9.21 Vestibular Review 2 Flashcards
What are some of the available tools to help us hone in on the problem?
- VAS
- disability scale
- activities-specific confidence scale
- multidimensional dizziness inventory
- screen for anxiety and depression
The VOR is the only visual vestibular interaction test that assesses
peripheral vestibular function
saccades: will see nystagmus at
periphery of visual field
saccades are a (central/peripheral) issue
CNS
3 sensory systems offering info for balance
- vision
- vestibular
- somatosensory
2 major theories behind pathology of BPPV
- free floating (canalithiasis)
- adhered to cupula (cupulolithiasis)
Most common cause of vertigo
BPPV
Where are the otoconia located?
- utricle
- saccule
What is the function of scarpa’s ganglion?
point on vestibular nerve that allows it to have a resting firing rate
What rate does Scarpa’s ganglion fire?
causes firing of about 100 spikes/second at rest
Fastes reflex we have
VOR (3-neuron arc)
What allows the VOR to be so fast?
close arrangement to extra ocular muscles
Most common cause of ototoxia
gentamycin
What is neuritis?
sudden-onset vestibular hypofunction
neuritis: first 3 days
- nausea, vomiting, dizziness
- nystagmus
neuritis: characteristics of the nystagmus
- spontaneous (only initially)
- static defect
neuritis: after 3 days
If they can visually fixate, they will have a VOR deficit
can visually fixate =
no nystagmus
Which disorder has periods of exacerbation and remission?
Meniere’s disease
There is never communication between these
- endolymph
- perilymph
Would you expect loss of hearing or aural fullness with a BPPV pt?
no
With horizontal, right-beating nystagmus, what is the vestibular system doing?
producing leftward eye movement
If the slow phase is to the left, the CNS thinks your head is turning….
right
A slow phase to the left indicates hypofunction of the (right/left) side
left
