Vestibular

Question 1

What are the roles of the vestibular system?

Answer 1

stabilize visual image during head movement
provide sensory information for spatial orientation
maintain postural stabillity when stationary and during movement

Question 2

what is postural control

Answer 2

control’s the body’s position in spce for stability and orientation between body segments and the environement

Question 3

what is postural stability

Answer 3

maintenace of the COM over the BOS

Question 4

what is postural orientation

Answer 4

ability to maintain relationship between body segments and between body and environment for a task

Question 5

What are the sesory input systems

Answer 5

visual
vestibular
somatosensory

Question 6

What are the motor output systems

Answer 6

VOR- vestibulo ocular reflex
VCR- vestibulo collic reflex
VSR- vestibulo spinal reflex

Question 7

what plane is the utricle

Answer 7

horiontal

Question 8

what plane is the saccule

Answer 8

vertical

Question 9

the urticle and saccules form…

Answer 9

the otolith

Question 10

what do the otoconia do?

Answer 10

provide shear forces for hair cell deflecion

Question 11

What do the otoliths do?

Answer 11

linear motion detection
tonic discharge
push/pull relationship

Question 12

What do the semicircular canals do?

Answer 12

angular motion detection
tonic discharge
push/pull relationship

Question 13

What does the thalamus do to contribute to postural control?

Answer 13

assists in discrimination between self and movement and environmental movement
multisensory integration for postural control

Question 14

What does the reticular formation do to contribute to postural control?

Answer 14

reticulospinal tract (RST) receives inpput from all vestibular nuclei

Question 15

what does the cerebellum contribute to postural controol?

Answer 15

interacts with LVST, MVST, RST
afferent impulse travel directly from the end organ to the cerebellum

Question 16

What is the vestibular cortex

Answer 16

junction of parietal and insular lobe
multisensory integration of vestibular information with somatosensation and vision

Question 17

What does the posterior inferior cerebellar artery (PICA) supply

Answer 17

the inferior vestibular nuclsupplies the inferior portion of the cerebellum

Question 18

What does the basilar artery supplu

Answer 18

supplies the pons and more superior vestibular nuclei

Question 19

What is the vestibular ocular reflex (VOR)

Answer 19

stabilizes gaze during head movement
VOR is intact and mature by 1 y.o.

Question 20

What is the vestibulo-spinal reflex (VSR)

Answer 20

coordinates the head and body movements to maintain head in upright position
LVST- adjusts limb movement for balance
MVST-cervial connections, branches to extrocular muscles

Question 21

What is the vestibulocollic reflex (VCR)

Answer 21

head righting– stabilizes the head and neck
produces coordinated movements to track a moving target

Question 22

What is a whiplash injury

Answer 22

common with flexion extension injury
20% experience dizziness
primary symptom is neck pain

Question 23

Common findings of cervicogenic dizziness

Answer 23

occipital or bitemporal HA
nekc pain
head is not straight
decreased ROM
dizziness
sensation of fallin
difficulty reading
feeling tired

Question 24

What is cervical vertigo

Answer 24

dizziness — an unpleasant and vague feeling involving spatial discomfort, unsteadiness, dullness
likely a proprioceptive cervical mechanism

Question 25

What are the three balance systems

Answer 25

somatosensory
vestibular
visual

Question 26

What are the ten vestibular functional classifications?

Answer 26

1. vestibular/somatosensory integration at rest
2. canal funciton
3. gaze stability
4. otolish function
5. impaired postural control
6. ooculomotor function
7. cervicogenic dizziness
8. visual motion hypersensitivity
9. somatosensory hypersensitivity
10. head position provoked dizziness

Question 27

What is the testing for vestibular/somatosensory integration at rest?

Answer 27

sensation of motion at rest.
sensation of motion when eyes are closed and body is stable
due to an asymmetry of info from inner ear

Question 28

What is an intervention for sensation of motion at rest

Answer 28

settling– mathcing the vestibulat/somatosensory inputs

Question 29

What is the test for canal function

Answer 29

head motion provioked dizziness
asymmetry of information from inner ear canals or brain

Question 30

What are interventions for canal function

Answer 30

habituation
rolling: eyes closed supine to prone
head turns/pitch eyes closed seated
standing spinning eyes closed
chair spins eyes closed

Question 31

Testing for gaze stability

Answer 31

VOR
head impulse test (eyes require catch up saccade to re focus)
dynamic visual acuity = gold standard (postive= >3lines of visual acuity
gaze stability with head turns (postive= blurred vision during head motion)

Question 32

What is otolith function

Answer 32

ability to utilize gravity sense to orient position

Question 33

What are otolith function test and interventions

Answer 33

head righting
tilt board/rocker
lateral reaching
tandem stance or tandem gait
2x4

Question 34

What is impaired postural control

Answer 34

vestibular referencing
somatosensory referencing
visual referencing

Question 35

What is impaired vestibulat referenncing

Answer 35

condition 4 of mCTSIB:
foam eyes closed

Question 36

What is impaired somatosensory referencing

Answer 36

feet together eyes closed
want to observe balance stratgeies
affects ankles or input through groun
condition 2 of MCTSIB

Question 37

What are interventions for impaired somatosensory referencing

Answer 37

weighted extremitites with function mobility
perturbations through ankles for ankle strategy– balnce rocker board
uneven surfaces

Question 38

What is somatosensory reliance test?

Answer 38

foam feet apart, eyes opne, hands at sides
if they are stiff, holding positiong
not able to be dynamic or lose balance they are reliant on somatosensory

Question 39

What is an intervention for somatosensory reliance

Answer 39

balance training on compliant, narrow or perturbed surface with cuing to decrease MM co-contraction
2x4 to promote hip strategy

Question 40

What is impaired visual referencing for postural control test and intervention

Answer 40

screen oculomotor for abnormalities

intervention –REFER

Question 41

What is visual relaince for postural control testins

Answer 41

compare feet together eyes closed to eyes open feet together test= should be similar
figur 8 test– (abnormal = sway pattern that follows thumb, indicates patient demonstrated visual dependence)

Question 42

What are visual reliance for postural control interventions?

Answer 42

balance tasks eyes closed
walking with head turns and pitch
figure 8’s
optokinetics

Question 43

What are the tests for oculomotor function

Answer 43

saccades
smooth pursuit
convergence/divergence
possible visual impairment
sccreen for central dysfunction causing sx

treat with testing

Question 44

What are the tests for cervicogenic dizziness

Answer 44

body rotation under stable head
laser= joint position error test— proprioception
motor control