Tests for Vestibular

Question 1

positive weber test

Answer 1

sound lateralizes positive for ipsilateal conductive loss
contralateral sensorineural loss

Question 2

positive rinne test

Answer 2

helps further confirm conductive loss

Question 3

1st degree of alexanders law

Answer 3

only present when gaze directed towards fast phase

Question 4

2nd degree of alexanders law

Answer 4

present in primary gaze and when directed towards fast phase

strongest in fast phase

Question 5

3rd degree alexanders law

Answer 5

present in all gazes

strongest in fast phase

Question 6

optokinetic nystagmus

Answer 6

involuntary nystagmus
works synergistically with VOR
normal function should cause nystagmus

Question 7

VOR testing

Answer 7

passively moving pt through horizontal canals at 30 deg below horizontal while maintaining gaze at nose

Question 8

abnormal findings of VOR testing

Answer 8

corrective saccade
nystagmus

Question 9

head thrust / head impulse test abnormal response

Answer 9

corrective saccade and/or post-thrust nystagmus

Question 10

when is sensitivity at max with the head thrust/head impulse test

Answer 10

unpredictable head thrusts
fq >2Hz and velocity of >180 deg/sec
maintaining head positioning 30 deg below neutral

Question 11

head shake test steps

Answer 11

fixation removed (close eyes)
120 bpm head shaking horizontal for 20s
keep eyes closed, therapist passively opens one eye and assess nystagmus

Question 12

abnormal result for head shake test

Answer 12

> 3 beats of nystagmus considered significant for unilateral vestibular dysfunction
horizontal nystagmus beating away from involved ear

Question 13

if you see vertical nystagmus following head shake test, what does that mean

Answer 13

central vestibular pathology

Question 14

dynamic visual acuity is what

Answer 14

functional challenge to VOR

obtain baseline
2 cycles/sec
horizontal and vertical fields

Question 15

what is the DVA better able to identify

Answer 15

dysfunction in subacute and chronic vestibular disorder

Question 16

DVA results

Answer 16

> 3 line degradation is significant

Question 17

what does skew deviation assess for

Answer 17

vertical dysconjugate gaze

Question 18

what is skew deviation predictor for

Answer 18

central vestibular path

Question 19

skew deviation abnormal response

Answer 19

deviation of one eye while it is being covered, followed by correction after uncovering it

Question 20

VOR evaluates what

Answer 20

cerebellar control

Question 21

abnormal results of VOR cancellation

Answer 21

ipsi corrective saccades

Question 22

what are the three tests involved in HINTS

Answer 22

head impulse test
nystagmus observation
test of skew

Question 23

what is the HINTS test used for

Answer 23

acute vestibular symptoms

Question 24

what does INFARCT stand for

Answer 24

for CNS Dx:

impulse
negative

fast phase
alternates

repositions with
cover
test

Question 25

the clinical test of sensory organization and balance is what

Answer 25

assess sensory contributions to postural control
involves observation of pt’s attempt to maintain balance

Question 26

CTSIB 6 conditions

Answer 26

firm, eyes open (E, S, V)
firm, eyes closed (S, V)
firm, visual conflict (S, V)

foam, eyes open (E, V)
foam, eyes closed (V)
foam, visual conflict (V)

Question 27

gans sensory organization performance test

Answer 27

modified romberg
CTSIB
fakuda step test

Question 28

fakuda step test

Answer 28

50 steps eyes closed

moves 0.5m or 30 deg = uncompensated peripheral vestibular dysfunction

Question 29

mini BESTest

Answer 29

observing anticipatory and reactive control, sensory organization and dynamic gait

Question 30

MCID of minibest

Answer 30

4

Question 31

BESS test

Answer 31

initially concussions and return to play - vestibular dysfunction

6 conditons, eyes closed for all, 20 seconds

measuring # of errors - max 10

Question 32

BESS test MCID

Answer 32

3

Question 33

computerized posturography: sensory organization testing

Answer 33

manipulate diff balance inputs to see how much person relies on
identifies malingering pt’s

Question 34

computerized posturography: sensory organization testing levels

Answer 34

fixed support: normal vision, absent vision, sway vision

sway reference support: normal vision, absent vision, sway vision