Rinne and Weber tests
Formal Definition
Tuning fork tests (512 Hz) used to classify hearing loss as conductive (outer/middle ear pathology) or sensorineural (inner ear/auditory nerve pathology): Rinne test compares air conduction vs bone conduction at one ear; Weber test places the fork on the midline of the forehead to determine lateralization of bone conduction.
How It's Used on the Ward
"Run a Rinne-Weber on them" or "what does the Weber show?" — the bedside tuning fork screen that directs whether the patient needs an audiogram or imaging.
Example
""Patient with right-sided hearing loss and tinnitus: Weber lateralizes to the right, Rinne shows bone conduction > air conduction on the right — conductive pattern on the affected side, consistent with right middle ear effusion or ossicular pathology. Refer to ENT for audiogram.""
Clinical Context
Rinne test: vibrating tuning fork held first at mastoid (bone), then at ear canal (air). Normal/sensorineural loss: AC > BC. Conductive loss: BC > AC (abnormal Rinne). Weber test: midline fork vibration. Normal/bilateral loss: midline (no lateralization). Conductive loss: lateralizes TO the affected ear. Sensorineural loss: lateralizes AWAY from the affected ear. Mnemonic: Conductive — the bad ear hears the Weber; Sensorineural — the good ear hears the Weber. Common error: students confuse which direction the Weber lateralizes. Conditions: otitis media/effusion = conductive; noise-induced or presbycusis = sensorineural; acoustic neuroma = unilateral sensorineural.