Lec 22 Disorders of Vestibular System Flashcards Preview

Brain and Behavior Exam 2 > Lec 22 Disorders of Vestibular System > Flashcards

Flashcards in Lec 22 Disorders of Vestibular System Deck (52):
1

Why are kids more prone to middle ear infection?

eustachian tube connect pharynx to middle ear

in adults --> eustachian tube is longer, more vertical = better safe guard

2

What are the 2 parts of the outer ear?

pinna and external auditory canal

3

What are the parts of the middle ear?

- tympanic membrane
- ossicles
- air containing space

4

What are the parts of the inner ear?

- cochlea
- vestibule
- semicircular canals

5

What does weber test tell you?

- if sound different on one side

--> will lateralize toward conductive hearing loss or away from sensorineural hearing loss

6

what does rinne test tell you?

normal or sensorineural == AC > BC [louder from air than on bone]

conductive loss == BC > AC [louder on bone than air]

7

What it tympanometry?

test movement of ear drum by presenting tone

8

What is the purpose of an audiogram?

way to diagnose hearing loss
-- establish pure tone threshold for air and bone
-- test speech reception threshold for each ear
-- provide speech discrimination score

9

What happens to air vs bone conduction in conductive hearing loss?

AC depressed
BC normal
air-bone gap (BC >> AC)

10

What happens to air vs bone conduction in sensory neural hearing loss?

AC and BC depressed
AC = BC
usually bilateral

11

What are possible causes of conductive hearing loss?

- cerumen [ear wax]
- fluid [infextion]
- eustachian tube swelling
- tympanic membrane perforation
- cholesteatoma
- otosclerosis, congenital

12

What is otosclerosis?

genetic fixation of stapes

13

what is cholesteatoma?

mass of keratinizing squamous epithelium invading middle ear

14

What is treatment for conductive hearing loss?

drainage or surgery

15

What part of ear usually affected in conductive hearing loss?

outer/middle ear

16

what part of ear usually affected in sensory neural hearing loss?

inner ear or CNS problem

17

What does audiogram show in sensorineural hearing loss?

both AC and BC are less, high frequencies lost

18

What are potential causes of sensorineural hearing loss?

aging
genetic
noise
acoustic neuroma
medieres
toxins/virus/trauma/meningitis

19

What are treatment for sensorineural hearing loss?

surgery, radiation [if neuroma], hearing aid, cochlear implant

20

What are 2 most prevalent causes of sensorineural hearing loss?

aging
noise exposure

21

What are signs of hearing loss do to aging?

- type of sensory neural
- high frequencies lost
- speech discrimination preserved

22

what are signs of hearing loss due to genetic cause?

- type of sensory neural
- middle frequencies lost
- u shaped audiogram [with lowest in the middle]

23

what are signs of hearing loss due to noise?

type of sensory neural
high frequencies lost [usually notch at 4 kHz]

24

what are signs of hearing loss due to acoustic neuroma

type of sensory neural
unilateral
low speech discrimination

25

Who should get cochlear implant?

- if bilateral sensory neural hearing loss = severe
- if not benefit from hearing aid

26

What is vertigo?

vestibular system disease causing false sense of motion

27

what is imbalance?

sensory disturbance in vestibular, visual, or proprioceptive
- orign can also be cerebella, motor, etc

28

what is disequilibrium? causes?

pt feels like things are off balance, drunk

due to: degenerative, brainstem, multisensory, psychogenic

29

What is lightheadedness? causes?

pt feels like will fall

- usually cardio or metabolic [NOT VESTIBULAR}

30

What is VNG?

videonystagmography [VNG] = ENG
- measures direction and velocity of eye movement

31

What is the difference peripheral vs central vertigo?

peripheral = more common, inner ear, positional, delayed horizontal nystagmus, acute onset

central = brain stem or cerebellar, directional change of nystagmus, immediate nystagmus in any direction with position testing, more persistent

32

What are some potential causes of central vertigo?

cerebellopontine angle tumor
- stroke
- migraine
- MS

33

what are some potential causes of peripheral vertigo?

inner ear --> semicircular canal or otolith problem
vestibular nerve: BPPV, meniere's labyinthitis

34

What are the 5 common vestibular syndromes?

- acute unilateral vestibular loss
- menieres
- BPPV
- bilateral vestibular loss
- migraine associated diziness

35

What are some causes of acute unilateral vestibular loss?

- vestibular neuritis
- temporal bone fracture
- infarction
- inflammation/infection of vestbular neve
- acoustinc neuroma, injury to inner ear, vestibular neuritis, acute labrynthtis, temporal bone fracture

36

What are symptoms of acute unilateral vestibular loss?

- sudden onset vertigo, N/V, nystagmus in acute phase
- + romber
- past pointing
- gate ataxic, veers toward lesion side

37

What is treatment for acute unilateral vestibular loss?

meclizine, anti-emetics +/- vestibular rehab PT

38

What causes meniere's syndrome?

too much endolymph fluid --> distension of inner ear

39

what are symptoms of meniere's?

episodic vertigo: spontaneous, unpredictable, lasts hrs
- accompanies by N/V
- unilateral gradual hearing loss, aural fullness, tinnitus

40

How do you diganose/treat menieres?

diagnose:audiogram with unilateral upsloping sensory neural hearing loss

treat: vestibular suppressants, diurectics to minimize fluid pressure

41

What causes BPPV?

otolith/otoconia dislodged and float in endolymph --> put angle affected side down, go to posterior canal and cause stimulation --> delayed rotatory nystagmus

42

What are symptoms of BPPV?

- abrupt positional vertigo, 5-10 sec nystagmus latency

43

How do you diagnose/treat BPPV?

diagnose: dix-hallpike maneuver
treat: particle repositioning

44

What causes bilateral vestibular loss?

age related, head trauma, ahminoglycosides, infectious, inflammatory

45

What symptoms of bilateral vestibular loss?

- ataxia, oscillopsia [perception of oscillating vision]
- no true vertigo

46

what is treatment for bilateral vestibular loss?

vestibular rehab PT but poor prognosis

47

hwo do you diagnose bilateral vestibular loss?

absent caloric response in both ears

48

What are symptoms of migraine-associated vertigo?

motion sickness, photo/phono phonbia
resembles episodic ataxia syndrome

49

how long does BPPV last?

seconds to minutes

50

how long does bilateral vestibular loss last?

continuous

51

how long does meniere's syndrome last?

minutes to hours

52

how long does acute unilateral vestibular lost last?

days to weeks