National Physical Therapy Examination (NPTE) Practice Exam

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Which of the following findings indicates conduction hearing loss?

  1. Weber's test shows louder sound in the left ear

  2. Weber's test shows louder sound in the right ear

  3. Rinne's test shows air conduction > bone conduction

  4. Rinne's test shows bone conduction = air conduction

The correct answer is: Weber's test shows louder sound in the left ear

The finding that indicates conduction hearing loss is when Weber's test shows louder sound in one ear compared to the other. In the context of the Weber test, a tuning fork is placed in the middle of the forehead, and sound will lateralize to the ear with conduction hearing loss. This is because sound waves are transmitted more effectively through bone than through air if there is a blockage or dysfunction in the ear canal or middle ear. Therefore, when the sound appears louder in the affected ear, it signifies that there is a conductive issue in that ear. The other findings do not indicate conduction hearing loss. In Rinne’s test, if air conduction is greater than bone conduction, this indicates normal hearing or sensorineural hearing loss, as sound is conducted better through air. If bone conduction equals air conduction, this would suggest a hearing loss that is either conductive or a mixed loss, but not purely conductive. Additionally, in the Weber test, if the sound is louder in the opposite ear, it indicates possible sensorineural hearing loss in the ear where the sound is quieter.