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Anatomy > Vestibular > Flashcards

Vestibular Flashcards

1
Q

what stimulates the vestibular system

A

linear/angular acceleration of head

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2
Q

what does vestibular stimulation cause to happen

A

clear vision with head movement
facilitate postural reflexes
orient body/head to vertical

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3
Q

types of input in the vestibular system

A

visual
vestibular
proprioceptive

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4
Q

what are the two areas that the sensory input in the vestibular system go to

A

vestibular nuclear complex
cerebellum

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5
Q

what makes up the peripheral vestibular system

A

inner ear
CN8 until brainstem

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6
Q

central vestibular system

A

nuclei and tracts in brain cortex
cerebellum
brainstem

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7
Q

what is not a part of the peripheral vestibular system

A

cochlea

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8
Q

what detects angular motion

A

semicircular canals

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9
Q

what are the names of the semicircular canals

A

anterior
posterior
horizontal

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10
Q

what is the ampula

A

enlargement at the end of each SCC

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11
Q

what are the otolith organs? what is another name for them

A

utricle and saccule

aka vestibule

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12
Q

what do the otolith organs detect

A

linear acceleration
static tilt of head

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13
Q

how are the canals oriented

A

orthogonal
- in the plane as the opposite canal on the other side

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14
Q

how are conjugate canals aligned

A

in optimal pulling directions of extraocular muscles

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15
Q

what is within the bony labyrinth

A

membranous labyrinth filled with endolymphatic fluid
hair cells

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16
Q

where are hair cells

A

cupula of the ampullae, utricle, saccule

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17
Q

how does endolymph fluid flow? what does this do?

A

opposite the direction of canal movement
deflects the ampulla’s cupula

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18
Q

where does vestibular nuclei relay info to

A

cerebellum
cerebral cortex
spinal cord
oculomotor muscles

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19
Q

what is abnormal vor sign on the head impulse test

A

eyes do not stay on target and need a saccade back to the target

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20
Q

describe nystagmus naming

A

fast phase

with specific direction, intensity and shape

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21
Q

what does the direction of nystagmus indicate

A

which inner ear and which structure is dysfunctioning

22
Q

what nystagmus suggests a central origin

A

pure vertical
pure torsional
direction changing

23
Q

how can nystagmus be changed

A

lighting in a room
- light = suppression of nystagmus because eyes can fixate on a target
- dark = eyes cannot fixate on a target

24
Q

what mostly causes dizziness

A

peripheral causes

25
Q

what causes vestibular system dysfunction

A

abnormal firing rate between L and R peripheral vestibular apparatus
impaired processing within CNS
damage to CNS

26
Q

symptoms of vestibular system dysfunction

A

sensation of motion (vertigo)
oscillopsia
dysequilibrium
motion sensitivity

27
Q

what are two things that indicate a central lesion other than nystagmus

A

lack of oscillopsia
severe headache

28
Q

what are the peripheral causes of vestibular dysfunction

A

BPPV
vestibular neuritis/neuroma
meniere’s disease
ototoxicity

29
Q

what are the central causes of vestibular dysfunction

A

stroke
MS
neoplasms

30
Q

what medical diagnoses result in vestibular hypofunction

A

vestibular neuritis
acoustic neuroma
meniere’s
ototoxicity

31
Q

what is BPPV

A

episodic, intense vertigo related to a change in head position

32
Q

what causes BPPV

A

otoconia becoming loose, clumping together and moving into SCC

33
Q

which canal does otoconia most typically move into

A

posterior

34
Q

what are symptoms of BPPV

A

brief episodes of vertigo (<60s) precipitated by head movement

35
Q

will nystagmus be seen with BPPV

A

yes

36
Q

what is the main cause of vestibular neuritis

A

upper respiratory infection
gastritis

37
Q

symptoms of vestibular neuritis

A

sudden onset 1-2 days, residual symptoms with head motion
vertigo
nausea
vomiting
intense dysequilibrium
oscillopsia

38
Q

sings of vestibular neuritis

A

nystagmus
abnormal VOR gain
– unilateral vestibular hypofunction

39
Q

what medical treatments are there for vestibular neuritis

A

anti-emetics, histamines, cholinergics
steroids

40
Q

prognosis of vestibular neuritis

A

6 weeks to 3 months

41
Q

what is acoustic neuroma

A

benign tumor within schwann cells of vestibular nerve sheath

42
Q

s/s of acoustic neuroma

A

hearing loss
dizziness
imbalance
– gradual onset / worsen as tumor grows

43
Q

medical management of acoustic neuroma

A

surgery

44
Q

what is meniere’s disease

A

malabsorption of endolymph fluid – increased fluid volume

45
Q

s/s of meniere’s

A

fullness feeling
tinnitus
fluctuating vertigo
hearing loss
imbalance
episodic - minutes to hours

46
Q

medical treatment of meniere’s

A

diuretics
diet-sodium restriction
shunt or ablation of vestibular nerve

47
Q

where is the damage from ototoxicity

A

bilaterally

48
Q

s/s of ototoxicity

A

impaired VOR
oscillopsia
dizziness
imbalance

49
Q

signs of central disorder

A

dysarthria
nystagmus
disequillibrium

50
Q

what can be used to test vestibular system

A

video nystagmography
electronystagmography

51
Q

what is computerized dynamic posturography

A

assessment of ability to maintain upright posture during various environmental conditions

evaluation of somatosensory and visual influences on posture/equilibrium

52
Q

does computerized dynamic posturography diagnose peripheral vs central causes

A

no
assesses one’s ability to integrate various sensory inputs to maintain postural control

Anatomy (19 decks)

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