EXAM 2 Flashcards

(238 cards)

1
Q

horizontal canals cause vertigo sx when you move your head

A

side to side

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2
Q

a VOR less than ___ indicates the eyes are moving slower than the head

A

1

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3
Q

vestibular sx often produce a ____output to correct

A

motor

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4
Q

vestibular anatomy is broken into 3 main categories, what are they

A

peripheral sensory apparatus (inner ear)
central processing center
motor ouput sx

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5
Q

what is peripheral sensory apparaus

A

inner ear

Provides sensory input about BOTH angular and linear acceleration

Orients the head with respect to gravity

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6
Q

what is central processing center

A

Somatosensory and visual cues
Cerebellum
Reticular formation, cortex

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7
Q

what is motor output sx

A

Generates compensatory eye movements for gaze stability

Body movements for postural stability with locomotion (through vestibulospinal tract

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8
Q

explain how your body detects movement in the inner ear

A

Canals detect head movement (ant, post and lateral)hair cells are sensory organs, when endolymph fluid moves it effects hair cells

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9
Q

what makes up the labyrinth (inner ear)

A
Contains 5 sensory organs:
3 semicircular canals
Anterior
Posterior
Lateral

2 otolith organs
Utricle
Saccule

Hair cells-motion sensors

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10
Q

each ear canal is ___to the other

A

perpendicular

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11
Q

explain the “push pull” reaction of the inner ear cannals

A

bc of the positioning of the canals, turning head 1 way would excite 1 canal but inhibit it’s opponent

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12
Q

information from the canals is used to

A

stabalize vision

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13
Q

Macula of the utricle is oriented in the ___plane

A

horizontal

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14
Q

macula of the sacule is oriented in the ___ plane

A

vertical

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15
Q

information from the otolith organs is used for

A

balance control

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16
Q

both the sacule and urtricle have

A

macula (hair cells and crystals here)

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17
Q

2 central processors (vestibular)

A

vestibular nuclei

cerebellum

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18
Q

explain how firing rate of nuclei can make a person feel dizzy

A

Both vestibular nuclei (each side) will fire at a certain frequency. For example, turning head to right, the right vestibular nuclei has higher frequency of firing (how your brain knows you have turned to the right) eyes and postural muscles will fall in line with what the brain tells them.

But, if one side of the nuclei is not firing as much, the other is firing all the time and the brain thinks the person is always turning head to the side it’s firing, so the eyes and postural muscles will try to fall in line (even though it’s not right) = dizziness

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19
Q

your eyes remain stationary during walking bc of your

A

VOR

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20
Q

deficit of the VOR results in

A

osscilopsia

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21
Q

the VOR is regulated by

A

Regulated by afferent input from semicircular canals

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22
Q

VOR is induced by ___ speed

A

FAST

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23
Q

nystagmus indicates

A

1 vestibular sx is more active than the other

when the vestibular nuclei aren’t equal

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24
Q

nystagmus is classified/named by

A

the direction of quick beat

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25
explain hypo/hyper active sides with nystagmus
If sx come on when head is turned to the right, then right side is hypofunction side
26
what is disuse disequilibrium
``` sedentary lifestyle (they don’t move much, but when they do get up they get dizzy) NON vestibular issue ```
27
examples of disuse disequilibrium
ortho hypotension panic attacks migraine TIA
28
Bacterial infection of the labyrinth | Can cause hearing loss
vestibular labyrinthitis
29
these occur at the round or oval window these seperate the middle ear and the inner ear d/t trauma or injury
perilymph fistula | peripheral vest. disorder
30
what irritates a perilymp fistula
auditory stimulus strain/increase in pressure causes sx of vertigo or imbalance
31
what is Meniere's disease
a peripheral vestibular disorder Onset in fourth- sixth decades of life (older pts get) Malabsorption of endolymph in the endolymphatic duct and sac = too much endolymp Devastating vestibular and HEARING LOSS Fullness in ear, reduced hearing, rotational vertigo, nausea.
32
bilateral vestibular Loss is often caused by
often caused by toxic drugs (if they are in sepsis) | Gentamyacin
33
sx of peripherial vestibular disorders
Hearing loss, tinnitus, VERTIGO, nystagmus, gait ataxia, impaired VOR vertigo with head movement
34
list the anatomy or the disorders assct. with peripheral disorders
Peripheral sensory apparatus | Vestibular neuritis, labyrinthitis, BPPV, Meniere’s, Perilymphatic fistula, Acoustic Neuroma
35
sx of central vestibular disorders
saccades, Oscillopsia, nausea, disequilibrium, ataxia, impaired smooth-pursuit eye movements, impaired VOR, headache, diploplia, bad Balance probs
36
what constitues a central vestibular disorder
Damage to vestibular nuclei, or central pathways that serve VOR and VSR, brain stem or cerebellum
37
with VOR, moving your head in 1 direction...your eyes move the ___ direction (if normal)
opposite | at equal velocity
38
what is VSR
is a reflex body movement that maintains your posture and stabilizes your body; this reflex keeps you upright.
39
peripherial vestibular disorder, vertigo is brought on by
head mvmt
40
balance is really effected with ____ vestibular disorders
central and bilateral are bad | may have some issues with peripheral, but not as bad
41
hearing loss or tinnitus occur with ___ vestibular disorders
peripheral
42
compensation for peripheral vest. disorders occurs ___, whereas compensation for central disorders occurs ___
peripheral -- fast | central--slow
43
What is DHI
dizziness handicapp inventory higher score is worse 60 is fall risk
44
For each of the following activities, please indicate your level of self confidence by choosing a corresponding number from the following scale 0% 10 20 30 40 50 60 70 80 90 100% No confidence completely confident
activities specific balance confidence scale
45
ABC under ___ increased fall risk
67
46
BPPV is usually
unilateral
47
sx with BPPV come on d/t
head position changes | the crystals fall out of place and land in one of the cannals
48
with BPPV, direction of nystagmus tells you___ | duration of nystagmus tells you ___
Direction of the nystagmus will tell you which canal is involved Duration will tell you the type of BPPV: canalithiasis or cupulolithiasis
49
anticipatory vs reactive control mechanisms
Anticipatory control mechanisms occur when you are expecting something to happen- ex: reaching to pick up a shoe from your chair so your back extensors kick in and you may grab the chair Reactive control: occurs when you don’t know it’s coming
50
loss of selective mvmt is an issue with the
cortex itself
51
quiet stance (balance maintanance) is affected by | in a healthy adult
Body alignment/ position/posture Muscle tone: Neural and non-neural factors Postural tone: Influenced by somatosensory system, cutaneous afferent input, visual and vestibular systems
52
anticipatory control is ___ initiated
self
53
amt of anticipatory control is based on
experience
54
what are the 3 motor strategies to maintain balance
ankle hip stepping
55
what are 3 sensory strategies to maintain balance
vestibular somatosensory (proprioception) vision
56
what are the quicker motor strategies for balance
ankle = fast | these kick in first usually
57
ankle strategies usually occur with what amplitude of mvmt
smaller
58
if you push a person posteriorly, what muscle kicks in for ankle strategy (lower leg is opp of hip)
tib ant
59
if pt is on a balance beam (small surface and Med/Lat) what strategies are likely to be dominant to keep them balanced
hip | hip strategies are for smaller surface area
60
for hip strategies, if you are pushed forward what kicks in
quads
61
for medial lateral forces, what strategies are dominant
hip (like balance beam - heel to toe activities) | but remember - for narrow BOS it's ankle
62
2 responses that occur with med/lat strategies
Cross-over response | Lateral step response
63
general reason why stroke pts have balance issues (adaptive)
for healthy people = Our balance responses are highly flexible – they adapt to forces and env around us But – stroke pts don’t have variability and adaptability of movement (they are in synergy)
64
when eyes are closed, what sx is used (by adults)
proprioception
65
at quiet stance, what sx are used
all 3
66
at perturbed stance, what sx are used | in a healthy adult
Somatosensory/proprioception big role (bc they are faster) Vestibular system becomes more active if: Support surface moves vertically (up down)
67
lack of ____ is usually the issue of cognition with regards to balance
attentiveness/attention
68
what is the cycle of balance issues and fear of falls
Imbalance = leads to a big fear of falling When someone fears falling they decrease their activity which leads to secondary impairment (like weakness) which can exacerbate future falls
69
most falls occur at ___ and are d/t ____
home - bathroom | tripping
70
big issue with pts who fall at home (the study listed)
51% cannot get up by themselves
71
this area of the brain controls adaptation abilities to modify muscle amplitude to respond to the need to move bc of env demands
cerebellum
72
number of meds for elderly that increase their fall risk
4 or more
73
classifications of meds that increase fall risk
``` Psychotropic Tricyclic antidepressants Seronin-reuptake inhibitors Cardiac medications Hypoglycemic agents ```
74
explain how stroke pts sequence their movement patterns
Stroke pts sequence proximal to distal pts post stroke have better mvmt proximally than distally (using hip hike to walk) These pts use proximal strategies over distal
75
based on the sequence of movement pattern of stroke pts, they use what strategies more
HIP (proximal)
76
issue of sequencing with PD pts
they co-contract
77
impaired adaptation (in order to move and respond) is due to
synergy | cognition issues
78
impaired timing is due to
timing occurs in cerebellum or fast twitch fiber loss dt coritical issue
79
what pts have impaired timing
stroke | PD
80
what pts have impaired scaling
Hypermetria – cerebellar issue (too much mvmt-issues regulating force) Hypometria- Parkinsons pt
81
what LOWER (below knee) ext muscles kick in if COM is placed forward
gastroc
82
what is the issue with strategies (muscles firing) for pts with PD when their COM is displaced
instead of sequential muscles kicking in normally in order to respond, PD pts have co contraction and everything kicks in at same time so normal response does not occur
83
according to the study, what is the issue with strategies (muscle firing) for pts with cerebellar disorders when COM is displaced
they have the sequencial response, but it's over done so the opposing muscle has to kick in too (this becomes cyclical)
84
loss of sensation or proprioception, pts have to rely on
vision
85
what is stability limit and why is it important
how far a person can move before losing balance | this is altered significantly if any of the 3 sx are lost/altered
86
what is inflexible weighting
a sensory selection prob when pts dont use the correct sx for balance ex: a pt post stroke who wont alter their stance or shift wt to effected side to prevent a fall
87
3 main reasons PD pts fall
postural instability festiation/freezing toppling over
88
pathology with highest risk for falls
PD
89
we should teach pts with stroke to fall to what side
non effected | fxs occur more when they fall on effected
90
post stroke, In pts are more likely to fall when
first 3 weeks of rehab (new normal and new env), then post dc from IP their risk increases again
91
balance deficits with stroke pts in quiet stance
⬆ reliance on uninvolved LE ⬆ sway ⬆ reliance on visual input ⬆deficits with dual-task conditions
92
balance deficits in stroke pts during anticipatory activity
⬇ weight shift involved LE ⬆ time to shift weight to involved LE ⬆ sway with UE movement with slowed motor latencies
93
balance deficits in stroke pts during reactive activity
slow muscle responses synergistic responses lack of coordination
94
when do MS pts typically fall
``` during movement (not quiet) turning, reaching ```
95
why do more men with MS fall typically
bc their MS is often more progressed
96
quick tests for ataxia
finger to nose | heel to shin
97
if vestibular sx is all a pt has (If that's their best of the 3 sx) what is their likely outcome
bad balance probs vest. is used last by healthy adults Vest doesn't stand well on its own
98
pts with MS fall usually bc of what 2 things
fatigue | distractions
99
important considerations when coming up with tx plan for balance (her general ones)
``` Static vs. progressive condition Acute vs chronicity Single- vs. multi-system involvement + and - prognostic indicators What can we change? What can’t be changed? ```
100
main concepts when tx balance with PD pts (the study we read)
With PD you are trying to help COM not be forward (alter their COM) We want to give them increased excursions of motion
101
main concepts when tx balance in stroke pts (study we read)
use BEST test | if they have balance issues work on balance not gait
102
main concepts with tx balance in pts with MS (study we read)
incorporate sensation with dynamic balance
103
Flexibility in what muscles is most relevant for standing balance
ant tib for if you are pushed backwards, gastroc for pushed forward
104
how might ROM effect balance
loss of strategies if tone is effected
105
will strength training alone do anything for balance
no
106
what muscles can contribute to decreased lateral stability which increases fall/fx risk
hip abd
107
is closed or open chain better for balance tx
To help balance work on closed chain txs
108
how does timing/speed of muscle contraction play into tx for balance
Stepping responses are fast Pts with neuro probs have more issues with fast speed Responding quickly can be a coordination therex bc it’s working on timing always do slow and fast speeds
109
tandem or single leg have to do with stance ___
position
110
what 2 pathologies do you want to increase excursion of mvmt
PD | stroke (towards effected side)
111
for ataxic pts you want to ____ excursion of mvmt
decrease
112
how would you increase challenge of perturbations
change: | force, frequency, surface level changes, eyes closed, velocity of the perturbation
113
balloon toss or badmitton are ex of ____ control reactions
reactive
114
3 sensory sx
visual proprioception (somatosensory) vestibular
115
when training balance, do you just want to do single task activities
no, incorporate dual task also
116
what is stroop task
a dual task activity | a neuro/psych test where color doesn’t match word
117
does altering env alone decrease fall risk
no | pts tend to add items to alter rather than take items away
118
for neuro pts is RW or SW better
RW requires least amt of attention | standard walkers require alot of attention
119
balance impariments, use what type of tests (OM)
predictive
120
psychometrics for predictive (diagnostic) tests
Sensitivity Specificity Probabilities Likelihood Ratios
121
psychometrics for evaluative tests
MDC | MDIC
122
sensitivity tells you
tells you how accurate the test is at identifiying the condition
123
How confident can we be in the diagnostic capabilities of the test has to do with
LR
124
probabilities deal with
the pt | if it starts with ....the pt
125
Probability that a patient with a + test result will have the condition
high prob
126
Probability that a patient with a - test result will not have the condition
low prob
127
interpret this data Postest prob test ≤ cut off the Standards for the OM is 69/108 pt score is 61.3% 6 months 69% 12 months 43%
this is the LESS than this means, if the pts score is less than the standard that is listed, than they have 69% chance of falls at 6 months and 43% chance of falls at 12 months Retro-pts score prospective -comparison scores
128
you want pos LR to be ___ and neg LR to be __
pos you want value to be high neg you want to be low In order to be in the green/confident category
129
formula for LR
Probability of + test in pt WITH condition/Probability of - test in pt WITHOUT condition
130
high confidence of LR (for pos and neg)
5 or greater (this is a pos LR) | .2 or lower (this is neg LR)
131
moderate confidence of LR
+ LR 2-5 | - LR 0.2 – 0.5
132
a LR of 1 or close to 1 is
not relevant, like it's neutral (.5-1 dont use)
133
list some specifics of the activities balance confidence scale
generic 16 items self reported Scoring: items rated on 0 – 100% continuous scale (higher = better); summed and divided by 16 = total score on 0 – 100 point scale
134
use ABC for what type of pts
community dweller, high level tasks, higher functioning pts. ABC is for balance
135
specifics of the Tinettes (FES) OM test
Type of measure: Generic Self-report Purpose: perception of ability to complete various tasks without falling Items: 10 – mainly household tasks Scoring: 0 – 10 point scale (higher = better); scores summed; total score 0 - 100 Limitations: Ceiling effect
136
lower level functioning and concerns/fear of falling, SNF pts what OM to use
Tinetti (FES) | FES is for FALLS
137
target population for Tinetti (FES)
SNF pts | homebound pts
138
specifics of BEST Test
Generic Performance-based Purpose: assist with identifying the underlying postural control systems responsible for poor functional balance Items: 27 tasks / 36 items testing 6 systems Scoring: 3 – 4 point scale; total score and subtest scores are obtained and calculated as a percentage of the total score Limitations: time consuming (20 – 30 min.)
139
dimensions tested in BEST test
``` biomechanical stability limits reactive anticipatory sensory gait ``` BRAGSS
140
4 components tested in mini BEST
anticipatory reactive sensory gait RAGS
141
immediatley post stroke, the pt tone is
flaccid
142
what OM is good for testing turning in place
BERG
143
4 approaches to vestibular rehab
Adaptation Substitution Habituation compensation
144
4 main categories of vestibular disorders
Unilateral Bilateral peripherial hypofunction Central –ex MS BPPV
145
difference in approach for partial vs full loss in regards to vest tx
partial - remediate | full -compensatory
146
Why are ROM exercises important to do with vestibular pts
ROM of head and neck is important bc they often develop muscle imbalances from compensation and not moving dt sx
147
tx approach of vestibular pts depends on
Unilateral or bilateral involvement | Complete or partial vestibular loss
148
neuroplasticity indicates what
CNS is adapting
149
gaze stabalization exercises are _____ approach
adaptation
150
explain gaze stabalization exercises
Gaze stabilization ex retrain/restore eye/head muscle mvmts and retrain the sensitivity of the VOR Aim to improve VOR by inducing retinal slip Involve active eye & head movement to improve coordination between the two
151
gaze stabalization (adaptation) is good for what pts
unilateral or bilateral with incomplete loss
152
explain substitution as a tx approach
Aim to improve the patient’s ability to use various sensory systems to improve balance control (vision/proprioception) Use central preprogramming to improve gaze stability and postural stability Stress system by reducing sensory cues -->forces patient to rely on other systems/cues
153
what is central pre programming
uses compensatory eye movements (use eye mvmts that are slower and maybe don’t correlate with head mvmt equally) purposefully not equal used in substitution
154
what approach do you use for pts with car sickness (motion sickness)
habituation
155
how long does habituation take
weeks to months
156
explain principle of habituation
Learned suppression of vertigo through repetitive exposure to provoking movements
157
compensation is used to improve__
NOT to improve VOR | but rather, to improve function
158
compensation is used for what pts
central issues bilateral issues complete loss
159
examples of compensation
lighting railings assistive devices (alternative strategies for function)
160
peripherial unilateral pts, what approach to use
adaptation/restoration
161
how long does tx for peripherial unilateral take
6-8 weeks
162
how to tx peripheral unilateral pts
``` Gaze stabilization exercises (matching eye to head) Vestibular stimulation (X1 viewing) Visuovestibular stimulation (X2 viewing) High level balance retraining Conditioning Education ```
163
how could you progress gaze stabalization exercises (X1, X2)
change background of what they are looking at change standing surface increase distance btwn them and object
164
VOR is really bad for what pts
Bilateral peripheral
165
prognosis for bilateral peripheral pts
not good | can take years, but may not fully recover
166
____ is a sign of retinal slip
oscilopsia
167
balance is poor and assistive devices needed for what type of pts
bilateral
168
why will bilateral complete loss yield a neg head shaking test
For typical nystagmus issues, there is a mismatch btwn R and L that causes the imbalance (if there are B issues, there is no mismatch).
169
vertical nystagmus indicates a _____ problem
o Vertical nystagmus indicates central problem
170
sx of bilateral peripheral disorder
Gaze instability & oscillopsia Negative head shaking test if a complete loss Postural instability, especially when vision or proprioception is reduced Gait abnormalities: WIDE BOS INSENSITIVE to motion in environment Deconditioning
171
tx approach for bilateral peripheral disorder
substitution
172
what sx do you want to increase when tx bilateral peripheral
increase vision and proprioception
173
fall risk for bilateral pts is
very high
174
focus of tx for bilateral pts is what 4 things
occulomoter ex (2 horizontal targets) balance ex education conditioning
175
use ___ approach for central disorder pts
compensatory
176
dosing of habituation
Select up to 4 movements Perform quickly - provoke symptoms Rest after each movement until sx. stop 3 – 5 sets of each 2 – 3 x/day
177
for BPPV, what two canals are tx the same
ant/post same | hor different
178
most common tx for ant/post BPPV
Canalith Repositioning Maneuver (CRM; a.k.a. Epley)
179
explain Epley/Canalith positions
start seated supine (head turns) SL ends seated
180
how often do you typically have to perform the Epley manuever
1 x
181
most common location of BPPV
right post
182
canalithiasis vs cupulothiasis
In canalithiasis the particles reside in the canal portion of the semicircular canals Cupulolithiasis refers to densities adhering to the cupula of the crista ampulla.
183
education you should provide to pts post Epley manuever
take it easy for 1-2 days | you may feel "off"
184
Epley only treats which _____athiasis
canalithias
185
what ant/post BPPV manuever is self done, and is for both ___athiasis
Brandt-Daroff Habituation Exercises
186
More violent rapid movements –used as a last resort for canalithiasis ant/post BPPV
Liberatory (Semont) manuever
187
what do you need to assess before doing vertigo tx (neck/head movements)
Need to test for vertebral artery dysfunction before doing tests that involve neck motion. For vert art test have them lean forward/sb/rotate
188
ataxia of the eye (difficulty stopping eye mvmt) is what
saccades
189
if the saccades test is pos, what should you do
refer bc it may indicates a CNS issue
190
more than 2 saccade jumps indicates what
cerebellar issues-CNS
191
to test for saccades, you only go about ___ degrees up/down/lateral
20
192
torsional nystagmus correlates with what disorder
BPPV
193
what degrees is uses with nystagmus
30 up/down/lateral
194
absence of nystagmus indicates normal vest sx, T or F
absence of nystagmus doesn’t mean normal vestibular system! (suppression or resolution could have occured)
195
upbeat/downbeat nystagmus indicates what type of disorder
CNS
196
frenzel lenses are used to test ___
nystagmus | they cannot stabalize gaze so it's really evident
197
head thrust test, tests the ___ canals
hor | peripheral or central issue
198
steps to head thrust test
Patient seated in front of PT; PT grasps patient’s head and flexes neck to 30degrees; patients head is thrust (eyes open) either R or L in unpredictable manner (to about 5 to 10 degrees; PT observes for corrective saccades; repeat in each direction 3 times
199
with peripheral loss, head thrust results are what when going towards involved side
sx are worse | will not be able to hold gaze and saccades will be present
200
head shake test, tests what canals
hor
201
explain head shake test
back and forth x 20 cycles then keep ahold of head and have them open eyes and observe for nystagmus
202
so head thrust looks for___ while head shake looks for ___, and both tests you position pt at ____
thrust -saccades shake -nystagmus both 30 degrees neck flexion
203
pos head shake test indicates what disorder
UNILATERAL periperial disorder of a horizontal canal
204
dynamic visual acuity test, tests what canals
hor
205
Patient in front of a wall-mounted eye chart; PT asks patient to read the lowest line s/he can see on the chart (test static first); patient then asked to read the chart while the PT oscillates patient’s head at frequency of 2 Hz (dynamic); PT compares visual acuity in static vs. dynamic condition abNormal: over 3 line difference indicating vestibular hypofunction (3 lines up or more is pos) this is what test
dynamic visual acuity
206
test to dx ant/post BPPV
dix hallpike
207
contraindications for dix hallpike
o Vertebral artery syndrome | o Cervical spine instability or other issues
208
in dix hallpike, if pt has sx and nystagmus when head is turned to the post left, which canals are involved
the side you are turning towards is effected side | left post
209
what are the pairings of the semi-circ-canals
Horizontal canals: rotation in the horizontal plane Left anterior and right posterior (LARP) Right anterior and left posterior (RALP)
210
cranial nerve-controls the down and inward movement of the eye
trochlear | 4
211
3 CN responsible for eye mvmt
3,4,6
212
occulomotor nerve movements
everything other than abduct and down and inward
213
what test would you perform for unilateral peripheral vest issue
head shake test for nystagmus
214
what tests would you perform for central vest issues
neuromotor functional tests | a series of neuromotor function tests
215
looking from nose to finger tests for
saccades
216
frenzel lenses are used when ___ is present
nystagmus
217
resting/static nystagmus indicates
can mean acute peripheral vestibular lesion (although not likely seen without Frenzel lenses) or brainstem/peripheral lesion
218
head thrust tests, tests what
assess the integrity of the VOR; tests horizontal canal | looking for sacaddes
219
head shake test, tests for what
assess the integrity of the VOR in patients with unilateral peripheral vestibular deficit looks for nystagmus
220
chance that pt does or does not have the condition
probability
221
disequilibrium, 'ataxia, 'impaired'smooth-pursuit'eye'movements,' (saccades) impaired'VOR all sx of
central disorders
222
test for CN function
H test
223
which lasts longer cupolithiasis or canalothiasis
cupolothiasis lasts longer than canalothias
224
typical motor strategies go ___ to ___
distal to proximal | ankle first usually
225
main sensory strategy used by adults
somatosensory
226
odds of pt having a disease based on pos or neg result
LR
227
3 self reported OM for this unit | have to do with participation
FES - low function DHI ABC - high function
228
X1 X2 viewing is for
unilateral peripheral disorder | hypofunction
229
dosing of X1 X2 viewing exercises
1-2 min x 5 x/day
230
going up in an elevator would enact which of the 3 sensory sx
vestibular | if vertical changes are made vestibular is enacted
231
dynamic visual acuity test is for what type of disorders
bilateral of hor canals
232
Roll test is for
HORIZONTAL BPPV
233
horizontal targets - move eyes then head imaginary targets- turn head, close eyes, image these treat what
bilateral disorders
234
peripheral disorder associated with CN 8 (non malignant tumor)
acoustic neuroma
235
Cranial N test
H test
236
how to test for saccades (2 ways)
nose to finger eye follow | head thrust
237
with saccades nose to finger follow test, what degrees to rotate L/R
20 for saccades
238
head shake is flex neck to ___ degrees, rotate head ___ degrees L/R, for ___ cycles
30/30/ 20 cycles