Vestib Unit 1 Review Flashcards
How common is dizziness?
Second most common complaint after LBP in adults
Who is more commonly affected by vestibular symptoms
Women
Vestibular rehab uses what concept to retrain the brain
neuro-plasticity
What is vertigo
False sense of movement
How are the semi-circular canals paired?
R anterior w/ L posterior
R Horizontal w/ L horizontal
R posterior w/ L anterior
The semicircular canals sense what kind of movements?
The otolithic organs (utricle and saccule) sense what kind of movement?
Rotational
Linear
How does the semicircular canal detect movement
Endolymph moves over haircells in the paired semicircular canals on each side
on one side it causes an excitatory signal, on the opposite side it causes an inhibitory signal
What does the Vestibulo-ocular reflex do?
Keeps eyes locked on target when head moves
What does the vesibulospinal reflex do?
Maintains head and body equilibrium
What is the most common peripheral vestibular condition
BPPV
How does BPPV happen?
An otoconia becomes dislodged from utricle and saccule and floats into the semi-circular canal, causing a sense of movement as it falls through the canal due to gravity
How do the symptoms of BPPV present
Brief vertigo 10-60s caused by changes of head position against gravity
Canalithiasis vs Cupulolithiasis
Both forms of BPPV
Canal- normal BPPV
Cupulolithiasis has more immediate onset and intensity of symptoms of more intense and constant. (rare)
What normally causes neuritis?
Viral infections
Neuritis vs labyrinthitis
what are the symptoms of both?
Neuritis has no hearing loss
labyrinthitis has hearing loss
Sudden onset of vertigo, lasts 3-7 days and can resolve in 2 weeks. Often follows respiratory infection
What is vestibular hypofunction?
Diminished or weak neurological signal from vesibular system
can cause postural instability, gaze instability, dizziness, motion sensitivity, kinesiophobia
How does an acoustic neuroma present
Benign slow growing tumor of myelin sheath
causes gradual onset of unilateral hearingloss, tinnitus, imbalance, motion-sensitivity
What is meniere’s disease
AKA Endolymphatic hydrops
Build up of fluid within inner ear causing increased pressure
Meniere disease presentation
Reoccuring episodes of vertigo lasting 1-3 days wtith gradual improvement over 1-2 weeks
low frequency hearing loss
What is a fistula/Dehiscence
Structural hole in inner ear causing constant pressure changes
causes reoccuring spells of vertigo
What is the cause of PPPD
how long must symptoms be present to qualify as PPPD
abnormal adaptation following vestibular trauma
has to last more than 3 months
What is MDDS (Mal de Debarquement)
mal-adaptation following disembarking a moving vehicle
associated w/ anxiety
Vestibular migraine
Reoccuring episodes of vertigo associated w/ headache, photophobia, phonophobia, and anxiety
can last 1-5 days
What is the most important part of the assessment of vestibular symptoms
subjective interview
When screening patients w/ dizziness what is it important to rule out
CNS problems
Cardiovascular problems
Nystagmus is named for the ____ Phase
fast
What causes the slow phase of nystagmus?
What causes the fast phase?
VOR
Corrective Saccades
Nystagmus caused by peripheral systems usually presents how?
Usually horizontal
Decreases intensity w/ fixation
Does not change sides
What is alexander’s law?
Peripheral nystagmus increases intensity if you gaze towards the fast phase
How does central nystagmus present?
Can change directions
not affected by fixation
Can be horizontal or vertical
What are the advantages of frenzel and infared goggles
takes away ability to fixate allowing medical team to see nystagmus
What is the VNG/ENG nystagmography
includes infrared goggles, video recording
electrodes on eye muscles
uses calorics (hot and cold air in the ear)
Gold standard for identifying unilateral vestibular hypofunction
What is the gold standard for identifying bilateral vestibular hypofunction
Rotary chair
What is included in the peripheral vestibular system
Inner ear
8th cranial nerve
If you turn your head to the left, which side semicircular canal is excitatory and which is inhibitory
L horizontal is excitatory
R Horizontal is inhibitory
