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30 Cards in this Set
- Front
- Back
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The 3 primary sensory modalities that contribute to postural control are: vestibular, somatosensory and:
Orientation Visual Cognition Sensation None of the Above |
Visual
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The vestibular system has 3 major components: __________, central processing system, and the motor output system.
Peripheral sensory apparatus Visual System Sensorimotor Functioning Cerebellar System None of the Above |
Peripheral Sensory Apparatus
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The peripheral sensory apparatus consists of 5 sensory organs. There are 3 semicircular canals and 2 swellings (collectively called the otolith) within the vestibule. The two swellings are the utricle and __________.
Ampulla Labyrinth Saccule Stapes Specialized Hair Cells |
Saccule
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The central processors of the vestibular system are the vestibular nuclei AND the __________.
Brain Stem Cerebral Cortex Thalamus Cerebellum |
Cerebellum
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In the otoliths, when the cilia of the hair cells are displaced toward the kinocilium, firing rates:
Increase and the vestibular nerve is excited Increase and the vestibular nerve is inhibited Decrease and the vestibular nerve is inhibited Decrease and the vestibular nerve is excited |
Increase and the vestibular nerve is excited
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The primary function of the VOR is to maintain gaze stability during head motion. In a healthy person, the gain of the VOR at velocities associated with the most functional activities is approximately equal to:
.5 10 1 5 |
1
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An example of distorted vestibular function is:
Neuritis Perilymphatic Fistula Drug-Induced Toxicity Meniere Disease BPPV |
BPPV
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Which of the three types of peripheral vestibular disorders shows the strongest evidence to support the use of Physical Therapy to resolve symptoms and dysfunction.
Reduced Vestibular Function Distorted Vestibular Function Fluctuating Vestibular Function |
Distorted Vestibular Function
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On the dizziness handicap inventory. Your patient scores 84/100. Do they display greater or lesser disability?
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Greater
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To test saccadic eye movements you:
Ask the patient to follow a moving target in all directions with his or her eyes while keeping the head stable Ask the patient to look back and forth quickly between 2 targets placed vertically and horizontally |
Ask the patient to look back and forth quickly between 2 targets placed vertically and horizontally
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Vestibular problems are NOT common but can BE VERY disabling.
True False |
False
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What is the mechanism by which vestibular rehab works?
A. Mechanical repositioning B. Adaptation of residual pathways/function C. Facilitates the development of alternative pathways D. Progressive desensitization E. All of the above |
E. All of the above
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When you lay a patient with Benign Paroxysmal Positional Vertigo (BPPV) down in a DixHallpike test , the crystal will move away from the cupula of the vertical canal (posterior or anterior) and will cause ________ of that canal and you will see a strong paroxsymal burst of nystagmus.
A. excitation B. inhibition |
A. excitation
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Fluid or debris motion TOWARD the cupula of the right horizontal canal causes _______ of that canal and will generate a ______ beating nystagmus ? (i.e. when you turn your head to the right)
A. Inhibition, Right B. Excitation, Right C. Inhibition, Left D. Excitation, Left |
B. Excitation, Right
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Your patient suffered an inner ear infection or vestibular neuritis and has a LEFT paretic vestibular lesion. Upon clinical evaluation you will see:
A. Corrective saccades to the LEFT head impulse, RIGHT beating after head shake nystagmus B. Corrective saccades to the RIGHT head impulse, RIGHT beating after head shake nystagmus C. Corrective saccades to the LEFT head impulse, LEFT after head shake nystagmus D. Corrective saccade to the RIGHThead impulse, LEFT beating after head shake nystagmus |
A. Corrective saccades to the LEFT head impulse, RIGHT beating after head shake nystagmus
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Timing of the length of vertigo/dizziness and whether it is provoked or spontaneous can be helpful in differential diagnosis of vestibular “end-organ” problems, all of the following are true EXCEPT….
A. Vertigo seconds in duration that is spontaneous is consistent with BPPV B. Vertigo that is minutes to hours in duration with spontaneous onset that is accompanied by hearing loss, tinnitus, and fullness is consistent with Meniere’s disease C. Vertigo that that is hours to days that comes on spontaneously usually results in a Emergency Department ED visit is consistent with Vestibular neuritis |
A. Vertigo seconds in duration that is spontaneous is consistent with BPPV
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What clinical abnormalities or findings are you NOT looking for when you complete SACCADE testing???
A. Conjugate eyes (both eyes move together) B. Accuracy of the eye motion (<1-2 motions) C. Speed of the motion (instantaneous) D. Smooth quality of the motion E. All of the Above |
D. Smooth quality of the motion
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True or False. Each canal can generate only one eye motion?
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False
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You completed a clinical examination on a dizzy patient and found that all of your central tests were normal (smooth pursuit, saccade, VOR cancellation) but then you saw corrective saccades to head impulse to the right and to the left, your interpretation is:
A. Right Peripheral Vestibular hypofunction B. Left Peripheral Vestibular hypofunction C. Bilateral Peripheral Vestibular hypofunction D. Central nervous system deficit E. Non-localizing finding, possible BPPV |
C. Bilateral Peripheral Vestibular hypofunction
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All of the following are nystagmus patterns that can be generated due to peripheral vestibular disease EXCEPT
A. Torsional-upbeating nystagmus B. Downbeating nystagmus C. Torsional-downbeating nystagmus D. Horizontal nystagmus |
B. Downbeating nystagmus
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The driving stimulus for VOR that provides the error message in vestibular rehab/vestibular healing is:
A. Retinal Slip B. Induced Postural Disturbances C. Sensory Mismatch D. Oscillopsia E. Dizziness |
A. Retinal Slip
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Besides dizziness/vertigo, the triad that leads you to suspect Menier’s disease is aural fullness, _________________, and hearing loss.
A. Sense of imbalance B. Oscillopsia C. Photosensitivity D. Tinnitus |
D. Tinnitus
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The Semicircular Canals are designed to detect angular acceleration.
True False |
True
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Positive results in all of the following but _________supports a CENTRAL DEFICIT.
A. Smooth Pursuit B. Saccade C. Vestibular-Ocular Reflex Cancellation D. Dynamic visual acuity. |
D. Dynamic visual acuity.
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The “Brand” name of Canalith Repositioning is__________________ maneuver. (vertical canals)
A. Vernucci B. Modified Brand Daroff C. Epley’s D. Fukuda’s |
C. Epley’s
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Which of the diagnoses are NOT an example of an irritative lesion?
A. BPPV B. Meniere’s (acute state) C. Labrynthitis |
C. Labrynthitis
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Under the umbrella of customized treatment protocols, the most common exercise for Gaze Stabilization is?
A. Saccades B. VOR C. VOR Cancellation D. Smooth pursuit |
B. VOR
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You are performing the roll test with your patient, when you turn the head to the right you see apogeotropic horizontal nystagmus. You suspect?
A. Horizontal Canal BPPV—Canalithiasis B. Horizontal Canal BPPV—Cupulolithiasis C. Posterior Canal BPPV—Canalithiasis D. Posterior Canal BPPV—Cupulolithiasis |
B. Horizontal Canal BPPV—Cupulolithiasis
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In order to treat BPPV, the otoconia must be mechanically repositioned to their correct location.
A. True B. False |
B. False
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The reason you see torsional upbeat nystagmus with BPPV in the posterior canal is because of the eye muscles that are associated with it. What are the muscles involved that produce the observed eye mvmts? (BPPV is an irritative lesion, and named after the fast phase)
A. Ipsilateral medial rectus and contralateral lateral rectus B. Ipsilateral superior rectus and contralateral inferior oblique C. Ipsilateral lateral rectus and contralateral medial rectus D. Ipsilateral superior oblique and contralateral inferior rectus |
D. Ipsilateral superior oblique and contralateral inferior rectus
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