Exam 2: Vestibular Pathology Flashcards

Question

What is Cupulolithiasis?

Answer 1

● DEBRIS FROM UTRICULAR MACULA SETTLES BY GRAVITY ON TO THE CUPULA OF THE SEMICIRCULAR CANAL ● CUPULA THUS OBTAINS A HIGHER SPECIFIC GRAVITY THAN THE ENDOLYMPH AND BECOMES SENSITIVE TO GRAVITY DURING CHANGES IN HEAD POSITION ● SHOULD IMPLY A LONGER DURATION OF POSITIONAL NYSTAGMUS ● SIMILAR EVENT OCCURS WITH ETOH

Answer 2

● LOOSE PARTICLES DISPLACED INTO SCC WHICH WOULD INDUCE A MOVEMENT AWAY FROM THE AMPULLA, PULLS ON THE CUPULA AND EXCITES THE NEURONS ● SHORT DURATION OF NYSTAGMUS WHEN SCC PLACED IN THE SAME PLANE WITH GRAVITY Symptoms: 1. ● BRIEF EPISODES OF VERTIGO INDUCED BY CHANGE IN HEAD POSITION 2. ● USUALLY INVOLVES THE POSTERIOR SCC 3. ● CONSISTENT TYPICAL CHARACTERISTICS Characteristics 1. POSITIONALLY INDUCED 2. LATENCY IN THE ONSET OF SYMPTOMS 3. MOST COMMONLY TORSIONAL NYSTAGMUS WITH THE SUPERIOR ASPECT OF THE EYE BEATING TOWARD THE AFFECTED EAR WHICH APPEARS WITH THE SAME LATENCY AS THE COMPLAINTS OF VERTIGO 4. A CRESCENDO AND DECRESCENDO OF THE VERTIGO AND NYSTAGMUS WITH LASTS LESS THAN 60 SECONDS

Answer 3

REMEMBER THAT MOVEMENT _TOWARD_ THE AMPULLA IS EXCITATORY IN THE HORIZONTAL CANALS, BUT IN THE ANTERIOR AND POSTERIOR CANALS, MOVEMENT _AWAY_ FROM THE AMPULLA IS EXCITATORY

Answer 4

1. ● LABYRINTHECTOMY 2. ● CHEMICAL LABYRINTHECTOMY 3. ● VESTIBULAR NERVE SECTION 4. ● PERILYMPHATIC FISTULA REPAIR 5. ● POSTERIOR CANAL PARTITIONING 6. ● ACOUSTIC NEUROMA REMOVAL 7. ● CHOLESTEATOMA REMOVAL 8. ● ENDOLYMPHATIC SAC DECOMPRESSION PROCEEDURES

Answer 5

1. USUALLY VIRAL 2. DURING OR FOLLOWING AN UPPER RESPIRATORY INFECTION 3. PEAK OF CASES IN WOMEN IN THE 4TH DECADE, MEN IN THEIR 60’S 4. DIZZINESS NAUSEA AND VOMITING 5. CALORIC TESTS IPSILATERAL HYPORESPONSIVENESS

Answer 6

● AFTER SURGICAL ABLATION ● ACUTE PHASE OF VESTIBULAR NEURITIS

Answer 7

1. ASSOCIATED WITH * HEAD TRAUMA * BAROTRAUMA * SURGERY * PENETRATING INJURY 2. LOUD POPPING SOUND 3. SEVERE VERTIGO, HEARING LOSS, TINNITUS ● TULIO’S PHENOMENON 4. FISTULA BETWEEN THE MIDDLE EAR AND THE PERILYMPH 5. SNEEZING, COUGHING, STRAINING, NOSE BLOWING WILL REPRODUCE THE SYMPTOMS 6. TREATED WITH BED REST 7. REQUIRES IMMEDIATE SURGERY IF SNHL (Sensorineural hearing loss) IS PRESENT

Answer 8

● IMPLOSION ON DESCENT ● EXPLOSION ON ASCENT ● USUALLY INVOLVES RUPTURE OF UTRICLE AND SACCULE (think of a diver)

Answer 9

1. ● INNER EAR FLUID CHEMISTRY SHOULD REMAIN CONSTANT 2. ● MALFUNCTION OF THE MECHANISMS WHICH MAINTAINS PRESSURE AND COMPOSITION CONSTANT 3. ● NERVE ENDINGS BECOME ABNORMALLY STIMUL ATED 4. ● AURAL FULLNESS, TINNUTUS, HEARING LOSS, VERTIGO

Answer 10

1. ● IDEOPATHIC SYNDROME OF ENDOLYMPHATIC HYDROPS 2. ● MALFUNCTION OF RESORPTIVE FUNCTION OF ENDOLYMPHATIC SAC 3. ● AURAL FULLNESS, DECREASED HEARING LOSS, TINNITUS, VERTIGO 4. ● SEVERE VERTIGO AND DYSEQUILIBRIUM 30 MIN TO 24 HOURS 5. Pt may elect to destroy vestibular system on that side (often using Microwick Procedure - insert ototoxic substance)

Answer 11

used to insert ototoxic substance into the inner ear to destroy the vestibular system (sometimeis used in Menier's disease)

Answer 12

1. ● OCCURS WITH AGING 2. ● COMMON IN PATIENTS WITH EARLY BALDING OR GRAYING 3. ● ESPECIALLY IS GRAYING OCCURRED BEFORE AGE 30

Answer 13

1. ● MAY BE INHERITED TENDENCY 2. ● TUMOR ON ACOUSTIC NERVE 3. ● SYMPTOMS * ● PROGRESSIVE HEARING LOSS * ● TINNITUS IN ONE EAR 4. ● VESTIBULAR BRANCH COMPRESSION * ● IMBALANCE * ● VERTIGO 5. ● MAY BE SLOW GROWING

Answer 14

1. ● CYST LIKE GROWTH 2. ● COMMONLY FORMS IN PTS WITH CHRONIC Middle EAR INFECTION OR PERFORATED EAR DRUM 3. ● BENIGN TUMOR OF MIDDLE EAR 4. ● ERODES THE BONE OF THE INNER EAR 5. ● HEARING LOSS 6. ● VERTIGO 7. ● FOUL DRAINAGE FROM THE EAR

Answer 15

1. ● OTOTOXIC DRUGS 2. ● BILATATERAL MENIERES DISEASE 3. ● AUTOIMMUNE DISEASE SJORGRENS 4. ● SYPHILLIS 5. ● BILATERAL ACOUSTIC NEUROMA 6. ● INFECTION 7. ● OTOSCLOSIS 8. ● PAGETS DISEASE

Answer 16

1. ● IF EQUAL ON BOTH SIDES NO VERTIGO NYSTAGMUS OR SKEW DEVIATION 2. ● NO GAZE STABILIZATION WITH HEAD MOVEMENT 3. ● SEVERELY IMPAIRED GAIT 4. ● VISUALLY AND PROPRIOCEPTIVELY DEPENDENT

Answer 17

1. Antibiotics (especially gentamicin) 2. Anti-Neoplastic Drugs 3. Loop Diuretics 4. Anti-inflamatory drugs (includes ibuprophen) 5. Anti-malarial drugs 6. MISCELLANEOUS * heavy metals * industrial chemicals * arsenicals * lead * carbon monixide * mercury

Answer 18

1. ● COMMON CAUSE OF VERTIGO IN THE ELDERLY 2. ● OCCURS SUDDENLY NO WARNING 3. ● LASTS SEVERAL MINUTES 4. ● OFTEN WITH NAUSEA AND VOMITING 5. ● HEADACHE IMPAIRED VISION CAN ALSO OCCUR

Answer 19

peripheral CNS is usually gradual onset

Answer 20

peripheral cause CNS usually causes continuous symptoms

Answer 21

1. ● NEURITIS 2. ● MENIERES 3. ● BPPV 4. ● BAROTRAUMA 5. ● OTOTOXIA 6. ● SURGERY 7. ● TRAUMA 8. ● ACOUSTIC NEUROMA 9. ● OTOSCLEROSIS

Answer 22

1. ● VERTIBROBASILAR INSUFFIENCY 2. ● MIGRAINE 3. ● LABYRININE, CEREBELLAR, BRAINSTEM INFARCTION 4. ● TIA, STROKE

Answer 23

1. ● HYPOTENSION 2. ● HYPERTENSION 3. ● CARDIAC ARRYTHMIA 4. ● CORONARY ARTERY DISEASE 5. ● INFECTION 6. ● MEDICATION 7. ● HYPOGLYCEMIA

Answer 24

1. ● ACUTE ANXIETY 2. ● CHRONIC ANXIETY 3. ● PANIC ATTACKS 4. ● SECONDARY GAIN