10 July: Vestibular Flashcards by Katie Donaho

vestibulo - ocular

keeps image steady of fovea during head movements

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vergence

to keep image on fovea predominately when the viewed objects is moved near

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BPPV is apart of what dysfunciton system

PERIPHERAL

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how do you diagnose BPPV?

Dix Hallpike Maneuver

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how do you treat BPPV?

Epley’s Manuever

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cranial nerves for vision:

optic
oculomotor
trochelar
abducens

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cranial nerves for the vestibular

facial and vestibulocochlear

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cranial nerves for swallowing / sucking

glossopharyngeal

vagus

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cranial nerves for tongue movement

hypoglossal

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cranial nerve for chewing / facial expression

facial n

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spontaneous nystagmus means that there is a

CENTRAL VESTIBULAR PROCESSING PROBLEM

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fixed gaze nystagmus means that

nystagmus occurs while they move thier eyes

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occulomotor range of motion is looking to see if

the eyes move together smoothly

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convergence is the ability to

converge on an that comes into your midline - less than 6 cm away you should start seeing double: X on brock string

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what do you do to help convergence?

a Brock String

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cover-uncover test tests for?

Tropia

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how do you test for tropia?

a cover uncover test

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alernate cover test tests for

phoria

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how do you test for phoria?

alternate cover test?

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tropia is when

the eye Adducts to focus once you cover the eye and then deviates when uncovered

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phoria is when

you cover the eye THAT eye ABducts and then return once you regain fixation on target

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how do you test VOR?

tilt pts head down 30 degree
start slowly moving head side to side start increasing speed? or do the thing in lab where he jilted the head = HEAD THRUST TEST

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spontaneous nystagmus present

acute UVL, brainstem/cerebellum abnormality

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Decreased VOR (+ Head Thrust Test)

Acute UVL and chronic vestibular hypofunction

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eye movements and vertigo elicited by maneuvers

vestibular asymmetry BPPV

impaired VOR smooth pursuits saccades

central deficits brain stem/ cerebellar abnormality

imbalance while standing or walking

any of the above

what are compensatory techniques?

increase response of remaining vestibular system | CNS changes to optimize functional cortical remapping / neuroplasticity

goal of compensation:

improve and equalize normal gaze and postural control

adaptation:

brain will adapt to input received and either tune out information it determines to be an error or activate another system to correct the mismatch

substitution

strengthen the function of intact systems to improve performance

habituation

repeatedly expose the individual to provoking stimuli so they no longer respond as strongly to it

substitution of other strategies to replace the lost or impaired function include:

eye tracking oculomotor exercises saccades

cheap dynavision is part of what method of increasing function?

SUBSTITION

the funky looking picutres with ALOT of stimulus was what method ?

HABITUATION

the looking at the finger while moving was what mehtod?

ADPATATION

name three convergence exercises?

pencil push ups brock string arrow chart / dot card

how many times should you do vestibular therapy in each setting?

outpatient : 1-2 times /week (4-6 weeks) HEP : 5 minutes 3x / day walking program ( health and fitness prescription)

VOR means

Vestibular Ocular Reflex

VOR works on

stabilizes vision when head moves

VSR means

vestibular spinal reflex

VSR works on

balance control

ampulla can detect what

linear/ angular motion

otolith organs hold what

the crystals that detect movement and determine gravity and acceleration

VCR stands for

Vestibular Collic Reflex

VCR works on

stabilizes the head in space

how does VCR work?

1. detects rotation 2. inhibits and excites the extra ocular muscles on the other side 3. creates compensating eye movement

the ratio of eye to head movement should be

1.1 abnormal ratios can cause symptoms of blurry vision or vertigo

the vestibular system has three output SYSTEMS:

peripheral senosry apparatus central processing mechanism for motor output

the peripheral sensory apparatus handles three things?

vestibular vision somatosensory / proprioception

which Vest System invovles the apparatus in the inner ear? (semiciruclar canals utricle saccule CN VII: )

PERIPHERAL

which vestibular systems has stuff to do with the brainstem and cerebellum?

CENTRAL

why is the vascular supply important

the vertebral-basilar a system is the main supplier to both central and peripheral vestibular system

vestibular neuritis:

vestibular crisis = vertigo imbalance nausea | - absence of associated auditory symptoms

viral endolymphatic labryinthitis

acute vestibular crisis lasting 1-4 days | - HEARING LOSS w/n a few hours before or after onset of vertigo

so main difference between vestibular neuritis and viral endolymphatic labryinthiits?

HEARING LOSS

acoustic neuroma

nerve sheath benign tumors arise from Scwann cells lining the axons of the cochleovestibular n. causes progressive unilateral hearing loss or tinnitus w/ o vestiubular s/s

meniere's disease:

disorder of the inner ear fx resulting in devastating hearing loss and vestibular symptoms

BPPV definition:

extereme vertigo triggered by lying down and other positions

BPPV is caused by

crystals in otilith to be "knocked out" and caused problems with acceleration and gravity

BPPV stands for :

benign paroxygmal positional vertigo

what are the two theories of BPPV?

canalithiasis | cupulolithiasis

canalithiasis is what?

debris floating freely in the endolymph in the long arm of the semi circular canal SCC

cuplolithiasis

debris, probably fragment of otconia from the utricle adhere to the cupula

which theory is the most excepted in the BPPV?

canalithiasis theory

how do you treat the canalithiasis theory of BPPV?

repositioning maneuver / procedure EPLEY

TORSION nystagmus suggests:

BPPV POSTERIOR!

persistent torsion nystagmus means that

cupulolithiasais

transient torsion nystagmus means that

its canalithiasis

what is the most common single bilateral vestibulopathy

gentamicin toxicity

how is gentamicin toxicity confirmed? tested?

rotary chair test

a migraine w/o aura is

periodic s/s of normal headaches throbbing worse with activity and associated w/ nausea and increased sensitivity to light and noise

a migraine w/ aura is

short lived symptoms : noises flashes of light tingling numbness vertigo and others known as the aura - s/s usually precede the headache and usually last 5-20 mins

a basilar migraine

include vertigo tinnitus, decreased hearing and ataxia

10 July: Vestibular Flashcards

(74 cards)