Dizziness and vertigo Flashcards
What is vertigo?
Sensation that you, or the environment around you, is moving or spinning
Name 2 symptoms vertigo may be associated with
- Nausea
- Vomiting
- Sweating
- Feeling generally unwell
Vertigo is caused by a mismatch between sensory inputs that are responsible for maintaining balance and posture. What are these 3 sensory inputs?
- Vision
- Proprioception
- Signals from the vestibular system
Vestibular system physiology (1)
1) The vestibular apparatus is located in the inner ear and is made up of what?
2) These are filled up with fluid called what?
3) How is this apparatus able to detect various head movements?
4) The fluid shift in the vestibular apparatus is detected by tiny hairs called what?
5) These are found in a section of the canal called what?
6) The sensory input of shifting fluid is transmitted to the brain by what?
1) 3 semicircular canals
2) Endolymph fluid
3) The semicircular canals are oriented in different directions
4) Stereocilia
5) The ampulla
6) Vestibular nerve
Vestibular system physiology (2)
1) The vestibular nerve carries signals from the vestibular apparatus to the vestibular nucleus which is located in which 2 areas?
2) Vertigo caused by a peripheral problem usually affects what?
3) Vertigo caused by a central problem usually affects what?
1) Brainstem and cerebellum
2) Vestibular system
3) Brainstem or cerebellum
Name 2 peripheral/vestibular causes of vertigo
- Benign paroxysmal positional vertigo
- Ménière’s disease
- Vestibular neuronitis
- Labyrinthitis
Benign paroxysmal positional vertigo (BPPV)
1) What causes BPPV?
2) How does this cause BPPV?
3) Name 2 potential causes of this displacement
4) What often triggers an episode of BPPV?
5) What special test can be used to diagnose BPPV?
6) What movement can treat BPPV?
7) How long do attacks typically last?
1) Crystals of calcium carbonate called otoconia that become displaced into the semicircular canals
2) The crystals disrupt the normal flow through the canals and therefore disrupt the function of the system
3) Viral infection, head trauma, ageing or without a clear cause
4) Movement/change in head position
5) Dix-Hallpike manoeuvre
6) Epley manoeuvre
7) Couple of minutes
Ménière’s disease
1) What causes Ménière’s disease?
2) As well as vertigo, name 2 other associated symptoms
3) How long do attacks typically last?
1) Excessive buildup of endolymph in the semicircular canals, causing a higher pressure than normal, disrupting the sensory signals
2) Hearing loss, tinnitus, nystagmus, and a sensation of fullness in the ear
3) Couple of hours
Acute vestibular neuronitis
1) What is this?
2) Is the cause normally bacterial or viral?
1) Inflammation of the vestibular nerve?
2) Viral
Labyrinthitis
1) What is this?
2) Is the cause normally bacterial or viral?
3) How can this be differentiated from acute vestibular neuronitis?
1) Inflammation of the structures of the inner ear
2) Viral
3) Can cause hearing loss
1) Name 2 central causes of vertigo
2) Specifically what kind of stroke would cause central vertigo?
3) Name a feature of central causes of vertigo
1) Stroke, tumour, MS, vestibular migraine
2) Posterior circulation infarct
3) Vertigo is sustained and non-positional
1) Which central cause of vertigo will have a gradual onset?
2) Which central cause of vertigo may be associated with visual aura and a headache?
3) Which central cause of vertigo will have a sudden onset
4) Which central cause of vertigo may sometimes cause no symptoms/mild symptoms, and sometimes cause severe symptoms?
1) Tumour
2) Vestibular migraine
3) Stroke
4) MS
What are the 4 things that need to be examined in a patient presenting with vertigo?
1) Ear examination, neurological examination (including cerebellar examination),
cardiovascular examination, special test
Name a cardiovascular cause of dizziness
- Arrhythmias
- Valve disease
What are the 3 special tests?
- Romberg’s test
- Dix-Hallpike manoeuvre
- HINTS examination
