vestibular

Question 1

vertigo

Answer 1

sensation of whirling and loss of balance, associated particularly with looking down from a great height, or caused by disease affecting the inner ear or the vestibular nerve; giddiness

Question 2

nystagmus

Answer 2

rapid, involuntary movements of the eyes

Question 3

pt reports

Answer 3

• lightheaded - dizzy - spinning room - I fall a lot

Question 4

vestibular rehab

Answer 4

1. fastest growing PT fields
2. disorders are commonly encountered in neurological settings, geriatric settings, and increasingly in outpatient ortho/sports clinics
3. PT frequently first point of entry

Question 5

vestibular system components

Answer 5

1. peripheral sensory apparatus
2. central processor
3. mechanism for motor output

Question 6

inner ear

Answer 6

• utricle: horizontal acceleration

- saccule: vertical acceleration

Question 7

otolith

Answer 7

each of three small oval calcareous bodies in the inner ear of vertebrates, involved in sensing gravity and movement

Question 8

concepts

1. signs and symptoms
2. success of rehab
3. sensory organization

Answer 8

1. s&s of disorders with different etiologies adn pronoses may be similar
2. depends on identifying the location and nature of the disorder, as treatments may be very different depending on the condition
3. vestibular - visual - proprioception

Question 9

evaluation / outcome measures

Answer 9

1. evaluation: describe symptoms and MUST differentiate peripheral vs central sources
2. activities specific balance confidence scale - dizziness handicapped inventory - functional disability scale - positive and negative affective scale

Question 10

dizziness handicap inventory

Answer 10

physical, emotional, functional = DHI

mild: 16-34
mod: 36-52
severe: 54+

Question 11

meniere’s disease

Answer 11

disorder of the inner ear that causes episodes in which you feel as if you’re spinning (vertigo), and you have fluctuating hearing loss with a progressive, ultimately permanent loss of hearing, ringing in the ear, and sometimes a feeling of fullness or pressure in your ear.

• usually only affects one ear
• usually 20-50yo
• chronic condition but various treatments can help relieve symptoms and minimize the long-term impact on your life

Question 12

benign paroxysmal positional vertigo (BPPV)

Answer 12

the sudden sensation that you’re spinning or that the inside of your head is spinning.

• brief episodes of mild-intense dizziness
• calcium carbonate crystals (otoconia) that are normally embedded in the gel in the utricle become dislodged and migrate into one or more of the 3 fluid-filled semicircular canals
• when enough particles accumulate in one of the canals, they interfere with the normal fluid movement that these canals use to sense head motion, causing inner ear to send false signals

Question 13

vestibular neuritis

Answer 13

(and labyrinthitis) are disorders resulting from an infection that inflames the inner ear or nerves connecting the inner ear to the brain

• inflammation disrupts the transmission of the sensory information from the ear to the brain
• vertigo, dizziness, and difficulties with balance, vision, or hearing may result

Question 14

dix hall pike

Answer 14

test for eliciting paroxysmal vertigo and nystagmus in which the patient is brought from the sitting to the supine position with the head hanging over the examining table and turned to the left or right
- vertigo and nystagmus are elicited when the head is rotated toward the affected ear

Question 15

epley maneuver

Answer 15

repositioning maneuver used to treat BPPV of the posterior or anterior canals

Question 16

interventions

Answer 16

1. education: postural reed on avoiding positions that reproduce or aggravate dizziness
2. manual therapy: STM to alleviate suboccipital myofascial restrictions. Joint mobs/manips to upper C/S and CT/S junction restriction
3. exercise: head nodding, chin tucks, C1-C2 self-sustained glide and potentially neural glides