Cognition & Senses 2: Vestibular Dz Flashcards

1
Q

FUNCTION of the VESTIBULAR system?

A

= MAINTAIN POSTURE/BALANCE of the HEAD, TRUNK, LIMBS & HEAD during REST & IN MOTION

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2
Q

VESTIBULAR DZ DESCRIBES A ___ ___, not a ____, meaning:

A

VESTIBULAR DZ DESCRIBES A NEUROANATOMICAL LOCALIZATION, not a DIAGNOSIS, meaning:

vestibular dz just tells us WHERE the problem is, NOT WHAT IT IS

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3
Q

CLINICAL SIGNS for DYSFUNCTIONAL VESTIBULAR SYSTEM?

signs are on the IPSILATERAL/CONTRALATERAL side for EACH?

A
  1. DECREASED EXTENSOR TONE of LIMB, TRUNK & NECK MUSCLES –> IPSILATERAL/SAME
  2. HEAD TILT, CIRCLING & ROLLING –> IPSILATERAL/SAME
  3. RESTING PATHOLOGICAL NYSTAGMUS –> goes towards CONTRALATERAL/OPPOSITE
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4
Q

projections to the ___ ___ provides _____ ___ of the body’s ____ in ___ via the ____

A

projections to the CEREBRAL CORTEX provides CONSCIOUS AWARENESS of the body’s POSITION in SPACE via the THALAMUS

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5
Q

projections to the VOMITING CENTER are located in the ____ ____

A

RETICULAR FORMATION

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6
Q

projections to the ____ can result in DECREASED ___ ___ on ONE SIDE and INCREASED _____ on the OTHER SIDE, causing ____

A

CEREBELLUM, EXTENSOR TONE, TONE, LEANING

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7
Q

projections via the ____ ___ to the ___, ____ & ____ allow for APPROPRIATE ___ or ___ POSITION relative to ____, and if dysfunctional causes ____ or ____

A

VESTIBULOSPINAL TRACT, NECK, TRUNK, LIMBS, HEAD, NECK, GRAVITY, LEANING, CIRCLING

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8
Q

what 3 CNs control EXTRAOCULAR EYE MUSCLES?

what do they project through? (3 words)

A

CN III, IV, VI

project through MEDIAL LONGITUDINAL FASCICULUS

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9
Q

CENTRAL vestibular system vs. PERIPHERAL vestibular system?

which one tends to have more BENIGN lesions?

A

CENTRAL vestibular = BRAINSTEM or CEREBELLUM

PERIPHERAL vestibular = EAR & EXTERNAL VESTIBULAR NERVES BEFORE they enter BRAINSTEM

PERIPHERAL = MORE BENIGN

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10
Q

PARADOXICAL VESTIBULAR DZ…

= where is the lesion?

causes what 2 clinical signs? TOWARDS or OPPOSITE from lesion?

look for UNILATERAL/BILATERAL ___ DEFICITS to CONFIRM

A

= lesion is in the CAUDAL CEREBELLAR PEDUNCLE in the ROSTRAL & MEDIAL VESTIBULAR NUCLEI

causes 2 what 2 clinical signs?
1. HEAD TILT/CIRCLING ON OPPOSITE SIDE OF LESION
2. FAST PHASE OF NYSTAGMUS TOWARDS SIDE OF LESION

look for UNILATERAL PROPRIOCEPTIVE DEFICITS

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11
Q

HORNER’S SYNDROME

tend to see PTOSIS on the AFFECTED/UNAFFECTED side

tend to see MIOSIS (define) on the AFFECTED/UNAFFECTED side

tend to see EXOPHTHALMOS/ENOPHTHALMOS on the AFFECTED/UNAFFECTED side

PERIPHERAL vs. CENTRAL VESTIBULAR SYSTEM affected?

A

PTOSIS, MIOSIS (PUPIL CONSTRICTS) & ENOPHTHALMOS on AFFECTED side

PERIPHERAL

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12
Q

CONGENITAL PERIPHERAL VESTIBULAR DZ

cause?

tends to present UNILATERAL/BILATERAL

can be caused by WHAT PRIMARY disease? what happens in this dz?

A

EXACT cause unknown

tends to be UNILATERAL, BILATERAL is RARE

can be caused by PRIMARY SECRETORY OTITIS MEDIA where MUCOID EFFUSION in TYMPANIC BULLA compromises NORMAL DRAINAGE

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13
Q

IDIOPATHIC PERIPHERAL VESTIBULAR DZ

tends to occur in WHAT AGE SA?

causes ACUTE/CHRONIC signs

severity is ___

often will RESOLVE in WHAT TIMELINE?

A

tends to occur in OLDER DOGS & CATS

causes ACUTE SIGNS

severity is VARIABLE

often will RESOLVE WITHIN 3 DAYS OF ONSET, but can be up to 3 WEEKS

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14
Q

INFECTIOUS PERIPHERAL/CENTRAL VESTIBULAR DZ

caused by WHAT INFECTION?

diagnosed via…

1 unique clinical sign?

common in ANIMALS with WHAT DZ? 2 species? (2)

treatment? (2, which is more effective?)

A

caused by OTITIS MEDIA/INTERNA that can ASCEND via AUDITORY TUBE; can be PERIPHERAL or VESTIBULAR

diagnosed via ADVANCED IMAGING (MRI/CT)

1 unique clinical sign? = FACIAL NERVE PARALYSIS ON SIDE OF LESION, aka HORNER’S SYNDROME

common in…
1. ANIMALS W/ SKIN ALLERGIES
2. BULLDOGS & CATS

treatment?
1. MEDICAL = ANTIBIOTICS, sometimes ANTIFUNGAL

  1. SURGICAL = SLIGHTLY more EFFECTIVE
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15
Q

what is the MOST COMMON INFLAMMATORY CAUSE of PERIPHERAL VESTIBULAR DZ in CATS?

what LESIONS do we see?

what AGE cats are affected?

treatment?

A

MOST COMMON INFLAMMATORY CAUSE = NASOPHARYNGEAL POLYPS

what LESIONS = SMALL BENIGN MASSES that OCCLUDE NORMAL DRAINAGE of NOSE & AUDITORY TUBE

AGE cats = 1-5 YEARS

Tx? = REMOVE POLYP via SURGERY or ENDOSCOPY

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16
Q

MOST COMMON CAUSE of PERIPHERAL VESTIBULAR DZ in DOGS?

dogs with this often have CONCURRENT DZ ___ ___

patients usually present with WHAT 3 CLINICAL SIGNS?

treatment? why?

A

MOST COMMONMOST COMMON CAUSE of PERIPHERAL VESTIBULAR DZ in DOGS? = CHOLESTEATOMA

dogs with this often have CONCURRENT DZ OTITIS MEDIA

patients usually present with WHAT 3 CLINICAL SIGNS?
1. PAIN OPENING MOUTH
2. PAIN ON PALPATION OF EAR
3. +/- PERIPHERAL VESTIBULAR SIGNS

treatment? why?
–> SURGICAL INTERVENTION because RISK OF RECURRENCE IS HIGH

17
Q

what DRUG is MOST COMMONLY REPORTED for OTOTOXICITY & PERIPHERAL VESTIBULAR DZ?

name 3 other drugs that can cause OTOTOXICITY & PERIPHERAL VESTIBULAR DZ?

A

MOST COMMON = AMINOGLYCOSIDES

3 others?
1. DIURETICS
2. ANTISEPTICS
3. PROPYLENE GLYCOL

18
Q

what METABOLIC DZ is POSSIBLY LINKED w/ PERIPHERAL VESTIBULAR DZ?

A

HYPOTHYROIDISM

19
Q

TRUE/FALSE

TRAUMA is a COMMON CAUSE OF PERIPHERAL VESTIBULAR DZ

A

FALSE, it’s UNCOMMON cause

20
Q

CONGENITAL CENTRAL VESTIBULAR DZ pathophys?

A

OCCIPITAL BONE is MALFORMED and PRESSES ONTO CEREBELLUM, causing OBSTRUCTIVE HYDROCEPHALUS and VESTIBULAR SIGNS

21
Q

what 2 INFECTIOUS diseases in SA most COMMONLY cause CENTRAL VESTIBULAR DZ?

A
  1. FIP in cats
  2. DISTEMPER in dogs
22
Q

MENINGIOENCEPHALITIS of UNKNOWN ETIOLOGY can cause ____ VESTIBULAR DZ

A

CENTRAL

23
Q

VASCULAR CENTRAL VESTIBULAR DZ

aka?

diagnostics?

prognosis?

A

aka = STROKE

diagnostics = do MRI SEQUENCES

prognosis = FAIR

24
Q

NEOPLASIA in the VESTIBULAR SYSTEM is MOST COMMONLY FOUND AT THE… (3 words)

A

CEREBELLAR PONTINE ANGLE

25
Q

DEFICIENCY in WHAT NUTRIENT can cause ____ VESTIBULAR DZ?

look for WHAT on diagnostics?

A

DEFICIENCY in THIAMIN (B1) can cause CENTRAL VESTIBULAR DZ

look for BILATERAL SYMMETRICAL CHANGES on MRI

26
Q

what ANTIBIOTIC can cause ____ VESTIBULAR DZ?

this occurs when… (2)

A

METRONIDAZOLE can cause CENTRAL VESTIBULAR DZ

this occurs when..
1. medication given AT HIGH DOSES
2. medication given OVER A LONG TIME

27
Q

what 2 CLINICAL SIGNS are KEY to DETERMINING AFFECTED SIDE in VESTIBULAR DZ?

A
  1. PRESENCE OF PROPRIOCEPTIVE DEFICITS
  2. HYPERMETRIA