Neurootology Flashcards
Which of the right ear pure tone audiograms shown below most resemble the pattern expected with Meniere’s disease?
c. Sensorineural hearing loss predominantly of the lower frequencies may be seen in Meniere’s disease
Vestibular schwannoma (acoustic neuroma) most commonly affects which one of the following nerves?
a. Cochlear nerve
b. Facial nerve
c. Inferior vestibular nerve
d. Superior vestibular nerve
e. Trigeminal nerve
d. Superior vestibular nerve
Vestibular-ocular reflex elicited during a right head turn is best described by which one of the following?
a. Relative motion between membranous labyrinth and endolymph causes right horizontal canal cupula to deflect towards the utricle with reflex movement of eyes to left with saccades to right 176
b. Relative motion between membranous labyrinth and endolymph causes left horizontal canal cupula to deflect towards the utricle with reflex movement of eyes to left with saccades to right
c. Relative motion between membranous labyrinth and endolymph causes right horizontal canal cupula to deflect towards
the utricle with reflex movement of eyes to left with saccades to left
d. Relative motion between membranous labyrinth and perilymph causes right horizontal canal cupula to deflect towards the utricle with reflex movement of eyes to left with saccades to right
e. Relative motion between membranous labyrinth and perilymph causes right horizontal canal cupula to deflect away from the utricle with reflex movement of eyes to right with saccades to right
a. Relative motion between membranous labyrinth and endolymph causes right horizontal canal cupula to deflect towards the utricle with reflex movement of eyes to left with saccades to right 176
In the brainstem auditory evoked response, which one of the following structures gives rise to wave V?
a. Cochlear nerve
b. Inferior colliculus
c. Lateral lemniscus
d. Superior olivary complex
e. Ventral cochlear nucleus
b. Inferior colliculus
A 25-year-old male had occasional difficulty in understanding speech over the telephone with his left ear. Brainstem auditory evoked
response is shown for both ears. Which one of the following is most likely?
a. Aminoglycoside toxicity
b. Gentamicin ototoxicity
c. Left acoustic neuroma
d. Right cochlear ischemia
e. Right glomus jugulare tumor
c. Left acoustic neuroma
In which one of the following situations is it NOT appropriate to use intraoperative brainstem auditory evoked response monitoring?
a. Basilar artery aneurysm surgery
b. Microvascular decompression of CN V
c. Posterior fossa surgery
d. Resection of acoustic neuroma in a deaf patient
e. Vestibular neurectomy for intractable tinnitus
d. Resection of acoustic neuroma in a deaf patient
Damage to hair cells in the basal turn of the cochlea is likely to result in which one of the following?
a. High frequency hearing loss
b. High-intensity hearing loss
c. Low-frequency hearing loss
d. Low-intensity hearing loss
e. Mid-frequency hearing loss
a. High frequency hearing loss
Which one of the following sites in the inner ear does gentamicin exert its ototoxic effect?
a. Apical turn of cochlea
b. Cochlear nerve
c. Hair cells
d. Macula densa
e. Striavascularis
c. Hair cells
A 34-year-old female presents with a HouseBrackmann grade IV facial palsy. Which one of the following best describes the clinical
findings?
a. Complete facial paralysis
b. Obvious asymmetry (not disfiguring); noticeable synkinesis, contracture, or hemifacial spasm; complete eye closure with effort.
c. Obvious weakness or disfiguring asymmetry; normal symmetry and tone at rest; incomplete eye closure.
d. Only barely perceptible motion with asymmetry at rest
e. Slight weakness noticeable on close inspection; slight synkinesis
c. Obvious weakness or disfiguring asymmetry; normal symmetry and tone at rest; incomplete eye closure.
Which one of the following best describes the target region for an auditory brainstem implant?
a. Cochlear nucleus
b. Inferior colliculus
c. Inferior olivary nucleus
d. Superior olivary nucleus
e. Vestibular nucleus
a. Cochlear nucleus
A 35-year-old NF-2 patient has sensorineural hearing loss and paresthesia of the posterior aspect of his right ear canal. MRI shows a large cerebellopontine angle tumor. Compression of which one of the following best explains the altered sensation?
a. Facial nerve
b. Glossopharyngeal nerve
c. Inferior vestibular nerve
d. Superior vestibular nerve
e. Vagus nerve
a. Facial nerve
Which one of the following is most accurate
regarding caloric testing in the right ear?
a. Cold water irrigation causes endolymph in
lateral portion to become dense and fall
pulling the right horizontal canal cupula
away from the utricle, reducing the firing
rate and causes a nystagmus with fast
phase to the left.
b. Cold water irrigation causes endolymph in
lateral portion to become dense and fall
pulling the right horizontal canal cupula
away from the utricle, reducing the firing
rate and causes a nystagmus with fast phase
to the right.
c. Cold water irrigation causes perilymph in
lateral portion to become dense and fall
pushing the right horizontal canal cupula
towards the utricle, reducing the firing
rate and causes a nystagmus with fast
phase away from the stimulus.
d. Warm water irrigation causes endolymph
in lateral portion to become less dense and
fall pulling the horizontal canal cupula
away from the utricle, reducing the firing
rate and causes a nystagmus with fast
phase away from the stimulus.
e. Warm water irrigation causes perilymph
in lateral portion to become dense and fall
pulling the horizontal canal cupula away
from the utricle, reducing the firing rate
and causes a nystagmus with fast phase
away from the stimulus.
a. Cold water irrigation causes endolymph in
lateral portion to become dense and fall
pulling the right horizontal canal cupula
away from the utricle, reducing the firing
rate and causes a nystagmus with fast
phase to the left.
