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Geriatric Neuro

Vestibular

QuestionAnswer
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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