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Brain and Behavior Exam 2 > Lec 22 Disorders of Vestibular System > Flashcards

Lec 22 Disorders of Vestibular System Flashcards

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1
Q

Why are kids more prone to middle ear infection?

A

eustachian tube connect pharynx to middle ear

in adults –> eustachian tube is longer, more vertical = better safe guard

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2
Q

What are the 2 parts of the outer ear?

A

pinna and external auditory canal

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3
Q

What are the parts of the middle ear?

A
  • tympanic membrane
  • ossicles
  • air containing space
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4
Q

What are the parts of the inner ear?

A
  • cochlea
  • vestibule
  • semicircular canals
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5
Q

What does weber test tell you?

A
  • if sound different on one side

–> will lateralize toward conductive hearing loss or away from sensorineural hearing loss

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6
Q

what does rinne test tell you?

A

normal or sensorineural == AC > BC [louder from air than on bone]

conductive loss == BC > AC [louder on bone than air]

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7
Q

What it tympanometry?

A

test movement of ear drum by presenting tone

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8
Q

What is the purpose of an audiogram?

A

way to diagnose hearing loss

    • establish pure tone threshold for air and bone
    • test speech reception threshold for each ear
    • provide speech discrimination score
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9
Q

What happens to air vs bone conduction in conductive hearing loss?

A

AC depressed
BC normal
air-bone gap (BC&raquo_space; AC)

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10
Q

What happens to air vs bone conduction in sensory neural hearing loss?

A

AC and BC depressed
AC = BC
usually bilateral

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11
Q

What are possible causes of conductive hearing loss?

A
  • cerumen [ear wax]
  • fluid [infextion]
  • eustachian tube swelling
  • tympanic membrane perforation
  • cholesteatoma
  • otosclerosis, congenital
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12
Q

What is otosclerosis?

A

genetic fixation of stapes

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13
Q

what is cholesteatoma?

A

mass of keratinizing squamous epithelium invading middle ear

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14
Q

What is treatment for conductive hearing loss?

A

drainage or surgery

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15
Q

What part of ear usually affected in conductive hearing loss?

A

outer/middle ear

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16
Q

what part of ear usually affected in sensory neural hearing loss?

A

inner ear or CNS problem

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17
Q

What does audiogram show in sensorineural hearing loss?

A

both AC and BC are less, high frequencies lost

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18
Q

What are potential causes of sensorineural hearing loss?

A 
aging
genetic
noise
acoustic neuroma
medieres
toxins/virus/trauma/meningitis
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19
Q

What are treatment for sensorineural hearing loss?

A

surgery, radiation [if neuroma], hearing aid, cochlear implant

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20
Q

What are 2 most prevalent causes of sensorineural hearing loss?

A

aging

noise exposure

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21
Q

What are signs of hearing loss do to aging?

A
  • type of sensory neural
  • high frequencies lost
  • speech discrimination preserved
22
Q

what are signs of hearing loss due to genetic cause?

A
  • type of sensory neural
  • middle frequencies lost
  • u shaped audiogram [with lowest in the middle]
23
Q

what are signs of hearing loss due to noise?

A

type of sensory neural

high frequencies lost [usually notch at 4 kHz]

24
Q

what are signs of hearing loss due to acoustic neuroma

A

type of sensory neural
unilateral
low speech discrimination

25
Q

Who should get cochlear implant?

A
  • if bilateral sensory neural hearing loss = severe

- if not benefit from hearing aid

26
Q

What is vertigo?

A

vestibular system disease causing false sense of motion

27
Q

what is imbalance?

A

sensory disturbance in vestibular, visual, or proprioceptive

- orign can also be cerebella, motor, etc

28
Q

what is disequilibrium? causes?

A

pt feels like things are off balance, drunk

due to: degenerative, brainstem, multisensory, psychogenic

29
Q

What is lightheadedness? causes?

A

pt feels like will fall

  • usually cardio or metabolic [NOT VESTIBULAR}
30
Q

What is VNG?

A

videonystagmography [VNG] = ENG

- measures direction and velocity of eye movement

31
Q

What is the difference peripheral vs central vertigo?

A

peripheral = more common, inner ear, positional, delayed horizontal nystagmus, acute onset

central = brain stem or cerebellar, directional change of nystagmus, immediate nystagmus in any direction with position testing, more persistent

32
Q

What are some potential causes of central vertigo?

A

cerebellopontine angle tumor

  • stroke
  • migraine
  • MS
33
Q

what are some potential causes of peripheral vertigo?

A

inner ear –> semicircular canal or otolith problem

vestibular nerve: BPPV, meniere’s labyinthitis

34
Q

What are the 5 common vestibular syndromes?

A
  • acute unilateral vestibular loss
  • menieres
  • BPPV
  • bilateral vestibular loss
  • migraine associated diziness
35
Q

What are some causes of acute unilateral vestibular loss?

A
  • vestibular neuritis
  • temporal bone fracture
  • infarction
  • inflammation/infection of vestbular neve
  • acoustinc neuroma, injury to inner ear, vestibular neuritis, acute labrynthtis, temporal bone fracture
36
Q

What are symptoms of acute unilateral vestibular loss?

A
  • sudden onset vertigo, N/V, nystagmus in acute phase
    • romber
  • past pointing
  • gate ataxic, veers toward lesion side
37
Q

What is treatment for acute unilateral vestibular loss?

A

meclizine, anti-emetics +/- vestibular rehab PT

38
Q

What causes meniere’s syndrome?

A

too much endolymph fluid –> distension of inner ear

39
Q

what are symptoms of meniere’s?

A

episodic vertigo: spontaneous, unpredictable, lasts hrs

  • accompanies by N/V
  • unilateral gradual hearing loss, aural fullness, tinnitus
40
Q

How do you diganose/treat menieres?

A

diagnose: audiogram with unilateral upsloping sensory neural hearing loss
treat: vestibular suppressants, diurectics to minimize fluid pressure

41
Q

What causes BPPV?

A

otolith/otoconia dislodged and float in endolymph –> put angle affected side down, go to posterior canal and cause stimulation –> delayed rotatory nystagmus

42
Q

What are symptoms of BPPV?

A
  • abrupt positional vertigo, 5-10 sec nystagmus latency
43
Q

How do you diagnose/treat BPPV?

A

diagnose: dix-hallpike maneuver
treat: particle repositioning

44
Q

What causes bilateral vestibular loss?

A

age related, head trauma, ahminoglycosides, infectious, inflammatory

45
Q

What symptoms of bilateral vestibular loss?

A
  • ataxia, oscillopsia [perception of oscillating vision]

- no true vertigo

46
Q

what is treatment for bilateral vestibular loss?

A

vestibular rehab PT but poor prognosis

47
Q

hwo do you diagnose bilateral vestibular loss?

A

absent caloric response in both ears

48
Q

What are symptoms of migraine-associated vertigo?

A

motion sickness, photo/phono phonbia

resembles episodic ataxia syndrome

49
Q

how long does BPPV last?

A

seconds to minutes

50
Q

how long does bilateral vestibular loss last?

A

continuous

51
Q

how long does meniere’s syndrome last?

A

minutes to hours

52
Q

how long does acute unilateral vestibular lost last?

A

days to weeks

Brain and Behavior Exam 2 (21 decks)

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