Vestibular Exam

Question 1

The Dix Hallpike test looks at function of which canal(s)?

Answer 1

AC and PC

Question 2

The direction of vertical nystagmus indicates which canal is affected with dix hall pike test.

Answer 2

AC = downbeating
PC = upbeating

Question 3

The duration of nystagmus with dix hall pike test tells us:

Answer 3

canalithiasis vs. cupulothiasis
canal = < 60sec
cupulo = sustained

Question 4

canalithiasis means the otoconia are:

Answer 4

free-floating in canal

Question 5

Cupulolithiasis means the otoconia are:

Answer 5

ahdhered to the cupola

Question 6

What happens with repeated dix hall pike test?

Answer 6

nystagmus and vertigo will fatigue

Question 7

Describe the steps in the dix hall pike test:

Answer 7

1. turn pts. head 45 degrees toward side you are testing
2. lay pt. back quickly with head over table and neck in 20-30 degrees extension
3. hold 45 sec or until sxs resolve

Question 8

What is an alternative to dix hallpike test?

Answer 8

• sidelying test
• still tests AC and PC
• can be used if pt. hx suggests BPPV but D-H is negative or if pt. can;t tolerate D-H positions

Question 9

Describe the steps in the side lying test:

Answer 9

1. pt. turns head 45 degrees AWAY from side you are testing

2. pt. lies down quickly on the other side

Question 10

How can you test the horizontal canal?

Answer 10

Roll test

Question 11

Describe the steps in the roll test:

Answer 11

1. Pt. lies supine with neck flexed 30 degrees
2. turn head quickly to one side
3. gradually return head to neutral
4. repeat to the other side

Question 12

Define geotrophic:

Answer 12

the side with more severe vertigo and stronger nystagmus = affected side
fast phase toward ground

Question 13

Define apogeotrophic:

Answer 13

the side with less severe vertigo and less nystagmus is the affected side
fast phase away from ground

Question 14

The roll test causes:

Answer 14

direction-changing horizontal nystagmus with no or short latency and >60 sec duration