Deficits

Question 1

Pupil structure

Answer 1

Controls the amount of light that enters the eye

The muscles that control pupil size are different than the muscles that control lens shape

Question 2

Lens structure

Answer 2

Helps us sharpen focus during visual tasks

Lens shape is controlled by the cillary muscle

Question 3

Retina structure

Answer 3

Where the cones and rods are

Allows us to view/perceive visual information, which then sends to the brain via optic nerve

Question 4

PERRLA

Answer 4

Pupils equal, round and reactive to light and accommodation

Question 5

Pupillary light reflex

Answer 5

Shine a light into the side of someones eye (directly is too uncomfortable)

The eye that has direct light stimulation will constrict (pupillary light reflex), and the opposite pupil, which is unaffected directly by the light, will also constrict (consensual pupillary light reflex)

Question 6

Eye accommodation

Answer 6

The eyes ability to focus on objects both near and far away

Muscles within the eye work to cause the lens of the eye to become rounder (near vision) or flatter (far vision)

Question 7

Convergence

Answer 7

Ability of your eyes to come together to keep an object in focus

Question 8

Cause of double vision

Answer 8

With bi-ocular vision, it can be the eyes not working together

With monocular vision, it can indicate that they may have an impairment within the eye (such as retinal detachment)

Question 9

Smooth pursuit eye tracking

Answer 9

The H test test

Common deficits include nystagmus, saccadic jumps within the smooth pursuit, and symptom provocation

Question 10

Nystagmus

Answer 10

Abnormal eye movement where the eye quickly beats in one direction and slowly returns to its current start point

Question 11

Saccades

Answer 11

A naturally occuring eye movement where the eye jumps from one fixation point to the next

However, can occur abnormally during eye tracking

All saccadic movements are relatively the same speed

Question 12

Saccade testing

Answer 12

Looking from one object to another in horizontal and vertical planes

Question 13

Saccadic dysmetria

Answer 13

An over or under shoot of the eyes when moving to look at a target

Question 14

Skew deviation

Answer 14

Vertical misalignment of the eyes due to improper neuromuscular function

Question 15

Testing skew deviation

Answer 15

Focus on an object infront of them, and while they focus, cover each eye one at a time. If skew deviation is present, the eyes will shift up or down to focus on the object

Question 16

Sense angular acceleration

Answer 16

The 3 semicircular canals

Question 17

Sense linear acceleration - horizontal

Answer 17

Utricle

Question 18

Sense linear acceleration - vertical

Answer 18

Saccule

Question 19

Houses the crista

Answer 19

Ampulla

Question 20

Houses the cupula and hair cells

Answer 20

Crista

Question 21

Cupula

Answer 21

Structure that surrounds the hair cells/bundles

Question 22

Hair cells/bundles movement

Answer 22

Causes a change in polarization of the structure it is associated with

Question 23

Otolithic membrane

Answer 23

Structure that encapsulates and shifts the hair cells in response to the effect of linear motion on the otoconia

Question 24

Otoconia

Answer 24

Calcium carbonate crystal that sits on top of the otolithic membrane

Question 25

Kinocillum

Answer 25

The longest hair cell (aka the parent)

Question 26

Stereocilia

Answer 26

The other, shorter hair cells of the cell bundle

Question 27

Benign

Answer 27

Not damaging, although very uncomfortable

Question 28

Peroxysmal

Answer 28

Sudden onset, does not last long

Question 29

Positional

Answer 29

Only occurs in a certain position/movement

Question 30

Vertigo

Answer 30

Feeling of the world around you spinning

Question 31

Dizziness

Answer 31

Feeling faint and unsteady (not the same as vertigo)

Question 32

Benign peroxysmal positional vertigo (BPPV)

Answer 32

Occurs when an otoconia crystal from one of the otolithic organs is knocked loose and falls into one of the semicircular canals

Changes how fluid movement in the semicircular canal is perceived by the hair cells and causes altered movement sensation (vertigo)

Question 33

Posterior canal BPPV is detected by

Answer 33

Dix-hallpike maneuver

Question 34

Vestibulo-ocular reflex (VOR)

Answer 34

A gaze stabilizing reflex that utilizes sensory signals from the vestibular system to create compensatory eye adjustments

Question 35

Head impulse test

Answer 35

Holding either side of the head, lightly rotate the head side to side then quickly move head back to midline. The patients VOR should allow them to maintain their eyes looking at the visual target

Question 36

Cervico-ocular reflex

Answer 36

Movement of the neck results in compensatory eye movement

Proprioceptors in the next provide feedback to initiate eye movement

Question 37

Optokinetic reflex

Answer 37

Head reamins stationary, but the eyes move to follow an object (sitting in a car watching individual telephone pass by without moving your head)

Question 38

Balance error scoring system

Answer 38

Hands on hips, eyes closed for 20 seconds, shoes removed

Each stand is done first on solid ground then on a foam pad

1. Double leg stance
2. Tandem stance
3. Single leg stance (non-dominant leg)

Question 39

Balance error scoring system errors

Answer 39

Remove hands from hips
Opening eyes
Step/stumble
Lifting forefoot or heel from testing surface
Hip flexion/abduction beyond 30 degrees
Stay out of test position for >5 seconds

Question 40

Balance Error Scoring System score

Answer 40

0-60 and represents the number of errors in each test position

Lower score is better

Can have max number of errors as 10 per stance position