Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Senior - ENT > 3a - Inner Ear (vertigo) > Flashcards

3a - Inner Ear (vertigo) Flashcards

1
Q

Fluids in the inner ear

A

Perilymph

Endolymph

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Perilymph is?

A

Chemically similar to CSF

Surrounds membranous labyrinth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Endolymph is?

A

Found w/in membranous labyrinth

High level of K

Role in generating auditory signals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is vertigo?

A

Symptom of vestibular dysfunction

  • Sensation of motion w no motion or an exaggerated sense of motion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

With vertigo you must differentiate between? How to differentiate them

A

Peripheral:

  • sudden onset
  • w tinnitus/hearing loss

Central:

  • gradual onset
  • no auditory symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Is Vertigo a disease?

A

No - its a symptom of vestibular disease not a diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

types of dizziness

A

Vertigo
Presyncope/syncope
Disequilibrium
Non-specific lightheadedness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Causes of peripheral vs central vertigo?

A

Peripheral (80% of cases)

  • BPPV
  • vestibular neuritis
  • meniere disease

Central (big deal)

  • vestibular migraine
  • vascular etiologies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Otolaryngologist focus primarily on?

A

Peripheral causes

Central is prob neuro

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Clinical approach to diagnosing vertiog?

A

Hx

  • duration
  • quality
  • triggers
  • associated sx
  • med hx

HEENT exam

  • ears
  • eye motion (w head turning)
  • CN exam
  • Romberg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Meds that often cause vertigo?

A 
Aminoglycosides
Anti-HTN drugs
Vasodilators
Phenothiazines
Tranquilizers
Antidepressants
Anticonvulsants
Hypnotics 
Analgesics
Alcohol
Caffeine
Tobacco
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

To differentiate central from peripheral evaluate?

A

Brainstem symptoms

  • diplopia
  • facial numbness
  • weakness
  • hemiplegia
  • dysphasia

Lack of these does not r/o central

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Tests to run for suspected central vertigo?

A 
Audiogram
ENG - electronystagmography
VNG - videonystagmography
Brain MRI
Caloric stimulation 
- (COWS - cold opposite Warm Same)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Peripheral vertigo nystagmus?

A
  • Fatiguable
  • Horizontal w rotary component
  • Latency
  • Suppressed by visual fixation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Peripheral causes of vertigo?

A
  • Meniere disease
  • Vestibular neuritis/labryinthitis
  • Benign positional vertigo
  • Traumatic vertigo
  • Perilymphatic fistula
  • Migrainous vertigo
  • Semicircular canal dehiscence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Inner ear digarm?

A

Slide 20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Endolymphatic hydrops is aka?

A

Meniere syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Endolymphatic hydrops cause?

A

Idiopathic - consider chronic condition

Also could be:

  • syphilis
  • head trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Classic diagnosis of endolymphatic hydrops (meniere syndrome)

A

Episodic vertigo - 20min-hrs
SNHL - fluctuating and lower freq
Tinnitus - low tone, blowing
Sensation of unilateral aural fullness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Eval for endolymphatic hydrops?

A

Audiometry: SHL

Caloric testing: loss/impairment on involved side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Tx for endolymphatic hydrops?

A

Symptomatic

  • Acute: meclazine/valium
  • Primary: low salt and diuretics

Refractory:

  • intratympanic cortoicosteroids
  • endolymphatic sac decompression
  • vestibular ablation (gentamicin, nerve section or surgical)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

With endolymphatic hydrops pts should avoid?

A 
High salt
MSG
Caffeine 
Nicotine
ETOH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Vestibular neuronitis is aka?

A

Labrynthitis (when unilateral HL is present)

Vestibular neuritis

Acute peripheral vestibulopathy

24
Q

Symptoms of vestibular neuronitis?

A 
Acute onset, persistent and severe 
N/V
Hearing is preserved
Unilateral SHL 
Tinnitus (+/-)

Pt will awaken w room-spinning vertigo that will continue but gradually get better over days/weeks

25
Q

What causes labrynthitis?

A

Idiopathic

  • may be inflammation of the labyrinth
  • poss following URI
26
Q

PE for labrynthitis?

A

Spontaneous horizontal nystagmus, suppressed w visual fixation

Positive head thrust test

27
Q

Tx for vestibular neuronitis?

A

Symptomatic
- antihistamines/benzos

Vestibular therapy (rehab)
- should begin after acute symptoms subside
28
Q

BPPV - benign paroxysmal positioning vertigo

A

Otoconia (calcium carbonate crystals) or other sediment become free floating and enter one of the semicircular canals

29
Q

Key word for BPPV?

A

Sudden onset vertgo lasting less than one minute

  • Triggered by change in head position
  • quick movements
  • goes away as sediment settles

They have a precise movement that cause it

30
Q

What test is key to diagnosing BPPV

A

Dix-hallpike maneuver (DHM)

31
Q

How is dix-hallpike maneuver conducted?

A

33-35
- moving head around and laying them down

  • nystagums and vertigo appear w a latency of few seconds and last <30 sec
32
Q

Tx for BPPV?

A

Meds dont work

Epley particualr repositioning maneuver
- moves debris toward common crus and out of the auricular cavity

(Pic on 36)

33
Q

Lsit of meds for vertigo?

A

Slide 38

34
Q

Traumatic causes of vertigo?

A

Labyrinth concussion Basilar skull fx

Chronic posttraumatic vertigo from cupulolithiasis

35
Q

MC cause of verticgo s/p head injury?

A

Labyrinth concussion

- diminish over days/month

36
Q

What is a perilymphatic fistula?

A

Rare
- leaking of perilymphatic fluid into middle ear

Vertico is worse w/ straining and SHL

37
Q

Causes of perilymphatic fistula?

A

Physical injury
Extreme barotrauma
Vigorous valsalva maneuvers
Post surgical (stapedectomy)

38
Q

Key word for perilymphatic fistula?

A

Worse with straining

39
Q

Tx for perilymphatic fistula?

A

Bed rest
Avoid straining

Failure of tx
- surgery/graft

40
Q

What is migranous vertigo?

A

Mixed peripheral/central etiology

  • episodic vertigo w HA
  • migraine symptoms
  • hx of motion intolerance
41
Q

Tx of migrainous vertigo?

A

Dietary and lifestyle changes

migraine meds

42
Q

Semicircular canal dehiscence?

A

Deficiency in bony covering of the superior semicircular canal

Causes vertigo from lout nosies

Conductive hearing loss is present

43
Q

Central vertigo etiologies?

A 
Brainstem vascular disease
A/V malformation
Tumor
MS
Vertebrobasilar migraine

Send them to neuro

44
Q

Differentation of vertigo chart?

A

Slide 46

45
Q

Lesions of CN VIII and central audiovestibular pathways can cause?

A

Neural HL and vertigo
Deterioration of speech discrimination
Auditory adaptation

46
Q

Eval for CN VIII lesion?

A

Brainstem auditory evoked response (BAER)

MRI

47
Q

Disorders associated w CN VIII lesion?

A

Vestibular schwannoma (acoustic neuroma)
Vascular compromise
MS

48
Q

What is acoustic neuroma?

A

Aka vestibular schwannoma

  • MC intracranial tumor
  • nerve sheath tumor of 8th CN
  • unilateral
49
Q

Keyword for acoustic neuroma?

A

Unilateral sensory hearing loss

50
Q

Preferred imaging for acoustic neuroma?

A

MRI w gandolinium

51
Q

Tx for acoustic neuroma?

A

Its a space occupying lesion

Asymptomatic - observation, annual MRI

Symptomatic - excision, radiation, annual MRI

52
Q

MS can present?

A

Symptoms identical to meniere’s disease

53
Q

MS is a?

A

Inflammatory and degnerative d/o involving CNS

Vertigo is sometimes the presenting symptom

54
Q

MS is commonly associated with (s/s)

A

Hyper/hypoacusis
Facial numbness
Diplopia

55
Q

Vertebrobasilar insufficiency is?

A

Elderly pts w arteriosclerosis
- reduced blood flow in vertebrobasilar system

Triggered by change in posture/extension of neck

56
Q

Tx for vertebrobasilar insufficiency?

A

Vasodilators
Aspirin

Vestibular rehab (mainstay of tx)

57
Q

What would bears be with bees?

A

Ears

Senior - ENT (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions