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Neuromus 1 > exam 2: vestibular review > Flashcards

exam 2: vestibular review Flashcards

1
Q

yaw

A

shaking your head no
on the z axis

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2
Q

pitch

A

nodding
on the y axis

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3
Q

roll

A

side bend
moving on the x axis

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4
Q

what three nerves do we find in the ear

A

vestibular, cochlear nerve and facial nerve are all intertwined

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5
Q

what is the function of the vestibular system

A

helps detect head position and movement of the head

helps maintain balance

involved in reflexive eye movements

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6
Q

what is the function of the otolith organs

A

detects static position of the head and linear acc

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7
Q

what is the function of the semicirccular canals

A

detect the rotational accc of the head

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8
Q

what are the name of the three semicircular canals

A

superior
horizontal
posterior

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9
Q

what is the ampullae

A

bulbous chamber at the end of each semicircular canals

this where hair cells are located

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10
Q

what do we find inside the ampullae

A

cupla

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11
Q

what is the cupula and it function

A

for a barrier that endolymph cannot pass - the endo distorts the cupula

this bend the hair cells and increase or decrease NT release depending on the direction of the endo flow

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12
Q

when are the horizontal canals horizontal to the ground

A

when we flex the head forward

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13
Q

what are the two type of otolith organs

A

saccule and utricle

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14
Q

what direction do the hair cells get excited

A

when they push towards the kinocilia

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15
Q

what is the otoconia

A

the sterocilia extend into a gelatinous layer that is covered with the otoconia

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16
Q

otoconia location

A

on to of hair cell in the utricle and saccule - otolith organs

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17
Q

otocconia and shifting of the head

A

when we shift our head the otocania shift that hair cells

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18
Q

is there one primary vetsibular cortex in the brain

A

no vestibular information is spread through the brain

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19
Q

what happen is we have dysregulation of the vestibular system

A

vertigo

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20
Q

VOR reflex is a connection of what two systems

A

vestibular system and the ocular system

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21
Q

what is the vestibular ocular reflex

A

produce eye movement that counters head movements

allows us to focus our gaze on one point even when our head it moving

EX: if we move our head to the right our eye can stay focused on an object

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22
Q

what is gain of VOR

A

the change in the eye angle divided by the change in the head angle during the head turn

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23
Q

what does a gain of 1.0 mean

A

meaning there is a compensatory eye velocity equal to the head velocity and in the opposite direction

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24
Q

how much of a gain decrease do we normally see with unilateral labyrinthine lesion

A

25-50%

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25
Q

which way does nys beat

A

away from the involved side

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26
Q

what is spontaneous nys

A

this is when you see nys in the resting posistion

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27
Q

what drives VOR adaptation

A

rentinal slip

an attempt is made to change the amp or speed of the eye movement to bring the target on the fovea

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28
Q

for vision to be normal what does rentinal slip have be less then

A

2 deg/secc

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29
Q

what is the center of the vestibular system

A

vestibular nuclei

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30
Q

otolith organs vs SSC

A

oto - detect static head position and linear accc

SSC - rot acc of the head

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31
Q

what is the def of retinal slip

A

the differencce between eye velocity and head velocity

32
Q

what are included in the vestibular peri organs

A

3 SSC
2 otolith organs - saccule and utricle

33
Q

what are the phases nystagmus

A

slow and fast phase

34
Q

what does the slow phase of nys reflect

A

the function of VOR

reflecting the underlying pathology

35
Q

what does left beating nys mean

A

fast phase to the left and right ear issue

36
Q

Fixation suppression of a spontaneous nys is a clue in to what

A

peripheral vestibular disorder

37
Q

how do we name torsional nys

A

named for the direction of the fast phase for the upper pole of the eye

38
Q

what are the two types of nys

A

physiological and pathological

39
Q

what are the three types of physiological nys

A

vestibular induce
visually induced
extreme endpoint induced

40
Q

vestibular induced

A

everyone can prestn with nys depending on the situation - spinning in a chair

caloric

41
Q

visually indiced

A

if you count strips this can induce nys

42
Q

end point induced nys

A

if you go to the end range of you visual field this can induce nys

43
Q

Caloric Nystagmus

A

irrigation of the external ear canal with ice-cold water or warm water for 3 to 5 minutes causes the endolymph to flow in the semicircular ducts.

44
Q

what are the three type of patho nys

A

spontaneous
gaze evoked
posiotional

45
Q

what is spontaneous nys

A

movement of the eyes without a cognitive, visual or vestibular stimulus

46
Q

spontaneous nys and fixation
central disorder

A

there nys does not change with light, focusing does not help
o Brian problem

47
Q

spontaneous nys and fixation
peripheral disorder

A

nys stops with fixation
- inner ear problem

48
Q

does Peri spontaneous change as we look differnt directions with out eye

A

no - in every direction the nys is the same

unilateral vestibular loss - uni directional problem

49
Q

Sym gaze evoked diagram presentation

A

o Center – nothing
o Right – beat right
o Left – beat left
o there is a change in direction without a change in head position

50
Q

BPPV nys

A

o This is associated with head movement
o Move the head and the nys changes direction

51
Q

presentation of Congenital nys

A

nys at center point

52
Q

what do you do if you see down beating nys

A

go see a neurologist

this does not fatigue and is highly unusual

53
Q

nys with peri issues straight or with torsion

A

with torsion

54
Q

is sym gaze evoked nys brain or peri issue

A

brain problem

there persons head is still and just their eye movements cause the nys

55
Q

cervico-ocular reflex (COR)

A

an ocular stabilization reflex that is elicited by rotation of the neck

interact with VOR to drive eye movement based on the cervical

work to prevent visual slip

56
Q

are smooth pursuits and sacccades effected by vestibular issue

A

no
they never have to do anything with the inner ear if there is a disorder this is most likely a brain issue

57
Q

what do smooth pursuit allow the eye to do

A

allow the eye to track moving object across the visual field without omving the head

58
Q

what is often the cause to issue with smooth pursuits

A

cerebellar lesions

59
Q

what are saccadic eye movements

A

rapid voluntary movement that allow re-foveation of stationary targets

maintain a visual object on the fovea voluntary or involuntary

60
Q

what is indicated by issue with smooth pursuit

A

brian issue

61
Q

what are possible causes for slow saccades

A

parkinsons
progressive supernuclear palsy
intranuclear opthamoplagia
drug intoxication
oliviopontocerebellar atrophy
huntingtons chorea

62
Q

is nys named for its slow or fast phase

A

fast ohase

63
Q

what happens to peri vestibular nys with visual fixation

A

it stops

64
Q

what happens to a central vestibular nys with visual fixation

A

the nys does not stop

65
Q

alexander law - looking in the direction of the the fast phase

A

looking in direction of fast phase increase the amp and freq of nys

66
Q

alexander law - looking in the opposite direction of the the fast phase

A

decrease the amp and freq

67
Q

what is first degree nys

A

seen only when we look in the direction of the fast phase of nys

68
Q

what is 2nd degree nys

A

nys is present in the primary position (looking forward) and when looking toward the fast phase

69
Q

what is third degree nys

A

nys is seen in all direction horizontal

70
Q

presentation of the person with 3rd nys

A

they are very sick - just had surgery, just go admitted to the hospital

71
Q

what does primary gaze mean

A

neutral - looking straight forward

72
Q

does central nys change intesity with fixation

A

no

73
Q

is peri nys worse or better with fixation

A

better

74
Q

what kind of nys do we see with posterior canal BPPV

A

torsional nystagmus

75
Q

what is BPPV

A

the sudden sensation of spinning

Neuromus 1 (15 decks)

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