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Vestibular Assessmet
Audiology Exam 4
| Question | Answer |
|---|---|
| Name the three canals of the vestibular system | Superior Canal Posterior Canal Horizontal Canal |
| The Superior Canal, Posterior Canal, and Horizontal Canal are responsible for what movements? | Angular |
| The utricle and saccule are responsible for what movements? | Linear |
| Like the Auditory system we are able to assess different parts of the ____________ using a series of different tests. | Vestibular system |
| What are the functions of the vestibular system? | Balance, Dizziness |
| Balance | Our ability to regulate and control our bodies position in a desired space or orientation |
| Our balance ability is dependent on the input from three different bodily systems, what are they? | • Vestibular system – Inner ear • Proprioceptive system – Skeletal Muscles and Joints • Visual system – Eyes |
| It is _________ for people to have poor balance in certain circumstances. Provide an example: | Normal, Walking on a tight rope |
| Issues occur when someone feels _________ when they normally should not. Provide two examples: | Off-balance • Walking a straight line • Sitting in a chair |
| Issues occur when someone feels off-balance when they normally should not, this is commonly referred to as? | Dizziness |
| The term __________ is complex and difficult for most patients to define. Name three ways you may describe this sensation. | Dizziness. • Lightheaded • Room spinning • Floating |
| “Dizziness” is the _____ most common complaint among patients seen in outpatient clinics | 3rd |
| ________% of elderly patients experience dizziness | 30-40% |
| Patients with ___________ average ______ visits without finding a resolution to the problem | Chronic dizziness, 4-6 |
| When assessing a patient reporting dizziness – it is critical to get a ____________ of the patients experience. An example of this is? | Qualitative description. Ex: Vertigo or non-vertigo |
| True Vertigo | Type of “dizziness” sensation that seems like either the person or the room is spinning, although no movement is actually taking place |
| Non-Vertigo Dizziness can be described in three different ways, what are they? | • Presyncope – lightheadedness just before fainting (Typically associated with cardiovascular system) • Off balance • Floating |
| When a patient has __________ related to inner ear dysfunction– there eyes will typically show | True vertigo, nystagmus |
| Nystagmus can also occur in the absence of _________ | True vertigo |
| Nystagmus | Involuntary repetitive eye movements |
| Nystagmus can result from ________ and ________ | True vertigo and visual deficits |
| The vestibular system has _______connections with the _______ muscles | Neural, eye |
| When a patient experiences vertigo – they often also display _______ | Nystagmus |
| Audiologists can use ________ as an _______ way of measuring the vestibular system | Nystagmus, indirect |
| An example of Indirectly measuring the Vestibular System with Nystagmus is? | Vestibular Ocular Reflex (VOR) |
| Videonystagmography | Uses infrared goggles to measure eye movements during visual stimulation or body position changes or thermal stimulation of the semicircular canals (calorics) |
| What are five tests of the vestibular system? | • Videonystagmography • Electrophysiology • Posturography • Rotary Chair • vHIT (Head impulse Test) |
| Videonystagmography include what tests? | • Ocular Motility Test • Positioning Test • Positional Test • Caloric Test |
| Electrophysiology include what tests? | • cVEMP • oVEMP |
| What are four Vestibular Ocular Motility Tests? | • Saccades • Smooth Pursuit • Optokinetic Test • Gaze Fixation |
| Saccades | Eye movements are tracked as patient follows dot jump from on location to another |
| Smooth Pursuit | Constant tracking of circulating dot |
| Optokinetic Test | Patient stairs straight as large objects move in single direction |
| Gaze Fixation | Eyes gaze to the far right, left, up and down –VNG investigates for nystagmus. |
| Abnormal results of Vestibular Ocular Motility Tests are generally a sign of? | Neurological disease |
| Positioning and Positional VNG are largely used to detect? | BPPV |
| _________ becomes detached from Gelatinous material and free floats in Semi-Circular Canals | Otoconia |
| Otoconia becomes detached from Gelatinous material and free floats in Semi-Circular Canals, four parts of this is? | • Provoked by head movements • Short lasting vertigo and nystagmus (~20-30 seconds) • Diagnosed using the Dix-Hallpike • Treated with Repositioning |
| Vestibular Positional Testing involve what two things? | Dix-Hallpike and Roll Test |
| Positioning testing is done systematically to do what? | Reorient the semi-circular canals |
| Different positions assess? | Different semi-circular canals |
| The Dix Hallpike assesses? | Posterior canal |
| The Roll Test assesses? | Horizontal canal |
| Caloric Testing is the only vestibular test that can measure? | Each ear individually |
| Caloric testing uses the principle of _______ to set inner ear fluid into motion without moving the patients head or body | Convection |
| Convection | The movement caused within a body of fluid due to thermal changes |
| With convection, hotter fluid becomes? | Less dense and rises |
| With convection, colder fluid becomes? | More dense and sinks |
| In vestibular caloric testing, present __________ or _________ into the ear canal stimulates ____________ (mainly the horizontal canal) through convection | Cold or hot water, air, semicircular canals |
| During vestibular caloric testing, patients head is supine then lifted _____ degrees so that horizontal canal is aligned ________ | ~30, vertically |
| In vestibular caloric testing, _____ goggles are used to track nystagmus during and after _________ stimulation | VNG, thermal |
| Nystagmus beats in a _______ direction | Predictable |
| Nystagmus beats in a predictable direction, what is it? | • COWS: Cold Opposite – Warm Same |
| What are the three VEMP Testing's? | VEMP, cVEMP, oVEMP |
| VEMP | Vestibular evoked myogenic potential |
| In VEMP, _______ induced fluid movement of vestibular region of ______ ear results in nervous system stimulating ______ muscles | Sound vibration, inner, skeletal |
| In VEMP, ________ measured from _______ muscles can be measured to ______ assess vestibular system | Potential changes, skeletal, indirectly |
| cVEMP | cervical VEMP – measured from the sternocleidomastoid muscle in the cervical region of the neck. |
| cVEMP provides functional status of the _______ and the ______________ | Saccule, inferior branch of vestibular nerve |
| oVEMP | Ocular VEMP measured from inferior oblique optic muscles |
| oVEMP provides functional status of the ________ and _________________ | Utricle, superior branch of the vestibular nerve |
| What are three other vestibular assessments? | Posturography, Rotary Chair, Head Impulse Test (vHIT) |
Created by:
RachelJClark
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