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Neuromus 1 > exam 2 -vetsibular issue > Flashcards

exam 2 -vetsibular issue Flashcards

1
Q

what is a vestibular issue

A

peri, central, or a combine vetsibular issue

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2
Q

is there a certain population vestibular issue are seen in

A

no seen in all population

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3
Q

what causes vestibualr issue

A

brain - cere, vest nuclei, BS
SSC
disorder of the otolith

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4
Q

peri vestibular issue sym presentations

A

o Dizziness with positional chnages
o Spinning
o Poor balance
o Vomiting
o Nausea
o Headache (seen more commonly in central issues)
o Ear issues
 There may be hearing loss
 Tinnitus
o Head movement during gait

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5
Q

what is oscillopsia

A

a vision problem in which still objects seem to jump, jiggle, or vibrate due to a misalignment of the eyes or systems controlling balance

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6
Q

is all dizziness vestibular

A

no I can be caused
medication
DM
POTS
thryroid conditions
renal failure
TIA
migraines

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7
Q

is upbeating nys central or peri

A

it can be either

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8
Q

is down beating nys central or peri

A

central - go see a neurologist

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9
Q

what are test of the cere

A

didiadokikinesia - rapid alternaing movement
alternative feet tapping
finger nose

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10
Q

what is included in the eye assesment

A

pupil size
pupil sym
facial nerve sym

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11
Q

what are signs that you should refer back to a physician

A

UMN signs
swallowing issues

change in sensation that is not explained by premorbid condition

having the worst headache of their life

LOC

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12
Q

eye change that would sign to refer back to a doctor

A

change in pupil size or ptosis that is not explained by a prior medical condition

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13
Q

falls and refferal to doctor

A

repeated unexplained falls

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14
Q

balance issue that should be referred to a docctor

A

sensation of being pushed off balance - may be a BS issue

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15
Q

ear issue that should be referred

A

fluctuating hearing loss

unilateral hearing loss

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16
Q

eye issue to referred

A

VF loss

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17
Q

memory and referred

A

memory loss

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18
Q

how long until you referrer back to the doctor

A

the pt status has not improved and you have seen the pt for 2-3 months of 3-5 visits

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19
Q

is is better to see vestibular pt is quick time period

A

no it is better to space out these patients

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20
Q

do we normally see straight or torsion nys with peri issue

A

torsional and vertical mixxed

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21
Q

do we normally see straight or torsion nys with central issue

A

straight/vertical

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22
Q

is vertigo common with central issue

A

uncommon

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23
Q

is vertigo common with peri issue

A

more common

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24
Q

do we see issue with saccades and smooth pursuits with central or peri issue more

A

central

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25
Q

is a report of LOC every a vestibular issue

A

no

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26
Q

what is positional dizziness assocciated with vertigo normallu caused by

A

free floating otoconia - it is a mechanical issue

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27
Q

how to test for hearing loss

A

rub your finger near the pt ears

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28
Q

is there a test for tinnitus

29
Q

what should you test if you thing someone has a vest issue

A

o Hearing loss
o Tinnitus
o Gait analysis
o Balance test
o Positional testing
o Dizziness handicap inventory

30
Q

what does DGI stand for

A

dynamic gait assessment

31
Q

dizziness handicap index number

A

40 - BPPV
50 or higher - long term issues

32
Q

when do we get imagine for the pt

A

risk factors for stroke
new onset of headaches with vertigo
neuro signs
vertigo that does resolve for 48 hours

33
Q

do people always report that they have fallen

A

no this is why we need to ask specific questions

34
Q

what is the clinically important change in gait speed for those with UVL

A

.2 –> .34

this lead to a large difference in self previeced balance and dizziness

35
Q

tullio phenomanon

A

eye movement hat are inducced by loud noises

associated with an inner ear issue

36
Q

hennebert sign

A

eye movements due to pressure in the external audiotory canal

37
Q

valsalva manuever

A

bearing down, glottic pressure, cough, sneeze can elicit vestibular signs

38
Q

who are surgical cadiates for Superior canal dehiscence

A

Debilitating Auditory and vestibular symptoms
physical finding - tuillo, hennebert

audiometric findings - low conductive hearing loss, intact stapes reflex

CT finding > canal dehisence

39
Q

what does vestibular loss look like in children

A

increase poor balance

1/2 have vestibular abnormalities with vest testing

40
Q

disequillibrum without vertigo possible causes

A

parkisons
neuropathy
senile gait
cere disorders
dementia - multi infract
normal pressure hyrocephalus

41
Q

cenrtal issues and eye changes

A

pupil changes
ptosis

42
Q

throat and central changes

A

diffuculty swallowing

43
Q

causes of recurrent dizziness

A

mirgrain

VBI

panic disorder

44
Q

causes of non-recurrent dizziness

A

concussion
BS stroke
cerebellar hemorrhage
MS
chiair malformation
multi-sensory disequilibrium

45
Q

what is a Chiari malformations

A

structural defects where the lower part of your brain presses on and through an opening in the base of the skull and cerebellum into the spinal cana

46
Q

physchatric dizziness

A

panic disorders
agoraphoria
hyperventilation syndrome

47
Q

agoraphoria

A

A person with agoraphobia is afraid to leave environments they know or consider to be safe

48
Q

what is PPPD

A

this is a a functional movement disorder

these individuals have a vest issue that they have a hard time recovering from

49
Q

what is the cause of the presentation of PPPD

A

difference in their grey matter

so when there is a vestibular issue they are maladpative

50
Q

recurrent attacks of vertigo - neuro signs

51
Q

recurrent attacks of vertigo - hearing loss

A

meniere’s
autoimmune disease
syphillis

52
Q

recurrent attacks of vertigo - normal audiogram

A

meniere’s
mirgraines
VBI

53
Q

what is vestibular mirgaine often confused with

A

sinus headache

54
Q

benign paroxysmal vertigo of a child - vertigo

A

5 episode of serve vertigowith no warning

55
Q

benign paroxysmal vertigo of a child - recovery

A

resolves spontaneously within min to hours

56
Q

benign paroxysmal vertigo of a child - vets testing

A

when no symptomatic vest testing is normal

57
Q

benign paroxysmal vertigo of a child - migrianes

A

consider as a precusor of migraines in adulthood

58
Q

vest migraine and BPPV - presentation

A

vets migraine may demostrate positional vertigo

59
Q

vest migraine and nys

A

persistant positional nys

60
Q

is dizzines ever normal

A

no it does not matter the age of the pt

61
Q

if you see gait ataxia is this most likely a central or a peri issue

A

central dysfunctionn

62
Q

aminoglycosides - vertigo

A

cause vertigo and disequillibrum

63
Q

what does pure vertical eye nys normally tell us

A

usually indicates cere atrophy, MS, cere tumor, Chiari malformation

64
Q

Central spontaneous nys indicates

A

cere ectopia (abnormal positioning), degeneration, or ischemia (inadequate blood supply)

65
Q

Down beating nys indicates

A

Chiari malformation, bilat BS lesion, bilat floccular lesion, vestibulocerebellum lesion

66
Q

what could be the cause of post traumtic dizziness

A

perilymphatic dizziness
temporal bone fracture
post conccussion syndrome
labyrinthine concussion
BS hemorrhage

67
Q

what is Valsalva

A

a forceful attempt at expiration when the airway is closed at some point

68
Q

what is - Barotrauma

A

physical tissue damage caused by a pressure difference between an unvented space inside the body and surrounding gas or fluid

Neuromus 1 (15 decks)

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