exam 2: vestibular review

Question 1

yaw

Answer 1

shaking your head no
on the z axis

Question 2

pitch

Answer 2

nodding
on the y axis

Question 3

roll

Answer 3

side bend
moving on the x axis

Question 4

what three nerves do we find in the ear

Answer 4

vestibular, cochlear nerve and facial nerve are all intertwined

Question 5

what is the function of the vestibular system

Answer 5

helps detect head position and movement of the head

helps maintain balance

involved in reflexive eye movements

Question 6

what is the function of the otolith organs

Answer 6

detects static position of the head and linear acc

Question 7

what is the function of the semicirccular canals

Answer 7

detect the rotational accc of the head

Question 8

what are the name of the three semicircular canals

Answer 8

superior
horizontal
posterior

Question 9

what is the ampullae

Answer 9

bulbous chamber at the end of each semicircular canals

this where hair cells are located

Question 10

what do we find inside the ampullae

Answer 10

cupla

Question 11

what is the cupula and it function

Answer 11

for a barrier that endolymph cannot pass - the endo distorts the cupula

this bend the hair cells and increase or decrease NT release depending on the direction of the endo flow

Question 12

when are the horizontal canals horizontal to the ground

Answer 12

when we flex the head forward

Question 13

what are the two type of otolith organs

Answer 13

saccule and utricle

Question 14

what direction do the hair cells get excited

Answer 14

when they push towards the kinocilia

Question 15

what is the otoconia

Answer 15

the sterocilia extend into a gelatinous layer that is covered with the otoconia

Question 16

otoconia location

Answer 16

on to of hair cell in the utricle and saccule - otolith organs

Question 17

otocconia and shifting of the head

Answer 17

when we shift our head the otocania shift that hair cells

Question 18

is there one primary vetsibular cortex in the brain

Answer 18

no vestibular information is spread through the brain

Question 19

what happen is we have dysregulation of the vestibular system

Answer 19

vertigo

Question 20

VOR reflex is a connection of what two systems

Answer 20

vestibular system and the ocular system

Question 21

what is the vestibular ocular reflex

Answer 21

produce eye movement that counters head movements

allows us to focus our gaze on one point even when our head it moving

EX: if we move our head to the right our eye can stay focused on an object

Question 22

what is gain of VOR

Answer 22

the change in the eye angle divided by the change in the head angle during the head turn

Question 23

what does a gain of 1.0 mean

Answer 23

meaning there is a compensatory eye velocity equal to the head velocity and in the opposite direction

Question 24

how much of a gain decrease do we normally see with unilateral labyrinthine lesion

Answer 24

25-50%

Question 25

which way does nys beat

Answer 25

away from the involved side

Question 26

what is spontaneous nys

Answer 26

this is when you see nys in the resting posistion

Question 27

what drives VOR adaptation

Answer 27

rentinal slip an attempt is made to change the amp or speed of the eye movement to bring the target on the fovea

Question 28

for vision to be normal what does rentinal slip have be less then

Answer 28

2 deg/secc

Question 29

what is the center of the vestibular system

Answer 29

vestibular nuclei

Question 30

otolith organs vs SSC

Answer 30

oto - detect static head position and linear accc SSC - rot acc of the head

Question 31

what is the def of retinal slip

Answer 31

the differencce between eye velocity and head velocity

Question 32

what are included in the vestibular peri organs

Answer 32

3 SSC 2 otolith organs - saccule and utricle

Question 33

what are the phases nystagmus

Answer 33

slow and fast phase

Question 34

what does the slow phase of nys reflect

Answer 34

the function of VOR reflecting the underlying pathology

Question 35

what does left beating nys mean

Answer 35

fast phase to the left and right ear issue

Question 36

Fixation suppression of a spontaneous nys is a clue in to what

Answer 36

peripheral vestibular disorder

Question 37

how do we name torsional nys

Answer 37

named for the direction of the fast phase for the upper pole of the eye

Question 38

what are the two types of nys

Answer 38

physiological and pathological

Question 39

what are the three types of physiological nys

Answer 39

vestibular induce visually induced extreme endpoint induced

Question 40

vestibular induced

Answer 40

everyone can prestn with nys depending on the situation - spinning in a chair caloric

Question 41

visually indiced

Answer 41

if you count strips this can induce nys

Question 42

end point induced nys

Answer 42

if you go to the end range of you visual field this can induce nys

Question 43

Caloric Nystagmus

Answer 43

irrigation of the external ear canal with ice-cold water or warm water for 3 to 5 minutes causes the endolymph to flow in the semicircular ducts.

Question 44

what are the three type of patho nys

Answer 44

spontaneous gaze evoked posiotional

Question 45

what is spontaneous nys

Answer 45

movement of the eyes without a cognitive, visual or vestibular stimulus

Question 46

spontaneous nys and fixation central disorder

Answer 46

there nys does not change with light, focusing does not help o Brian problem

Question 47

spontaneous nys and fixation peripheral disorder

Answer 47

nys stops with fixation - inner ear problem

Question 48

does Peri spontaneous change as we look differnt directions with out eye

Answer 48

no - in every direction the nys is the same unilateral vestibular loss - uni directional problem

Question 49

Sym gaze evoked diagram presentation

Answer 49

o Center – nothing o Right – beat right o Left – beat left o there is a change in direction without a change in head position

Question 50

BPPV nys

Answer 50

o This is associated with head movement o Move the head and the nys changes direction

Question 51

presentation of Congenital nys

Answer 51

nys at center point

Question 52

what do you do if you see down beating nys

Answer 52

go see a neurologist this does not fatigue and is highly unusual

Question 53

nys with peri issues straight or with torsion

Answer 53

with torsion

Question 54

is sym gaze evoked nys brain or peri issue

Answer 54

brain problem there persons head is still and just their eye movements cause the nys

Question 55

cervico-ocular reflex (COR)

Answer 55

an ocular stabilization reflex that is elicited by rotation of the neck interact with VOR to drive eye movement based on the cervical work to prevent visual slip

Question 56

are smooth pursuits and sacccades effected by vestibular issue

Answer 56

no they never have to do anything with the inner ear if there is a disorder this is most likely a brain issue

Question 57

what do smooth pursuit allow the eye to do

Answer 57

allow the eye to track moving object across the visual field without omving the head

Question 58

what is often the cause to issue with smooth pursuits

Answer 58

cerebellar lesions

Question 59

what are saccadic eye movements

Answer 59

rapid voluntary movement that allow re-foveation of stationary targets maintain a visual object on the fovea voluntary or involuntary

Question 60

what is indicated by issue with smooth pursuit

Answer 60

brian issue

Question 61

what are possible causes for slow saccades

Answer 61

parkinsons progressive supernuclear palsy intranuclear opthamoplagia drug intoxication oliviopontocerebellar atrophy huntingtons chorea

Question 62

is nys named for its slow or fast phase

Answer 62

fast ohase

Question 63

what happens to peri vestibular nys with visual fixation

Answer 63

it stops

Question 64

what happens to a central vestibular nys with visual fixation

Answer 64

the nys does not stop

Question 65

alexander law - looking in the direction of the the fast phase

Answer 65

looking in direction of fast phase increase the amp and freq of nys

Question 66

alexander law - looking in the opposite direction of the the fast phase

Answer 66

decrease the amp and freq

Question 67

what is first degree nys

Answer 67

seen only when we look in the direction of the fast phase of nys

Question 68

what is 2nd degree nys

Answer 68

nys is present in the primary position (looking forward) and when looking toward the fast phase

Question 69

what is third degree nys

Answer 69

nys is seen in all direction horizontal

Question 70

presentation of the person with 3rd nys

Answer 70

they are very sick - just had surgery, just go admitted to the hospital

Question 71

what does primary gaze mean

Answer 71

neutral - looking straight forward

Question 72

does central nys change intesity with fixation

Answer 72

no

Question 73

is peri nys worse or better with fixation

Answer 73

better

Question 74

what kind of nys do we see with posterior canal BPPV

Answer 74

torsional nystagmus

Question 75

what is BPPV

Answer 75

the sudden sensation of spinning