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Neurology-Week 3 > Vestibular & Visual System/Reflexes > Flashcards

Vestibular & Visual System/Reflexes Flashcards

1
Q

Function of Pretectum

A

Pupillary Light Reflex

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2
Q

In the Midbrain-Superior Colliculus, the Edinger-Wesphal nucleus is more (ventral/dorsal) in location in comparison to the Oculomotor Nucleus

A

Dorsal

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3
Q

The Edinger-Wesphal nucleus is responsible for (sympathetic/parasympathetic) control of the pupil and causes (constriction/dilation)

A

Parasympathetic; Constriction

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4
Q

Horner’s Syndrome is characterized by what 4 characteristics

A

Miosis (pupils constricted)
Ptosis (eyelid droop)
Anhidrosis (no sweat)
Facial Flushing (vasodilation)

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5
Q

Horner’s Syndome is usually (uni/bi)lateral and (contra/ipsi)lateral

A

unilateral; ipsilateral

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6
Q

Accomodation WITHOUT responsiveness; pupil is small and can constrict with PROXIMITY of objects but not with LIGHT; usually due to tertiary SYPHILIS

A

Argyll-Robertson Pupil

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7
Q

Argyll-Robertson Pupil is caused by what infectious disease

A

Syphilis

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8
Q

Argyll Robertson Pupil presentation

A

Pupil accommodates but doesn’t react to light

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9
Q

Relative Afferent Pupillary Defect or aka. Marcus Gunn Pupil is due to damage in what cranial nerve?

A

CN II (optic nerve)

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10
Q

What happens when light is shone to HEALTHY eye in RAPD patient?

A

Constriction of healthy eye and affected eye

  • Direct and consensual constriction is intact
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11
Q

What happens when light is shone to affected eye in RAPD patient?

A

Both pupils dilate instead of constrict

  • No CN II conduction of light information
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12
Q

The (utricle/saccule) detects static head position and linear head movements in the HORIZONTAL plane.

The (utricle/saccule) detects static head position and linear head movements in the VERTICAL plane.

A

Utricle

Saccule

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13
Q

Movement of the stereocilia bend TOWARD the Kinocilium, the hair cell is (de/hyper)polarized

A

Depolarized

*due to the opening of K+ channels allowing entry

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14
Q

Movement of the stereocilia bend AWAY from the Kinocilium, the hair cell is (de/hyper)polarized

A

Hyperpolarized

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15
Q

Filamentous bridges that connect hair bundles to kinocilium and pull open the ion channels

A

Tip links

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16
Q

The Utricle and Saccule have a (macula/crista) for the sensation of movement

A

Macula

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17
Q

The Semicircular Canals have a (macula/crista) within ampulla for the sensation of movement

A

Crista

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18
Q

The direction of the inertia of the endolymph displaces the cupula and hair cells (towards/away from) the direction of head motion, therefore causing depolarization of the hair cells

A

AWAY FROM

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19
Q

Describe the pathway for vestibular information to the CNS for balance

A

Vestibular Apparatus –> CN 8 –> Vestibular nuclei in ipsilateral medulla & Purkinje cells in ipsilateral cerebellum –> Vestibular nuclei in ipsilateral medulla –> Vestibulospinal (VST) UMN tracts –> control our posture/balance

20
Q

The vestibular nuclei project to the spinal cord via ________ tract to control head and neck movements as well as posture to compensate for changes in position

A

Vestibulospinal UMN tracts

21
Q

The vestibular nuclei project to the CN 3, 4, 6 nuclei via ____________ tract to control eye movements when we move our head

A

Medial Longitudinal Fasciculus (MLF)

22
Q

Voluntary horizontal gaze (“look to the right”) is activated by the

A

cerebral cortex

23
Q

Involuntary horizontal gaze (move head to the right) is activated by the

A

vestibular apparatus/nuclei

24
Q

brainstem gaze center

A

PPRF (paramedian pontine reticular formation)

25
Q

When asked to “look to the right”, voluntary control of horizontal gaze allows both eyes to look to the (left/right)

A

RIGHT

26
Q

involuntary control of horizontal gaze is governed by

A

Vestibul-Ocular Reflex (VOR)

27
Q

When asked to “move head to the right”, involuntary control of horizontal gaze allows both eyes to look to the (left/right).

A

LEFT

28
Q

Under normal conditions, when the head is turned to the RIGHT, the firing rate of CN 8 ______ on the right side and _______ on the left side; that’s how the brain knows the head is turning to the right

A

increases; decreases

29
Q

Under vestibular dysfunction on the LEFT side, the firing rate of CN 8 ______ on the left, therefore, the EYES are going to reflexively move to the ______ producing a nystagmus to the ______

A

decreases; LEFT; LEFT

  • the brain thinks the head is moving to the right (when actually not), so eyes reflexively move the left.
30
Q

In caloric testing to test for nystagmus, cold water stimulates eye movement to ____ side and warm water stimulates eye movement to ____ side if nystagmus is present.

A

opposite; same

  • they are fast phase of nystagmus
31
Q

What disorders can present with vertigo as one of their symptoms?

A
  1. MS
  2. Migraine
  3. Neoplasm (vestibular swannoma, meningioma)
  4. BPPV
  5. Meniere’s Disease
  6. Labyrinthitis
  7. Vestibular Neuritis
  8. Ototoxicity
  9. Perilymph Fistula
  10. Labyrinthine Fistula
32
Q

caused by otoconia (canaliths) dislodging and migrating into one of the semicircular canals, most commonly the POSTERIOR semicircular canal, where it disrupts the endolymph dynamics

A

BPPV

33
Q

Diagnosis of BPPV

A
    • Dix-hallpike
  2. Vertigo > 1 minute with changes in head positions
  3. unaffected hearing
34
Q

Tx for BPPV

A

Epley maneuver

35
Q

a disorder of the inner ear caused by impaired endolymph resorption (increased endolymph pressure in scala media/cochlear duct); very strict diagnostic criteria

A

Meniere’s disease (aka. endolymph hydrops)

36
Q

What are the diagnostic criteria of meniere’s disease?

A
  1. Episodic vertigo lasting at least 20 min
  2. Tinnitus
  3. Hearing loss (low frequency is affected first; interesting!)
  4. Aural fullness (feels like something is in the ear)
37
Q

What could be a clue pointing to meniere’s disease when there is a HL?

A

low frequency (where as other sensorineural HL are high-frequency first)

38
Q

Tx for Meniere’s disease

A

Medical (low salt, diuretics) or Surgical

39
Q

Infection of the endolymph and perilymph caused by bacteria or virus

A

Labyrinthitis

40
Q

the idiopathic inflammation of the vestibular nerve. It is thought to be viral in origin because it commonly occurs AFTER URI.

A

Vestibular neuritis

41
Q

Only _____ is present in vestibular neuritis; no hearing loss and other symptoms

A

Vertigo

42
Q

A congenital or acquired abnormal connection between the inner ear and middle ear. Can cause sensorineural hearing loss, dizziness, and vertigo.

A

Perilymph Fistula

43
Q

An abnormal opening in the inner ear. This can result in leakage of the perilymph into the middle ear. Can cause sensorineural hearing loss and vertigo.

A

Labyrinthine Fistula

44
Q

reactivation of VZV in the geniculate ganglion, affecting the seventh (facial) and eighth (vestibulocochlear) cranial nerves; clinical features include shingles in pinna/EAM, vertigo, SNHL, and facial paralysis

A

Herpes zoster oticus

  • aka. Ramsay Hunt Syndrome
45
Q

The most common site of lesion leading to Bell’s palsy

A

Meatal foramen of fallopian canal

46
Q

Fallopian canal is aka.

A

facial nerve canal

47
Q

Tx for Herpes zoster oticus and Bell’s Palsy

A
  1. Steroids

2. Antivirals (NOT for Bell’s Palsy though!)

Neurology-Week 3 (11 decks)

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