Clinical Conditions II Final Flashcards
BPV cupulolithiasis
debris attached to the cupula - sitting on top of the cupula
no delay
BPV canalithiasis
otoconia are inside the canal and moves the endolymph
debris within long arm
there is a delay
BPV vestibulithiasis
debris within the short arm (type 2)
what maneuver will help with nystagmus
Epley maneuver/canalith repositioning procedure, rotating in four different directions
Vestibular Neuritis
no hearing loss
right-beating nystagmus/ intensity increased w/gaze to the right
caused by viral infection of CN VIII
nausea/vomiting, severe vertigo
treatment of vestibular neuritis
medications and vestibular rehab
Labryinthitis
viral or bacterial infection of the inner ear
COMPLETE HEARING LOSS - unilateral profound sensorineural
severe vertigo, nausea/vomiting
symptoms of unilateral vestibular deficit
increased tone of the contralateral extensor muscles due to inadequate postural muscles
possible oscillopsia
unidirectional nystagmus
chronic= 5 days to 8 years
head impulse test (HIT)
rotate the head quickly to one side and the catch up saccade is towards the side of the lesion
use for BPV, unilateral peripheral vestibular deficit
dynamic visual acuity test/dynamic illegible E Test
reading while rotating, if they can’t read during rotation but they can when static then it could be BILATERAL but it would be alongside oscillopsia
tests for vestibular tone imbalance
spontaneous nystagmus and head shaking nystagmus
postural imbalance tests
dynamic gait index
modified clinical test of sensory interaction and balance
Bithermic Caloric Testing
test of lateral SCC and superior vestibular nerve cold/warm air or water (more accurate) unilateral weakness >25% difference b/w sides measures of movements
video head impulse test (vHIT)
test of lateral and vertical SSCs (all of the canals)
measure movements 5-6 Hz
Cervical Vestibular Evoked Myogenic Potential (cVEMP)
test for saccule and inferior vestibular nerve function
(oVEMP) ocular vestibular evoked myogenic potential
test for utricle and superior vestibular nerve
stimulus on C/L side
acoustic stimulus elicits eye movements
Rotary Chair Testing
lateral canal test
head is tilted forward 30 degrees to bring it into horizontal position
tests for bilateral vestibular weakness
check for compensation from unilateral vestibular loss
platform posturography
an objective eval of the vestibular system
common cause of bilateral peripheral vestibular deficit
toxic exposure to aminoglycosides, loop diuretics IV, IV erthromycin, Quinine, Neoplastics
symmetric bilateral peripheral vestibular deficit
no vertigo, no nystagmus
testing for bilateral peripheral vestibular deficit
postural imbalance
look for oscillopsia
dynamic visual acuity
Meniere’s Disease
episodic, spontaneous
sensorineural hearing loss
possible neuritis
aural fullness
long term treatment of Meniere’s
diuretics, low sodium diet, beta-histamine
intratympanic steroid/gentamicin
surgery
perilymphatic fistula
leak of perilymph into the middle ear
most of the time from blast injury/barotrauma
hearing loss, tinnitus, vertigo, disequilibrium
worse with coughing, nose blowing
presents like meniere’s disease
superior semicircular canal dehiscence (SCDS)
dizziness, chronic disequilibrium pulse-synchronous oscillopsia hyperacusis low-frequency conductive hearing loss pulsatile tinnitus brain fog/fatigue oculophilia (hear your eyes move)
central nystagmus
vertical- up or down beating sustained, gaze evoked- nystagmus- inability to maintain stable conjugate eye deviation away from primary position central position may mimic benign positional nystagmus EYES GO TOWARDS GROUND Dysmetria ocular tilit gait/limb ataxia lateropulsion
first degree burn appearance
pink or red edema no blisters blanches skin/sensation intact pain is tender
first degree superficial burn healing
3-5 days through epithelization
second degree/superficial partial thickness appearance/pain
pink or red, edema, moist with blisters, blanches with quick refill , sensation intact
very painful
second degree/superficial partial thickness healing
1-2 weeks through epithelization
changes in pigmentation
second degree/deep partial thickness appearance, pain
pink or ivory, dry with blisters, can feel deep pressure but not light touch, decrease pinprick, hair easily removed, black with a slower refill
pain present but less with more depth
second degree/deep partial thickness healing
2-3 weeks with epithelization
likely will need graft and scar is likely
Third or Fourth degree/full thickness appearance/pain
white, red, brown or black
dry with possible blisters, no blanching, no sensation
no pain
Third or fourth degree/full thickness healing
> 3 weeks with granulation and epithelization, usually requires surgery
First degree burn injuries the _____
epidermis
partial thickness/second degree superficial injures the
dermis
partial thickness/second degree deep injures which layer?
dermis with hair follicles and sweat glands intact
full thickness third degree burn injures the ____
entire dermis
Full thickness/fourth degree injures ______
all the layers plus the muscle and bone
zone of coagulation
occurs at the point of maximum damage/ damage is irreversible tissue loss due to coagulation of the constituent proteins
zone of stasis
characterized by decreased tissue perfusion
damage is potentially salvageable
main aim of burns resuscitation is to increase tissue perfusion here and prevent any damage becoming irreversible
zone can be converted into complete tissue loss
zone of hyperemia
outermost zone tissue perfusion is increased
tissue will recover unless there is severe sepsis or prolonged hypoperfusion
these three zones of a burn are three dimensional and loss of tissue in the zone of stasis will lead to the wound developing as well as widening
