Evaluation of Vestibular System Flashcards

1
Q

What are the structures for hearing and balance?

A
  1. Cochlea
  2. Semicircular Canals
  3. 8th Nerve
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2
Q

For vestibular dysfunction, what are the common concerns?

A
  1. Disequilibrium & Vertigo
  2. Can be acute/chronic
  3. Ranges from mild-severe
  4. Most recover spontaneously
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3
Q

For Vestibular Dysfunction, who’s at a greater risk?

A

Elders

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4
Q

What causes of Vestibular Dysfunction should an audiologist care about? and what of vestibular dysfunction are they?

A
  1. Meniere’s Disease
  2. Perilymph Fistula
  3. Vestibular Neuritis
  4. Benign Paroxysmal Positional Vertigo

They are Peripheral Vestibular Dysfunction

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5
Q

What are the symptoms for Meniere’s Disease?

A
  1. Fluctuating low frequency SNHL
  2. Typical unilateral
  3. Roaring (low frequency sound) tinnitus
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6
Q

What is the cause for Meniere’s disease?

A

An increase in endolymphatic fluid pressure

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7
Q

What are the symptoms for Vestibular Neuritis?

A
  1. Sudden onset of vertigo
  2. Nausea
  3. Vomiting
  4. Usually w/o auditory symptoms
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8
Q

What is the cause for Vestibular Neuritis?

A

Thought to be a viral infection of vestibular portion of VIIIth nerve

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9
Q

What are the symptoms for Perilymph Fistula?

A
  1. Fluctuating and typically unilateral but not limited to low frequencies
  2. Tinnitus
  3. Vertigo
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10
Q

What causes Perilymph Fistula and what is?

A

a. It’s caused by abnormal communication between ME and IE

b. It’s essentially an extra opening in the cochlea

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11
Q

Why can a Perilymph Fistula occur?

A
  1. Trauma
  2. Surgery
  3. Congenital Anomalies
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12
Q

What’s the main different between Perilymph Fistula & Meniere’s Disease?

A

Meniere’s Disease only pertains to low frequencies while Perilymph Fistula does not

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13
Q

For BPPV, what are most cases?

A

Idiopathic

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14
Q

What is the most frequent cause of vertigo?

A

BPPV

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15
Q

What test do we use to assess the Peripheral Vestibular Dysfunctions?

A

Nystagmus

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16
Q

What is Nystagmus?

A

It’s a rocking motion of the eyes

17
Q

When does nystagmus occur?

A

Always with true vertigo

18
Q

Can nystagmus occur spontaneously? What is it called?

A

Yes, Congenital Nystagmus

19
Q

For the many tests used for vestibular function to look at nystagmus, what do we analyze?

A
  1. Presence
  2. Degree
  3. Type in comparison to norms
20
Q

For Nystagmus, which assessment is commonly used?

A

Electronystagmography (ENG)

21
Q

For Nystagmus, what is VNG or ENG?

A

It analyzes eye movement through an electrical response since our cornea has a positive charge and the retina has a negative charge

22
Q

For VNG or ENG, what does the difference in the electrical potential tells us?

A

As our eyes moves the ENG will obtain an objective measurement of nystagmus to determine if the patient really have nystagmus

23
Q

While we’re doing an ENG or VNG, what are we doing?

A

A caloric test

24
Q

What is the purpose of a caloric test?

A

To get them dizzy and see if they truly have vertigo

25
For caloric testing, what do you do to make the patient have vertigo?
Irrigate the ear canal with warm or cold water or air to stimulate the vestibular system
26
For caloric testing, what does irrigate the EAC do?
Stimulate the vestibular system. The warm temperature would stimulate the vestibular system in one way while the cold temperature would stimulate the vestibular system in another way
27
For caloric testing, what's the rule for direction of nystagmus?
COWS: Cold opposite, Warm Same
28
For caloric testing. how can the response be classified?
1. Normal 2. Absent 3. Hyperactive 4. Hypoactive
29
Define Rotary Chair
Mechanized chair that rotates at varying velocity in both clockwise and counterclockwise directions
30
The purpose of the Rotary Chair is to...?
View nystagmus during movement since we're trying to make our client have a vertiginous reaction
31
What two tests does not use nystagmus?
1. Computerized Dynamic Posturography | 2. Vestibular-Evoked Myogenic Potential (VEMP)
32
What does the Computerized Dynamic Posturography assess?
1. The ability to coordinate movement by measuring vestibulospinal reflexes
33
What does the Computerized Dynamic Posturography measure?
The patient's ability to compensate for various disruptions in balance
34
What is VEMP?
A test that measures the sound-evoked muscular reflex of our sternocleidomastoid muscle by placing electrodes on the sternocleidomastoid muscle
35
What's the purpose of the sternocleidomastoid muscle?
Purpose of reflex is thought to stabilize the head in response to unpredictable movements
36
What causes the sternocleidomastoid muscle to contract?
The saccule, which is responsible for linear acceleration sends a message to this muscle
37
When we identify that the patient has difficulty, what do we do about it?
1. Balance Rehabilitation 2. Medical 3. Surgical
38
For medical treatment for Peripheral Vestibular Dysfunction, what are the factors and what do we treat?
1. Depends on cause 2. Typically provide symptomatic treatment The medication would treat: Nausea and Vestibular Suppressant
39
For surgical treatment for Peripheral Vestibular Dysfunction, what are the factors and what do we treat?
1. Depends on cause 2. Most invasive treatment 3. Two types of procedures: Preservation & Ablation