Question

A 34-year-old Caucasian male report to the emergency room as a result of acute onset of nausea, vomiting, and the worst headache of his life. He stated that his headache as increased in severity over the past three days. B.P 88/48. On a pain scale of 1 to 10; his pain is a 10/10. He has a past medical history of hypertension, sleep apnea, dissection of the aorta, Weber and Rinne Test negative. On physical examination the physician noticed petechiae over his arms and neck. Range of motion examination demonstrated hyperflexion of all joints with random dislocation. During the physical examination the patient collapsed. Ocular examination and emergency CT was performed (view attached imaged). 6. What is the normal hertz heard for Weber’s and Rinne’s test? 7. Does this patient have a normal or abnormal Weber’s Test? 8. Why does this patient have sleep apnea? 9. Explain this patient current blood pressure?

Answer 1

Answer: The normal hertz heard for Weber’s and Rinne’s test is 512 Hz, this test is used to detect the hearing loss. A Rinne test evaluates hearing loss by comparing air conduction to bone conduction. If the test becomes positive then that generally means the absence of conduction loss in that ear. The patient doesn't have abnormal Webers test as the result is negative, that means his hearing capabilities is normal. The patient is having sleep apnea due to of many reasons such as he is having severe headache, low blood pressure which causes less oxygen to reach to the lungs, hence breathing problem occurs. Lungs and heart are unable to get sufficient amount of oxygen as well as blood supply which leads to breathing problem. The patient is having a tear in the inner layer of the large blood vessel branching off the heart (aorta).