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Vestibular Flashcards

1
Q

Central vs. Peripheral Pathologies: definitions

A

Central: brain-related
Peripheral: labyrinth-related

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2
Q

Examples of CENTRAL pathologies

A

CVA
Cerebellar disorders
MS

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3
Q

Examples of PERIPHERAL pathologies

A

BPPV
Vestibular neuritis
Labyrinths
Acoustic neuroma

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4
Q

Central vs Peripheral Symptoms: Ataxia

A

Central: severe
Peripheral: none or mild

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5
Q

Central vs Peripheral Symptoms: Smooth Pursuits & Saccades

A

Central: abnormal
Peripheral: normal

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6
Q

Central vs Peripheral Symptoms: Red Flags

A

Central: diplopia & scanning speech
Peripheral: none

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7
Q

Central vs Peripheral Symptoms: Hearing

A

Central: not affected
Peripheral: hearing loss, fullness in ears, tinnitus

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8
Q

Central vs Peripheral Symptoms: Nystagmus

A

Central: pendular & vertical
Peripheral: jerk

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9
Q

Central vs Peripheral Symptoms: Visual Fixation

A

Central: does not change sxs
Peripheral: improves sxs (esp nystagmus)

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10
Q

How to assess for Smooth Pursuits

A

Follow my finger with your eyes (H)

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11
Q

How to assess for Saccades

A

Look at nose, finger, nose, finger

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12
Q

How to assess VOR

A

Ability to maintain visual fixation during rapid head movements.
Head Thrust (AKA Impulse) test.

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13
Q

Head Thrust: which side is being tested?

A

Side where head is turning TOWARDS

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14
Q

Abnormal Head Thrust looks like…

A

eyes follow the head, then return to the target

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15
Q

BPPV: is VOR abnormal or intact?

A

INTACT

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16
Q

BPPV definition

A

Otoconia displaced from utricle & goes into semi canals.

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17
Q

BPPV Canalithiasis vs Cupulolithiasis: definitions

A

Canal: crystals floating around canal.
Cupulo: crystals stuck in cupula.

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18
Q

BPPV Canalithiasis vs Cupulolithiasis: episode durations

A

Canal <1min
Cupulo >1min

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19
Q

Dix Hallpike tests for…

A

BPPV of Posterior or Anterior canal.
Both Canalithiasis & Cupulolithasis (duration of sxs differentiates).

20
Q

Dix Hallpike - Posterior Canal nystagmus

A

Upbeating torsional

21
Q

Dix Hallpike - Anterior Canal nystagmus

A

Downbeating torsional

22
Q

Dix Hallpike - which side is affected?

A

(+) when head is turned towards affected ear

23
Q

Treatment for Canalithiasis

A

Epley Maneuver

24
Q

Treatment for Cupulolithiasis

A

Liberatory (Semont) Maneuver:
-Turn head AWAY from affected.
-Fall into side-lying TOWARD affected.
-Rapidly move to side-lying on other side.
-Return to sitting.

25
Brandt Daroff can be used to treat...
Mild vertigo. Pt cannot tolerate repositioning maneuvers.
26
Supine Roll Test tests for...
Horizontal Canal BPPV
27
Supine Roll Test procedure
Turn head TOWARDS affected side, while in supine. Head slightly FLEXED (pillow under head).
28
How to identify: Horizontal Canalithiasis BPPV
Geotropic nystagmus with Supine Roll Test
29
How to identify: Horizontal Cupulolithiasis BPPV
Ageotropic nystagmus with Supine Roll Test
30
How to identify which side is affected with: Horizontal Canalithiasis BPPV
Side of more intense nystagmus on Supine Roll Test
31
How to identify which side is affected with: Horizontal Cupulolithiasis BPPV
Side of less intense nystagmus on Supine Roll Test
32
Treatment for Horizontal BPPV
Canalith Repositioning Maneuver (AKA BBQ Roll): -Supine position. -Maintain slight cervical flexion throughout. -Turn head 90deg toward affected side. -Return to center. -Turn head 90deg toward other side. -Roll into prone.
33
Labyrinthitis: definition
Inflamed labyrinth
34
Labyrinthitis: duration of sxs
Days to weeks
35
Labyrinthitis: key sxs
-Vertigo -Nausea, vomiting -Hearing loss -Tinnitus
36
Vestibular Neuritis: definition
Inflamed nerve
37
Vestibular Neuritis: duration of sxs
Days to weeks
38
Vestibular Neuritis: key sxs
-Vertigo -Nausea, vomiting
39
Meniere's: definition
Overproduction of fluid causing pressure
40
Meniere's: duration of sxs
Minutes to hours
41
Meniere's: key sxs
-Vertigo -Hearing loss -Tinnitus -Fullness in ear
42
Acoustic Neuroma (AKA Vestibular Schwannoma): definition
Tumor of CN 8 May affect CN 7 too
43
Acoustic Neuroma (AKA Vestibular Schwannoma): duration of sxs
Gradual onset
44
Acoustic Neuroma (AKA Vestibular Schwannoma): key sxs
-Vertigo -Hearing loss -Tinnitus -Loss of balance -Facial numbness/weakness
45
Unilateral Hypofunction treatments
-VOR x1 -VOR x2 -Postural stability, balance -Habituation
46
Bilateral Hypofunction treatments
-VOR x1 only (x2 too difficult). -Imaginary targets -Walking

NPTE (28 decks)

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