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MISC > VESTIB > Flashcards

VESTIB Flashcards

1
Q

When the stereocilia bend toward the kinocilium, which of the following occurs?
I. Opening of cation channels resulting to receptor membrane depolarization
II. Nerve afferents from the hair cells transmit impulses with increasing rate of a several hundred per second
III. Filamentous attachments of the stereocilia become tensed in sequence
IV. Hyperpolarization of the receptor membrane occurs as the cation channels become closed
a. I and II
b. I, II, III
c. III and IV
d. IV only

A

b. I, II, III

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2
Q

The otolith organs of the peripheral vestibular system maintain equilibrium when the body is at rest. They also operate in detection of angular acceleration.
a. 1st statement is true; 2nd is false
b. 1st statement is false; 2nd is true
c. Both statements are true
d. Both statements are false

A

a. 1st statement is true; 2nd is false

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3
Q

Provides the primary control for many vestibular reflexes:
a. Cerebellum
b. Cerebral cortex
c. Basal ganglia
d. Brainstem

A

d. Brainstem

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4
Q

Brain detects head movement and direction through comparison of inputs between 2 vestibular systems
a. Tonic firing rate
b. Oculovestibular reflex
c. Push pull mechanism
d. None of these

A

c. Push pull mechanism

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5
Q

Which of the following structures is maximally sensitive to linear head movement in the vertical plane?
a. Macula of the utricle
b. Macula of the saccule
c. Crista ampullaris of the anterior semicircular duct
d. Crista ampullaris of the horizontal semicircular duct

A

b. Macula of the saccule

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6
Q

The vestibular nuclei need to relay signals to the _____________ for maintenance of postural control of the body:
a. Thalamus
b. Oculomotor nuclei
c. Vestibulospinal tract
d. Spinal nucleus

A

c. Vestibulospinal tract

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7
Q

Normal tonic firing rate of the vestibular system:
a. 60-80 spikes/sec
b. 30-60 spikes/sec
c. 70-100 spikes/sec
d. 110-150 spikes/sec

A

c. 70-100 spikes/sec

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8
Q

Central part of bony labyrinth
a. Vestibule
b. Semicircular canals
c. Cochlea
d. None of these

A

a. Vestibule

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9
Q

Part of the cerebellum involved in balance, specifically dynamic equilibrium:
a. Anterior lobe
b. Posterior lobe
c. Vermis
d. Flocculonodular lobe

A

d. Flocculonodular lobe

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10
Q

Which part of the peripheral vestibular system can predict that disequilibrium in an individual is going to occur during rapid, intricate, changing body movements?
a. Utricle
b. Saccule
c. Cochlea
d. Semicircular canals

A

d. Semicircular canals

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11
Q

Head rotation to the right will cause:
I. Excitation of right vestibular system
II. Excitation of left vestibular system
III. Inhibition of left vestibular system
IV. Inhibition of right vestibular system
a. I and II
b. II and IV
c. I and III
d. III and IV

A

c. I and III

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12
Q

Which of the following sensory systems of the sensory organization of balance has the fastest processing time for rapid responses?
a. Vestibular system
b. Visual system
c. Somatosensory system
d. All have equal processing times

A

c. Somatosensory system

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13
Q

Sensory organ important for signaling head orientation when the person is positioned upright:
a. Macula of the saccule
b. Macula of the utricle
c. Semicircular canals
d. Ductus cochlearis

A

b. Macula of the utricle

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14
Q

Which of the following head movements is primarily detected by the semicircular canals?
a. Sideways head tilt
b. Rapid lateral movement
c. Up-down movement
d. Turning around

A

d. Turning around

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15
Q

What structure causes the stereocilia to bend inside the maculae of the utricle and saccule?
a. Endolymph
b. Kinocilium
c. Otoconia
d. Cupula

A

c. Otoconia

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16
Q

Which of the following is/are TRUE of the static labyrinth?
a. Composed of the semicircular canals and the ampullae
b. Can predict impending disequilibrium and signals equilibrium centers to make anticipatory adjustments
c. Detect linear acceleration using the maculae sensory organs of the utricle and saccule
d. All of these

A

c. Detect linear acceleration using the maculae sensory organs of the utricle and saccule

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17
Q

A mechanism that generates rapid compensatory eye movements in the direction opposite the head rotation:
a. Vestibulospinal reflex
b. Tonic firing rate
c. Vestibulo-ocular reflex
d. Push-pull mechanism

A

c. Vestibulo-ocular reflex

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18
Q

Viral affectation of the vestibulocochlear nerve, along with the facial nerve, is termed as:
a. Infectious mononucleosis
b. Ramsay-Hunt syndrome
c. Bell’s palsy
d. Meniere’s disease

A

b. Ramsay-Hunt syndrome

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19
Q

The most common cause of unilateral vestibular hypofunction:
a. Acoustic neuroma
b. Vestibular neuritis
c. Multiple sclerosis
d. Perilymphatic fistula

A

b. Vestibular neuritis

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20
Q

Which of the following during gait assessment would present with pronounced ataxia?
a. BPPV
b. UVH
c. Central lesion
d. BVH

A

c. Central lesion

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21
Q

Most common vestibular pathology
a. BVH
b. UVH
c. BPPV
d. Cerebellar lesions

A

c. BPPV

22
Q

A peripheral vestibular pathology most commonly caused by ototoxicity
a. Unilateral vestibular hypofunction
b. Bilateral vestibular hypofunction
c. Benign paroxysmal positional vertigo
d. Central vestibular pathology

A

b. Bilateral vestibular hypofunction

23
Q

The following are causes of perilymphatic fistula:
a. Excessive pressure from deep-sea diving
b. Extremely loud noises
c. Blunt head trauma
d. All of these

A

d. All of these

24
Q

During assessment, a patient with vestibular pathology tests negative in the Romberg test, does not lose balance during single-limb standing, and has normal gait. However, the patient presents with slight unsteadiness when asked to turn the head while walking. This patient MOST likely has what condition?
a. Benign paroxysmal positional vertigo
b. Unilateral vestibular hypofunction
c. Bilateral vestibular hypofunction
d. Central vestibular pathology

A

a. Benign paroxysmal positional vertigo

25
Q

A patient is diagnosed with benign paroxysmal positional vertigo (BPPV). What intervention should the plan of care for this patient emphasize?
a. Habituation exercises using provocative positions and movements
b. Postural stability exercises in sitting using a therapy ball
c. Gaze stability exercises using horizontal head rotation (X1 viewing)
d. Epley maneuver

A

d. Epley maneuver

26
Q

This condition is defined as the sensation of being off balance. Typically, acute and chronic vestibular lesion will produce this manifestation.
a. Vertigo
b. Disequilibrium
c. Oscillopsia
d. Dizziness

A

b. Disequilibrium

27
Q

This is a subjective experience of motion of objects in the visual environment that are known to be stationary. This can occur with head movements in patients with vestibular hypofunction since the vestibular system is not generating an adequate compensatory eye velocity during the head motion.
a. Vertigo
b. Oscillopsia
c. Dizziness
d. Disequilibrium

A

b. Oscillopsia

28
Q

Primary complaint of patients with bilateral vestibular hypofunction:
a. Disequilibrium
b. Oscillopsia
c. Visual blurring
d. Gait ataxia

A

a. Disequilibrium

29
Q

Most commonly affected semicircular canal in BPPV:
a. Superior semicircular canal
b. Lateral semicircular canal
c. Posterior semicircular canal
d. Horizontal semicircular canal

A

c. Posterior semicircular canal

30
Q

This condition is defined as an illusion of movement. Patient may experience that they sense their environment is moving or that they see the environment moving.
a. Oscillopsia
b. Dysequilibrium
c. Vertigo
d. Dizziness

A

c. Vertigo

31
Q

A patient with acute Meniere’s disease may benefit from physical therapy; patients with perilymphatic fistula in most cases are typically contraindicated for PT.
a. 1st statement is true; 2nd is false
b. 1st statement is false; 2nd is true
c. Both statements are true
d. Both statements are false

A

b. 1st statement is false; 2nd is true

32
Q

Bilateral vestibular deficits result in the following, EXCEPT:
a. Disequilibrium
b. Oscillopsia
c. Postural instability
d. Skew deviation

A

d. Skew deviation

33
Q

A patient is recovering from surgical resection of an acoustic neuroma and presents with symptoms of dizziness, vertigo, horizontal nystagmus, and postural instability. To address these problems, what should the physical therapy plan of care incorporate?
a. Hallpike’s exercises to improve speed in movement transitions
b. Prolonged bedrest to allow vestibular recovery to occur
c. Strengthening exercises focusing on spinal extensors
d. Repetition of movements and positions that provoke dizziness and vertigo

A

d. Repetition of movements and positions that provoke dizziness and vertigo

34
Q

During cranial nerve examination of extraocular muscle function, a therapist notes that the patient has vertical nystagmus. The therapist suspect:
a. Central nervous system lesion
b. Lesion of optic nerve
c. Posterior canal BPPV
d. Acoustic neuroma

A

a. Central nervous system lesion

35
Q

A patient with left BPPV is noted to have cupulolithiasis as the mechanism of the condition. The patient is treated with the liberatory maneuver. The first part of the maneuver should include:
a. Rotation of the head to the left side while sitting, then shifting to right side-lying
b. Rotation of the head to the right side while sitting, then shifting to left side-lying
c. Rotation of the head to the left side while sitting, then shifting to left side-lying
d. Rotation of the head to the right side while sitting, then shifting to right side-lying

A

b. Rotation of the head to the right side while sitting, then shifting to left side-lying

36
Q

A patient is referred to physical therapy for vestibular rehabilitation. The patient presents with spontaneous nystagmus that can be suppressed with visual fixation, oscillopsia, and loss of gaze stabilization. Additional postural findings include intense disequilibrium, and an ataxic wide-based gait with consistent veering to the left. Based on these findings, the PT determines that the patient is MOST LIKELY exhibiting signs and symptoms of:
a. Benign paroxysmal positional vertigo (BPPV)
b. Acute unilateral vestibular dysfunction
c. Acoustic neuroma
d. Meniere’s disease

A

b. Acute unilateral vestibular dysfunction

37
Q

A patient has been suspected to have Ménière disease. Which of the following is/are possible causes of Ménière disease?
a. All of these
b. It is an autosomal dominant genetic disorder that weakens the membranous labyrinth of the inner ear.
c. The hair cells of the cochlea are altered to give the sensation of motion even at rest.
d. The otoliths dislodge, enter the semicircular canal, and stimulate the hair cells.
e. An inflammatory response increases fluid volume within the membranous labyrinth, causing it to rupture.

A

e. An inflammatory response increases fluid volume within the membranous labyrinth, causing it to rupture.

38
Q

A patient who had been dosed with aminoglycoside experienced serious side effects of ototoxicity. The following PT management is/are beneficial for this patient, EXCEPT:
a. Gaze stability exercises
b. Habituation training
c. Proprioceptive balance training
d. Use of night lights during evening

A

b. Habituation training

39
Q

Otoconia become adhered to a cupula, rendering it heavier than a surrounding endolymph
a. Canalithiasis
b. Cupulolithiasis
c. Meniere’s Disease
d. Acoustic Neuroma

A

b. Cupulolithiasis

40
Q

The primary diagnostic indicator used in identifying most peripheral and central vestibular lesions.
a. Nystagmus
b. Oscillopsia
c. Vertigo
d. Dizziness
e. Dysequilibrium

A

a. Nystagmus

41
Q

Involuntary, oscillating eye movement
a. Vertigo
b. Lightheadedness
c. Dysequilibrum
d. Nystagmus
e. Oscillopsia

A

d. Nystagmus

42
Q

Presence of free-floating otoconia inside the semicircular canals
a. Canalithiasis
b. Cupulolithiasis
c. Meniere’s disease
d. Acoustic neuroma

A

a. Canalithiasis

43
Q

Most common positional test used to examine BPPV
a. Dix-Hallpike test
b. Sharpened Romberg test
c. VEMP
d. Head impulse test

A

a. Dix-Hallpike test

44
Q

Normal saccadic and smooth pursuit eye movements, but with presence of nystagmus during positional testing
a. Central vestibular pathology
b. Peripheral vestibular pathology
c. Both
d. None of these

A

b. Peripheral vestibular pathology

45
Q

Acute vertigo that cannot be suppressed by visual fixation
a. Central vestibular pathology
b. Peripheral vestibular pathology
c. Both
d. None of these

A

a. Central vestibular pathology

46
Q

Severe ataxia with incoordination
a. Central vestibular pathology
b. Peripheral vestibular pathology
c. Both
d. None of these

A

a. Central vestibular pathology

47
Q

Sudden onset of permanent hearing loss
a. Central vestibular pathology
b. Peripheral vestibular pathology
c. Both
d. None of these

A

a. Central vestibular pathology

48
Q

Horizontal, jerk nystagmus
a. Central vestibular pathology
b. Peripheral vestibular pathology
c. Both
d. None of these

A

b. Peripheral vestibular pathology

48
Q

Altered consciousness with lateropulsion
a. Central vestibular pathology
b. Peripheral vestibular pathology
c. Both
d. None of these

A

a. Central vestibular pathology

49
Q

Tinnitus and sensation of fullness in the ear
a. Central vestibular pathology
b. Peripheral vestibular pathology
c. Both
d. None of these

A

b. Peripheral vestibular pathology

MISC (6 decks)

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