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Flashcards in Vestibular Deck (113)
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1

Which vestibular system includes the inner ear and functions to detect and relay info about velocity of the head?
a. peripheral sensory apparatus
b. central processing system
c. motor output system
d. none of the above

peripheral sensory apparatus

2

Which vestibular system includes the brainstem, cerebellum, cerebral cortex and functions to receive info from the inner ear along with other sensory info and processes that info?
a. peripheral sensory apparatus
b. central processing system
c. motor output system
d. none of the above

central processing system

3

Which vestibular system includes the VOR and VSR and functions to generate compensatory eye and body movements?
a. peripheral sensory apparatus
b. central processing system
c. motor output system
d. none of the above

motor output system

4

Which system includes the semicircular canals and otoliths?
a. peripheral sensory apparatus
b. central processing system
c. motor output system
d. none of the above

peripheral sensory apparatus

5

Within the semicircular canals, hair cells in the _ convert mechanical information into neural firing

cupula

6

What are the 3 semicircular canals?
a. anterior, medial and lateral
b. posterior, medial and vertical
c. anterior, posterior and horizontal
d. posterior, horizontal and medial

anterior, posterior and horizontal

7

The semicircular canals function to detect _

rotation

8

Horizontal semicircular canals function to detect _ movement

front and back head movement

9

What is detected in the frontal plane?

side to side head movement

10

Which canal is most likely to get debris in it?
a. anterior
b. posterior
c. horizontal

posterior

11

the utricle and saccule can detect _ _

linear acceleration

12

Within the Otoliths, hair cells in the _ convert mechanical information into neural firing

macula

13

The central processing system is controlled by interconnections between

brainstem (thalamus, vestibular nuclei, retinacular formation)
cerebellum
cerebral cortex (portions of parietal and insular lobes)

14

Which system is responsible for reflexive eye movement that stabilizes images on the retina during head movement?
a. vestibulo-ocular reflex
b. vestibulo-spinal reflex
c. central processing system
d. peripheral sensory apparatus

vestibulo-ocular reflex

15

The VOR produces eye movement in the direction (opposite/same) to head movement

opposite

16

Which system is responsible for controlling the head movement and stabilizing the body?
a. vestibulo-ocular reflex
b. vestibulo-spinal reflex
c. central processing system
d. peripheral sensory apparatus

vestibulo-spinal reflexes (VSR)

17

The VSR utilizes input from the _ system

peripheral sensory apparatus

18

The VSR assists in the control of _ alignment in relationship to gravity and body _ responses

head
postural

19

Which of the following is classified as a mechanical vestibular disorder?
a. Acoustic neuroma and Ototoxicity
b. BPPV and Perilymph Fistula
c. Vestibular migraine and Mal de Debaruement
d. Cervicogenic Dizziness and BPPV

BPPV and Perilymph Fistula

20

What vestibular disorders are classified as altered receptor input?

Labyrinthitis/Vestibular Neuritis
Endolymphatic hydrops
Acoustic Neuroma
Ototoxicity

21

Which of the following is classified as a central vestibular disorder?
a. Acoustic neuroma and Ototoxicity
b. BPPV and Perilymph Fistula
c. Vestibular migraine and Mal de Debaruement
d. Cervicogenic Dizziness and BPPV

Vestibular migraine and Mal de Debaruement

22

Which of the following is classified as non-vestibular disorder?
a. Perilymph fistula
b. Ototoxicity
c. Mal de Debarquement
d. Cervicogenic Dizziness

Cervicogenic Dizziness

23

Which disorder can be described as having vertigo, dizziness and is due to debris that has collected within a part of the inner ear?
a. Ototoxicity
b. Perilymph fistula
c. Labyrinthitis/Vestibular Neuritis
d. BPPV

BPPV

24

the debris called _ is made of small crystals of _ _

otoconia
calcium carbonate

25

With this vestibular disorder, head movements will displace otocnia shift and send false signals to the brain

BPPV

26

Symptoms of BPPV are almost always precipated by
a. a headache
b. dizziness
c. vertigo
d. change in head position

change in head position

27

What is the most common cause of BPPV?

people under age 50 is head injury

28

BPPV is not associated with a migraine (true/false)

false

29

Diagnostic testing for BPPV is looking for

nystagmus

30

How can BPPV be treated?
a. medication
b. surgery
c. Epley maneuver
d. it is untreatable

Epley maneuver

31

What is the goal with maneuvers for treating BPPV?

move the detached otoconia out of one of the semicircular canals

32

Which of the following vestibular disorders is most commonly caused by head trauma, can be after rapid changes in intracranial pressure like scuba diving or weightlifting?
a. Ototoxicity
b. Perilymph fistula
c. Labyrinthitis/Vestibular Neuritis
d. BPPV

Perilymph Fistula

33

Fistulas may be present from birth (true/false)

true

34

Which of the following is a tear or defect in the oval window and it changes ear pressure stimulating balance and hearing structures?
a. Ototoxicity
b. Perilymph fistula
c. Labyrinthitis/Vestibular Neuritis
d. BPPV

Perilymph Fistula

35

This type of disorder has symptoms of dizziness, vertigo, imbalance, nausea, vomiting, ringing or fullness in the ears, hearing loss and patients symptoms get worse with changes in altitude, air pressure and activity?
a. Ototoxicity
b. Perilymph fistula
c. Labyrinthitis/Vestibular Neuritis
d. BPPV

Perilymph Fistula

36

How is Perilymph Fistula diagnosed?

tympanotomy and viewing the suspected fistula

37

How is Perilymph Fistula treated?
a. Epley maneuver
b. medications
c. rest then surgery if severe
d. exercises

rest then surgery if severe

38

Which disorder is a result of an infection that inflames the inner ear or the vestibulo-cochlear nerve?
a. Ototoxicity
b. Perilymph fistula
c. Labyrinthitis/Vestibular Neuritis
d. BPPV

Labrinthitis/Vestibular Neuritis

39

Infections of the inner ear are usually _

viral

40

Which disorder affects the vestibular branch of the vestibulocochlear nerve, results in dizziness or vertigo but no change in hearing?

Neuritis

41

Which disorder occurs when an infection affects both branches of the nerve, results in hearing changes as well as dizziness or vertigo?

Labyrinthitis

42

Symptoms can be mild or severe, vertigo, nausea, vomiting, unsteadiness and imbalance, difficulty with vision and impaired concentration
a. Neuritis
b. Labyrinthitis
c. Ototoxicity
d. BPPV

Neuritis

43

The difference between Neuritis and Labyrinthitis is that symptoms include tinnitus and hearing loss

Labyrinthitis

44

Labyrinthitis is a (gradual/sudden) onset of dizziness during daily activities

sudden

45

People can be completely free of symtpoms after several weeks with Labyrinthitis/Neuritis (true/false)

true

46

Test to diagnose Labyrinthitis/Neuritis
a. Epley
b. dix-hall pike
c. MRI
d. none

none

47

How is Labyrinthitis/Neuritis treated?
a. surgery
b. medication
c. exercises
d. rest

medication

48

Which of the following is described as a disorder that produces a recurring set of symptoms as a result of abnormally large amounts of fluid called endolymph collecting?
a. Perilymph Fistula
b. Acoustic Neuroma
c. Endolymphatic Hydrops
d. BPPV

Endolymphatic Hydrops

49

Secondary Endolymphatic hydrops occur because
a. no reason
b. trauma or underlying condition
c. environmental factors
d. none of the above

trauma or underlying condition

50

This disorder has symptoms of vertigo, ringing or roaring in the ears (tinnitus), feeling of fullness or pressure in the ear and fluctuating hear loss
a. Perilymph Fistula
b. Acoustic Neuroma
c. Endolymphatic Hydrops
d. BPPV

Endolymphatic Hydrops

51

What may precede a Meniere's disease attack?

fullness
hearing fluctuating or changes in tinnitus

52

An episode or attack of Endolymphatic Hydrops involves

severe vertigo
imbalance
nausea
vomiting
acute reduction in hearing

53

An average attack for Endolymphatic Hydrops is
a. 2 days
b. 1 hour
c. 3-5 hours
d. 2-4 hours

2-4 hours

54

After an attack from _, patients feel they are exhausted and need sleep for hours

Endolymphatic Hydrops

55

During an attack of Endolymphatic Hydrops, nystagmus cannot be seen (true/false)

false

56

There is a large amount of variability in _
can experience _ or _ _

Endolymphatic Hydrops
shocks
invisible hand

57

Patients with Endolymphatic Hydrops are highly sensitive to _ stimuli
a. auditory
b. vibration
c. vestibular
d. visual

visual

58

This disorder is a benign tumor on the vestibular portion of the 8th CN
a. Perilymph Fistula
b. Acoustic Neuroma
c. Endolymphatic Hydrops
d. BPPV

Acoustic Neuroma

59

What can be affected with Acoustic Neuroma?
a. hearing and vision
b. vision and balance
c. hearing and balance
d. vision and proprioception

hearing and balance

60

Symptoms of this disorder include one-sided hearing loss, tinnitus, period of unsteadiness or imbalance
a. Perilymph Fistula
b. Acoustic Neuroma
c. Endolymphatic Hydrops
d. BPPV

Acoustic Neuroma

61

How is Acoustic Neuroma treated?
a. medication
b. exercises
c. microsurgery or radiation
d. Epley maneuver

microsurgery or radiation

62

Which disorder is "ear poisoning" due to drugs or chemicals that damage the inner ear or the vestibularcochlear nerve?
a. Ototoxicity
b. Acoustic Neuroma
c. Endolymphatic Hydrops
d. BPPV

Ototoxicity

63

Ototoxicity can result in _ or _ disturbances of _ or _

temporary or permanent
hearing or balance (or both)

64

What are common causes of ototoxicity

aminoglycoside antibiotics
anti-neoplastics
environmental chemicals
loop diuretics
aspirin and quinine products

65

Symptoms of ototoxicity (vary/consistent)

vary

66

Symptoms of this disorder include headache, a feeling of ear fullness, imbalance to the point of being unable to walk and bouncing and blurring of vision
a. Perilymph Fistula
b. Acoustic Neuroma
c. Ototoxicity
d. BPPV

Ototoxicity

67

Patients with this vestibular disorder have an inability to tolerate head movement, wide-based gait, difficulty walking in the dark, unsteadiness and actual unsteadiness while moving, lightheadedness and severe fatigue
a. Perilymph Fistula
b. Acoustic Neuroma
c. Ototoxicity
d. BPPV

Ototoxicity

68

Is there a specific test for Ototoxicity?

no

69

how is ototoxicity treated?
a. surgery
b. reduce effects of damage and rehabilitating function
c. medications
d. untreatable

reduce effects of damage and rehabilitating function

70

What is the goal of Physical therapy for a patient with ototoxicity?

help balance
habituation exercises

71

This disorder is an illusion of movement felt as an after affect of travel by ship or boat
a. Acoustic Neuroma
b. Mal de Debarquement
c. Ototoxicity
d. BPPV

Mal de Debarquement

72

What is the theory of Mal de Debarquement

balance areas of the brain
adapts to motion of ship or other vehicle
brain unable to readapt once again

73

Symptoms of this disorder include bobbing, rocking, swaying, floating, and/or tumbling, unsteadiness, disequilibrium, anxiety, difficulty concentrating and a loss of self-confidence
a. vestibular migraine
b. Mal de Debarquement
c. cervicogenic dizziness
d. BPPV

Mal de Debarquement

74

with Mal de Debarquement symptoms _ in closed spaces and when _

increase
motionless

75

with Mal de Debarquement symptoms _ during _ movement

improve
steady (moving car)

76

symptoms of Mal de Debarquement do not include

spinning vertigo
vomiting
cold seat
ear pressure
ear pain
sound sensitivity
tinnitus
hearing loss of distortion
double vision or bouncing vision

77

When do symptoms of Mal de Debarquement begin?

within hours of stopping the novel movement

78

When do symptoms of Mal de Debarquement stop?

6-12 months

79

to diagnose Mal de Debarquement there must be a history of

ship voyage - return to normal - start of symptoms

80

Do symptoms start immediately or weeks/months later after ship voyage?

immediately

81

How is Mal de Debarquement treated?
a. surgery
b. manuever
c. habituation and drugs
d. medication

habituation and drugs

82

This disorder is usually associated with a headache and can cause several vestibular syndromes
a. Vestibular Migraine
b. Cervicogenic Dizziness
c. BPPV
d. Mal de Debarquement

Vestibular Migraine

83

_ can occur before, during or separate from episodes of migrainous headaches
a. dizziness
b. nausea
c. vertigo
d. unsteadiness

vertigo

84

Vestibular syndromes caused by migraines can be caused by (adults)

recurrent vertigo of adults
occasionally with tinnitus but without hearing loss

85

Vestibular syndromes caused by migraines can be caused by (child)

vertigo of childhood consists of spells or imbalance and vertigo without hearing loss or tinnitus

86

This is described as a migraine with aura associated with a stroke and one symptom may be vertigo

migrainous infarction or complicated migraine

87

What symptoms are experienced with a vestibular migraine?

vertigo usually with a headache/migraine symptoms
motion sensitivity/motion sickness

88

How are vestibular migraines treated?

changing diet
reducing stress and anxiety
control blood sugar and hormone function
stop smoking
medications

89

For this disorder, neck pain normally accompanies dizziness

cervicogenic dizziness

90

How is cervicogenic dizziness diagnosed?

no test confirms

91

Symptoms for this include worse during head movements or after maintaining one head position for a long time
dizziness after neck pain and a headache
imbalance that increases with head movement and movement of the environment

cervicogenic dizziness

92

What type of injury can cause cervicogenic dizziness?

whiplash or head injury

93

cervicogenic dizziness is seen with what type of injury?

brain injury or injury of the inner ear

94

How do you treat cervicogenic dizziness?

treatment of neck problem

95

How do you select habituation treatments?

based on results of the exam
movement that brings on symptoms but not to the point of making them sick

96

How much should symptoms of dizziness be increased with habituation exercises?

2 points

97

How often should exercises be performed?

15-30 minutes
2-3 times/day

98

What are Cawthorne Cooksey movements in bed or sitting that can be done?

eye movements
head movements

99

How do you progress head movements?

slow, then quick, later with eyes closed

100

What Cawthorne Cooksey movements can be done sitting?

shoulder shrugging and circling
bending forward and picking up objects from the ground

101

What Cawthorne Cooksey movements can be done standing?

eye, head and shoulder movements
sitting to standing with eyes open and shut
throwing a small ball from hand to hand
throwing a ball from hand to hand under knee
changing from sitting to standing and turning in between

102

The _ and more _ exercise is carried out, the faster and more _ will be the return to normal activity

earlier
regularly
complete

103

For patients with reduced vestibular function, what exercises can be done?

eye-head coordination exercises - combine movement of image on retina with head movement
start in sitting - progress to standing
various direction and speed
progress to busy background

104

In-phase ocular tracking the patient will

attempt to track objects that are moving with their heads

105

in phase encourages to _ their _ system

desensitize vestibular system

106

counter-phase ocular tracking the patient will

attempt to track objects that are moving in counter-phase to their heads

107

Which type of disorder is ocular tracking useful for?

Menieres disease

108

dynamic balancing exercises are not appropriate for all vestibular disorders (true/false)

false

109

What is the difference in symptoms between Labryinthitis and Neuritis?

Labryinthitis - change in hearing (loss)
Neuritis - difficulty with vision

110

What substances are related to Ototoxicity?

antibiotics
anti-cancer
loop diuretics
aspirin

111

The vestibulo-ocular reflex is the most effective at detecting a complete loss in

peripheral sensory apparatus

112

Semicircular canals and Otolithis are apart of what system
a. peripheral sensory apparatus
b. central processing system
c. motor output system

peripheral sensory apparatus

113

The VOR produces eye movement (same/opposite) the direction of the head

opposite