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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
Q

Brandt Daroff can be used to treat…

A

Mild vertigo.
Pt cannot tolerate repositioning maneuvers.

26
Q

Supine Roll Test tests for…

A

Horizontal Canal BPPV

27
Q

Supine Roll Test procedure

A

Turn head TOWARDS affected side, while in supine.
Head slightly FLEXED (pillow under head).

28
Q

How to identify: Horizontal Canalithiasis BPPV

A

Geotropic nystagmus with Supine Roll Test

29
Q

How to identify: Horizontal Cupulolithiasis BPPV

A

Ageotropic nystagmus with Supine Roll Test

30
Q

How to identify which side is affected with: Horizontal Canalithiasis BPPV

A

Side of more intense nystagmus on Supine Roll Test

31
Q

How to identify which side is affected with: Horizontal Cupulolithiasis BPPV

A

Side of less intense nystagmus on Supine Roll Test

32
Q

Treatment for Horizontal BPPV

A

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
Q

Labyrinthitis: definition

A

Inflamed labyrinth

34
Q

Labyrinthitis: duration of sxs

A

Days to weeks

35
Q

Labyrinthitis: key sxs

A

-Vertigo
-Nausea, vomiting
-Hearing loss
-Tinnitus

36
Q

Vestibular Neuritis: definition

A

Inflamed nerve

37
Q

Vestibular Neuritis: duration of sxs

A

Days to weeks

38
Q

Vestibular Neuritis: key sxs

A

-Vertigo
-Nausea, vomiting

39
Q

Meniere’s: definition

A

Overproduction of fluid causing pressure

40
Q

Meniere’s: duration of sxs

A

Minutes to hours

41
Q

Meniere’s: key sxs

A

-Vertigo
-Hearing loss
-Tinnitus
-Fullness in ear

42
Q

Acoustic Neuroma (AKA Vestibular Schwannoma): definition

A

Tumor of CN 8
May affect CN 7 too

43
Q

Acoustic Neuroma (AKA Vestibular Schwannoma): duration of sxs

A

Gradual onset

44
Q

Acoustic Neuroma (AKA Vestibular Schwannoma): key sxs

A

-Vertigo
-Hearing loss
-Tinnitus
-Loss of balance
-Facial numbness/weakness

45
Q

Unilateral Hypofunction treatments

A

-VOR x1
-VOR x2
-Postural stability, balance
-Habituation

46
Q

Bilateral Hypofunction treatments

A

-VOR x1 only (x2 too difficult).
-Imaginary targets
-Walking

NPTE (28 decks)

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