Vestibular Exam Flashcards
what are the lab tests for peripheral vestibular pathology
audiogram
ENG, VNG, Caloric testing
vestibular evoked myogenic potential testing (VEMP)
what are three things you would look for in an audiogram
auditory asymmetry
retrocochlear pathology
ear canal & tympanic membrane integrity
what is auditory asymmetry? and what does it indicate?
- significant difference in threshold hearing levels btw the ears
- indicates the possibility of peripheral vestibular or auditory n. pathology
what pathologies show auditory asymmetry
menieres, acoustic neuroma, peilymph fistula, labyrinthitis
what is retrocochlear pathology
damage of the CN VIII, cerebellopontine angle or CN VIII nerve root
what does retrocochlear pathology result in
unilateral sensorineural hearing loss
impaired speech recognition
what pathologies would result in retrocochlear pathology
acoustic neuroma, MS, variety of brainstem lesions
ENG
electronystagmography
electrodes placed around the eye to measure the VOR via muscular activation
VNG
videonystagmography
more common than ENG
utilizes video goggles with to monitor eye movement and VOR
what is the gold standard for unilateral peripheral hypofunction
caloric testing
caloric testing
evals integrity of unilateral vestibular apparatus - SCC endolymph manipulation
what does COWS mean
Cold irrigations generates nystagmus in Opposite direction
Warm irrigations generates nystagmus in Same direction
what does VEMP measures
measurement of otolith function - sensitive to sound
cVEMP
measures saccule function via VST
measurement of reflexive SCM ipsilaterally respond to sound
oVEMP
measures utricle function via MLF
measurement of reflexive inferior oblique contralaterally to air or bone conducted sound
