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ENT Accessory > Causes of dizziness > Flashcards

Causes of dizziness Flashcards

1
Q

What is the difference between vertigo and dizziness?

A

Vertigo is a type of dizzy which is related to spinning

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2
Q

What motion is the lateral semicircular canal responsible for?

A

Left to right movement

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3
Q

What motion is the posterior semicircular canal responsible for?

A

Moving head to shoulder

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4
Q

What motion is the superior semicircular canal responsible for?

A

Nodding

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5
Q

What is the basics of the vestibularoccular reflex?

A

Means to focus on a point even when head not directly looking at it

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6
Q

In what way can the eye affect balance?

A

Cataracts

Diabetes Mellitus

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7
Q

How can joints affect balance?

A

Arthritis may make it mechanically difficult to stand

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8
Q

What neurological impairments affect the balance system?

A

Migraines
MS
Space occupying lesions

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9
Q

Where exactly in the SCC is the vestibulooccular reflex set up?

A

The cupula in the crista ampullaris

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10
Q

What is the mechanism for the vestibule-ocular reflex?

A

Calcium carbonate crystals on the cupula activate hair cells to make APs when the endolymph causes the crystals to move

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11
Q

If the vestibulo-ocular reflex isn’t working, what might occur?

A

Nystagmus

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12
Q

In what direction does the nystagmus move?

A

Away from the affected ear.

E.g. if right ear then will point towards nose

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13
Q

Why might anxiety lead to dizziness?

A

Hyperventilation

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14
Q

What would you do on examination if dizzy was PC?

A

Otoscopy
Neurological exam
BP
Audiometry

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15
Q

What is BPPV?

A

Benign positional paroxysmal vertigo

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16
Q

What is the pathophysiology of BPPV?

A

Otoconia are displaced into the SCC causing the hair cells in the SCC to become depolarised unnecessarily

17
Q

What is the difference between BPPV and vertebrobasilar insufficiency?

A

VBI needs other symptoms e.g. visual disturbance, weakness or numbness

18
Q

When are vertigo symptoms often seen?

A

Looking up
Turning in bed
Getting out of bed in morning
Rising from bending

19
Q

True or False

There is tinnitus associated with BPPV

A

False

20
Q

What is Hallpike’s test?

A

Lie on couch so head is off the back and turn head away from affected side and to 45degrees

21
Q

What is Hallpike’s test for?

A

Nystagmus

22
Q

What is important to note about repeating Hallpike’s test?

A

Doesn’t give as accurate results the second time around

23
Q

What manoeuvre can be done to treat BPPV?

A

Epley manouevre

24
Q

What is the Epley manoeuvre?

A

Manual exercise involving turning the patient to move the otoconia from the SCC to the utricle

25
Q

What is vestibular neronitis?

A

Inflammation of vestibular nerve

26
Q

What symptoms does vestibular neuronitis present with?

A

Prolonged vertigo

NO tinnitus/hearing loss

27
Q

What causes labyrynthitis?

A

Virus

28
Q

What is different about labyrinthitis in terms of presentation as compared with vestibular neuronitis?

A

Labyrinthitis is associated with tinnitus or hearing loss

29
Q

What is the pathophysiology of Meniere’s disease?

A

Too much endolymph

30
Q

What is a classic history of Meniere’s disease?

A

Periodic vertigo with pro-drome
Hearing loss
Tinnitus
Aural pressure

31
Q

What kind of hearing loss is present in Meniere’s disease?

A

Sensory-neural

32
Q

What is conductive hearing loss?

A

Gap between bone conduction and that in air

33
Q

What is an example of conductive hearing loss?

A

OME

34
Q

Where is the problem is sensorineural hearing loss?

A

Cochlea

35
Q

What is the management for Meniere’s disease?

A

Tinnitus therapy
Hearing Aids
Tx during episodes

36
Q

What symptomatic management is available for Menieres disease?

A

Betahistine

Anti-emetics

37
Q

Why is a low salt diet and diuretics prescribed for Meniere’s disease?

A

To reduce levels of fluid (endolymph)

38
Q

What role does gentamicin play in Meniere’s disease?

A

Destroys OHC so no sensation of falling

ENT Accessory (16 decks)

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