Clinical applications of tuning forks
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Clinical applications of tuning forks
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[ID] => 559512
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[post_date] => 2025-01-09 08:20:51
[post_date_gmt] => 2025-01-09 13:20:51
[post_content] => Practice Passage (Question 1-5)
*This passage is the property of Khan Academy and has been reformatted into an AAMC-style interface in their entirety by MedLife Mastery. MedLife Mastery does not endorse and is not an affiliate of Khan Academy.
Tuning forks are an effective tool clinicians can employ to test a patient’s hearing, but this goes beyond the simple task of being able to hear a tone. Because hearing is a function of both mechanical components of the ossicles and neural components of the cochlea, hearing loss can be either conductive (a complication with the physical aspect of hearing), or sensorineural (a problem with the neural component of hearing). Sensorineural hearing loss can result in the loss of ability to hear specific frequencies of sound. For example, most humans will lose their ability to hear high frequencies as they age. Conductive hearing loss generally causes decreased perception of all frequencies of sound.
A physician can utilize the simple physics of a tuning fork to determine whether hearing loss is conductive or sensorineural using the Weber and Rinne tests. The Weber test involve placing a tuning fork’s base in the center of a patient’s forehead. If a patient has unilateral conductive hearing loss, the sound from the tuning fork will seem louder in the affected ear. This is because the sound waves travel through bone and bypass the conduction of sound through air.
The Rinne test takes advantage of this phenomena as well; instead of the forehead, a tuning fork is held on the mastoid process just behind the ear. Once a patient is no longer able to hear it via bone conduction, the clinician then removes the fork from the bone, and hold the tuning fork closer to their ear. Because hearing is more sensitive to air conduction, a patient with normal hearing should still be able to hear the tuning fork. If they cannot hear it, this illustrates that the patient’s bone conduction is better than their air conduction, indicating that passage of sound to the inner ear is being inhibited. This suggests the patient has conductive hearing loss.
[post_title] => Clinical applications of tuning forks
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[question] => Two tuning forks of frequencies 440 Hz and 444 Hz are struck, one is held on a patient’s forehead, and the other is held away from their ear at a distance of 5 cm. What is the beat frequency produced by the two sound waves?
[value] => Array
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[answer] => 4
[description] => Reason for the Correct Answer:
The beat frequency is dependent only upon the different frequencies of pitch.
To find beat frequency, you simply find the magnitude of the first pitch subtracted from the second: i.e. |440-444| = 4
Because Hertz are measured as cycles per second, the beat frequency should be 4 beats per second, not per minute.
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[answers] => Array
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[each_answer] => A. 20 beats per minute1.0m
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[each_answer] => B. 4 beats per minute
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[each_answer] => C. 20 beats per minute
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[each_answer] => D. 4 beats per second
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[1] => Array
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[quiz_unique_key] => 3873426850
[question] => To test whether a patient has sensorineural hearing loss, you strike a tuning fork and place it on their forehead. The tuning fork produces a tone of 60 dB. If you struck the tuning fork harder to increase the intensity of a tone by 100, what sound level would the tuning fork produce?
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[answer] => 1
[description] => Reason for the Correct Answer:
Sound intensity in decibels can be found using the equation β=10 log I/Io.
For every order of magnitude the intensity of a sound increases, the decibel amount increases by adding 10.
Since the sound in this case increases by 100, this is 2 orders of magnitude, so we add 20 to our initial decibel level. This gives us a value of 80 dB.
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[each_answer] => A. 80 dB
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[each_answer] => B. 100 dB
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[each_answer] => C. 120 dB
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[each_answer] => D. 60 dB
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[2] => Array
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[quiz_unique_key] => 83407773
[question] => A patient notices that as the physician moves a vibrating tuning fork quickly past their ear, the pitch increases slightly as it moves toward their ear, and decreases slightly as it moves away. Which aspect of the sound wave would have to change to produce this effect?
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[answer] => 3
[description] => Reason for the Correct Answer:
A change in pitch would be equivalent to a change in frequency. Pitch is our hearing’s perception of frequency.
The wave function states that the velocity of a wave is equal to the wavelength multiplied by the wave’s frequency, therefore frequency is velocity divided by wavelength. The period and amplitude of a wave are not involved.
Because the tuning fork is staying within the same medium (air) the wavelength would not change.
Since there is a change in frequency without a change in wavelength, the velocity of a wave must be increasing then decreasing.
.
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[0] => Array
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[each_answer] => A. The wavelength is decreasing then increasing
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[each_answer] => B. The period of the wave is increasing then decreasing
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[each_answer] => C. The velocity of the wave is increasing then decreasing
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[each_answer] => D. The amplitude of the wave is decreasing then increasing
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[3] => Array
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[quiz_unique_key] => 2261298308
[question] => One of the primary reasons for conductive hearing loss is build-up of earwax in the ear canal. What phenomena of sound is responsible for the loss of intensity of sound in such a case?
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[answer] => 4
[description] => Reason for the Correct Answer:
Resonance is a synchronistic effect within a wave function which allows hearing to occur. Specific frequencies will resonate with specific portions of the basilar membrane in the cochlea, resulting in stimulation to nerves there. This would not be affected by earwax.
A harmonic is a frequency that is an integer multiple of a fundamental frequency, i.e. if the fundamental frequency is 50 Hz, then a harmonic would be 100 Hz, then 150 Hz, then 200 Hz, etc. The production of a harmonic would not result in a loss of intensity.
Refraction is the change in direction of a wave due to a change in medium. While this would occur as sound encounters the earwax, the change in direction of the wave would not influence the intensity of the sound.
Attenuation is the term for a loss of sound intensity of as it changes mediums. Because sound attenuation is greatest for soft, elastic materials, earwax can act just the same as a foam earplug!
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[each_answer] => A. Resonance
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[each_answer] => B. Harmonic
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[each_answer] => C. Refraction
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[each_answer] => D. Attenuation
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[quiz_unique_key] => 2377279144
[question] => A clinician testing for hearing loss notices that the patient cannot hear a tone at 440Hz, but they could hear a tone of identical intensity at multiple other frequencies above and below 440Hz easily. Which of the following would also be true of a hearing loss of only a certain frequency?
[value] => Array
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[answer] => 1
[description] => Reason for the Correct Answer:
Sensorineural hearing loss would be due to a neural deficit, not a physical one.
Neural components of hearing are solely located within the inner ear.
Blasts of single frequency at high decibel levels can damage specific portions of the cochlea, which would produce sensorineural hearing loss of a specific frequency.
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[answers] => Array
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[0] => Array
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[each_answer] => A. Damage to hair cells in the cochlea from intense levels of a pure tone can result in hearing loss of a specific frequency
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[each_answer] => B. A puncture of the tympanic membrane could cause hearing loss of specific frequencies
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[each_answer] => C. Otitis media, or a middle ear infection, results in increased pressure within the middle ear, which can cause hearing loss of a specific frequency
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[each_answer] => D. Otosclerosis, or abnormal growth of bone within the middle ear, can lead to decreased movement of the ossicles, could cause hearing loss of specific frequencies
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