Cervicogenic Dizziness (lecture 13)

Question 1

What is halusination of the OUTSIDE WORLD spinning?

Answer 1

Vertigo

Question 2

Do pts w/ cervigo genic dizziness have vertigo?

Answer 2

No

normally its interinlized dizziness - not the outside world spinning

Question 3

What is proprioception

Answer 3

KNowing where you are in space

Question 4

KNOW: Cervical proprioception can lead to cervicogenic dizziniess

Question 5

KNOW: Cervicogenic dizziness is often wiplash disorder

often problems are cervicogenic in nature

Question 6

KNOW: Cervicogenic dizziniess
* could have tracking issues (smooth prusuit)
* could feel like vision is just shifting a little
* might have feels of unsteadiness - especially when their vision isnt working well (think night)

Question 7

What is nystagmous

Answer 7

shaking of eyes

Question 8

Neurovascular hypothesis of whats happening w/ cervicogenic dizziness

Answer 8

Barre-Lieou syndrome

neurovascular comprimise of vertebral artery complex

thought process process was whenever i turn my head Im compressing the vertebral artery. this then cuts blood flow off to vestibular system

not widely excepted anymore

Question 9

Somatosensory input hypothesis for cervicogenic dizziness

Answer 9

Some kind of impaired information being brough to brain is more than likely being brough from the NECK. can be from dis use / miss use or pain - they’re just not stimulating those proprioceptors in the neck.
* if you dont move it you lose it - so they’re just not as acustumed to using those receptors as much because they havent been moving around their neck as much so they’ve lost it / used it inproperly
* essentially jumbled up information being sent to the brain and the brain trying to process it

“I feel like my head is a bowling ball - or I don’t feel like i have control over my head / neck”

So some of those reflex patterns are going to be more impaired
* think VOR / cervical reflexes (cervicospinal / cervicooculuar / cervical collic reflexes)
* all telling where our head and neck is in space

Question 10

cervical ocular relex

Answer 10

neck to eyes
* where neck is in space adjusts eyes
* cervicogenic dizziness pts often have impairments w/ this reflex

Question 11

cervico collic reflex

Answer 11

neck to head
* lets brain know where neck is in space so head stays in the correct position
* cervicogenic dizziness pts often have impairments w/ this reflex

Question 12

cervico spinal reflex

Answer 12

neck to extremities

Question 13

5D’s and 3N’s?

Answer 13

Dizziness
Displopia
Drop attacks
Dysphagia
Dysarthria

Nystagmus
Numbness
Nausa

Question 14

Horners syndrome is made up of what 3 things

Answer 14

ptosis
miosis
hydrosis

Question 15

KNOW: things that make us think vertebrobasilar ischemic symptoms

5D’s 3N’s
Limb ataxia
photophobia
Limb weakness
Anhidrosis
Hearing disturbances
Cranial nerve palsys

Question 16

When testing cervical range of motion for cervicogenic pts they may just say it feels a little off and not an actaul loss of ROM

Question 17

Ischemic means

Answer 17

blood supply is blocked

Question 17

Internal carotid ischemic signs (4)

Answer 17

Head and neck pain near the ICA

Horners syndrome

Tinnitus

Cranial Nerve palsies

Question 17

ICA Non-Schemic symptoms 4

Answer 17

Ischemic stroke

transiet ischemic attack

Retinal infarction

Transient visual disturbances

Question 17

Do we do OP on a joint when symptoms are present?

Answer 17

No

Question 18

What are saccades testing?

Answer 18

quick rapid position from one position to the next
* were looking for them to overshoot

Question 18

what are smooth pruits

Answer 18

following a target
* were looking for jagged eye movements

Question 18

What is the head impulse test

Answer 18

high velocity low amplitude thrust
* fast and short arc
* pt trys to keep eyes on you while you do that

Question 19

for the head thrust test the direction you thrust is the direction your testing
* so if they cant stay on the target when going to the right its a right nerve issue

Question 21

Smooth Pursuit neck torsion test

Answer 21

assessment of cerico-collic and cervico ocular reflex

pt seated
Eye movements are assessed with head in neutral and body in neutral first, then head in neutral and body roatetd bilatearl. this places the cervical proprioceptors active and the vesitbular receptors inactive

Question 22

Head neck differeition test

Answer 22

turn body w/ head then body alone

Question 23

Joint poosition sense

Answer 23

looks at cervical proprioception

sits 90 cm away from wall and has laser pointer on head and a mat infront of them

start seated - therapist is going to draw where they start in neck nutral on the mat

then have them close eyes rotate head and try to come back to neutral

see how close you can get laser

Question 24

KNOW: For dizzy pts you need to bring on their symptoms - thats the only way the brain can fix it

Question 25

CGD - typically dizziness coming from the neck - a proprioception error

best way to test is head neck differination and smooth prusuit test and joint prioprioception tesinting

move head and neck w/ speed to treat

add in upper cervical mobilization (most of proprioceptors here because thats where rotation typically occurs)