BPPV

Question 1

benign

Answer 1

not malignant

Question 2

paroxysmal

Answer 2

recurrent, sudden intensification of symptoms

Question 3

positional

Answer 3

placement dependent (of ear)

Question 4

vertigo

Answer 4

false inner sensation of rotational movement

Question 5

BPPV symptoms are almost always precipitated by

Answer 5

a change in position of the head with respect to gravity

Question 6

mechanism of BPPV centers around

Answer 6

utricular debris (otoconia)

Question 7

BPPV occurs when

Answer 7

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

displacement can have several causes

Question 8

two main causes of BPPV

Answer 8

trauma
age

Question 9

utriculopedal

Answer 9

TOWARDS
- excitatory for horizontal
- inhibitory for A/P

Question 10

utriculofugal

Answer 10

AWAY
- excitatory for A/P
- inhibitory for horizontal

Question 11

canalithiasis

Answer 11

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

Question 12

characteristics of canalithiasis

Answer 12

• 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

Question 13

why is anterior BPPV rare

Answer 13

it is hard for crystals to get into that canal

Question 14

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

Answer 14

LEFT

Question 15

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

Answer 15

LEFT TORSION and UP

Question 16

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

Answer 16

LEFT TORSION and DOWN

Question 17

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

Answer 17

RIGHT

Question 18

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

Answer 18

RIGHT TORSION and UP

Question 19

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

Answer 19

RIGHT TORSION and DOWN

Question 20

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

Answer 20

RIGHT BEATING

Question 21

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

Answer 21

RIGHT TORSION and DOWN BEATING

Question 22

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

Answer 22

RIGHT TORSION and UP BEATING

Question 23

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

Answer 23

LEFT BEATING

Question 24

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

Answer 24

LEFT TORSION and DOWN BEATING

Question 25

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

Answer 25

LEFT TORSION and UP BEATING

Question 26

cupulolithiasis

Answer 26

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

Question 27

characteristics of cupulolithiasis

Answer 27

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

Question 28

incidence of BPPV

Answer 28

#1 cause of dizziness women> men older> younger posterior> horizontal or anterior

Question 29

predisposing factors of BPPV

Answer 29

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

Question 30

common triggers of BPPV

Answer 30

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

Question 31

3 most common types of BPPV

Answer 31

posterior canalithiasis horizontal canalithiasis horizontal cupulolithiasis

Question 32

techniques for posterior canal

Answer 32

dix hallpike sidelying test

Question 33

techniques for horizontal canal

Answer 33

roll test bow and lean test

Question 34

techniques for anterior canal

Answer 34

dix hallpike (contra)

Question 35

GOLD STANDARD for posterior canal

Answer 35

dix hallpike ROTATE SAME SIDE

Question 36

left dix hallpike tests _____

Answer 36

left posterior and right anterior

Question 37

right dix hallpike tests _____

Answer 37

right posterior and left anterior

Question 38

slide lying test

Answer 38

posterior canal opposite head turn as DIX

Question 39

left sidelying tests _____

Answer 39

L posterior and R anterior

Question 40

right sidelying tests _____

Answer 40

R posterior and L anterior

Question 41

geotropic

Answer 41

towards the ground

Question 42

ageotropic

Answer 42

away from the ground

Question 43

roll test-- horizontal canalithiasis results in

Answer 43

GEOTROPIC nystagmus with both directions

Question 44

roll test-- horizontal cupuloithiasis results in

Answer 44

AGEOTROPIC nystagmus with both directions

Question 45

bow and lean canalithiasis

Answer 45

bow-- excitatory= ipsi nystagmus lean-- inhibitory= contra nystagmus

Question 46

bow and lean cupulolithiasis

Answer 46

bow-- inhibitory= contra nystagmus lean-- excitatory= ipsi nystagmus

Question 47

posterior canal BPPV treatment options

Answer 47

modified eply maneuver semont maneuver

Question 48

horizontal canal BPPV treatment options

Answer 48

BBQ roll maneuver appiani/gufoni maneuver casani maneuver

Question 49

anterior canal BPPV treatment options

Answer 49

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

Question 50

what should you make sure of in modified epley maneuver

Answer 50

that nystagmus resolves before changing position

Question 51

speed is helpful for best results when used with ___

Answer 51

semont maneuver ** best results for cupulo

Question 52

BBQ roll

Answer 52

roll AWAY from problems more helpful with canulolithiasis

Question 53

appiani/gufoni maneuver

Answer 53

AWAY from involved ear used if prone is an issue

Question 54

casani maneuver

Answer 54

drop towards affected ear

Question 55

casani if otoconia on utriculoside, dump _______

Answer 55

down

Question 56

casani if otoconia on canal side, dump ______

Answer 56

up