Week 5.8 BPPV Exam and Eval

Question 1

is BPPV central or peripheral

Answer 1

peripheral

Question 2

what happens with BPPV

Answer 2

the otoconia become dislodged from the utricle, and enter the semicircular canals

Question 3

the otoconia disrupt

Answer 3

the VOR

Question 4

what is the key symptom of BPPV, and what causes this

Answer 4

vertigo, caused by the incorrect reflexive repositioning of the eyes

Question 5

do you have vertigo symptoms a the time with BPPV?

Answer 5

no, only when you are moving

Question 6

what is the type of dizziness, the circumstance and the duration of BPPV

Answer 6

true vertigo
with sudden head movements
lasting less than 1-2 minutes

Question 7

what is BPPV testing and what is the overall goal

Answer 7

BPPV testing is looking at a variety of different head positions to isolate canals in gravity dependent positions, and try to rule in the involved semicircular canal

Question 8

TF: if you expect BPPV, you should go ahead and perform other vestibular or ocular motion test

Answer 8

false, you should not. BPPV can lead to inaccurate findings.

Question 9

what is a medication that is prescribed to people with vertigo

Answer 9

meclizine to try and suppress the VOR to reduce vertigo

Question 10

TF: patients should refrain from taking Meclizine 24 hours before testing

Answer 10

true

Question 11

what two exams must you do first before doing a BPPV exam

Answer 11

vertebral artery and sharp purse and alar ligament test if you suspect trauma

Question 12

how do you do vertebral artery testing

Answer 12

induce compression in the arteries by placing the neck in full extension, and rotation and holding for 30 seconds, looking for cranial nerve signs

Question 13

what tests look at anterior and posterior canals

Answer 13

dix hall pike

Question 14

what test looks at the horizontal Canals

Answer 14

the horizontal rill test

Question 15

what are the 3 keys to BPPV testing

Answer 15

1. tell patient to keep eyes open
2. assess for both vertigo and nystagmus
3. note the direction (canal) and the time (canalith vs. cupolo) of the nystagmus

Question 16

the side affected for canalithiasis is the side with more/less geotropic/ageotropic nystagmus?

Answer 16

more, and geotropic

Question 17

the side affected for cupulolithiasis is the side with more/less geotropic/ageotropic nystagmus?

Answer 17

less and ageotropic

Question 18

nystagmus lasting less than 60 seconds is considered

Answer 18

canalthiasis

Question 19

what does canalthiasis indicate

Answer 19

that the otoconia are not adhered to the semicircular canals, and able to reduce back to the utricle with canalith repositioning

Question 20

nystagmus lasting longer that 60 seconds is considered

Answer 20

cupulolithiasis

Question 21

what does cupulolithiasis indicate

Answer 21

that the otoconia are adhered to the semicircular canals and need to be treated with a library maneuver before you can use canalith repositioning