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NEURO 2 > BPPV > Flashcards

BPPV Flashcards

1
Q

benign

A

not malignant

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2
Q

paroxysmal

A

recurrent, sudden intensification of symptoms

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3
Q

positional

A

placement dependent (of ear)

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4
Q

vertigo

A

false inner sensation of rotational movement

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5
Q

BPPV symptoms are almost always precipitated by

A

a change in position of the head with respect to gravity

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6
Q

mechanism of BPPV centers around

A

utricular debris (otoconia)

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7
Q

BPPV occurs when

A

otoconia falls out of utricle and into either neighboring semicircular canals/cupulas

displacement can have several causes

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8
Q

two main causes of BPPV

A

trauma
age

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9
Q

utriculopedal

A

TOWARDS
- excitatory for horizontal
- inhibitory for A/P

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10
Q

utriculofugal

A

AWAY
- excitatory for A/P
- inhibitory for horizontal

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11
Q

canalithiasis

A

free floating otoconia within the SCC resulting in abnormal endolymphatic flow with the affected canal

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12
Q

characteristics of canalithiasis

A
  • delay in the onset of vertigo (1-40 seconds)= LATENCY
  • nystagmus appears after latency
  • fluctuation in the intensity of the vertigo and nystagmus and then decreases while in provoking position= disappears in about 60s
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13
Q

why is anterior BPPV rare

A

it is hard for crystals to get into that canal

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14
Q

NONPATHOLOGICAL
where do eyes go if R horizontal canal and R head turn

A

LEFT

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15
Q

NONPATHOLOGICAL
where do eyes go if R anterior canal and R head turn

A

LEFT TORSION and UP

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16
Q

NONPATHOLOGICAL
where do eyes go if R posterior canal and R head turn

A

LEFT TORSION and DOWN

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17
Q

NONPATHOLOGICAL
where do eyes go if L horizontal canal and L head turn

A

RIGHT

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18
Q

NONPATHOLOGICAL
where do eyes go if L anterior canal and L head turn

A

RIGHT TORSION and UP

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19
Q

NONPATHOLOGICAL
where do eyes go if L horizontal canal and L head turn

A

RIGHT TORSION and DOWN

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20
Q

PATHOLOGICAL
where is nystagmus if R horizontal canal and R head turn

A

RIGHT BEATING

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21
Q

PATHOLOGICAL
where is nystagmus if R anterior canal and R head turn

A

RIGHT TORSION and DOWN BEATING

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22
Q

PATHOLOGICAL
where is nystagmus if R posterior canal and R head turn

A

RIGHT TORSION and UP BEATING

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23
Q

PATHOLOGICAL
where is nystagmus if L horizontal canal and L head turn

A

LEFT BEATING

24
Q

PATHOLOGICAL
where is nystagmus if L anterior canal and L head turn

A

LEFT TORSION and DOWN BEATING

25
Q

PATHOLOGICAL
where is nystagmus if L posterior canal and L head turn

A

LEFT TORSION and UP BEATING

26
Q

cupulolithiasis

A

otoconia are adherent to the cupula of the affect SCC.
Canal becomes gravity sensitive

27
Q

characteristics of cupulolithiasis

A

immediate vertigo onset while in provoking position
persistence of vertigo and nystagmus for as long as the head maintains that position
NO LATENCY, RAMP UP, or WIND DOWN

28
Q

incidence of BPPV

A

1 cause of dizziness

women> men
older> younger
posterior> horizontal or anterior

29
Q

predisposing factors of BPPV

A

age
head trauma
inner ear disease
genetics
osteopenia/osteoporosis
CV disease
DM
migraines
vit D deficiency
sleeping position

30
Q

common triggers of BPPV

A

bed mobility
reaching for object on floor or top shelf
washing hair
working under the car
changing a lightbulb

31
Q

3 most common types of BPPV

A

posterior canalithiasis
horizontal canalithiasis
horizontal cupulolithiasis

32
Q

techniques for posterior canal

A

dix hallpike
sidelying test

33
Q

techniques for horizontal canal

A

roll test
bow and lean test

34
Q

techniques for anterior canal

A

dix hallpike (contra)

35
Q

GOLD STANDARD for posterior canal

A

dix hallpike
ROTATE SAME SIDE

36
Q

left dix hallpike tests _____

A

left posterior and right anterior

37
Q

right dix hallpike tests _____

A

right posterior and left anterior

38
Q

slide lying test

A

posterior canal
opposite head turn as DIX

39
Q

left sidelying tests _____

A

L posterior and R anterior

40
Q

right sidelying tests _____

A

R posterior and L anterior

41
Q

geotropic

A

towards the ground

42
Q

ageotropic

A

away from the ground

43
Q

roll test– horizontal canalithiasis results in

A

GEOTROPIC nystagmus with both directions

44
Q

roll test– horizontal cupuloithiasis results in

A

AGEOTROPIC nystagmus with both directions

45
Q

bow and lean canalithiasis

A

bow– excitatory= ipsi nystagmus

lean– inhibitory= contra nystagmus

46
Q

bow and lean cupulolithiasis

A

bow– inhibitory= contra nystagmus

lean– excitatory= ipsi nystagmus

47
Q

posterior canal BPPV treatment options

A

modified eply maneuver
semont maneuver

48
Q

horizontal canal BPPV treatment options

A

BBQ roll maneuver
appiani/gufoni maneuver
casani maneuver

49
Q

anterior canal BPPV treatment options

A

modified epley maneuver (CONTRA)
semont maneuver (CONTRA)
deep head hanging maneuver

50
Q

what should you make sure of in modified epley maneuver

A

that nystagmus resolves before changing position

51
Q

speed is helpful for
best results when used with ___

A

semont maneuver

** best results for cupulo

52
Q

BBQ roll

A

roll AWAY from problems

more helpful with canulolithiasis

53
Q

appiani/gufoni maneuver

A

AWAY from involved ear
used if prone is an issue

54
Q

casani maneuver

A

drop towards affected ear

55
Q

casani
if otoconia on utriculoside, dump _______

A

down

56
Q

casani
if otoconia on canal side, dump ______

A

up

NEURO 2 (6 decks)

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