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8531 Bringman > 9.21 Vestibular Review 2 > Flashcards

9.21 Vestibular Review 2 Flashcards

1
Q

What are some of the available tools to help us hone in on the problem?

A
  • VAS
  • disability scale
  • activities-specific confidence scale
  • multidimensional dizziness inventory
  • screen for anxiety and depression
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2
Q

The VOR is the only visual vestibular interaction test that assesses

A

peripheral vestibular function

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3
Q

saccades: will see nystagmus at

A

periphery of visual field

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4
Q

saccades are a (central/peripheral) issue

A

CNS

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5
Q

3 sensory systems offering info for balance

A
  • vision
  • vestibular
  • somatosensory
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6
Q

2 major theories behind pathology of BPPV

A
  • free floating (canalithiasis)

- adhered to cupula (cupulolithiasis)

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7
Q

Most common cause of vertigo

A

BPPV

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8
Q

Where are the otoconia located?

A
  • utricle

- saccule

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9
Q

What is the function of scarpa’s ganglion?

A

point on vestibular nerve that allows it to have a resting firing rate

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10
Q

What rate does Scarpa’s ganglion fire?

A

causes firing of about 100 spikes/second at rest

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11
Q

Fastes reflex we have

A

VOR (3-neuron arc)

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12
Q

What allows the VOR to be so fast?

A

close arrangement to extra ocular muscles

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13
Q

Most common cause of ototoxia

A

gentamycin

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14
Q

What is neuritis?

A

sudden-onset vestibular hypofunction

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15
Q

neuritis: first 3 days

A
  • nausea, vomiting, dizziness

- nystagmus

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16
Q

neuritis: characteristics of the nystagmus

A
  • spontaneous (only initially)

- static defect

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17
Q

neuritis: after 3 days

A

If they can visually fixate, they will have a VOR deficit

18
Q

can visually fixate =

A

no nystagmus

19
Q

Which disorder has periods of exacerbation and remission?

A

Meniere’s disease

20
Q

There is never communication between these

A
  • endolymph

- perilymph

21
Q

Would you expect loss of hearing or aural fullness with a BPPV pt?

A

no

22
Q

With horizontal, right-beating nystagmus, what is the vestibular system doing?

A

producing leftward eye movement

23
Q

If the slow phase is to the left, the CNS thinks your head is turning….

A

right

24
Q

A slow phase to the left indicates hypofunction of the (right/left) side

A

left

25
Q

What is indicative of a posterior canal BPPV?

A

upbeat and torsional nystagmus

26
Q

How would you tell if the BPPV was due to cupulolithiasis?

A
  • less latency (immediately deflects the cupula)

- longer duration of nystagmus (over 60s)

27
Q

How would you tell if the BPPV was due to canalithiasis?

A

comes on slowly because the otoconia tumble through the endolymph

28
Q

purpose of Brandt Daroff habituation exercises?

A
  • repeatedly provoke the aggravating position

- idea is that you become desensitized to the stimulus

29
Q

Another name for the Semont maneuver

A

liberatory maneuver

30
Q

Torsional nystagmus will be present with which of the SCC?

A
  • anterior

- posterior

31
Q

What will be used to treat BPPV for anterior and posterior canals?

A

Epley maneuver

32
Q

What are the 5 techniques to know

A
  • Dix-Hallpike
  • Semont/liberatory maneuver
  • Canalith repositioning maneuver/Epley
  • Brandt Daroff
33
Q

Dix-Hallpike position: If nystagmus subsides within 60s, how do you treat?

A

perform carnalith repositioning (Employ)

34
Q

Dix-Hallpike position: If nystagmus subsides after 60s, how do you treat?

A

liberatory maneuver (Semont)

35
Q

The Semont/liberatory maneuver is for

A

adherent otoconia

36
Q

The Epley maneuver is for

A

free floating otoconia

37
Q

horizontal nystagmus is tested in

A

sidelying

38
Q

beats toward the ground in both positions (will be worse on one side than the other)

A

geotropic

39
Q

beats upward

A

ageotropic

40
Q

Which side will be worse with geotropic nystagmus?

A

On the side with the most pronounced nystagmus

8531 Bringman (43 decks)

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