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FF: neuro content > class 4: vestibular > Flashcards

class 4: vestibular Flashcards

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1
Q

what is central vest issues 2/2

A

damage to the central vestibular ocular pathway, brain – cerebellum, BS, vestibular nuclei

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2
Q

what are peri vest issues 2/2

A

an issue of the SCC (posterior and horizontal) or otolith organs, debris moving in the SSC

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3
Q

Peripheral: Labyrinth related conditions

A
  • BPPV
  • Vestibular neuritis
  • Labyrinthitis
  • Acoustic neuroma
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4
Q

Central: Brain-related related conditions

A
  • CVA
  • Cerebellar disorder
  • MS
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5
Q

Central - nys

A

o Does not change with fixation
o Changes in direction
o Unable to suppress nys

o Types
Down beating nys – almost always a central issue

Gaze evoked

Non-fixation nys

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6
Q

Peri - nys

A

Decreases with fixation

Does not change direction

The nys presentation decreases – fatigable

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7
Q

Abnormal Smooth Pursuits and Saccades indicates peri or central

A

central disorder

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8
Q

what makes up the Labyrinth of the inner ear

A

Semicircular canal + otolith organs

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9
Q

what makes up the SCC

A
  • Anterior
  • Posterior
  • Horizontal
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10
Q

what make up the Otolith Organs

A
  • Saccule
  • Utricle
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11
Q

what are the two types of BPPV can we fix

A

posterior and horizontal

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12
Q

what are some causes of BPPV

A
  • Infection
  • Head trauma
  • Vestibular weakness
  • Advancing age
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13
Q

what mech causes BPPV at the physiological level

A

Mechanical disorder caused
by otoconia displaced from
the macula of the utricle

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14
Q

Types of BPPV

A

Canalithiasis

Cupulolithiasis

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15
Q

what is Canalithiasis

A

a condition where particles become loose and float in a semicircular canal of the inner ear, causing vertigo.

< 1 min

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16
Q

what is Cupulolithiasis

A

a type of benign paroxysmal positional vertigo (BPPV) that occurs when otolith crystals become detached from the utricle and stick to the cupula of the inner ear’s semicircular canals.

> 1 min

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17
Q

BPPV – Signs and Symptoms

A

Vertigo: with change in head position, such as when turning over in bed, getting into or out of bed, or when bending over/coming up

Nystagmus: (involuntary, rapid and repetitive movement of the eyes) – Most important symptom

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18
Q

Posterior Canal BPPV - canal or cupulo

A

CANALITHIASIS

update: either depending on time

canal < 60 secs

cupulo >60 secs

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19
Q

what is the test for posterior canal BPPV

A

dix hall pike

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20
Q

what is the treatment for posterior canal BPPV

A

Modified Epley (first choice)

Li maneuver for the posterior canal

Semont plus (from Strupp RCT)

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21
Q

Posterior canal - nys

A

nys upbeating and torsional toward the tested side

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22
Q

what is the testing that we do for horzontal canal BPPV

A

bow and lean

roll test

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23
Q

what is the procedure for bow and lean

A

bow
- geo: nys will beat towards the affected ear
-ageo: nys will beat towards the healthy ear

lean
- geo: nys will beat towards the Good ear.
-ageo: nys will beat towards the affected ear

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24
Q

what is the name for the two type of horzontal canal BPPV

A

geotrophic and ageotrophic

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25
what is the procedure for the roll test
- pt head flexed 20‐30 degrees - PT lowers patient to supine - with head still flexed - PT quickly moves head to right and holds for 30 sec o Look for nys - Move head back to midline – 30 secs - PT quickly moves head to left and holding for 30 sec. o Look for nys
26
roll test geo
nys towards the ground (canal)
27
roll test ageo
nys towards the ceiling (cuplo)
28
what are the choices for posterior canal repositioning
Modified Epley (first choice) Li maneuver for the posterior canal Semont plus (from Strupp RCT)
29
what are the choices for horizontal canal repositioning - geo
Gufoni maneuver Li quick repositioning maneuver
30
what are the choices for horizontal canal repositioning - ageo
Kim maneuver Gufoni maneuver for ageotropic
31
what is Labyrinthitis
Inflammation of labyrinth
32
what are the sym of Labyrinthitis
Sudden onset of vertigo, nausea, vomiting Positive head-impulse test HEARING LOSS, TINNITUS
33
HIT is positive with central or peri disorder
peri disorder
34
what side is the HIT testing
Turn to the left the left ear is affected
35
do we see axtai with central of peri disorders
central - cere
36
how long does Labyrinthitis normally last
Days to weeks
37
what is Vestibular Neuritis
condition that causes inflammation of the vestibular nerve in the inner ear, which can lead to vertigo, dizziness, and imbalance
38
what are the sym of Vestibular Neuritis
* Sudden onset of vertigo, nausea, vomiting * Positive head-impulse test
39
do we normally have hearing loss with central disorders
no - this is a peri issue
40
dipolpia a central or per issue normally
central
41
durtion of Vestibular Neuritis
Days to weeks
42
what is the Vestibulo-Ocular Reflex (VOR)
Responsible for maintaining focus on an image during rapid head movements. VOR must generate rapid compensatory eye movements in the direction opposite the head rotation.
43
Menière’s Disease
Overproduction of fluid within the inner ear > Increase in pressure > Vertigo
44
what are the sym of Menière’s Disease
* Vertigo * Hearing loss * Tinnitus * Aural fullness - drop attacks
45
duration of meniere's diase attacks
min to hours
46
what is Acoustic Neuroma/ Vestibular Schwannoma:
Slow-growing tumor that develops from the balance and hearing nerves supplying the inner ear
47
Acoustic Neuroma/ Vestibular Schwannoma: symptoms
* Hearing loss * Tinnitus * Loss of balance * Vertigo * Facial numbness and weakness or loss of muscle movement
48
Unilateral Vestibular Hypofunction - treatment
* Gaze stability: Improves VOR e.g., VOR x 1, VOR x 2 * Postural stability and balance * Habituation
49
what is habituation
Thought is repeated exposure to a provocative stimulus (e.g. head movements) will lead to a reduction of the motion-provoked symptoms. Reduction of symptoms after repeated stimulus. EX: turing head in grocery store cause symptoms then do this or something like this
50
Bilateral Vestibular Hypofunction - treatment
* Gaze stability: x1 yes; x2 no (unless asymmetrical involvement) * Imaginary targets - subsition * Walking
51
do we ahve hearing loss with BPPV
no
52
what is a another name for the semount plus
liberatory
53
what is the brandt daroff exercise
HEP for BPPV
54
is geo canal or cupulo
canal
55
is ageo canal or cupulo
cupulo
56
for the roll test how do we know what ear is effected
geo: ear with the worst symptoms ageo: ear with the better symss
57
would labrinthitis or vestibular neuritis present with hearing loss
labryrinthitis
58
why do we do the HIT
check the VOR
59
do we see a postive HIT test with vestibular neuritis
yes
60
is the HIT positive for BPPV
no
61
if we see downbeating and torsional BPPV during dix hall pike testing what does this indicate
anterior canal BPPV
62
modified epley is for canal or cupulo
canal
63
is liberatory manuver for canal or cupulo
cupulo
64
how many time can we do brandt daroff exercises
up to x5 times
65
roll test and geo - how do we know what side
side effected has stronger more intense symtoms
66
rol test ageo - how do we know what side
side effected has less intense sym
67
which part of the bow and lean do we memorize
the lean part - geo: nys will beat towards the Good ear. -ageo: nys will beat towards the affected ear
68
what is the one treatment we do for all horizontal for the NPTE
horizontal canal reposiotioning manuever - BBQ roll turn to side effected to start
69
what is pendular nys
the eye oscillate as equal soeeds
70
pendular nys is seen with what kind of disorders
central
71
what medications are helpful for meinere's disease
diuretic's getting rid of the fluid
72
meinere's disease - diet changes
less salt

FF: neuro content (8 decks)

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