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FF: neuro content > class 4: vestibular > Flashcards

class 4: vestibular Flashcards

1
Q

what is central vest issues 2/2

A

damage to the central vestibular ocular pathway, brain – cerebellum, BS, vestibular nuclei

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2
Q

what are peri vest issues 2/2

A

an issue of the SCC (posterior and horizontal) or otolith organs, debris moving in the SSC

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3
Q

Peripheral: Labyrinth related conditions

A
  • BPPV
  • Vestibular neuritis
  • Labyrinthitis
  • Acoustic neuroma
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4
Q

Central: Brain-related related conditions

A
  • CVA
  • Cerebellar disorder
  • MS
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5
Q

Central - nys

A

o Does not change with fixation
o Changes in direction
o Unable to suppress nys

o Types
Down beating nys – almost always a central issue

Gaze evoked

Non-fixation nys

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6
Q

Peri - nys

A

Decreases with fixation

Does not change direction

The nys presentation decreases – fatigable

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7
Q

Abnormal Smooth Pursuits and Saccades indicates peri or central

A

central disorder

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8
Q

what makes up the Labyrinth of the inner ear

A

Semicircular canal + otolith organs

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9
Q

what makes up the SCC

A
  • Anterior
  • Posterior
  • Horizontal
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10
Q

what make up the Otolith Organs

A
  • Saccule
  • Utricle
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11
Q

what are the two types of BPPV can we fix

A

posterior and horizontal

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12
Q

what are some causes of BPPV

A
  • Infection
  • Head trauma
  • Vestibular weakness
  • Advancing age
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13
Q

what mech causes BPPV at the physiological level

A

Mechanical disorder caused
by otoconia displaced from
the macula of the utricle

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14
Q

Types of BPPV

A

Canalithiasis

Cupulolithiasis

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15
Q

what is Canalithiasis

A

a condition where particles become loose and float in a semicircular canal of the inner ear, causing vertigo.

< 1 min

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16
Q

what is Cupulolithiasis

A

a type of benign paroxysmal positional vertigo (BPPV) that occurs when otolith crystals become detached from the utricle and stick to the cupula of the inner ear’s semicircular canals.

> 1 min

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17
Q

BPPV – Signs and Symptoms

A

Vertigo: with change in head position, such as when turning over in bed, getting into or out of bed, or when bending over/coming up

Nystagmus: (involuntary, rapid and repetitive movement of the eyes) – Most important symptom

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18
Q

Posterior Canal BPPV

A

CANALITHIASIS

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19
Q

what is the test for posterior canal BPPV

A

dix hall pike

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20
Q

what is the treatment for posterior canal BPPV

A

Modified Epley (first choice)

Li maneuver for the posterior canal

Semont plus (from Strupp RCT)

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21
Q

Posterior canal - nys

A

nys upbeating and torsional toward the tested side

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22
Q

what is the testing that we do for horzontal canal BPPV

A

bow and lean

roll test

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23
Q

what is the procedure for bow and lean

A

bow
- geo: nys will beat towards the affected ear
-ageo: nys will beat towards the healthy ear

lean
- geo: nys will beat towards the Good ear.
-ageo: nys will beat towards the affected ear

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24
Q

what is the name for the two type of horzontal canal BPPV

A

geotrophic and ageotrophic

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25
Q

what is the procedure for the roll test

A
  • pt head flexed 20‐30 degrees
  • PT lowers patient to supine - with head still flexed
  • PT quickly moves head to right and holds for 30 sec
    o Look for nys
  • Move head back to midline – 30 secs
  • PT quickly moves head to left and holding for 30 sec.
    o Look for nys
26
Q

roll test geo

A

nys towards the ground (canal)

27
Q

roll test ageo

A

nys towards the ceiling (cuplo)

28
Q

what are the choices for posterior canal repositioning

A

Modified Epley (first choice)

Li maneuver for the posterior canal

Semont plus (from Strupp RCT)

29
Q

what are the choices for horizontal canal repositioning - geo

A

Gufoni maneuver

Li quick repositioning maneuver

30
Q

what are the choices for horizontal canal repositioning - ageo

A

Kim maneuver

Gufoni maneuver for ageotropic

31
Q

what is Labyrinthitis

A

Inflammation of labyrinth

32
Q

what are the sym of Labyrinthitis

A

Sudden onset of vertigo, nausea, vomiting

Positive head-impulse test

HEARING LOSS, TINNITUS

33
Q

HIT is positive with central or peri disorder

A

peri disorder

34
Q

what side is the HIT testing

A

Turn to the left the left ear is affected

35
Q

do we see axtai with central of peri disorders

A

central - cere

36
Q

how long does Labyrinthitis normally last

A

Days to weeks

37
Q

what is Vestibular Neuritis

A

condition that causes inflammation of the vestibular nerve in the inner ear, which can lead to vertigo, dizziness, and imbalance

38
Q

what are the sym of Vestibular Neuritis

A
  • Sudden onset of vertigo, nausea, vomiting
  • Positive head-impulse test
39
Q

do we normally have hearing loss with central disorders

A

no - this is a peri issue

40
Q

dipolpia a central or per issue normally

A

central

41
Q

durtion of Vestibular Neuritis

A

Days to weeks

42
Q

what is the Vestibulo-Ocular Reflex (VOR)

A

Responsible for maintaining focus on an image during rapid head
movements.

VOR must generate rapid compensatory eye movements in the
direction opposite the head rotation.

43
Q

Menière’s Disease

A

Overproduction of fluid within the inner ear > Increase in pressure > Vertigo

44
Q

what are the sym of Menière’s Disease

A
  • Vertigo
  • Hearing loss
  • Tinnitus
  • Aural fullness
  • drop attacks
45
Q

duration of meniere’s diase attacks

A

min to hours

46
Q

what is Acoustic Neuroma/
Vestibular Schwannoma:

A

Slow-growing tumor that
develops from the balance
and hearing nerves supplying
the inner ear

47
Q

Acoustic Neuroma/
Vestibular Schwannoma: symptoms

A
  • Hearing loss
  • Tinnitus
  • Loss of balance
  • Vertigo
  • Facial numbness and
    weakness or loss of muscle
    movement
48
Q

Unilateral Vestibular Hypofunction - treatment

A
  • Gaze stability: Improves VOR e.g., VOR x 1, VOR x 2
  • Postural stability and balance
  • Habituation
49
Q

what is habituation

A

Thought is repeated exposure to a provocative stimulus (e.g. head movements) will lead to a reduction of the motion-provoked symptoms.

Reduction of symptoms after repeated stimulus.

50
Q

Bilateral Vestibular Hypofunction - treatment

A
  • Gaze stability: x1 yes; x2 no (unless asymmetrical involvement)
  • Imaginary targets - subsition
  • Walking
51
Q

do we ahve hearing loss with BPPV

A

no

52
Q

what is a another name for the semount plus

A

liberatory

53
Q

what is the brandt daroff exercise

A

HEP for BPPV

54
Q

is geo canal or cupulo

A

canal

55
Q

is ageo canal or cupulo

A

cupulo

56
Q

for the roll test how do we know what ear is effected

A

geo: ear with the worst symptoms

ageo: ear with the better symss

57
Q

would labrinthitis or vestibular neuritis present with hearing loss

A

labryrinthitis

58
Q

why do we do the HIT

A

check the VOR

59
Q

do we see a postive HIT test with vestibular neuritis

A

yes

60
Q

is the HIT positive for BPPV

A

no

FF: neuro content (7 decks)

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