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Neuro 1 > Vestibular > Flashcards

Vestibular Flashcards

1
Q

Which vestibular system includes the inner ear and functions to detect and relay info about velocity of the head?

a. peripheral sensory apparatus
b. central processing system
c. motor output system
d. none of the above

A

peripheral sensory apparatus

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2
Q

Which vestibular system includes the brainstem, cerebellum, cerebral cortex and functions to receive info from the inner ear along with other sensory info and processes that info?

a. peripheral sensory apparatus
b. central processing system
c. motor output system
d. none of the above

A

central processing system

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3
Q

Which vestibular system includes the VOR and VSR and functions to generate compensatory eye and body movements?

a. peripheral sensory apparatus
b. central processing system
c. motor output system
d. none of the above

A

motor output system

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4
Q

Which system includes the semicircular canals and otoliths?

a. peripheral sensory apparatus
b. central processing system
c. motor output system
d. none of the above

A

peripheral sensory apparatus

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5
Q

Within the semicircular canals, hair cells in the _ convert mechanical information into neural firing

A

cupula

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6
Q

What are the 3 semicircular canals?

a. anterior, medial and lateral
b. posterior, medial and vertical
c. anterior, posterior and horizontal
d. posterior, horizontal and medial

A

anterior, posterior and horizontal

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7
Q

The semicircular canals function to detect _

A

rotation

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8
Q

Horizontal semicircular canals function to detect _ movement

A

front and back head movement

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9
Q

What is detected in the frontal plane?

A

side to side head movement

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10
Q

Which canal is most likely to get debris in it?

a. anterior
b. posterior
c. horizontal

A

posterior

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11
Q

the utricle and saccule can detect _ _

A

linear acceleration

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12
Q

Within the Otoliths, hair cells in the _ convert mechanical information into neural firing

A

macula

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13
Q

The central processing system is controlled by interconnections between

A

brainstem (thalamus, vestibular nuclei, retinacular formation)
cerebellum
cerebral cortex (portions of parietal and insular lobes)

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14
Q

Which system is responsible for reflexive eye movement that stabilizes images on the retina during head movement?

a. vestibulo-ocular reflex
b. vestibulo-spinal reflex
c. central processing system
d. peripheral sensory apparatus

A

vestibulo-ocular reflex

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15
Q

The VOR produces eye movement in the direction (opposite/same) to head movement

A

opposite

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16
Q

Which system is responsible for controlling the head movement and stabilizing the body?

a. vestibulo-ocular reflex
b. vestibulo-spinal reflex
c. central processing system
d. peripheral sensory apparatus

A

vestibulo-spinal reflexes (VSR)

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17
Q

The VSR utilizes input from the _ system

A

peripheral sensory apparatus

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18
Q

The VSR assists in the control of _ alignment in relationship to gravity and body _ responses

A

head

postural

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19
Q

Which of the following is classified as a mechanical vestibular disorder?

a. Acoustic neuroma and Ototoxicity
b. BPPV and Perilymph Fistula
c. Vestibular migraine and Mal de Debaruement
d. Cervicogenic Dizziness and BPPV

A

BPPV and Perilymph Fistula

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20
Q

What vestibular disorders are classified as altered receptor input?

A

Labyrinthitis/Vestibular Neuritis
Endolymphatic hydrops
Acoustic Neuroma
Ototoxicity

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21
Q

Which of the following is classified as a central vestibular disorder?

a. Acoustic neuroma and Ototoxicity
b. BPPV and Perilymph Fistula
c. Vestibular migraine and Mal de Debaruement
d. Cervicogenic Dizziness and BPPV

A

Vestibular migraine and Mal de Debaruement

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22
Q

Which of the following is classified as non-vestibular disorder?

a. Perilymph fistula
b. Ototoxicity
c. Mal de Debarquement
d. Cervicogenic Dizziness

A

Cervicogenic Dizziness

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23
Q

Which disorder can be described as having vertigo, dizziness and is due to debris that has collected within a part of the inner ear?

a. Ototoxicity
b. Perilymph fistula
c. Labyrinthitis/Vestibular Neuritis
d. BPPV

A

BPPV

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24
Q

the debris called _ is made of small crystals of _ _

A

otoconia

calcium carbonate

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25
Q

With this vestibular disorder, head movements will displace otocnia shift and send false signals to the brain

A

BPPV

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26
Q

Symptoms of BPPV are almost always precipated by

a. a headache
b. dizziness
c. vertigo
d. change in head position

A

change in head position

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27
Q

What is the most common cause of BPPV?

A

people under age 50 is head injury

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28
Q

BPPV is not associated with a migraine (true/false)

A

false

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29
Q

Diagnostic testing for BPPV is looking for

A

nystagmus

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30
Q

How can BPPV be treated?

a. medication
b. surgery
c. Epley maneuver
d. it is untreatable

A

Epley maneuver

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31
Q

What is the goal with maneuvers for treating BPPV?

A

move the detached otoconia out of one of the semicircular canals

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32
Q

Which of the following vestibular disorders is most commonly caused by head trauma, can be after rapid changes in intracranial pressure like scuba diving or weightlifting?

a. Ototoxicity
b. Perilymph fistula
c. Labyrinthitis/Vestibular Neuritis
d. BPPV

A

Perilymph Fistula

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33
Q

Fistulas may be present from birth (true/false)

A

true

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34
Q

Which of the following is a tear or defect in the oval window and it changes ear pressure stimulating balance and hearing structures?

a. Ototoxicity
b. Perilymph fistula
c. Labyrinthitis/Vestibular Neuritis
d. BPPV

A

Perilymph Fistula

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35
Q

This type of disorder has symptoms of dizziness, vertigo, imbalance, nausea, vomiting, ringing or fullness in the ears, hearing loss and patients symptoms get worse with changes in altitude, air pressure and activity?

a. Ototoxicity
b. Perilymph fistula
c. Labyrinthitis/Vestibular Neuritis
d. BPPV

A

Perilymph Fistula

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36
Q

How is Perilymph Fistula diagnosed?

A

tympanotomy and viewing the suspected fistula

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37
Q

How is Perilymph Fistula treated?

a. Epley maneuver
b. medications
c. rest then surgery if severe
d. exercises

A

rest then surgery if severe

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38
Q

Which disorder is a result of an infection that inflames the inner ear or the vestibulo-cochlear nerve?

a. Ototoxicity
b. Perilymph fistula
c. Labyrinthitis/Vestibular Neuritis
d. BPPV

A

Labrinthitis/Vestibular Neuritis

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39
Q

Infections of the inner ear are usually _

A

viral

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40
Q

Which disorder affects the vestibular branch of the vestibulocochlear nerve, results in dizziness or vertigo but no change in hearing?

A

Neuritis

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41
Q

Which disorder occurs when an infection affects both branches of the nerve, results in hearing changes as well as dizziness or vertigo?

A

Labyrinthitis

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42
Q

Symptoms can be mild or severe, vertigo, nausea, vomiting, unsteadiness and imbalance, difficulty with vision and impaired concentration

a. Neuritis
b. Labyrinthitis
c. Ototoxicity
d. BPPV

A

Neuritis

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43
Q

The difference between Neuritis and Labyrinthitis is that symptoms include tinnitus and hearing loss

A

Labyrinthitis

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44
Q

Labyrinthitis is a (gradual/sudden) onset of dizziness during daily activities

A

sudden

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45
Q

People can be completely free of symtpoms after several weeks with Labyrinthitis/Neuritis (true/false)

A

true

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46
Q

Test to diagnose Labyrinthitis/Neuritis

a. Epley
b. dix-hall pike
c. MRI
d. none

A

none

47
Q

How is Labyrinthitis/Neuritis treated?

a. surgery
b. medication
c. exercises
d. rest

A

medication

48
Q

Which of the following is described as a disorder that produces a recurring set of symptoms as a result of abnormally large amounts of fluid called endolymph collecting?

a. Perilymph Fistula
b. Acoustic Neuroma
c. Endolymphatic Hydrops
d. BPPV

A

Endolymphatic Hydrops

49
Q

Secondary Endolymphatic hydrops occur because

a. no reason
b. trauma or underlying condition
c. environmental factors
d. none of the above

A

trauma or underlying condition

50
Q

This disorder has symptoms of vertigo, ringing or roaring in the ears (tinnitus), feeling of fullness or pressure in the ear and fluctuating hear loss

a. Perilymph Fistula
b. Acoustic Neuroma
c. Endolymphatic Hydrops
d. BPPV

A

Endolymphatic Hydrops

51
Q

What may precede a Meniere’s disease attack?

A

fullness

hearing fluctuating or changes in tinnitus

52
Q

An episode or attack of Endolymphatic Hydrops involves

A 
severe vertigo 
imbalance 
nausea
vomiting 
acute reduction in hearing
53
Q

An average attack for Endolymphatic Hydrops is

a. 2 days
b. 1 hour
c. 3-5 hours
d. 2-4 hours

A

2-4 hours

54
Q

After an attack from _, patients feel they are exhausted and need sleep for hours

A

Endolymphatic Hydrops

55
Q

During an attack of Endolymphatic Hydrops, nystagmus cannot be seen (true/false)

A

false

56
Q

There is a large amount of variability in _

can experience _ or _ _

A

Endolymphatic Hydrops
shocks
invisible hand

57
Q

Patients with Endolymphatic Hydrops are highly sensitive to _ stimuli

a. auditory
b. vibration
c. vestibular
d. visual

A

visual

58
Q

This disorder is a benign tumor on the vestibular portion of the 8th CN

a. Perilymph Fistula
b. Acoustic Neuroma
c. Endolymphatic Hydrops
d. BPPV

A

Acoustic Neuroma

59
Q

What can be affected with Acoustic Neuroma?

a. hearing and vision
b. vision and balance
c. hearing and balance
d. vision and proprioception

A

hearing and balance

60
Q

Symptoms of this disorder include one-sided hearing loss, tinnitus, period of unsteadiness or imbalance

a. Perilymph Fistula
b. Acoustic Neuroma
c. Endolymphatic Hydrops
d. BPPV

A

Acoustic Neuroma

61
Q

How is Acoustic Neuroma treated?

a. medication
b. exercises
c. microsurgery or radiation
d. Epley maneuver

A

microsurgery or radiation

62
Q

Which disorder is “ear poisoning” due to drugs or chemicals that damage the inner ear or the vestibularcochlear nerve?

a. Ototoxicity
b. Acoustic Neuroma
c. Endolymphatic Hydrops
d. BPPV

A

Ototoxicity

63
Q

Ototoxicity can result in _ or _ disturbances of _ or _

A

temporary or permanent

hearing or balance (or both)

64
Q

What are common causes of ototoxicity

A 
aminoglycoside antibiotics 
anti-neoplastics 
environmental chemicals 
loop diuretics
aspirin and quinine products
65
Q

Symptoms of ototoxicity (vary/consistent)

A

vary

66
Q

Symptoms of this disorder include headache, a feeling of ear fullness, imbalance to the point of being unable to walk and bouncing and blurring of vision

a. Perilymph Fistula
b. Acoustic Neuroma
c. Ototoxicity
d. BPPV

A

Ototoxicity

67
Q

Patients with this vestibular disorder have an inability to tolerate head movement, wide-based gait, difficulty walking in the dark, unsteadiness and actual unsteadiness while moving, lightheadedness and severe fatigue

a. Perilymph Fistula
b. Acoustic Neuroma
c. Ototoxicity
d. BPPV

A

Ototoxicity

68
Q

Is there a specific test for Ototoxicity?

A

no

69
Q

how is ototoxicity treated?

a. surgery
b. reduce effects of damage and rehabilitating function
c. medications
d. untreatable

A

reduce effects of damage and rehabilitating function

70
Q

What is the goal of Physical therapy for a patient with ototoxicity?

A

help balance

habituation exercises

71
Q

This disorder is an illusion of movement felt as an after affect of travel by ship or boat

a. Acoustic Neuroma
b. Mal de Debarquement
c. Ototoxicity
d. BPPV

A

Mal de Debarquement

72
Q

What is the theory of Mal de Debarquement

A

balance areas of the brain
adapts to motion of ship or other vehicle
brain unable to readapt once again

73
Q

Symptoms of this disorder include bobbing, rocking, swaying, floating, and/or tumbling, unsteadiness, disequilibrium, anxiety, difficulty concentrating and a loss of self-confidence

a. vestibular migraine
b. Mal de Debarquement
c. cervicogenic dizziness
d. BPPV

A

Mal de Debarquement

74
Q

with Mal de Debarquement symptoms _ in closed spaces and when _

A

increase

motionless

75
Q

with Mal de Debarquement symptoms _ during _ movement

A

improve

steady (moving car)

76
Q

symptoms of Mal de Debarquement do not include

A 
spinning vertigo
vomiting
cold seat
ear pressure
ear pain
sound sensitivity 
tinnitus
hearing loss of distortion 
double vision or bouncing vision
77
Q

When do symptoms of Mal de Debarquement begin?

A

within hours of stopping the novel movement

78
Q

When do symptoms of Mal de Debarquement stop?

A

6-12 months

79
Q

to diagnose Mal de Debarquement there must be a history of

A

ship voyage - return to normal - start of symptoms

80
Q

Do symptoms start immediately or weeks/months later after ship voyage?

A

immediately

81
Q

How is Mal de Debarquement treated?

a. surgery
b. manuever
c. habituation and drugs
d. medication

A

habituation and drugs

82
Q

This disorder is usually associated with a headache and can cause several vestibular syndromes

a. Vestibular Migraine
b. Cervicogenic Dizziness
c. BPPV
d. Mal de Debarquement

A

Vestibular Migraine

83
Q

_ can occur before, during or separate from episodes of migrainous headaches

a. dizziness
b. nausea
c. vertigo
d. unsteadiness

A

vertigo

84
Q

Vestibular syndromes caused by migraines can be caused by (adults)

A

recurrent vertigo of adults

occasionally with tinnitus but without hearing loss

85
Q

Vestibular syndromes caused by migraines can be caused by (child)

A

vertigo of childhood consists of spells or imbalance and vertigo without hearing loss or tinnitus

86
Q

This is described as a migraine with aura associated with a stroke and one symptom may be vertigo

A

migrainous infarction or complicated migraine

87
Q

What symptoms are experienced with a vestibular migraine?

A

vertigo usually with a headache/migraine symptoms

motion sensitivity/motion sickness

88
Q

How are vestibular migraines treated?

A 
changing diet 
reducing stress and anxiety
control blood sugar and hormone function 
stop smoking 
medications
89
Q

For this disorder, neck pain normally accompanies dizziness

A

cervicogenic dizziness

90
Q

How is cervicogenic dizziness diagnosed?

A

no test confirms

91
Q

Symptoms for this include worse during head movements or after maintaining one head position for a long time
dizziness after neck pain and a headache
imbalance that increases with head movement and movement of the environment

A

cervicogenic dizziness

92
Q

What type of injury can cause cervicogenic dizziness?

A

whiplash or head injury

93
Q

cervicogenic dizziness is seen with what type of injury?

A

brain injury or injury of the inner ear

94
Q

How do you treat cervicogenic dizziness?

A

treatment of neck problem

95
Q

How do you select habituation treatments?

A

based on results of the exam

movement that brings on symptoms but not to the point of making them sick

96
Q

How much should symptoms of dizziness be increased with habituation exercises?

A

2 points

97
Q

How often should exercises be performed?

A

15-30 minutes

2-3 times/day

98
Q

What are Cawthorne Cooksey movements in bed or sitting that can be done?

A

eye movements

head movements

99
Q

How do you progress head movements?

A

slow, then quick, later with eyes closed

100
Q

What Cawthorne Cooksey movements can be done sitting?

A

shoulder shrugging and circling

bending forward and picking up objects from the ground

101
Q

What Cawthorne Cooksey movements can be done standing?

A

eye, head and shoulder movements
sitting to standing with eyes open and shut
throwing a small ball from hand to hand
throwing a ball from hand to hand under knee
changing from sitting to standing and turning in between

102
Q

The _ and more _ exercise is carried out, the faster and more _ will be the return to normal activity

A

earlier
regularly
complete

103
Q

For patients with reduced vestibular function, what exercises can be done?

A

eye-head coordination exercises - combine movement of image on retina with head movement
start in sitting - progress to standing
various direction and speed
progress to busy background

104
Q

In-phase ocular tracking the patient will

A

attempt to track objects that are moving with their heads

105
Q

in phase encourages to _ their _ system

A

desensitize vestibular system

106
Q

counter-phase ocular tracking the patient will

A

attempt to track objects that are moving in counter-phase to their heads

107
Q

Which type of disorder is ocular tracking useful for?

A

Menieres disease

108
Q

dynamic balancing exercises are not appropriate for all vestibular disorders (true/false)

A

false

109
Q

What is the difference in symptoms between Labryinthitis and Neuritis?

A

Labryinthitis - change in hearing (loss)

Neuritis - difficulty with vision

110
Q

What substances are related to Ototoxicity?

A

antibiotics
anti-cancer
loop diuretics
aspirin

111
Q

The vestibulo-ocular reflex is the most effective at detecting a complete loss in

A

peripheral sensory apparatus

112
Q

Semicircular canals and Otolithis are apart of what system

a. peripheral sensory apparatus
b. central processing system
c. motor output system

A

peripheral sensory apparatus

113
Q

The VOR produces eye movement (same/opposite) the direction of the head

A

opposite

Neuro 1 (7 decks)

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