Vestibular Flashcards

1
Q

Feeling that you are about to faint or “pass out“, do not feel as though you or your surroundings are moving

A

Lightheadedness

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2
Q

Feeling that you or your surroundings are moving when there is no actual movement, feel as though you are spinning, falling, etc.

A

Vertigo

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3
Q

What part of the vestibular system detects angular acceleration (any rotational movement)?

A

Semicircular canals

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4
Q

What part of the vestibular system detects linear acceleration and gravity

A

Otoliths

  • Utricle = horizontal acceleration
  • Saccule = vertical acceleration
  • Have hair cells that project into gelatinous matrix that have embedded otoconia
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5
Q

What causes positional vertigo?

A

Crystals break free and float through semicircular canals

- can be caused by trauma, can be caused by certain head movements

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6
Q

fluid in inner ear

A

Endolymph

- as we the head moves in one direction, the fluid moves another

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7
Q

Reflex eye movement that stabilizes images during head movement; Produces eye movement in the direction opposite the head movement; Preserves the image in the center of visual field

A

Vestibulo-ocular reflex

- when moves to the right, eyes move to the left

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8
Q

Provide automatic control of the postural muscles in order to stabilize the body

A

Vestibulospinal reflex

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9
Q

What are the 3 sensory systems that contribute to balance?

A
  1. Vestibular
  2. Vision
  3. Somatosensory (proprioception)
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10
Q

What are the possible causes of vestibular dysfunction in the CNS?

A
  1. Stroke or TIA
  2. Multiple sclerosis
  3. Trauma (TBI)
    - abnormally with oculomotor testing
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11
Q

What S and S will you see with central pathology?

A
  1. Abnormal smooth pursuit and saccadic eye movements
  2. Diplopia
  3. Altered conscious
  4. More severe ataxia than with a peripheral lesion
  5. Vertigo less intense than with a peripheral lesion and not suppressed by visual fixation
  6. Spontaneous vertical nystagmus
  7. Eyes oscillate at equal speeds
    - Keys to point towards central: problems with vision, problems with confusion - if pt has 2-3 of these and its not dx yet, refer out to get dx, then we can help
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12
Q

How is PT incorporated with central lesions?

A
  1. Educate on safety precautions and fall prevention strategies
  2. Gait training
  3. Balance exercises
  4. Habituation exercises
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13
Q

What are the types of peripheral vestibular dysfunction?

A
  1. Mechanical (BPPV)
  2. Decreased receptor input (UVH, BVH)
    - we have a firing rate in our inner ear, and on each side they should be the same; when firing is not the same on both sides, get hypofunction
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14
Q

Otoconia misplaced in semicircular canals; Vertigo provoked by changes in head position in relationship to gravity; Most commonly involves posterior canal

A

Benign paroxysmal positional vertigo (BPPV)

- Anterior, posterior, horizontal are 3 but posterior is 90% of cases

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15
Q

What is the Dix-Hallpike test

A

test for posterior canal BPPV

  • 45* to side testing
  • ~30* of ext
  • tell pt to keep their eyes open
  • latency – need to hold them in that position for a few seconds up to a min
  • looking for nystagmus
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16
Q

Vestibular nerve is firing less than it should

A

Decreased receptor input

  1. UVH – Unilateral vestibular hypofunction more common, easier to tease out
  2. BVH – Bilat. vestibular hypofunction – much more rare than UVH
    - hypofunction= if move head fast triggers it; if environment around you or loss of stimuli, it can trigger it; will walk into clinic grabbing stable furniture around them, with their head stable, etc
17
Q

What are the S and S of peripheral pathology?

A
  1. Normal smooth pursuit and saccades (not normal in central)
  2. Positional testing may reproduce nystagmus
  3. May report hearing loss, fullness in ears, tinnitus
  4. Mild ataxia
  5. Vertigo usually intense and suppressed by visual fixation
  6. Vertigo may be accompanied by nausea/vomiting
  7. Nystagmus will have slow and fast phases
    - side sx are triggered = side problems are on
    - pt needs to keep keys open during tx
18
Q

Otoconia break free from the otoliths and float freely in one of the semicircular canals

A

Canalithiasis

19
Q

Otoconia break free from the otoliths and adhere to the cupula of one of the semicircular canals

A

Cupulolithiasis

20
Q

How do you treat BPPV

A

Positional tx techniques

- dix-hallpike position

21
Q

How do you treat UVH and BVH?

A
  1. Gaze stability exercises - Holding up something with words on it, etc; trying to desensitize the brain- trigger what makes them dizzy, then
  2. Gait training - b/c will be unsteady on their feet
  3. Balance exercises
  4. Habituation exercises - doing small amts of what makes them dizzy to desensitize brain
22
Q

Disorder of inner ear function; 40-60 years old; Low-frequency hearing loss; Episodic vertigo (mins, hours or days); Fullness in ear or tinnitus; Can be very limiting

A

Meniere’s disease

  • Dizziness, regardless of what you’re doing – versus positional which they’re in a specific pos and that triggers it
  • different from positional vertigo where there is no fullness in ear or tinnitus
23
Q

What is the medical tx for meniere’s disease?

A

Reduce fluid buildup

- Low sodium diet, avoid caffeine/alcohol, diuretics otherwise no good treatment for this