Deck 8: Examination and Evaluation of Vestibular Function

Question 1

Which of the following would be characteristics of a central vestibular pathology?

A)Sudden onset of vertigo with vertical nystagmus and nausea
B)Gradual onset of dizziness with torsional nystagmus and hearing loss
C)Sudden onset of vertigo with torsional/horizontal nystagmus and hearing loss
D)Gradual onset of dizziness with vertical nystagmus and upper limb weakness

Answer 1

D

Question 2

A patient complains of dizziness and imbalance with loud noises and when coughing.She also reports she can hear her heart beat in one ear.This patient most likely has:

A)Benign paroxysmal positional vertigo (BPPV)
B)Vestibular neuritis
C)Superior canal dehiscence
D)Meniere's disease

Answer 2

C

Question 3

Posterior canal BPPV is characterized by:

A)Pure downbeat nystagmus.
B)Horizontal torsional nystagmus.
C)Upbeat torsional nystagmus.
D)Pure upbeat nystagmus.

Answer 3

C

Question 4

According to research by Schubert (2004) the Horizontal Head Thrust Test is most sensitive when the patient's head is flexed

A)10 degrees.
B)20 degrees.
C)30 degrees.
D)40 degrees.

Question 5

When performing the Dix-Hallpike Test the therapist should first:

A)Extend the neck 20 degrees before moving the patient from long-sitting to supine.
B)Rotate the head 45 degrees to one side before moving the patient from long-sitting to supine.
C)Maintain the head in midline and move the patient from long-sitting to supine.
D)Rotate the head 90 degrees to one side before moving the patient from long-sitting to supine.

Question 6

Based on evidence by Marchetti (2006) the 4-item Dynamic Gait Index (DGI) can:

A)Be used to determine fall risk in patients with vestibular disease.
B)Differentiate between people without vestibular and balance deficits and people with vestibular disease.
C)Take the same amount of time and equipment as the 8-item DGI
D)Differentiate between people who have not fallen and people who have experienced multiple falls in the past 6 months.

Question 7

A therapist is using the sidelying test to examine the posterior canal for BPPV.Which of the following statements would be true?

A)The sidelying test may be poorly tolerated by some patients as an alternative to the Dix-Hallpike Test.
B)The scientific evidence indicates that there is no significant difference in efficacy between the sidelying test and the Dix-Hallpike Test.
C)The scientific evidence indicates that there is a significant difference between the sidelying test and the Dix-Hallpike Test.
D)The sidelying test is better tolerated by some patients when used as an alternative to the Dix-Hallpike Test.

Question 8

Which of the following would be characteristics of a peripheral vestibular pathology?

A)Sudden onset of vertigo with vertical nystagmus and nausea
B)Gradual onset of dizziness with torsional nystagmus and hearing loss
C)Sudden onset of vertigo with torsional/horizontal nystagmus and hearing loss
D)Gradual onset of dizziness with vertical nystagmus and upper limb weakness

Question 9

A 76 year-old patient complains of falling at least once every 2 weeks in a variety of situations and he is concerned about the frequency of falls increasing.Which outcome measure might best assess this patient's fall risk?

A)Activities-Specific Balance Confidence Scale
B)Dizziness Handicap Inventory
C)Vertigo Handicap Questionnaire
D)Vestibular Disorders Activities of Daily Living

Question 10

A patient with a complaint of vertigo that began 48 hours ago is presenting with horizontal eye movements with slow phases directed toward right side and quick phases directed toward the left side.The therapist is most likely observing:

A)Gaze-evoked nystagmus due to a low tonic output on the left
B)Positional nystagmus due damage to the vestibular nuclei
C)Spontaneous nystagmus due to the low tonic output on the right
D)Jerk nystagmus due to the a peripheral lesion on the right

Question 11

Which of the following outcome measures was found to have excellent test-retest, (inter-rater and intra-rater reliability) when used with school-aged children with mild to moderate impairment?

A)Bruininks-Oseretsky Test of Motor Proficiency 2
B)Functional Reach Test
C)Peabody Developmental Motor Scales II
D)Pediatric Balance Scale

Question 12

Which of the following assessment tools would best assess a patient's functional problems related to vestibular dysfunction?

A)Balance Evaluation Systems Test (BESTest)
B)Bithermal caloric testing
C)Manual muscle testing
D)Auditory brainstem response

Question 13

Which of the following are components of the peripheral vestibular system?

A)The otoliths,the vestibular nerve,sensory hair cells
B)The vestibular nerve,semicircular canals,vestibular nuclei
C)The semicircular canals,cerebellum,the otoliths
D)The sensory hair cells,vestibulospinal tract,the vestibular nerve

Question 14

A patient with a vestibular disorder complains of decreased concentration,feeling embarrassed when around people outside of his immediate family,and difficulty doing light house work.Which outcome measure would best evaluate the emotional aspect of his complaints?

A)Activities-Specific Balance Confidence Scale
B)Dizziness Handicap Inventory (DHI)
C)Vertigo Handicap Questionnaire
D)Vestibular Disorders Activities of Daily Living

Question 15

A patient complains of her hearing fading in and out,high-pitch ringing in the left ear,and episodes of severe spinning lasting for 2 hours once every 3 months.This patient has symptoms consistent with:

A)Benign paroxysmal positional vertigo
B)Vestibular neuritis
C)Superior canal dehiscence
D)Meniere's disease

Question 16

A patient complains of sudden onset of spinning,with imbalance,nausea,and vomiting for the past 24 hours.This patient has symptoms consistent with:

A)Benign paroxysmal positional vertigo
B)Vestibular neuritis
C)Superior canal dehiscence
D)Meniere's disease