Module 8 - Neuro & Musculoskeletal Flashcards Preview

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Flashcards in Module 8 - Neuro & Musculoskeletal Deck (45)
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1

What is BPPV?

Benign Paroxysmal Positional Vertigo - a syndrome that may be a manifestation of several varied inner ear conditions. ** Occurs with position change.

2

What does the Hallpike-dix maneuver test for?30-45 degrees
How is it done?

Nystagmus.
1. 1st check pt for spontaneous nystagmus while seated.
2. Next, bring the pt quickly back to recumbent or supine position with head extended 30-45 degrees over table and tilted 30-45 degrees to one side.
3. Repeat above two times - once with head to right and once with head to left.
4. Observe the pt for latency, duration, direction, and fatifability of nystagmus in supine and upright position.

3

If nystagmus is vertical or torsional in nature and lasts less than 30 sec. it is consistent with a:

posterior semicircular canal variant

4

If nystagmus is direction and horizontal (beating toward ground) and lasts about 1 min. it is consistent with a:

horizontal canal variant

5

Vertigo that is spontaneous (not position related) and the presence of focal neurologic findings suggest a:

central etiology

6

BPPV can be confirmed by ____________ and a ____________ Hallpike-dix test result.

history; postitive

7

When the Hallpike-dix test is positive if ____________ is characteristic and _________ and ________ are elicited with the affected ear _________.

nystagmus; dizziness, vertigo; down.

8

Symptom of vertigo is differentiated from sycope or disequilibrium by careful ____________.

history.

9

Treatment for BPPV are typically ____________ maneuvers.

postional (liberatory maneuvers and physical therapy interventions

10

Describe Epley's manuever

Moving the patient from one head-hanging positon to another. Must not lie flat for 48-72 hours following.

11

Meniere's is a ___________ condition of the inner ear characterized by ___________ _________ and _____________ ___________.

chronic; recurrent vertigo, hearing loss

12

Four sx assoc with Meniere's:

1. spinning vertigo/dizziness
2. sensorineural hearing loss
3. tinnitus
4. feeling of fullness in affected ear

13

Weber test result in Meniere's? Rinne result?

Sound will lateralize to the unaffected ear.
air conduction will be greater than bone conduction.

14

Should Meniere's pt be referred?

Yes

15

Definitive dx for Meniere's requires ________ episodes of spontaneous vertigo lasting __________min., _______________ documented _________ ________ and _____________ or aural ______________. With the exclusion of other causes.

2; 20min; audiometrically, hearing loss; tinnitus, fullness

16

Tension headache: bilateral or unilateral, pulsating or nonpulsating?

bilateral, nonpulsating

17

Is bell's palsy unilateral or bilateral facial paralysis?

unilateral

18

Which cranial nerve is affected with Bell's?

VII

19

Bell's has acute onset with max paralysis in ____ to _____ _______.

48-72 hours

20

Bell's pt may have altered _________ and sensitivity to _________.

taste; sound

21

Bell's palsy is a common neuropathy with __________ disease.

Lyme

22

T/F
Bell's is more common in pregnancy.

True

23

Prevention of _____ ___________ is the most important goal in Bell's.

eye injury

24

In Bell's, ____________ _____________ can cause blindness. To prevent administer ______________ bid and ___________ at HS.

exposure keratitis; methylcellulose; ocular lubricant

25

What med is recommended for all Bell's pts? Dose?

Prednisone 60-80mg/day for 1 wk with tapered dose 2nd week

26

What med should be added if Bell's is severe? dose?
What for pain?

Valcyclovir 1000mg TID
NSAIDs

27

Recovery time for Bell's? at most?

4-6months; 12 at most

28

Bell's and pregnancy.

Referral should be considered

29

What disorders should be referred to neuro?

Trigeminal neuralgia, meningitis

30

Things to look for in meningitis:

nuchal rigidity, brudzinki's , kernig