Stapes it gets amplified therefore Bone conduction > Air Conduction. First we do Rinne Test if there is a problem in that ear we know that there is a problem but to ascertain if it is Conductive or Sensoneural we do Weber - if Sound is heard more in the ear which is normal it is Sensoneural problem this makes sense but in conductive hearing loss the sound is heard more in damaged ear this is quite counterintuitive - this happens because in damaged ear there is less noise coming from outside through ear canal and also there is less of sound waves leaving through ear canal as the ear canal is damaged - the reasoning is good but it can be confusing so the mnemonic used here is Sensoneural makes sense.
I have a question to follow up....im doing occupational medicine, and this video was very helpful, but: If hearing loss is noise induced, i learned now it should be sensorineuronal, and BILATERAL in hearing loss. How can we use the weber and rinne test to determine if its sensorineuronal, in both of the ears, bilaterally and symmetrically, as is the requirement for noise-induced hearing loss?
I'm wondering if you have sensorineural hearing loss are you going to hear anything at all in rinnes test. Like your nerves are gone how is rinnes test normal in an ear with sensorineural loss. How will you hear anything?
![I.N "HALLUCINATION" | [Stray Kids : SKZ-PLAYER]](http://i.ytimg.com/vi/n5B5q1Hwt_U/mqdefault.jpg)
6 years have passed since this video was uploaded and i still go back to it for revision as it is the best and most concise . Thank you very much
If anyone would like to know why air conduction is longer than bone conduction in the first place. Remember the mastoid process is full of air pockets, IT IS NOT 100% SOLID. And sound travels slower and tends to be dampened more in air than in a solid. You may ask how does that make sense if sound is traveling only through the air when we remove the tuning fork from the mastoid. The reason is that the malleus, incus, and stapes are designed in such a way as to AMPLIFY sound coming from the air and that increases the ability of the neurons in the cochlea to sense sound from the moving lymph. Because the sound is being amplified from the air, it lasts longer than if sound was moving through the mastoid process which is full of air cells. Maybe someone is curious and it's the least I can do for this helpful video. I hope it helps someone.
Thank you, Amazing easy explanation.
I think that one thing is missing: when there is conductive hearing loss 1. yes in Rinne test BC > AC in the affected ear, plus 2. in Weber test (same patient, same conductive defect) sound will be more audible on affected side. so I'm saying that in the conductive hearing loss both Rinne and Weber tests are abnormal.
exactly........this thing confuses most of the people! thanks for bringing that up
this is correct. I'm commenting here so it pushes this post to the top so other people can enjoy your wisdom. thank you!
You need to remove and redo this video, or add an annotation letting viewers know that these is missing information.
S M this actually came up on my exam.
One way to make this easier, is to add arrow heads to the tips of the letters; S for sensorineural and C for conductive. This can tell you the direction of the Webber test.
Sensorineural: arrows point in opposite directions, indicating the opposite ear is affected vs. the one that sound was conducted to.
Conductive: arrows are on the same side, indicating that the ear the sound was localized to was the one with the defect.
S M I agree. It was really amazing. And you addressed a very valuable point. Thankyou to both of you dirty USMLE and S M.
Patient with hearing issues:
Step 1: Rinne
Rinne (BC>AC) = Conductive hearing loss in that ear --> Done
Rinne (AC>BC) = Not conductive hearing loss --> use Weber to localize sensiorneural hearing loss
Step 2: if Rinne (AC>BC) --> Weber for SNHL
Weber Louder ear is good ear--right if they can hear it, ear is working
Weber softer ear is bad ear --> SNHL
Great video !
i would say do Weber first because it tests both sensorineural and conduction issue. If abnormal, you confirm with Rinne if it's conduction. If not, it must be sensorineural.
I'm an MS3 and this is the first time these tests have made sense to me. THANK YOU!!
I have always struggled to remember the tests but to simplify things, try imagining yourself with complete conductive hearing loss or sensorineural hearing loss:
First, perform Rinne:
1. We know Rinne test mainly tests for conductive hearing loss. If Rinne test is negative (abnormal) on one side, that means your air conduction is not working, i.e. bone conduction works better than air conduction. This happens when you have a blockage in the outer ear, so the sound doesnt get transmitted through the chain of ossicles to the cochlear. = Conductive hearing loss
Then, perform Weber:
2. If Weber test makes you hear louder on that same side of the ear, that confirms the conductive hearing loss. (try shutting your ear with your hand in a quiet room and say something) you always hear louder with conductive hearing loss, softer with sensorineural loss.
3. If Weber test makes you hear louder on the other side, it could indicate sensorineural hearing loss on the first side of the ear. Because you pretty much can't hear anything on the ear you just tested, maybe the cochlear/nerve is dead, so only the other ear can hear something. Tricky part is, there could also be conductive hearing loss on this other ear (remember you hear louder when your ear is blocked), therefore it's hard to distinguish when this happens, best to perform audiogram to confirm.
I think there are many variations and possibilities to this but hopefully this simple idea/concept help you pass your exams XD, in practice you will end up asking them to do audiogram or refer to ENT if concerning anyway
Cohen Goh ,Thank you ....best explanation👍
Cohen Goh thanks a lot!!
Best explanation I have heard in a while!
thank you so much
What really sucks is figuring this stuff out after DV past statute of limitations.
Omg I couldn’t understand this concept for the longest time and now I totally understand it after watching your video. Thank you so much!
Same
Since R comes before We Do Rinne before Weber. Bone conduction > Air conduction, why? When sound passes through ear canal through Malleus Incus and Stapes it gets amplified therefore Bone conduction > Air Conduction. First we do Rinne Test if there is a problem in that ear we know that there is a problem but to ascertain if it is Conductive or Sensoneural we do Weber - if Sound is heard more in the ear which is normal it is Sensoneural problem this makes sense but in conductive hearing loss the sound is heard more in damaged ear this is quite counterintuitive - this happens because in damaged ear there is less noise coming from outside through ear canal and also there is less of sound waves leaving through ear canal as the ear canal is damaged - the reasoning is good but it can be confusing so the mnemonic used here is Sensoneural makes sense.
This is by far the BEST explanation EVER!!! I’ve been avoiding delving into this seemingly confusing topic since I was in med school. Thank you much!!!
I can’t express enough the perfection of this explanation. Thank you!
I mean this so sincerely - you are the reason I am surviving medical school! Thank you!
"Weber it's right or left" is GOLD...I bet you're good at making dad jokes.
Thank you so much, I have no idea why the so-called expert professors at my med school can't explain this concept in an easy-to-follow way like you just did.
Wow! I am clutching this high yield concept with 3 days left as I take the Philippine National Licensure Examination (PNLE). Very helpful. I will comeback to this once I passed my exam! :)
A very good explanation. Loved the mnemonics. I will sure never forget this now.
hey, its been 2 years now.. did u forget it ?? haha
😅I had to keep reviewing the topic a few times after this video... But the video is brilliant and it's a shame I forgot I even watched it. I would've watched it over and over again.
Wow just wow literally you made a topic of number of pages into a simple one page concept so... good I mean my professor was explaining this thing since 1 hour still i was confused and you are a genius ♥️
7 years old and still you are the best @Dirty!
I have been trying to understand it since first year of my medschool, but I never understand. And this guy fixed it in my mind within 2 minutes ! Thanks man... I really appreciate it 👍🏻
OMG THANK YOU SOOO VERY MUCH.. you saved my huge amount of time by this 5:40 min of video.. really made it supereasy !
Thanks!
I’ve watched so many videos about it. Finally, I got it. Thank you so much!
Thank you, this is an awesome video. You do an excellent job breaking the concepts down in a way that fosters rapid recall of the information. I love your videos!
Thank youuuu!! This is the first time these tests have made sense to me.
Thank you for this easy to understand/concise explanation of this difficult concept! I found it very helpful that you gave the example as a follow up, thank you! :)
Very easy explanation using diagram and pneumonics.. Any body can understand so easily.. Crystal clear
Thanku so much
U make my day...This topic was a headache for me but u make it clear absolutely...thanku u so much ...Keep making awesomes like this
You made this information very simple, we need like you for explanation… Thanks🙏🏻
Thanks for this video, I've struggled with understanding Rinne vs Weber and this video was really helpful.
best video ever, love from Türkiye
So clear! Thanks! English is not even my first language and I was still able to understand it perfectly.
Thank you for this video! I have been procrastinating to truly learn this for the longest time. I have my PANCE licensing exam soon and your video helped to clarify this concept that they too also often test.
Thank you for explaining this I finally understand! Where were you all my life!
Bro just summarized 2 hour lecture practical in 5 minutes 💀. Thank you Doc 🫡
Thank you very much for this video! I have watched other videos and read some material to help me distinguish between the Weber and Rinne, and yours, is very helpful.
Great presentation. Right on point. Very clear and fully understanding.
You just made 5 pages in a text book so easy, I wish you could teach me everything
Thank you very much. This video simplified everything for me before my test tomorrow.
Lol I've been coming back to this video every year for the last 4 years now 😅 thanks for this everlasting piece
I couldn't understand what this test until i found this video thank you very much such a life saver
Clear, concise and relevant as always tyvm !
Best video on RUclips for this topic
This was so helpful thank you! this has confused me for years at med school and suddenly makes sense!
You are a saviour!
Thank you so much! I take my FNP Boards tomorrow and this was a very helpful refresher!
YOU ARE AMAZING!!! I am writing tomorrow and I really needed this thank you so much! Thank you.
Best Explanation👍
Thank you very much 🙏
This video is very informative.I want to ask if you could organize your videos categorically under the playlist section so that navigating will be easier for us. Thanks!
Thank you very much. Very simple and memorizable explanation! Today is exam day. Wish me luck. :)
Omgg thanx that help me a lot, my OSCE exam after one day and I am about to cry cuz it’s so implicated for me
Awesome. Simply put. Now I have it. So grateful!
The sample really help, so clear finally got it, thank you!
Thank you so much, this is an amazing and simple examination. A very grateful med student!!
Amazing. Been studying for my NP boards and couldn't get it until now!!!! Thank you!!
this is the best explanation!! it makes soooo much sense!! thank you
Thank you very much. It was confusing every time I heard it. This is the first time I got it correct
Honestly brilliant explanation and thank you for finding a great way to make it memorable!!!! :D
Loved this video. It provided alot of help for completing my assignment. Thanks alot 😊
I thought this would be awesome, and it did not disappoint.
Great, my friend told me this question was on our A&P practical. Thanks!
Best video
I can't understand from few days but now I can now understand 👌👌
😍
im had trouble with rinne and weber before, but got it right after watching this. thanks
Which of the following is a risk factor for inflammation of the outer ear?
1) Installing headphones or hearing aids
Eustachian Tube Dysfunction (2
3) Older age (compared to children at a younger age)
4) A child who does not follow the frequent use of ear sticks
Very magnificent video and the first one I saw meaningful to both tests
amazing i literally learnt this in five mins! thank you
You're actually a God holy crap! well explained my guy!
thank you for making this fun and easy. I finally understood it... thank you!
OMG BEAUTIFUL. this is great. WAY better than my neuro professor
Excellent break down and then a bonus with mnemonics.😃
Thank you friend. This helped
I guess I forgot, because I'm back again
One of the best explanations
THANKYOUUUUU!!!!!!!!! Fully understood in less than 5 mins!
Incredibly helpful and easy to digest! Thank youuuu
Such a great explanation! love it
Since R comes before We Do Rinne before Weber. Bone conduction > Air conduction, why? When sound passes through ear canal through Malleus Incus and Stapes it gets amplified therefore Bone conduction > Air Conduction. First we do Rinne Test if there is a problem in that ear we know that there is a problem but to ascertain if it is Conductive or Sensoneural we do Weber - if Sound is heard more in the ear which is normal it is Sensoneural problem this makes sense but in conductive hearing loss the sound is heard more in damaged ear this is quite counterintuitive - this happens because in damaged ear there is less noise coming from outside through ear canal and also there is less of sound waves leaving through ear canal as the ear canal is damaged - the reasoning is good but it can be confusing so the mnemonic used here is Sensoneural makes sense.
Just a different way to remember which one goes where:
Rinna (Rinne) goes to the Pinna (outer part of ear)
The best explanation ever.
Wow great explanation very succinct. Subscribed!
This guy is simply amazing!!
Finally understood after a very long time
I have a question to follow up....im doing occupational medicine, and this video was very helpful, but:
If hearing loss is noise induced, i learned now it should be sensorineuronal, and BILATERAL in hearing loss.
How can we use the weber and rinne test to determine if its sensorineuronal, in both of the ears, bilaterally and symmetrically, as is the requirement for noise-induced hearing loss?
thank you for explaining this confusing topic so well
This video saved my life ❤
AMAIZING METHOD & EXPLINATION ONCE AND FOR ALL..
THANKS FOR SHARING
Very well explained! I finally got it 🎉
I'm wondering if you have sensorineural hearing loss are you going to hear anything at all in rinnes test. Like your nerves are gone how is rinnes test normal in an ear with sensorineural loss. How will you hear anything?
Thank you it's so brief and easy to remember 🙏🏼
Thank you very much!!! may God bless you!
It is conductive hearing loss if there's localization of sound (hear better with right ear)!
This video is an awesome explanation, THANK YOU!!!
thank you! simple but very helpful explanation.
This is so friggin awesome!!!!!! Thank u!!
Oh my god this video is amazing. Thanks 🙏🏾
Thank you!!!! My instructor kinda confused me but this made sense of it for me!
you are a life saver man , great job :D
Great concise explanation!
Very easy explanation, thank you so much❤
This video is AMAZING!!
How can you conclude that it's sensorineural loss? Wouldn't you need more information?
Thanku I watched more than 5 video i did not understand but now i m understand thanku
Excellent explanation! 👏