Balance And Equilibrium

Question 1

HINTS Exam

Answer 1

-ensure no neck px
-sitting up right facing each other
-Fix gaze on examiners nose
-laterally rotate (quickly) 10-20°
-do this bilaterally
Normal:
-keep eyes fixed on nose
-central cause of vertigo
Abnormal:
-eye corrective saccade
-peripheral cause of vertigo
-abnormally functioning vestibular system

Question 2

Causes of Vertigo:

Answer 2

Vestibular causes:
-Benign Paroxysmal Positional Vertigo
-Meniere’s disease
-Acute vestibular neuritis
-otosclerosis
- Acoustic Neuroma
-Herpes Zoster

Central causes:
-Posterior circulation stroke
-Tumor
-MS
-Vestibular migraine

Question 3

Hearing loss:

Answer 3

Conductive:
- from outside the ear
-Tympanic puncture
Sensorineural:
- within the ear
-Damage to CN8
-Sensory system

Question 4

Hearing loss S/S?

Answer 4

-Tinnitus
-Vertigo
-Pain
-Discharge
-Neurological symptoms

Question 5

Webber’s Test:

Answer 5

Normal:
Patient hears running fork equally bilaterally.

Sensorineural hearing loss:
- Sound is LOUDEST in NORMAL ear!

Conductive hearing loss:
-LOUDEST in the AFFECTED ear!

Question 6

Rinnes test:

Answer 6

Tunning fork is placed in mastoid process.

Conduction bone test:
“Tell me when you can no longer hear”

Air conduction test:
“Can you hear this”

Normal result:
Heard both bone and air conduction (air is more sensitive)

Abnormal result:
-Bone conduction>air conduction
-Sound not heard in air conduction test.
-Conduction cause as a result

Question 7

Causes of sensorineural hearing loss?

Answer 7

-age
-noise exposure
-Méniere’s disease
-Labyrinthitis
-Acoustic Neuroma
-Neurological conditions- stroke, MS and brain tumor
-infection- meningitis
-Medications-loop diuretics, chemotherapy

Question 8

Causes of conductive hearing loss?

Answer 8

-ear wax
-foreign body
-exostoses- “surfers ear”
-otitis -int/ext
-perforated tympanic membrane