Vestibular System Flashcards
(194 cards)
1
Q
Thin elastic cartilage covered by skin that collects air vibration
A
Auricle
2
Q
Curved tube from the auricle to eardrum
A
External Auditory Meatus
3
Q
Length of EAM
A
1 inch
4
Q
Outer 1/3 of EAM
A
Elastic Cartilage
5
Q
Inner 1/3 of EAM
A
Bony Cartilage
6
Q
A narrow oblique slit-like cavity in the ear
A
Middle Ear
7
Q
Another name of Middle Ear
A
Tympanic Cavity
8
Q
Wall of the ear: Fenestra Vestibuli
A
Medial Wall
9
Q
Wall of the ear: Canal of Tensor Tympani
A
Anterior Wall
10
Q
Wall of the ear: Tympanic Membrane
A
Lateral Wall
11
Q
Wall of the ear: Pyramid
A
Posterior Wall
12
Q
Wall of the internal ear
A
Fenestra Vestibuli
13
Q
Muscle located at the pyramid
A
Stapedius
14
Q
Another name of the tympanic membrane
A
Eardrum
15
Q
Shape of Eardrum
A
Concave Laterally
16
Q
Innervation of outer tympanic membrane
A
CN 5 and 10
17
Q
Innervation of the inner tympanic membrane
A
CN 9
18
Q
Three auditory ossicles of the ear
A
Malleus, Incus, Stapes
19
Q
Largest auditory ossicles
A
Malleus
20
Q
Shape of Malleus
A
Hammer
21
Q
Shape of Incus
A
Anvil
22
Q
Shape of Stapes
A
Stirrup
23
Q
Attachment of Malleus
A
Long process = ear drum; Head = incus
24
Q
Attachment of Incus
A
Body = malleus; Long process = stapes
25
Attachment of Stapes
Head = incus; Base = fenestra vestibuli
26
Two movements of air in the ear
Medially and laterally
27
Movement of Eardrum + LP of the Malleus
Medially
28
Movement of LP of incus + Head of Stapes
Medially
29
Movement of Head of Malleus + Body of Stapes
Laterally
30
Two muscles of the ear
Tensor Tympani and Stapedius
31
Origin of Tensor Tympani
Own Canal
32
Insertion of Tensor Tympani
Handle of Malleus
33
Nerve of Tensor Tympani
CN 5
34
Action of Tensor Tympani
Dampens vibration
35
Origin of Stapedius
Pyramid
36
Insertion of Stapedius
Neck of Stapes
37
Nerve of Stapedius
CN 7
38
Action of Stapedius
Dampens vibration
39
"Labyrinth"
Internal Ear
40
Two major components of Internal Ear
Bony and Membranous Labyrinth
41
Series of cavities in the internal ear
Bony Labyrinth
42
The fluid that fills the Bony Labyrinth
Perilymph
43
Three parts of Bony Labyrinth
Vestibule, Semi-circular canals and Cochlea
44
Central part of the bony labyrinth
Vestibule
45
What is contained inside the Vestibule?
Otolith organs
46
Posterior part of the bony labyrinth
Semi-circular canals
47
What is contained inside the Semi-circular canals?
Semi-circular ducts
48
Three Semi-circular canals
Superior or Anterior, Inferior or Posterior, Lateral or Horizontal
49
Hollow bony tube making 2 1/2 spiral turns
Cochlea
50
What does cochlea resemble?
Snail shell
51
Orientation of the base of the cochlea
Posteromedial
52
Orientation of the apex of the cochlea
Anterolateral
53
What is contained inside the cochlea?
Duct of cochlea
54
What is lodged within the bony labyrinth?
Membranous Labyrinth
55
What surrounds the membranous labyrinth?
Perilymph
56
The fluid that fills the Membranous Labyrinth
Endolymph
57
What is the description of endolymph?
Higher density than water
58
Two parts of Membranous Labyrinth
Cochlear System and Vestibular System
59
What composes the cochlear system
Duct of Cochlea
60
Forms of spinal organ of corti
Duct of Cochlea
61
Receptor for hearing
Spinal Organ of Corti
62
3 canals at the cochlear system
Scala Vestibuli, Scala Media, Scala Tympani
63
Canals at the cochlear system: Oval Window
Scala Vestibuli
64
"Oval window"
Fenestra Vestibuli
65
Canals at the cochlear system: Round window
Scala Tympani
66
Canals at the cochlear system: Duct of Cochlea
Scala Media
67
What prevent scatter of vibration
Scala Tympani
68
What pitch is the anterior canals of the cochlear system?
High pitch
69
What pitch is the posterior canals of the cochlear system?
Low pitch
70
Three primary functions of the peripheral vestibular system
(1) Stabilizes visual image during head motion; (2) Maintains postural stability; (3) Provides information about spatial orientation
71
5 neural structures in each labyrinth
3 SCC and 2 otolith organs
72
Responsible for angular rotation
SCC
73
Responsible for linear rotation
Otolith Organs
74
What structure at the end of SCC?
Ampula
75
What is the gel-like structure contained in the ampulla?
Cupula
76
What is contained in the cupula?
Hair cells
77
Two types of hair cells in the cupula
Kinocilia and Stereocilia
78
Where do the hair cells sit in the cupula?
Crista ampularis
79
Sensory organ for angular motion
Crista ampularis
80
Responsible for horizontal linear acceleration
Utricle
81
Responsible for vertical linear acceleration
Saccule
82
Crystals in the otolith organs
Otoconia
83
The nerve that branched out in the hair cells of SCC and otolith organs
CN 8
84
Where does CN 8 bring the signals to the brainstem?
Vestibular Nuclei
85
4 places where signals from vestibular nuclei send off to
CN 346, Thalamus, SC, and Cerebellum
86
What is the function of the signals sent in CN 3,4,6?
For Visual Image
87
What is the function of the signals sent in the Cerebellum?
For Balance
88
What is the function of the signals sent in SC?
For Postural Stability
89
What is the function of the signals sent in the Thalamus to the cortex?
For Spatial Orientation
90
3 principles of the vestibular system
Tonic Firing Rate, Push-pull mechanism, Vestibulo-ocular reflex
91
"Brain detects head motion and direction through comparison of inputs between 2 vestibular system"
Push-pull mechanism
92
"Vestibular system can detect head motion through excitation and inhibition"
Tonic Firing Rate
93
"Stabilizes visual image in the retina by generating compensatory eye motions in the direction opposite to head motion"
Vestibulo-ocular reflex
94
Resting Firing Rate
70-100 spikes/sec
95
VOR when the head rotates to the right
MR of Right and LR of left
96
Eye movement when looking at the right
LR of Right and MR of Left
97
Eye movement when the head rotates right and down
Right IO and Left SR
98
Eye movement when the head rotates right and up
Right SO and Left IR
99
True or False: Head motion is C/L with eye motion
True
100
5 signs and symptoms saw in patients with Vestibular conditions
Vertigo, Lightheadedness, Dysequilibrium, Oscillopsia, Nystagmus
101
The only s/sx cannot be seen in patients with pure vestibular pathology
Lightheadedness
102
"Out-of-balance"
Dysequilibrium
103
Primary diagnostic indicator for most central and peripheral pathology
Nystagmus
104
Illusion of movement
Vertigo
105
"Fainting is about to occur"
Lightheadedness
106
The motion of objects that are known to be stationary
Oscillopsia
107
Possible causes of vertigo
BPPV, UVH, Central Lesion
108
Possible causes of lightheadedness
HOPA: Hypoglycemia, OH, Panic attack, Anxiety
109
Possible causes of dysequilibrium
BVH, UVH, Central lesion
110
Possible cause of oscillopsia
Vestibular Hypofunction
111
Nystagmus is slow and fast movement
Jerk Nystagmus
112
Nystagmus that are equal in movement
Pendular Nystagmus
113
Three peripheral vestibular pathologies
BPPV, UVH, BVH
114
Most common vestibular pathology
Benign Paroxysmal Postural Vertigo (BPPV)
115
BPPV is secondary to _______?
Biomechanical disorder
116
Two biomechanical disorder that causes BPPV
Canalithiasis and Cupulolithiasis
117
Otoconia adhered to the cupula
Cupulolithiasis
118
Otoconia are found in SCC
Canalithiasis
119
Signs and symptoms of BPPV
Vertigo and Nystagmus
120
Vestibula condition due to asymmetric firing rate
Unilateral Vestibular Hypofunction (UVH)
121
Possible causes of UVH
Viral insults, vascular events, trauma
122
4 signs and symptoms of UVH
Vertigo, Oscillopsia, Dysequilibrium, Nystagmus
123
Vestibula condition due to otoxicity
Bilateral Vestibular Hypofunction (BVH)
124
The antibiotic that causes ototoxicity in BVH
Aminoglycosides
125
Primary complaints by the patients with BVH
Dysequilibrium
126
Do patients experience nystagmus and vertigo in BVH?
Usually NO
127
When do patients experience nystagmus and vertigo in BVH?
Unless there is an asymmetry in firing rate
128
4 CNS injuries that may affect the vestibular system
Vertebral Artery damage, TBI, TIA, MS
129
What is the structure affected in Vertebral Artery damage?
Cerebellum
130
What is the vestibular s/sx of Vertebral Artery damage?
Mimics vestibular pathologies
131
What is the vestibular s/sx of TBI and TIA?
Vertigo
132
What is the structure affected in MS?
Cranial nerve 8
133
What is the vestibular s/sx of MS?
Identical to UVH
134
Central or Peripheral: Severe Ataxia
Central
135
Central or Peripheral: Nystagmus that can be suppressed by visual fixation
Peripheral
136
Central or Peripheral: Mild Ataxia
Peripheral
137
Central or Peripheral: (+) Vertigo
Both
138
Central or Peripheral: (+) Diplopia
Central
139
Central or Peripheral: (-) Hearing Loss
Central
140
Central or Peripheral: (+) Hearing Loss
Peripheral
141
Central or Peripheral: (+) Nystagmus
Both
142
Central or Peripheral: Nystagmus that cannot be suppressed by visual fixation
Central
143
Central or Peripheral: Altered Consciousness
Central
144
Central or Peripheral: Tinnitus
Peripheral
145
Central or Peripheral: Lateropulsion
Central
146
Central or Peripheral: Fullness of Ear
Peripheral
147
Nystagmus seen in Peripheral Vestibular Pathology
Horizontal and Jerky
148
Nystagmus seen in Central Vestibular Pathology
Vertical and Pendular
149
Two examinations for Eye Movements
Dix-Hallpike and Head-Shaking Induced Nystagmus
150
The most common cause of vertigo
BPPV
151
The most common positional test for BPPV
Dix-hallpike Test
152
What is the tested ear in the Dix-hallpike test?
The ear that is pointed to the ground or rotation of the head
153
5 steps in the Procedure of Dix-Hallpike Test
(1) Long Sitting (2) Rotate head any side (3) Supine (4) Extension of head or neck (5) Check for nystagmus
154
A positive sign of Dix-Hallpike Test
(+) Nystagmus
155
Condition tested in Dix-Hallpike Test
BPPV
156
5 steps in the Procedure of Head-Shaking Induced Nystagmus Test
(1) EC (2) Flexion of head or neck (3) Oscillate head HORIZONTALLY (20 cycles) (4) EO (5) Check for Nystagmus
157
A positive sign of Head-Shaking Induced Nystagmus Test
(+) Nystagmus
158
Condition tested in Head-Shaking Induced Nystagmus Test
UVH
159
Three assessments used for vestibular function
Rotation Chair Test, Caloric Test, Vestibular Evoked Myogenic Potential (VEMP)
160
Two test used to check of SCC function
Rotation Chair Test, Caloric Test
161
SCC: Administration of infusing warm/cold air or water in the auditory canal
Caloric Test
162
Condition tested in Caloric Test
UVH
163
SCC: Patient is rotated in the darkroom
Rotation Chair Test
164
Condition tested in Rotation Chair Test
BVH
165
The assessment used to check the function of otolith organs
Vestibular Evoked Myogenic Potential (VEMP)
166
Two subtypes of VEMP
Ocular and Cervical VEMP
167
The muscle tested in Ocular VEMP
Inferior Oblique
168
The muscle tested in cervical VEMP
SCM
169
How many decibels are exposed to the patient while administering the VEMP?
95 decibels
170
Procedure of VEMP
The patient is exposed to loud clicks
171
Interpretation of VEMP
If VEMP is absent = (+) UVH
172
Two exercises used to treat patients with UVH
Gaze Stability Exercise and Habituation Exercise
173
UVH exercise to improve VOR
Gaze Stability Exercise
174
UVH exercise to improve motion sensitivity
Habituation Exercise
175
What item is used in Gaze Stability Exercise?
Card
176
3 steps in Gaze Stability Exercise
(1) Focus on card, (2) Rotate head to 1 side (3) Move card to opposite direction
177
3 steps in Habituation exercise
(1) Determine provoking position, (2) Maintain provoking position (3) Repetition: 3-5x
178
Habituation exercise is done how many seconds per position?
30 secs per position
179
Four exercises used to treat patients with BVH
Tai Chi, Balance Exercise, Pool Exercise, Exercise to improve central programming movements
180
What item is used in Exercise to improve central programming movements?
Cards
181
4 step procedure of exercise to improve central programming movements using 2 cards
(1) Arrange cards horizontally, (2) focus on card A then B, (3) Arrange cards vertically, (4) focus on card A then B
182
5 step procedure of exercise to improve central programming movements using 1 card
(1) Focus on the card, (2) EC, (3) Rotate head to one side (imagine that you are looking at card), (4) EO, (5) Focus on the card
183
Three exercises used to treat patients with BPPV
Canalith Repositioning Maneuver (CRM), Brandt-Daroff Exercise, Liberatory Semont Maneuver
184
Position of the patient in CRM: Anterior & Posterior SCC
Sitting
185
Position of the patient in CRM: Horizontal SCC
Supine
186
6 step procedure of CRM: Anterior & Posterior SCC
(1) Sitting (2) Rotate head to affected side (3) Supine with head/neck extension (4) Rotate head to unaffected side (5) Roll to shoulder (unaffected) (6) Assist to sitting (fit with collar)
187
5 step procedure of CRM: Horizontal SCC
(1) Supine (2) Rotate head to affected side (3) Rotate head to the unaffected side; wait for few seconds 2x (4) Roll to prone (unaffected) (5) wait for the symptoms to stop
188
What SCC does Brandt-Daroff Exercise use to improve?
Posterior SCC
189
5 step procedure of Brandt-Daroff Exercise
(1) SItting (2) Rotate head to 1 side (3) Side-lying to opposite side (4) Sitting (5) Repeat to another side
190
What SCC does Liberatory Semont Maneuver use to improve?
Posterior SCC
191
4 step procedure of Liberatory Semont Maneuver
(1) Sitting (2) Rotate head to unaffected side (3) Sidelying on the affected side (4) from 1 side-lying to opposite side-lying (180 degrees turn to unaffected side)
192
2 exercise of central lesions
Balance and Gait exercises
193
Purpose of Central Pathology exercise
For safety
194
Important Patient education
Without head motion, the vestibular system will not improve maximally
