The sound vibrations are then transmitted through the middle ear via the ossicular chain before reaching the cochlea. The purpose of the outer ear is to direct sounds onto the tympanic membrane. The inner ear: Cochlea (organ of hearing), vestibular labyrinth (organ of balance) Clinical and animal studies have shown that cochlea is stimulated by bone conduction mainly through two routes: The mechanism underlying sound lateralization of the Weber test has been intriguing to health professionals for many decades. In conductive hearing loss, the sound should lateralize to the affected side however, in patients with sensorineural hearing loss, the sound lateralizes to the contralateral side. The Weber test is often combined with the Rinne test to detect the location and nature of the hearing loss. The inner ear mediates sensorineural hearing. The outer and middle ear mediate conductive hearing. The test can detect unilateral conductive and sensorineural hearing loss. The Weber test is a useful, quick, and simple screening test for evaluating hearing loss. The Weber test has been mainly used to establish a diagnosis in patients with unilateral hearing loss to distinguish between conductive and sensorineural hearing loss. The general appearance or general survey is the first step in a head-to-toe assessment.Tuning fork tests have been the mainstay of otologic examination for more than a century. NOTE: Remember to use the COLDSPA mnemonic (Character, Onset, Location, Duration, Severity, Patterns, and Associated Factors) to investigate and collect information for each symptom the client shares. We’ll start with the general survey and identify the patient’s chief complaint, then the assessment of each body system. This section is where we’ll start the head-to-toe assessment. These are usually open-ended questions to promote dialogue with the client. These questions are used to assess how the clients are managing their lives, their awareness of health, and unhealthy living patterns. The family history should include as many generic relatives as the client can recall in addition to genetic predisposition, it is also helpful to see other health problems that may have affected the client by virtue of having grown up in the family and being exposed to these problems. These are questions to elicit data related to the client’s past, strengths, and weaknesses in their health history. This section takes into account several aspects of the health problem and asks questions whose answers can provide a detailed description of the concern. What other symptoms occur with it? How doe it affect you? How bad is it? How much does it bother you? Where is it? Does it radiate? Does it occur anywhere else? Mnemonicĭescribe the sign or symptom (appearance, feeling, sound, smell, or taste) The COLDSPA mnemonic is a useful memory aid for exploring each symptom of health concern.
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