Remade vestib for my own purposes - alex

Question 1

What is the fastest sense, and the first line of defense against falls?

Answer 1

Somatosensory system

Question 2

When you rotate your head one way, the endolymph moves ___________

Answer 2

in the opposite direction

Question 3

How is the horizontal semicircular canal positioned?

Answer 3

30 degrees off of 0

Question 4

When you move your head to the right, the VOR activates the Right side ____________ and the left side ____________ nerves to move the eyes to the left

Answer 4

right side occulomotor (ipsilateral to head movement direction)

left side abducens (contralateral to headmovement direction)

Note: the opposite nerves are inhibited

Question 5

Movement that bends hair cells towards the kinocilium ____________, movement that bends hair cells away from kinocilium _____________

Answer 5

causes activation

causes deactivation

Question 6

The semicircular canals detect ________

Answer 6

angular acceleration

Question 7

Which semicircular canal detects pitching your head foward?

Answer 7

Anterior

Question 8

which semicircular canal detects pitching your head back?

Answer 8

Posterior

Question 9

Which semicircular canal detects shaking your head left to right?

Answer 9

horizontal

Question 10

The anterior L semicircular canal is paired w/ the

Answer 10

R posterior semicircular canal

Question 11

The L horizontal semicircular canal is paired w/ the

Answer 11

right horizontal semicircular canal

Question 12

When you turn your head to the left, the displacement is _________the center of head and cupula on the left, and _________ the center of the head and cupula on the right

Answer 12

Towards the center on the left, activating the cupula

Away from the center on the right, deactivating/hyperpolarizing the R side

Question 13

Both the utricle and saccle sense linear acceleration

the Utricle senses what direction?

The saccule senses what direction?

Answer 13

Utricle - Horizontal

Saccule - Vertical

Question 14

What does the VOR do?

Answer 14

maintains gaze during headmovement keeping eyes fixed on target

Question 15

What does the vestibulospinal reflex do?

Answer 15

Maintain head and body equilibrium

Question 16

What reflex is taught as a substitution when patient is missing VOR

Answer 16

Cervical Occular reflex

-alters head position on body to maintain gaze stability

Question 17

What is the most common peripheral vestibular dysfunction

Answer 17

BPPV

Benign paroxysmal positional vertigo

Rocks go into semicircular canal from utricle or saccule

Question 18

What canal most commonly is affected by BPPV

Answer 18

Posterior semicircular

Question 19

How long does the vertigo last w/ BPPV

Answer 19

Brief 10-60 seconds w/ change in head position against gravity

Question 20

Nystagmus is _______ for BPPV in the PSCC, but the condition is named for it’s ________ component that indicates whether it’s the R or the L affected

Answer 20

Upbeat (eyes go fast upward then drift back down)

Rotary

Question 21

What is cupulolithiasis

This conditon presents with ________ onset of vertigo

Does the vertigo eventually go away or not?

Answer 21

Otoconia adhere to cupula in PSCC

An immediate onset of vertigo

Persistence of vertigo the entire time the head is held in provoking posiition

Question 22

What is Canalithiasis

This condition presents with ________ onset of vertigo

Does the vertigo eventually go away or not?

Answer 22

Otoconia are free floating in the long arm of the canal

Latent onset (delayed) after head movement in provoking position

yes, Fluctuating insensity that eventually goes away when the otoconia settle

Question 23

What is more common: cupulolithiasis or Canalithiasis

Answer 23

Canalithiasis

Question 24

Neuritis - vestib nerve inflammation

Labyrinthitis - inner ear inflammation

which one causes hearing loss and tinnitus?

Answer 24

Labyrinthitis

Neuritis often causes vestibular nerve hyperstimulation

Question 25

What is the hallmark of neuritis and labyrinthitis

Answer 25

direction fixed nystagmus and if it occurs in 1st 2nd or 3rd degrees of gaze

Note: first rule out central causes

Question 26

Nystagmus is named for the _______________

Answer 26

Fast component

Nystagmus always has a fast and a slow component

Question 27

What are the 4 kinds of pathological nystagmus?

Answer 27

Spontaneous

Positional

Gaze evoked

Congenital

Question 28

2 kinds of positional nystagmus

Torsional/rotary: Likely a ________ problem like BPPV

Downbeat/upbeat: Likely a ___________ problem

Answer 28

peripheral

Central

Question 29

Nystagmus is normally named by fast phase, but what is the exception?

Answer 29

BPPV where it’s named for rotary component

Question 30

For peripheral problems:

The slow phase of nystagmus is caused by ____

The fast phase of nystagmus is caused by ______

Answer 30

VOR

Corrective saccades

Question 31

Central nystagmus will have what 2 systems moving the eyes:

Peripheral nystagmus will have what 2 systems moving the eyes:

Answer 31

Central- Smooth pursuit and saccades

Peripheral: VOR and Saccades

Question 32

How can a patient suppress nystagmus? (Peripheral nystagmus only)

Answer 32

fixating on object in well lit room

Question 33

How is nystagmus best examined?

Answer 33

Frenzel or Infared video goggles

Question 34

How to identify central nystagmus from peripheral?

Answer 34

Central nystagmus can change direction (Beats R if you look L, beats L if you look R).
* Not suppressed by fixation on object.

Peripheral: always same direction (always beats L if its L nystagmus, even if you look left).
* Can be suppressed by fixation on object.

Question 35

Peripheral nystagmus is usually _______

Answer 35

horizontal R or L

decreases intensity w/ fixation

gazing towards the fast phase increases the intensity