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Geriatric Neuro
Vestibular
| Question | Answer |
|---|---|
| What are 3 sensory inputs for balance? | Vision, Vestibular, Somatosensory |
| What vestibular apparatus provides information about angular motion? | Simcircular motion |
| What vestibular apparatus provides information about linear motion? | Otoliths |
| What vestibular apparatus conveys information about eye and head coordination? | VOR |
| What vestibular apparatus conveys information about balance strategies? | VSR (vestibulospinal reflex) |
| What cranial nerve conveys vestibular cochlear function? | CN VIII vesibulocochlear |
| How is CN VIII tested? | Rhines, Webber, finger rubbing test |
| What is primary processor of vestibular cues? | vestibular nuclear complex |
| Where are the major vestibular nuclei located? | pons, medulla |
| Where do vestibular nuclei project? | SC, cerebellum, CN's III, IV, VI |
| What is adaptive processor of vestibular cues? | Cerebellum |
| The MLF delivers 2nd order neurons to cranial nerves ___, ___, and ____ to provide compensatory eye and head movements, resulting in the _____. | III, IV, VI / VOR |
| The MVST projects to the _____ spinal cord via _____ and results in compensatory head movements. | cervical/MLF |
| The LVST projects to _____ spinal cord and results in appropriate postural adjustments known as “______” strategies. | Lumbar/balance |
| Which element of pt client management? The process of obtaining a history, Performing relevant systems reviews, and selecting and administering specific tests and measures to obtain data. | Examination |
| Which element of pt client management? A dynamic process in which the physical therapist makes clinical judgments based on data gathered during the examination | Evaluation |
| The process and the end result of evaluating information obtained from the examination, which the physical therapist then puts into defined clusters, syndromes, or categories to help determine the most appropriate intervention strategies. | Diagnosis |
| Determination of the level of optimal improvement that might be attained through intervention and the amount of time required to reach that level. | Prognosis |
| Purposeful and skilled interaction of the PT w/the patient and, if appropriate, w/others involved in the care, using various physical therapy methods and techniques to produce changes in the condition that are consistent with the dx and prognosis. | Intervention |
| Results of patient management, with the dx and prognosis, which include remediation of functional limitation and disability, optimization of pt satisfaction, and primary or secondary prevention. | outcomes |
| Central or peripheral?...sudden onset usu followed by illness, severe intensity, paroxysmal, frequent nausea, usu no CNS signs, may have tinnitus or hearing loss, tosional/horizontal nystagmus that is fatigable. | peripheral |
| Central or peripheral?...may be VERY sudden or gradual, intensity varries, constant in duration, infrequent nausea, CNS signs present, usu no tinnitus/hearing loss, vertical nystagmus that is non-fatiguable | central |
| What vestibular pathology?...sudden onset; hrs to days; nausea; NO hearing loss | neuritis |
| What vestibular pathology?...sudden onset; hrs to days; nausea; hearing loss | labyrinthitis |
| What vestibular pathology?...Brief, episodic vertigo related to position changes (rolling over, looking up/down, bending over) | BPPV |
| What vestibular pathology?...Recurrent, spontaneous spells of intense vertigo lasting several hrs; hearing loss, tinnitus, aural fullness | Meniere's Disease |
| What vestibular pathology?...Dizziness, vertigo, oscillopsia; hearing loss –typically associated w/changes in pressure | Fistula |
| What vestibular pathology?...Benign tumor most commonly associated w/hearing loss & tinnitusClues | Acoustic Neuroma |
| Arrhythmias; symptoms w/supine>sit>stand; symptoms w/cervical extension (& rotation); drop attacks; HA and difficulty w/speech;...these are most likely caused by what? | vascular issues |
| Double vision, incoordination, dementia, seizures, CVA, TBI, neurodegenerative diseases, demyelinating diseases, hereditary diseases, Parkinson‟s Disease, medications, toxicity...are most likely caused by what? | neurological issues |
| What vestibular pathology?...Typically described as “rocking/swaying” sensations –more notable with being still and improved with movement,–Most commonly occur after a prolonged boat ride. | Mal de Debarquement Syndrome (MdDS) |
| When testing for BPPV what test would you do to test the anterior and posterior canals? | Dix-Hallpike |
| When testing for BPPV what test would you do to test the horizontal canal? | Roll test |
| What objective test is used to diagnose BPPV? | Dix-Hallpike |
| Vertigo usually associated with lying down, rolling over in bed and/or tilting the head back to look up. These complaints are often accompanied with nausea and imbalance...subjective info for what? | BPPV |
| ______ nystagmus is red flag for CNS. | Vertical |
| Nystagmus away from downward ear in all testing positions indicates possible ____. | CNS |
| How would you stimulate the somatosensory system? | remove vision, destabilize vision, or confuse vision |
| How would you stimulate vision? | destabilize somatosensory, or confuse somatosensory |
| How would you stimulate vestibular? | Remove vision with unstable/compliant surfaces, Destabilize vision with unstable/compliant surfaces, Confuse vision with unstable/compliant surfaces |
| Which organ provides sensory input about linear motion? | otoliths |
| Which part of the otolith senses horizontal motion? | utricle |
| Which part of the otolith senses vertical motion? | saccule |
| Which organ provides sensory input about angular motion? | semi circular canals |
| What are the central vestibular organs? | vestibular nuclear complex and cerebellum |
| What are the peripheral vestibular organs?(5) | 3 semicircular canals, utricle and saccule(otolith) |
Created by:
txst fall 2009
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