Eye Movements and Vestibular Disorders

Question 1

Definition: rapid eye movements to direct the eyes to the target

Answer 1

saccades

Question 2

definition: eye movements following a moving object

Answer 2

smooth pursuit

Question 3

definition: eyes directed to near or far targets

Answer 3

vergence

Question 4

What are the conjugate eye movements?

Answer 4

saccades and smooth pursuit

Question 5

What are non-conjugate eye movements

Answer 5

vergence

Question 6

Saccades can be ___ or ___ guided

Answer 6

voluntary or memory

Question 7

(true/false) Saccades can have a slow component

Answer 7

true

Question 8

How do you label a saccade?

Answer 8

By the direction it is moving into

Question 9

The eyes can move up to ___ degrees/second when saccades is present

Answer 9

700

Question 10

What initiates saccades?

Answer 10

• Frontal eye fields of the frontal lobe
• superior colliculus

Question 11

definition: structure that gets the eye to a target

Answer 11

PPRF (paramedian pontine reticular formation)

Question 12

What provides voluntary and memory guidance for saccades?

Answer 12

frontal eye fields

Question 13

What structure has neurons that help with reflexive movements?

Answer 13

superior colliculus

Question 14

Having a R Saccade results in the ______ muscle of the ipsilateral eye to move and the _____ muscle of the contralateral eye to move.

Answer 14

ipsilateral side: lateral rectus muscle (abducens n.)
contralateral side: medial rectus muscle (oculomotor n)

Question 15

What initiates smooth pursuit?

Answer 15

parietal and frontal cortex

Question 16

Smooth pursuit is made up of (slow/fast) eye movements.

Answer 16

slow (30-100 degrees/sec)

Question 17

Vergence involves the BILATERAL activation of the ____ or ____ muscles.

Answer 17

medial rectus or lateral rectus

Question 18

With vergence, the eyes are moving in the (same/opposite) directions.

Answer 18

opposite

Question 19

What initiates Vestibular Ocular Reflexes (VOR)?

Answer 19

semicircular canals w/ head movement

Question 20

With VOR, the head and eyes move the (same/different) amount.

Answer 20

same

Question 21

VOR has a ___ reflex.

Answer 21

plastic reflex

Question 22

definition: slow eye movement in the direction of a moving object and a rapid return of eye position in the opposite direction.

Answer 22

optokinetic nystagmus

Question 23

The type of nystagmus is determined by the (slow/fast) component

Answer 23

fast

Question 24

What are the causes of optokinetic nystagmus?

Answer 24

• brainstem infarcts
• INO
• vestibular issues
• TBI
• cerebellar damage
• MS
• DM
• disruption of the MLF pathway

Question 25

What are the s/s of optokinetic nystagmus?

Answer 25

- diplopia - dizziness - nausea - vomiting

Question 26

Semicircular canals detect the ___ motion of the head.

Answer 26

angular motion

Question 27

Otoliths (utricle/saccule) detect the ____ motion of the head.

Answer 27

linear motion

Question 28

definition: sensory organ for the semicircular canals

Answer 28

ampulla

Question 29

The ampulla contains a ____.

Answer 29

cupula

Question 30

definition: crystals that move the gelatinous substance and the hair cells in the ampulla

Answer 30

otoconia

Question 31

Otoconia move with ___.

Answer 31

gravity

Question 32

When bending to the R, the ipsilateral semicircular canal (increases/decreases) its firing rate while the contralateral semicircular canal (increases/decreases) its firing rate.

Answer 32

increases, decreases

Question 33

What are common s/s of vestibular disorders?

Answer 33

- vertigo - nystagmus - nausea - vomiting - hearing loss

Question 34

definition: the illusion of movement (can be described as "spinning")

Answer 34

vertigo

Question 35

definition: rhythmic oscillation of the eyes

Answer 35

nystagmus

Question 36

Definition: the sudden sensation that you're spinning or that the inside of your head is spinning

Answer 36

BPPV

Question 37

What is the most common cause of vertigo?

Answer 37

BPPV

Question 38

The incidence of getting BPPV increase when a person is in what age range?

Answer 38

> 50 y/o

Question 39

What are the s/s of BPPV?

Answer 39

- dizziness - (+) dix-hallpike maneuver - Disrupted VOR

Question 40

What indicates a (+) test for the dix-hallpike maneuver?

Answer 40

- paroxysmal vertigo - nystagmus

Question 41

Vestibular neuritis/labyrinthitis has a ____ etiology.

Answer 41

viral

Question 42

definition: acute onset of rotational vertigo

Answer 42

vestibular neuritis/labyrinthitis (can look like BPPV)

Question 43

(true/false) Vestibular neuritis never goes away

Answer 43

False

Question 44

definition: the vestibular system is not properly functioning

Answer 44

vestibular hypofunction

Question 45

Vestibular hypofunction is (unilateral/bilateral)

Answer 45

unilateral

Question 46

What are the s/s of vestibular hypofunction?

Answer 46

- dizziness/vertigo - balance difficulties - difficulty walk in the dark and/or crowded areas

Question 47

Meniere's disease is associated with ___.

Answer 47

BPPV

Question 48

What are the s/s of meniere's disease AND acoustic neuromas?

Answer 48

- tinnitus (unilateral ringing in the ear) - hearing loss - episodes of vertigo

Question 49

An acoustic neuroma is a BENIGN tumor of _____.

Answer 49

CN VIII (RARE)

Question 50

What types of medications are used to treat meniere's disease?

Answer 50

- anticholinergics - antibiotics - diuretics - surgery

Question 51

Tumors in the ___ and ___ can cause vestibular disorders.

Answer 51

brain and cerebellum

Question 52

What are diseases/conditions that cause problems with equilibrium?

Answer 52

- MS - Seizure medications - alcohol abuse - cortical lesions

Question 53

What are the three medication groups used to treat vertigo?

Answer 53

- anticholinergics - antihistamines - benzodiazepines