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Neuroendocrine > Vestibular System > Flashcards

Vestibular System Flashcards

1
Q

What are the 2 things that the vestibular system can detect?

A

Static and kinetic movement of the head

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2
Q

A proprioceptive system that influences axial and proximal limb muscle tone and the oculomotor system

A

Vestibular system

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3
Q

What Vestibuloocular Response (VOR) would you perform on an unconscious patient?

A

Doll’s Eye Maneuver

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4
Q

What are the contraindications for Doll’s Eye Maneuver?

A

CANNOT HAVE A Cervical Injury!!!! And they must be unconscious

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5
Q

Describe the Doll’s Eye maneuver and the expected response

A

Side-to-side movement of the patient’s head results in their eyes turning gaze to the opposite direction

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6
Q

If you are performing the Doll’s Eye maneuver and the head is turned right, what is wrong if the left eye remains neutral and the right eye is correctly ADducted?

A

Left CN VI palsy

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7
Q

If you are performing the Doll’s Eye maneuver and the head is turned right, what is wrong if the right eye remains neutral and the left eye is ABducted correctly?

A

Right CN III palsy

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8
Q

If you are performing the Doll’s Eye maneuver and the gaze is neutral and forward, what is wrong?

A

Possible midbrain damage

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9
Q

For Doll’s Eye maneuver, if the head is turned left where should the eyes go?

A

Right side gaze

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10
Q

What Vestibuloocular Response (VOR) can you perform on a conscious patient?

A

Ice or Warm water caloric test

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11
Q

Describe the Ice/Warm water caloric test

A

Injecting ice water or warm water into the patients external acoustic meatus

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12
Q

What is the expected response of an ice cold water caloric test?

A

Eyes turn TOWARD the affected ear and then have nystagmus AWAY

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13
Q

What is the expected response of a warm water caloric test?

A

Eyes turn AWAY from the affected ear and then have nystagmus TOWARD

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14
Q

What is the pneumonic to remember the direction of the nystagmus in the water caloric test for conscious patients?

A

COWS -
Cold water = Opposite
Warm water = Same

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15
Q

What are the vestibular receptors?

A

Neuroepithelial cells in the cristae ampullaris and maculae of the ear

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16
Q

What is the vestibular ganglion?

A

Bipolar neurons near the membranous labyrinth

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17
Q

What nuclei does the vestibular nerve terminate into after getting signal from the vestibular receptors/ganglion?

A

Vestibular nucleus, Fastigial nucleus and Flocculo-nodular lobe

18
Q

What nuclei make up the vestibulocerebellum?

A

Fastigial nucleus and Flocculo-nodular lobe

19
Q

What are the tracts/areas of the Vestibular nucleus?

A

Medial Longitudinal Fasciculus (MLF)
Medial Vestibulospinal Tract (MVST)
Lateral Vestibulospinal Tract (LVST)
Reticular formation (RF)

20
Q

Some fibers of CN VIII do not go to the vestibular nucleus; where do they go directly?

A

Vestibulocerebellum (Fastigial nucleus and Flocculo-nodular lobe)

21
Q

Medial longitudinal fasiculus

A

Eyes turn toward stimulus

22
Q

Medial Vestibulospinal tract

A

Head turns toward stimulus

23
Q

Lateral Vestibulospinal tract

A

Body turns toward stimulus

24
Q

Reticular formation

A

Nausea, vertigo, visceral disturbances

25
Q

PPRF

A

Paramedian Pontine Reticular Formation

26
Q

What is the PPRF involved in?

A

Coordination of horizontal gaze

27
Q

What pathway is involved with the Doll’s Eye maneuver and the oculocaloric testing?

A

Medial longitudinal Fasciculus (MLF) - horizontal gaze

28
Q

Where does the MVST terminate?

A

Intermediate grey matter at the cervical and upper thoracic levels ONLY in the spinal cord

29
Q

What type of pathways are the MVST and the LVST?

A

Descending

30
Q

What is the function of the MVST?

A

Controls positioning of head relative to the eye movements by influencing the muscles of the neck, upper back and proximal upper limb

31
Q

Where does the LVST terminate?

A

Intermediate grey matter at ALL levels of the spinal cord

32
Q

What does the LVST fibers descend in?

A

Lateral funiculus of the spinal cord

33
Q

What is the function of the LVST?

A

Control extensor tone and reflexes of the axial and appendicular musculature (body)

34
Q

What test would you perform to test for lesions of the vestibular system?

A

Romberg’s Test

35
Q

Describe the Romberg’s Test

A

Have patient close their eyes and stand still. If they sway or when gently touched they almost fall over, that is a positive finding.

36
Q

What is a lesion of the Median longitudinal Fasciculus (MLF) called?

A

Internuchlear Opthalmoplegia

37
Q

If there is a unilateral lesion on the right side of the MLF, what are the results?

A

Horizontal gaze to the right is normal
Horizontal gaze to the left shows the following:
- Right eye unable to ADduct
- Left eye exhibits nystagmus

38
Q

If there is a lesion on the PPRF, what will be lost?

A

Horizontal gaze to the affected side!

39
Q

If a patient is unable to look to the right, where is the likely lesion?

A

Right PPRF

40
Q

A PPRF lesion destroys fibers that are going where?

A

Ipsilateral Abducens nucleus and contralateral oculomotor nucleus

Neuroendocrine (47 decks)

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