CH14: Deafness, Dizziness, Disquilibrium Flashcards
End organ of hearing
Spiral Organ of Corti
sensory epithelium located on hillocks in the dilated openings of the semicircular canals (p. 303)
Cristae ampularis
sensory epithelium located on hillocks in the dilated openings of the utricle and sacule (p. 304)
Maculae acusticae
Brodman area of the primary auditory cortex (p. 306)
Brodman Area 41
lesion of cortical deafness (p. 306)
geniculocortical fasciculi
Superior vestibular nuclei (p. 306)
Bechterew
Lateral vestibular nuclei (p. 306)
Deiters
Medial vestibular nuclei (p. 306)
Schwalbe
Inferior vestibular nuclei (p. 306)
Spinal
Lesions here impairs verticality, body orientation and movement (p.307)
Posterior insula
Frequency of tuning fork used for Weber (p. 308)
512 Hz
heightened perception of loudness once the threshold for hearing has been exceeded (p. 308)
Recruitment
defect in frequence discrimination that is manifest by a lack of clarity of spoken syllables of perception of music as out of tune (p. 308)
Diplacusis
threshold percentage of words not heard for speech discrimination indicating a retrocochlear lesion (p. 309)
less than 30%
In audiometry, which types has retrocochlear implications? (p. 309)
Type III and IV
subjective tinnitus, common persistent form that arises in the middle or inner ear, associated with chochlear damage (p. 309)
tonal tinnitus
superior canal dehiscence (p. 310)
Lloyd Minor syndrome
Meniere’s tinnitus– low pitched or high pitched? (p. 310)
Low pitched
dysacusis, tinnitus, sensorineural deafness + vitiligo, poliosis, iritis, retinal depigmentation, recurrent meningitis (p. 312)
Vogt Koyanagi Harada
Pure word deafness localization (p. 312)
Left temporal lobe
mutation in this gene found in half of recessive familal cases of pure deafness (p. 313)
Connexin 26 on Chromosome 13 (GJB2)
Deafness from mitochondrial disorders (p. 313)
Kearns Sayre, MELAS, Wolfram
absence of otic capsule and eigth nerve (p. 313)
Michel defect
incomplete development of the bony and membranous labyrinth and spinal ganglion (p. 313)
Mondini defect
membranous cochleosaccular dysplasia with atrophy of the vestibular and chochlear nerves (p. 313)
Scheibe defect
reflexes to check for hysterical deafness (p. 313)
cochleo- orbicular reflex and psychogalvanic skin reflex
loud sound, yawning, produces a brief sensation of vertigo or tilting of the environment, attributed to thining of the roof of the superior SSC (p. 317)
Tullio phenomenon
Infarct of this artery maybe indistinguishable from a vertigo caused by a labyrinthine disorder (p. 318)
Posterior Inferior Cerebellar Artery
In labyrinthine disease, the unidirectional nystagmus fast phase is SAME or OPPOSITE to the saide of the impaired labyrinth? (p. 318)
OPPOSITE
requires the patient to march in place with eyes closed and arms stretched; execessive rotation to AWAY from the diseased side (p. 319)
Unterberger- Fukuda Maneuver
UF Maneuver if labytinthine: AWAY or TOWARD the affected side? (p. 319)
AWAY
UF Maneuver if cerebellar: AWAY or TOWARD the affected side? (p. 319)
TOWARD
Bilateral irrigation of cold water. Where is the fast component of the nystagmus? (p. 319)
UPWARD
Main pathologic changes in Meniere’s disease (p. 320)
Increase in volume of endolymph and distention (endolymphatic hydrops)
episodic deafness without vergico (p. 320)
chochlear Meniere syndrome
T/F In BPPV, vertigo is accompanied with oscillopsia and nystagmus; rapid components AWAY from the affected ear (p. 321)
TRUE
T/F Changing from a recumment to a sitting postition reverses the direction of vertigo and nystagmus (p. 321)
TRUE
In 90% of cases, the posteriror SCC is implicated; in 10% which canal? (p. 321)
lateral
Risk of Epley maneuver (p. 323)
Conversion of Posterior SCC to Lateral SCC
Epley maneuver substitute involving sitting, sidelying, sitting (p. 324)
Brandt Daroff Exercises
Sitting and turned 45 degrees to one side, then drops laterally to side lying position on the opposite ear (p. 323)
Semont Maneuver
What differentiates vestibular neuritis from Meniere’s disease (p. 324)
In VN, the symptoms can last for days
portion of the vestibular pathway that is primarily affected by vestibular neuritis (p. 324)
Superior portion of vestibular nerve trunk
Labyrinthine infarction component of a stroke syndrome from occlusion of this artery (p.325)
Anterior Inferior Cerebellar Artery
associated with vertigo, tinnitus, nystagmus and rapidly progressive deafness. Prognosis for vision is good; for hearing and balance poor. (p. 325)
Nonsyphilitic interstitial keratitis
Vertigo and nystagmus induced by pressure in the external ear canal (p. 325)
Fistula test
Attacks of vertigo followed by intense unilateral and often suboccipital headache and vomiting (p. 326)
basilar artery migraine
Symptomatic treatment for attacks of familial vestibulocerebellar syndrome (p. 327)
Acetazolamide
