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Maturity II Final > Vestibular > Flashcards

Vestibular Flashcards

1
Q

What makes up the peripheral system?

A

semicircular canals, otolith organs, CN 8

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2
Q

What makes up the central system?

A

vestibular nuclei, cerebellum

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3
Q

What makes up the output system?

A

ocular mm
spinal cord/ postural mm
VOR and VSR

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4
Q

What is the otolith organs?

A

sensitive to gravity and detects acc/decel

made up of Saccule & Utricle

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5
Q

What are the semicircular canals?

A

right angle to each other, 3 parts ANT, POST, HORZ

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6
Q

What are Otolith Organs?

A

has hair cells, gel layer, otoconia

and it mediates VSR

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7
Q

What are those crystal cells called? and where are they?

A

otoconia in the Otolith Organs

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8
Q

How does the semicircular canals work?

A

detects angular velocity by using functional pairs of firing rates

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9
Q

What is the peripheral vestibular system’s resting neuronal firing rate?

A

70-100 spikes/sec

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10
Q

How does the left/right semicircular canal act?

A

acts in a push/pull fashion

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11
Q

In the semicircular canals, which side is excited /inhibited?

A

the side you turn to is excited

vice versa

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12
Q

What stucture mediates the VOR?

A

semicircular canals

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13
Q

What does the OTR, VOR and VSR mean? and do?

A

VOR: vestibulo-ocular reflex; eye adjust to movement
VSR: vestibulo-spinal reflex; righting/eq rxn, postural stability
OTR: ocular-tilt reflex: from the Utricle

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14
Q

What is the purpose of the VOR and VSR?

A

works together to help the motor system in responding, such as controlled gaze, walking, balance

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15
Q

Where is the central system’s vestibular nucleus located?

A

medulla/pons

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16
Q

What is the hallmark sign of vestibular disorder?

A

Nystagmus

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17
Q

What is Oscillopsia?

A

eye jumps

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18
Q

What are the two phases of nystagmus?

A

quick phase and slow phase

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19
Q

Is end range nystagmus normal?

A

yes

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20
Q

Why does nystagmus happen?

A

bc VOR is trying to adjust eye bc brain thinks you are still in motion

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21
Q

What does it mean when Nyst is present in fixation?

A

acute peripheral lesion or central lesion

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22
Q

Which has a greater moving Nyst, central or peripheral lesion?

A

central lesion

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23
Q

what type of lesion: has unidirectional horizontal nyst?

A

peripheral lesion

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24
Q

peripheral lesion move in same or diff direction?

A

same direction

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25
what type of lesion: quick phase beats towards the healthy ear?
peripheral lesion
26
what type of lesion: Nyst beats the same direciton with lateral gaze, give an example
peripheral lesion | look R: beats R, look L, beats R
27
in peripheral lesion: 1st degree of R gaze, 2nd degree of central gaze, and 3rd degree of L gaze are what?
all right beating
28
what type of lesion: Nyst changes direction
central lesion
29
what type of lesion: look R: beats R, Look L: beats L?
central lesion
30
with strong central lesion what can you see?
downward beating
31
What are the 4 peripheral vestibular disorders? | Movado
vestibular neuritis Menieres disease Acoustic neuroma Ototoxicity
32
Which peripheral disorder is bilateral?
Ototoxicity
33
Which peripheral disorder lasts several days and may have BPPV secondarily, and its sudden vertigo onset? ALL due to viral/bacterial infection?
Vestibular Neuritis
34
What peripheral disorder is chronic, due to increase in fluid in the inner ear, with EPISODIC vertigo that last 30 min to 2 hours with Tinnitus?
Meniere's disease
35
What peripheral disorder is due to rupture of the oval window with leakage into the middle ear, due to sudden pressure change?
Perilymphatic Fistula
36
What peripheral disorder is due to a benign tumor of the Schwann cells on the CN VIII?
Acoustic neuroma
37
What peripheral disorder is bilateral and due to aminoglycosides, results in Severe imbalance especially in the dark or uneven surfaces, with Oscillopsia present?
Ototoxicity
38
What rehab technique is used for ototoxicity?
substitution of other systems
39
What are 4 central vestibular disorders?
TBI Migraine-related dizziness multisystem balance disorder Cervicogenic dizziness
40
Is vestibular rehab appropriate for a migraine related vestibular?
yes with medication
41
Who usually had multisystem balance disorder and why?
geriatic from 2 or more systems have been affected
42
What central dysfunction is a non-specific sensation of altered orientation in space from abnormal afferent activity of the neck? has no vertigo but has ataxia, headache, and c/s pain.
Cervicogenic dizziness
43
What is a mechanical issue leading to vertigo?
BPPV
44
What does BPPV stand for?
benign paroxysmal positional vertigo
45
Why does BPPV occur?
displacement of otoconia into the semicircular canal.
46
What is the S&S of BPPV?
brief episodes of vertigo that last less than a minute triggered by head position change
47
What are the two types of BPPV?
Canalithiasis | Cupulolithiasis
48
What is Canalithiasis BPPV? tx?
the common type of BPPV, where the Otoconia floats freely in endolymph, and treated with Epley maneuver NYST: latency: for 5-50 sec
49
What is Cupulolithiasis BPPV? tx?
when the Otoconia attaches to the Cupula treated with Sermont *fast Epley NYST: immediate: for 50 or more sec
50
How is BPPV diagnosed?
Dix-Hallpike
51
BPPV: what type of Nyst do you see in posterior canal? and involved rate?
upbeat and rotation nyst | 75-80%
52
BPPV: what type of Nyst do you see in horizontal canal? and involved rate?
horizontal nyst | 15-20%
53
BPP: what type of Nyst do you see in anterior canal? and involved rate?
downbeating and rotational nyst | 5-10%
54
What do you see with BPPV: Posterior canal in right/left?
Right: up and R rotation Left: Up and L rotation
55
What do you see with BPPV: Anterior canal in right/left?
Right: down and R rotation Left: down and L rotation
56
What do you see with BPPV: Horizontal Canalithiasis in right/left?
Right: geotrophic R Left: geotrophic L
57
What is the gold standard for testing unilateral peripheral disorders?
VNG/ENG: Caloric Test
58
What is VNG Caloric Test?
warm/cold temp, and watch eye movement
59
which vestibular has the biggest asymmetry during VNG caloric test?
Neuritis
60
Which testing is best for bilateral vestibular and central vestibular involvement?
Rotational chair test

Maturity II Final (12 decks)

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