Term
| pathologic conditions that contribute to dizziness can be split into what 2 major categories |
|
Definition
PNS conditions
CNS lesions |
|
|
Term
| PNS conditions that contribute to dizziness are split into what 3 subcategoreis |
|
Definition
BPPV
hypofunctioning conditions
bilateral vestibular disorders |
|
|
Term
| PNS conditions that contribute to dizziness: hypofunctioning conditions are split into what 4 subcategories? |
|
Definition
vestibular neuritis
Meniere's Disease and Endolymphatic Hydrops
Perlymphatic fistula
Vestibular paroxysmia |
|
|
Term
| what is the most common cause of vertigo d/t PNS disorder |
|
Definition
|
|
Term
| BPPV and population affected |
|
Definition
|
|
Term
| BPPV: how long does the sensation of vertigo last |
|
Definition
|
|
Term
| BPPV: negative symptoms (3) |
|
Definition
no hearing loss
no aural fullness
no tinnitus |
|
|
Term
|
Definition
cupulolithiasis
canalithiasis |
|
|
Term
|
Definition
| deposition of otoconia material in the cupula of posterior semicircular canal |
|
|
Term
|
Definition
| debris of higher density than endolymph is free floating |
|
|
Term
| BPPV: what has to happen to cause BPPV |
|
Definition
| otoconia in the utricle become loose and fall of macula and drop most often into posterior semicircular canal |
|
|
Term
|
Definition
| nystagmus with both a vertical and torsional component and will most likely follow the pattern of the posterior canal with short duration <1 minute |
|
|
Term
| BPPV: cupulolithiasis will present how (3) |
|
Definition
horizontal nystagmus
bilateral ageotrophic
long lasting |
|
|
Term
| BPPV: canalithiasis will present how (3) |
|
Definition
horizontal nystagmus
geotrophic
short duration |
|
|
Term
| BPPV: if BPPV pt should respond wel lto what |
|
Definition
|
|
Term
| what is the second most common vertigo |
|
Definition
| hypofunctioning: vestibular neuritis |
|
|
Term
| what is vestibular neuritis |
|
Definition
acute uniltareal idiopathic vestibulopathy
infection results in hypofunctioning of the vestibular nerve |
|
|
Term
| vestibular neuritis etiology |
|
Definition
| unsure, potentially viral? |
|
|
Term
| Vestibular neuritis symptoms: |
|
Definition
| prolonged severe rotational vertigo increased with head movement |
|
|
Term
| Vestibular neuritis: subjective complaints |
|
Definition
| room spinning dizziness that can last around 3-4 days with associated imbalance and nausea |
|
|
Term
| Vestibular neuritis: nystagmus presentation |
|
Definition
spontaneous and gaze holding
can be seen acutely
will follow Alexander's law (increased when looking toward's fast phase) |
|
|
Term
| recurring set of symptoms as a result of abnormally large amounts of endolymph collecting in the inner ear |
|
Definition
|
|
Term
| Meniere's disease: etiology |
|
Definition
unknown
theories include circulation problems, viral infection, allergies, an autoimmune reaction, migraine, possible genetic connection |
|
|
Term
| Meniere's disease: possible triggers include (5) |
|
Definition
stress
fatigue
emotional distress
pressure changes
certain food's |
|
|
Term
| Meniere's disease: symptoms (5) |
|
Definition
during an attack of of early stage Meniere's, main symptoms are:
spontaneous, violent vertigo
fluctuating hearing loss
ear fullness
and/or tinnitus
vertigo can last minutes to hours, but not usually more than 24 hrs |
|
|
Term
| Meniere's disease: vertigo type after the initial "attack" |
|
Definition
|
|
Term
| Meniere's disease: Nystagmus and meniere's |
|
Definition
usually does not follow the typical BPPV pattern
can have purely vertical or horizontal characteristics and will last for longer periods of time |
|
|
Term
| Meniere's disease: what can make the pt worse with repetition |
|
Definition
|
|
Term
| Perilymphatic fistula: vertigo and sensorineural hearing loss d/t what |
|
Definition
| fistula developing at round and oval windows of the middle ear |
|
|
Term
| Perilymphatic fistula: etiology |
|
Definition
| usually blow to the head causes the fistual or surgical intervention (popping sound heard) |
|
|
Term
| Perilymphatic fistula: S/S |
|
Definition
| imbalance, positional vertigo, nystagmus, hearing loss |
|
|
Term
| Perilymphatic fistula: tx |
|
Definition
bedrest
no straining which would cause perilymph to leak
goal for fistula to heal or close over |
|
|
Term
| Vestibular paroxysmia: what is it |
|
Definition
| neurovascular compression of root entry zone of the vestibular nerve can cause local demyelination |
|
|
Term
| Vestibular paroxysmia: analogus to what |
|
Definition
|
|
Term
| Vestibular paroxysmia: s/s |
|
Definition
positional vertigo
tinnitus |
|
|
Term
| Vestibular paroxysmia: pharmaceutical help |
|
Definition
| antiepileptic rugs (carbamazepine) helps |
|
|
Term
| Bilateral Vestibular disorders: secondary to other pathologic conditions including (3) |
|
Definition
Paget's
polyneuropathy
inner ear disorders |
|
|
Term
| Bilateral Vestibular disorders: what happens? |
|
Definition
autoimmune response causing otologic symtoms precipitated by other diseases
Sensorineural hearing loss accompanied by bilateral loss of vestibular function |
|
|
Term
| Bilateral Vestibular disorders: toxcititys |
|
Definition
seen with ethyl alcohol toxicity
ototoxicity |
|
|
Term
| Bilateral Vestibular disorders: ototoxcity can be d/t what |
|
Definition
| gentamyacin (unilateral or bilateral) |
|
|
Term
| Central Vestibular system consists of: (7) |
|
Definition
vestibular nuclei
vestibulo-ocular pathways
vestibulospinal pathways
vestibulocolic pathways (C-spine)
Vestibulo-autonomic pathways
Vestibulocerebral pathways
vestibulocerebellum |
|
|
Term
| Pathologic conditions of the CNS that contribute to dizziness: (5) |
|
Definition
migraine
head trauma
brain-stem stroke or vertebrobasilar insuffiency
cerebellar degeneration
MS |
|
|
Term
| Migraine Mechanism is called what |
|
Definition
| cortical spreading depression |
|
|
Term
| Migraine/Cortical Spreading Depression: theory behind CSD |
|
Definition
| some type of stimulus (chemical, mechanical), results in a transient wave front that supresses central neuronal activity |
|
|
Term
| Migraine/Cortical Spreading Depression: depression spreads in all direction from its site of origin and is accompanied by large ion flexions including |
|
Definition
increases in extracelluar K+
decreases in extracelluar Ca++ |
|
|
Term
| Migraine/Cortical Spreading Depression: large ion changes results in what? |
|
Definition
| reduction in cerebral blood flow in teh areas of spreading depression |
|
|
Term
| Migrain Mechanism (Cutrer and Baloh): dizziness that is unrelated to headache is a result of what substances |
|
Definition
| dizizness occurs from teh release of neuropeptides (substance P, neurokini A, calcitonin gene-related peptide [CGRP]) |
|
|
Term
| Migrain Mechanism (Cutrer and Baloh): the release of the neuropeptides has what effect |
|
Definition
| excitatory effect on the baseline firing rate of the sensory epithelium of the inner ear, as well as on the vestibular nuclei in the pons |
|
|
Term
| Migraine Clinical Presentation: subjective complaints |
|
Definition
headache
dx of migraine before
phonobobia and/or photophobia |
|
|
Term
| Migraine Clinical Presentation: migraine related dizziness and headaches |
|
Definition
| migrain related dizziness can be independent of headache |
|
|
Term
| Migraine Clinical Presentation: vertigo |
|
Definition
| spontaneous and lasts seconds to more than 24 hrs however less than 7 days |
|
|
Term
| Migraine Clinical Presentation: nystagmus (3) |
|
Definition
not typical BPPV pattern
has a longer duration
pure vertical or torsional component can be seen |
|
|
Term
| Migraine Clinical Presentation: symptom aggravatin |
|
Definition
CRM and 270/360 roll may exacerbate symptoms
vestibular stimulus can cause migraines |
|
|
Term
|
Definition
branch of subclavian aa/brachiocephalic trunk
two vertebra all join together to form basilar aa |
|
|
Term
| Arterial supply: vertebral aa supplies what |
|
Definition
|
|
Term
| Arterial supply: vertebral aa contributes to what |
|
Definition
| midle and anterior cerebral aa |
|
|
Term
| Arterial supply: vertebral aa supplies posterior cerebral aa which supplies what |
|
Definition
part of temporal lobe
occiptal obe |
|
|
Term
| Arterial supply: vertebral aa contributes to middle and anterior cerebral aa which supplies what |
|
Definition
part of temporal lobe
frontal
parietal lobe |
|
|
Term
| Cerebellar stroke: cerebellum is supplied by how many major aa on each side? |
|
Definition
|
|
Term
| Cerebellar stroke: 3 major aa that supply the cerebellum |
|
Definition
superior cerebellar aa
Anterior inferior cerebellar aa
Posterior inferor cerebellar aa |
|
|
Term
| Cerebellar stroke: most common cerebellar stroke syndrome |
|
Definition
| PICA aka Wallenber'gs syndrome or lateral medullary syndrome |
|
|
Term
| Cerebellar stroke: second most common syndrome |
|
Definition
|
|
Term
| Cerebellar stroke: least frequent syndrome |
|
Definition
|
|
Term
| Upper cervical spine: neck mm to consider |
|
Definition
SCM (innervation: C2 and C3)
Trapezius (innervation: C3 and C4) |
|
|
Term
| Upper cervical spine: mechanoreceptors to consider |
|
Definition
|
|
Term
| Upper cervical spine: type I mechanoreceptors are located where |
|
Definition
|
|
Term
| Upper cervical spine: type I mechanoreceptors are active when |
|
Definition
|
|
Term
| Upper cervical spine: type II mechanoreceptors are located where |
|
Definition
| deep capsule and fats pads |
|
|
Term
| Upper cervical spine: type II mechanoreceptors are active with what |
|
Definition
| start and finish of motions |
|
|
Term
| PT Exam/Eval: exam and eval must consider a diff dx which includes what (7) |
|
Definition
neurocardiogenic
sinus
medication
stress/anxiety
C-spine
CNS
vestibular dysfunction-PNS |
|
|
Term
| most common source of dizziness in children |
|
Definition
|
|
Term
| how long does BPPV induced vertigo usually last |
|
Definition
|
|
Term
|
Definition
|
|
Term
| dietary factors that can cause BPPV |
|
Definition
| dehydration, high caffeine, excess sodium intake |
|
|
Term
| if pt's nystagmus only has a vertical component, what is the basis of the pathology |
|
Definition
|
|
Term
| hypofunctioning vestibular neuritis can be mistaken as what in the ER |
|
Definition
|
|
Term
| Hypofunctioning vestibular neuritis tx |
|
Definition
|
|
Term
| vestibular neuritis: pt's with nystagmus can have their vertigo last how long? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| nausea is from what nn structure |
|
Definition
|
|
Term
| cerebellar lesion will present with what kind of tone |
|
Definition
|
|
Term
| cerebellar lesion will have low tone d/t effect on what |
|
Definition
|
|
Term
| antidepressant category which tends to cause dizziness as a die effect |
|
Definition
|
|
Term
| the articulation of the Dens wiht the fat pad hsould be what |
|
Definition
|
|
Term
|
Definition
| sensation that things the pt is looking at are moving up or down |
|
|
Term
| _____ nystagmus is not inhibited by visual fixation |
|
Definition
|
|
Term
| INO will have this test dysfunctino |
|
Definition
|
|
Term
| when checking a pt's balance (anatomy of balance), what else should you check |
|
Definition
|
|
Term
| Alexander's law vertigo: which way does the nystagmus occur |
|
Definition
the eyes will beat toward the side that is functioning, the opposite side is dyfunctional
left beating nystagmus = left appartus works, right does not |
|
|
Term
| Downbeating nystagmus is present in what (3) dx |
|
Definition
|
|
Term
| which posturography section, tests vestibular the most |
|
Definition
C5
removes visual input and relies soley on vestbiular system function with platform moving
failure indicates visual depdendcy |
|
|
