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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
With this vestibular disorder, head movements will displace otocnia shift and send false signals to the brain
BPPV
26
Symptoms of BPPV are almost always precipated by a. a headache b. dizziness c. vertigo d. change in head position
change in head position
27
What is the most common cause of BPPV?
people under age 50 is head injury
28
BPPV is not associated with a migraine (true/false)
false
29
Diagnostic testing for BPPV is looking for
nystagmus
30
How can BPPV be treated? a. medication b. surgery c. Epley maneuver d. it is untreatable
Epley maneuver
31
What is the goal with maneuvers for treating BPPV?
move the detached otoconia out of one of the semicircular canals
32
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
Perilymph Fistula
33
Fistulas may be present from birth (true/false)
true
34
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
Perilymph Fistula
35
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
Perilymph Fistula
36
How is Perilymph Fistula diagnosed?
tympanotomy and viewing the suspected fistula
37
How is Perilymph Fistula treated? a. Epley maneuver b. medications c. rest then surgery if severe d. exercises
rest then surgery if severe
38
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
Labrinthitis/Vestibular Neuritis
39
Infections of the inner ear are usually _
viral
40
Which disorder affects the vestibular branch of the vestibulocochlear nerve, results in dizziness or vertigo but no change in hearing?
Neuritis
41
Which disorder occurs when an infection affects both branches of the nerve, results in hearing changes as well as dizziness or vertigo?
Labyrinthitis
42
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
Neuritis
43
The difference between Neuritis and Labyrinthitis is that symptoms include tinnitus and hearing loss
Labyrinthitis
44
Labyrinthitis is a (gradual/sudden) onset of dizziness during daily activities
sudden
45
People can be completely free of symtpoms after several weeks with Labyrinthitis/Neuritis (true/false)
true
46
Test to diagnose Labyrinthitis/Neuritis a. Epley b. dix-hall pike c. MRI d. none
none
47
How is Labyrinthitis/Neuritis treated? a. surgery b. medication c. exercises d. rest
medication
48
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
Endolymphatic Hydrops
49
Secondary Endolymphatic hydrops occur because a. no reason b. trauma or underlying condition c. environmental factors d. none of the above
trauma or underlying condition
50
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
Endolymphatic Hydrops
51
What may precede a Meniere's disease attack?
fullness | hearing fluctuating or changes in tinnitus
52
An episode or attack of Endolymphatic Hydrops involves
``` severe vertigo imbalance nausea vomiting acute reduction in hearing ```
53
An average attack for Endolymphatic Hydrops is a. 2 days b. 1 hour c. 3-5 hours d. 2-4 hours
2-4 hours
54
After an attack from _, patients feel they are exhausted and need sleep for hours
Endolymphatic Hydrops
55
During an attack of Endolymphatic Hydrops, nystagmus cannot be seen (true/false)
false
56
There is a large amount of variability in _ | can experience _ or _ _
Endolymphatic Hydrops shocks invisible hand
57
Patients with Endolymphatic Hydrops are highly sensitive to _ stimuli a. auditory b. vibration c. vestibular d. visual
visual
58
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
Acoustic Neuroma
59
What can be affected with Acoustic Neuroma? a. hearing and vision b. vision and balance c. hearing and balance d. vision and proprioception
hearing and balance
60
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
Acoustic Neuroma
61
How is Acoustic Neuroma treated? a. medication b. exercises c. microsurgery or radiation d. Epley maneuver
microsurgery or radiation
62
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
Ototoxicity
63
Ototoxicity can result in _ or _ disturbances of _ or _
temporary or permanent | hearing or balance (or both)
64
What are common causes of ototoxicity
``` aminoglycoside antibiotics anti-neoplastics environmental chemicals loop diuretics aspirin and quinine products ```
65
Symptoms of ototoxicity (vary/consistent)
vary
66
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
Ototoxicity
67
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
Ototoxicity
68
Is there a specific test for Ototoxicity?
no
69
how is ototoxicity treated? a. surgery b. reduce effects of damage and rehabilitating function c. medications d. untreatable
reduce effects of damage and rehabilitating function
70
What is the goal of Physical therapy for a patient with ototoxicity?
help balance | habituation exercises
71
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
Mal de Debarquement
72
What is the theory of Mal de Debarquement
balance areas of the brain adapts to motion of ship or other vehicle brain unable to readapt once again
73
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
Mal de Debarquement
74
with Mal de Debarquement symptoms _ in closed spaces and when _
increase | motionless
75
with Mal de Debarquement symptoms _ during _ movement
improve | steady (moving car)
76
symptoms of Mal de Debarquement do not include
``` spinning vertigo vomiting cold seat ear pressure ear pain sound sensitivity tinnitus hearing loss of distortion double vision or bouncing vision ```
77
When do symptoms of Mal de Debarquement begin?
within hours of stopping the novel movement
78
When do symptoms of Mal de Debarquement stop?
6-12 months
79
to diagnose Mal de Debarquement there must be a history of
ship voyage - return to normal - start of symptoms
80
Do symptoms start immediately or weeks/months later after ship voyage?
immediately
81
How is Mal de Debarquement treated? a. surgery b. manuever c. habituation and drugs d. medication
habituation and drugs
82
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
Vestibular Migraine
83
_ can occur before, during or separate from episodes of migrainous headaches a. dizziness b. nausea c. vertigo d. unsteadiness
vertigo
84
Vestibular syndromes caused by migraines can be caused by (adults)
recurrent vertigo of adults | occasionally with tinnitus but without hearing loss
85
Vestibular syndromes caused by migraines can be caused by (child)
vertigo of childhood consists of spells or imbalance and vertigo without hearing loss or tinnitus
86
This is described as a migraine with aura associated with a stroke and one symptom may be vertigo
migrainous infarction or complicated migraine
87
What symptoms are experienced with a vestibular migraine?
vertigo usually with a headache/migraine symptoms | motion sensitivity/motion sickness
88
How are vestibular migraines treated?
``` changing diet reducing stress and anxiety control blood sugar and hormone function stop smoking medications ```
89
For this disorder, neck pain normally accompanies dizziness
cervicogenic dizziness
90
How is cervicogenic dizziness diagnosed?
no test confirms
91
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
cervicogenic dizziness
92
What type of injury can cause cervicogenic dizziness?
whiplash or head injury
93
cervicogenic dizziness is seen with what type of injury?
brain injury or injury of the inner ear
94
How do you treat cervicogenic dizziness?
treatment of neck problem
95
How do you select habituation treatments?
based on results of the exam | movement that brings on symptoms but not to the point of making them sick
96
How much should symptoms of dizziness be increased with habituation exercises?
2 points
97
How often should exercises be performed?
15-30 minutes | 2-3 times/day
98
What are Cawthorne Cooksey movements in bed or sitting that can be done?
eye movements | head movements
99
How do you progress head movements?
slow, then quick, later with eyes closed
100
What Cawthorne Cooksey movements can be done sitting?
shoulder shrugging and circling | bending forward and picking up objects from the ground
101
What Cawthorne Cooksey movements can be done standing?
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
The _ and more _ exercise is carried out, the faster and more _ will be the return to normal activity
earlier regularly complete
103
For patients with reduced vestibular function, what exercises can be done?
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
In-phase ocular tracking the patient will
attempt to track objects that are moving with their heads
105
in phase encourages to _ their _ system
desensitize vestibular system
106
counter-phase ocular tracking the patient will
attempt to track objects that are moving in counter-phase to their heads
107
Which type of disorder is ocular tracking useful for?
Menieres disease
108
dynamic balancing exercises are not appropriate for all vestibular disorders (true/false)
false
109
What is the difference in symptoms between Labryinthitis and Neuritis?
Labryinthitis - change in hearing (loss) | Neuritis - difficulty with vision
110
What substances are related to Ototoxicity?
antibiotics anti-cancer loop diuretics aspirin
111
The vestibulo-ocular reflex is the most effective at detecting a complete loss in
peripheral sensory apparatus
112
Semicircular canals and Otolithis are apart of what system a. peripheral sensory apparatus b. central processing system c. motor output system
peripheral sensory apparatus
113
The VOR produces eye movement (same/opposite) the direction of the head
opposite

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