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Don't Get surprised by the Cranial Nerve Examination

2/12/2021

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We all approach cranial nerves in the same way..... we ignore cranial nerve I and VIII.
However a very valid question would be to discuss how you would differentiate between a conductive versus sensorineural hearing loss in the exam.

Really simple if you've pre-thought it.
It's all about the Rinne and the Weber.

The Rinne test involves a 512Hz tuning fork to try and decide of conductive or not. Tap the tuning fork on your knee and hold it onto the patient’s mastoid. When the sound is no longer heard, place it 3-4cm in front of the ear.
A normal test is one where the air conduction is better heard than the bone conduction ie., when the patient no longer hears the sound with the tuning fork held against the mastoid, but then hears it when placed in front of the ear.
The Weber test identifies lateralisation. Tap the tuning fork and hold it high against the middle of the forehead. In a conductive loss of one side, the sound is heard more on that side
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