Flashcards in Clinical- 8 Deck (60)
True or False: dizziness = vertigo.
What is dizziness?
sensations of light-headedness, faintness or giddiness. NOT associated with an illusion of movement.
ILLUSIONS, MICHAEL. TRICKS ARE WHAT WHORES DO FOR MONEY.
What is vertigo?
The illusion that you're moving but you're not actually moving.
What happens in peripheral vertigo?
lesions that affect the labrynth of the inner ear, or VIII
What is central vertigo?
lesions of the brainstem vestibular nuclei or their connections, possible froma cerebral Cx lesion
QUICK FIRE: I'll give a Sx and you tell me whether it's peripheral or central vertigo. Ready?
Contant, less severe vertigo
Nystagmus always present, unidirectional, never vertical
Tinnitus/heading loss often present
Usually has brainstem or cerebellar signs
Verigo is intermittent, brief, and more severe
Nystagmus possible, can be uni- or bidirectional, can be vertical
There are no intrinsic brainstm or cerebellar signs
Rarely is there tinnitus/hearing loss
What is ataxia?
incoordination or clumsiness of movement that s not the result of muscular weakness
What is vestibular ataxia?
gravity-dependent (only when walking, standing), incoordination from the same central and peripheral lesions that cause vertigo
What is cerebellar ataxia?
irrgular rate, rhythm, amplitude and force of voluntary movements caused by lesions of the cerebelum or its afferent or efferent connections in the peduncle.s, red nucleus, pons, or spinal cord.
What is sensory ataxia?
impaired sensation of propriocepton and vibratory sense form disorders that affect those pathways.
True or False: There is NO vertigo, nystagmus and dysarthria in sensory ataxia.
Demonstrate the Dix-Hallpike technique (5 steps)
1. sit pt on table with eyes forward
2. quickly bring them supine with head over edge of table (30-45 deg)
3. repeat with head turned 45 deg to the R
4. repeat with head turned 45 deg to the L
5. observe for nystagmus or vertigo
Positional nystagmus and vertigo are usually assoacited with lesions where?
peripheral vestibular lesions
What are the characteristics of peripheral nystagmus?
tends to remit spontaneously (fatigue), reduces with repetition.
Caloric testing can test disorders from where?
What are the expected results from COLD water caloric testing?
Remember COWS (cold opposite, warm same)
Slow phase to irrigated ear, fast to opposite ear (side of nystagmus)
What are the expected results from WARM water caloric testing?
slow phase opposite of irrigated ear, fast to same side
What are the causes for the FAILURE of nystagmus to form fromcaloric testing?
unilateral labrynthine, vestibulocochlear n. or vestibular N dysfxn
What is the most common cause of vertigo of peripheral origin, and is caused by canalolithiasis?
Benign positional vertigo
What are the Sx of BPV?
breif episodes of severe vertigo, N/V, worse in lateral decubitus position with affected ear down,no hearing loss. can be peripheral or central Sx.
respositioning (epley) maneuvers that use gravity to move the canaloliths out of the SC canals and into the vestibule where they can be reabsorbed.
Define: disorder that has repeated episodes of vertigo lasting minutes-days and accompanied by tinnitus and progressive sensorineural hearing loss.