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ENT-HNS > Dizziness > Flashcards

Dizziness Flashcards

1
Q

Balance is coordinated by streams of which systems?

A

Visual, Vestibular, Proprioceptive

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2
Q

T/F Semicircular canals are sensitive to linear accelerations

A

F
They are sensitive to angular accelerations

Otolithic apparatus is sensitive to linear accelerations

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3
Q

T/F The lateral semicircular canal is strictly on a horizontal plane

A

F
It is angulated at around 20-30 degrees

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4
Q

In what orientation does the lateral canal lie during caloric testing?

A

When in supine position during caloric testing, the head is elevated by 30 degrees, and the lateral canal lies VERTICALLY

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5
Q

T/F: In functional pairs of semicircular canals, one canal gets stimulated when another is inhibited

A

T

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6
Q

Describe the ampullopetal motion when head rotates to the right

A

On the right horizontal SCC,
fluid moves towards the
ampulla causing excitation
● On the left horizontal SCC, fluid moves away from the ampulla
causing inhibition

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7
Q

Describe the ampullofugal motion when the head bows down

A

The fluid in the left and right anterior SCC moves upward, away from the ampulla → ampulla becomes excited
● In the posterior SCC, fluid moves
towards the ampulla →
inhibition

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8
Q

HSC = fluid movement towards the ampulla causes _____

A

excitation

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8
Q

ASC = fluid movement towards the ampulla causes _____

A

inhibition

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9
Q

PSC = fluid movement away from the ampulla causes _____

A

excitation

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10
Q

What is the movement of the right ear fluid if the head does yaw motion to the right?

A

To the left towards the ampula = excitation

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11
Q

What is the movement of the left ear fluid if the head does yaw motion to the right?

A

to the right away from the ampulla = inhibition

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12
Q

What is the movement of the left ear fluid if the head does yaw motion to the left?

A

to the right towards the ampulla = excitation

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13
Q

What is the movement of the right ear fluid if the head does yaw motion to the left?

A

towards the right away from the ampulla = inhibition

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14
Q

T/F: Otolithic apparatus is a component of the Proprioceptive System

A

F - otolithic apparatus is a component of the vestibular system

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15
Q

T/F: Otolithic apparatus is made up of the utricle and saccule with maculae that are
approximately positioned parallel to each other

A

F
They are positioned PERPENDICULAR to each other

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16
Q

T/F: Utricle is same plane as the horizontal canal, wile the saccule is in the vertical parasagittal plane

A

T

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17
Q

Which otolithic apparatus component detects linear acceleration when one moves side to side?

A

Utricle

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18
Q

Which otolithic apparatus component detects linear acceleration when one moves front to back?

A

Utricle

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19
Q

Which otolithic apparatus component detects linear acceleration when one moves up and down?

A

Saccule

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20
Q

T/F: Semicircular canals: angular acceleration :: otolithic apparatus: linear acceleration

A

T

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21
Q

This nuclei processes and integrates vestibular and non-vestibular information

A

Vestibular nuclei

It processes visual and spinal afferents for visuospatial orientation

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22
Q

The following are systems included in maintaining balance, except:

Eyes
Vestibular labyrinth
Cortex
Cerebellum
Muscles
Joints
Brainstem
Spinal Cord

A

Spinal cord

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23
Q

When doing slow head movements, _______ reflex is used

A

Optokinetic reflex

24
Q

When doing fast head movements where you have to recognize where is up, down left, right, _____ reflex is used

A

Vestibuloocular reflex

25
Q

How does vestibulospinal reflex in elderly work?

A

The vestibulospinal reflex in the elderly is decreased. This means that they do not have much reflex to adjust their muscle tone in response to changes in head movements for stability.

26
Q

How does the vestibulospinal reflex work?

A

The vestibular system in the inner ear detects head movements -> sends signals to the spinal cord to activate muscles -> gait stability and coordination

27
Q

What is the subjective disturbance of integrity caused by contradictory sensory information processing or impaired central processing?

A

Dizziness

28
Q

T/F: Impaired central processing can be caused by metabolic or circulatory abnormalities, infection, trauma, or alcohol intoxication

A

T

29
Q

4 Types of Dizziness

A

Presyncope
Lightheadedness
Disequilibrium
Vertigo

30
Q

Rotary movement in vertigo involves the _____

A

semicircular canals

31
Q

Body tilt or impulsion in vertigo involves the _______

A

saccule or utricle

32
Q

Dizziness with duration of seconds could be:

A

Benign paroxysmal positional vertigo

33
Q

Dizziness with duration of minutes to hours could be _______

A

Meniere’s Disease

34
Q

Dizziness with duration of days to weeks could be_________

A

Vestibular neuronitis

35
Q

what is the SNNOOP approach?

A

Systemic, neurologic, neck, otolaryngologic, ophthalmologic, psychatric

36
Q

Romberg’s, Unterberger Tests are examples of ___________

A

Vestibulospinal Test (Neurologic Exam)

37
Q

T/F: The vestibular disorders lead to a directional instability on the side of the affected vestibular organ

A

T

38
Q

T/F Vestibular exams are usually done first in physical examination for dizziness

A

F: it is done last as it may provoke vertigo

39
Q

T/F The corrective saccade indicates a deficient VOR on the opposite side of the head turn, indicating a peripheral vestibular lesion on the opposite side

A

The corrective saccade indicates a deficient VOR on the same side of the head turn, indicating a peripheral vestibular lesion on the same side

40
Q

Conjugated, coordinated eye movement on an axis

A

Nystagmus

41
Q

Which indicates direction, slow or fast phase nystagmus?

A

Fast phase nystagmus

42
Q

This gaze-evoked nystagmus is due to toxicity from barbiturates, phenytoin and alcohol. It is present at rest

A

Spontaneous nystagmus

43
Q

Common provocative measures for nystagmus

A

Head shaking, Positional Testing, Dix-hallpike maneuver

44
Q

What part of the vestibular system is tested by positional testing?

A

Lateral Semicircular canal

45
Q

What part of the vestibular system is tested by the Dix-hallpike maneuver?

A

Posterior semicircular canal

46
Q

Most commonly used and easiest test to assess BPPV

A

Dix Hallpike Maneuver

47
Q

Positive Dix hallpike maneuver indicative of BPPV on the RIGHT will present as a clockwise/counterclockwise torsional movement of the eyes

A

Counterclockwise

48
Q

Positive Dix hallpike maneuver indicative of BPPV on the LEFT will present as a clockwise/counterclockwise torsional movement of the eyes

A

clockwise

49
Q

Caloric Testing stimulates which part of the vestibular system?

A

lateral semicircular canal

50
Q

Triad for Meniere’s Disease

A

Hearing Loss, Tinnitus, Ear Fullness

51
Q

T/F Vestibular migraine is a central problem that behaves as a peripheral vestibular disorder

A

T

52
Q

T/F Vestibular neuritis, similar to meniere’s disease, have horizontal or horizontal-torsional nystagmus

A

T

53
Q

T/F Bilateral vestibular loss have up beating, torsional nystagmus

A

F: It has no nystagmus as both L and R peripheral vestibular apparatus have failed to function properly

54
Q

Faster-acting anti-vertigo drugs

A

Cinnarizine
Dimenhydrinate
Meclizine

55
Q

T/F: Treatments of BPPV aim to reposition the otoliths back to its original position in the UTRICLE

A

T

56
Q

This should always be a differential diagnosis when faced with patient complaining of imbalance

A

Neural Vestibular Disorder

57
Q
A

ENT-HNS (8 decks)

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