Deck 24: Vestibular Disorders

Question 1

What is lightheadedness?

A)The sensation that the environment is moving
B)The sensation that one is about to faint
C)The sensation that objects are moving
D)The sensation of being off balance

Answer 1

B

Question 2

What is oscillopsia?

A)The sensation that the environment is moving
B)The sensation that one is about to faint
C)The sensation that objects are moving
D)The sensation of being off balance

Answer 2

C

Question 3

How does angular rotation of the head stimulate the semicircular canals?

A)It stimulates one of the canals on each side.
B)It stimulates each of the canals equally.
C)It stimulates each canal to a varying extent.
D)It stimulates two canals on each side.

Answer 3

C

Question 4

What would indicate a normal functioning vestibular system with head-shaking induced nystagmus test?

A)Nystagmus will be present with head shaking up and down.
B)Nystagmus will be present with head shaking left and right.
C)Nystagmus will be present with eyes open and closed.
D)Nystagmus will not be present after opening of the eyes.

Question 5

What is dysequilibrium?

A)The sensation that the environment is moving
B)The sensation that one is about to faint
C)The sensation that objects are moving
D)The sensation of being off balance

Question 6

Once deflection of the cupula has stopped,the neurons continue to fire for up to 10 seconds in a normal vestibular system.What is this called and what purpose does it serve?

A)The velocity storage system is thought to assist the brain in detecting low-frequency head movement.
B)The velocity storage system is thought to allow the system to make continuous adjustments.
C)The inhibitory cutoff mechanism is thought to assist the brain in determining the velocity of the movement.
D)The inhibitory cutoff mechanism is thought to prohibit excessive facilitation of the neurons during movement.

Question 7

Dizziness is the most common reason for seeing a physician for which age group?

A)Under 25 years old
B)Over 75 years old
C)40 to 50 years old
D)80 to 90 years old

Question 8

What would be a normal response of the semicircular canals to the rotary chair test?

A)Nystagmus will be generated by the rotations.
B)No nystagmus will be present at completion.
C)The patient will report dizziness and nausea.
D)Loss of balance will occur upon standing.

Question 9

Which of the following movements would stimulate the otolith organs?

A)Moving forward in a car while looking out the front window
B)Moving backward in a car while turning to look behind
C)Walking in the grocery looking at each side of the aisle
D)Turning to greet a friend who has just walked into a room

Question 10

What does a corrective saccade of the eyes indicate during a head thrust test?

A)A hypoactive vestibulo-ocular reflex
B)A hyperactive vestibule-ocular reflex
C)A hypoactive vestibular system
D)A hyperactive vestibular system

Question 11

What is the cause of the most common type of vertigo,benign paroxysmal positional vertigo?

A)Decreased receptor input as a result of a trauma or virus
B)Increased receptor sensitivity from a viral or vascular event
C)Ototoxicity from use of certain antibiotics or meningitis
D)Stimulation of the semicircular canals from dislodged utricle

Question 12

Why is a high tonic firing rate important for the functioning of the vestibular system?

A)It means the system responds more quickly to changes in head position.
B)It means the system responds to changes by rapid excitation of the neurons.
C)It prevents the system from responding to small changes in head position.
D)It allows detection of head motion through excitation and inhibition.

Question 13

How are the semicircular canals stimulated to depolarize?

A)The stereocilia are deflected toward the kinocilia in the crista ampullaris.
B)The stereocilia are deflected away from the kinocilia in the crista ampullaris.
C)The endolymph moves the kinocilia back and forth within the ampulla.
D)The endolymph prevents movement of the kinocilia within the ampulla.

Question 14

During turning of the head toward the left,the left horizontal semicircular canals will increase firing and the right will decrease firing.What is this mechanisms called?

A)Forward-back mechanism
B)Opposition mechanism
C)Push-pull mechanism
D)Unequaled mechanism

Question 15

What is a characteristic presentation of benign paroxysmal positional vertigo?

A)Vertigo occurs with any head movement and lasts several hours.
B)Vertigo is present with or without any type of head movement.
C)Vertigo occurs with any head movement and is usually of brief duration.
D)Vertigo is present only with sudden,extreme movement of the head.

Question 16

Following the sound application (series of loud clicks)during a vestibular-evoked myogenic potential test of the otoliths,the patient demonstrates an initial inhibitory potential in the sternocleidomastoid muscle.What follows that response in a patient with a normal vestibular system?

A)Nothing,that is considered a normal response
B)Continued inhibition of the sternocleidomastoid
C)Initial inhibitory potential followed by an excitatory potential
D)An excitatory potential in the opposite muscle followed by an inhibitory potential

Question 17

What is vertigo?

A)The sensation that the environment is moving
B)The sensation that one is about to faint
C)The sensation that objects are moving
D)The sensation of being off balance

Question 18

What is a cause of bilateral vestibular hypofunction?

A)Decreased receptor input as a result of a trauma or virus
B)Increased receptor sensitivity from a viral or vascular event
C)Ototoxicity from use of certain antibiotics or meningitis
D)Stimulation of the semicircular canals from dislodged utricle

Question 19

What is a cause of unilateral vestibular hypofunction?

A)Decreased receptor input as a result of a trauma or virus
B)Increased receptor sensitivity from a viral or vascular event
C)Ototoxicity from use of certain antibiotics or meningitis
D)Stimulation of the semicircular canals from dislodged utricle

Question 20

During a Hallpike-Dix maneuver a patient presents with nystagmus.What does that indicate?

A)Malignant paroxysmal positional vertigo
B)Benign paroxysmal positional vertigo
C)Positional nystagmus inducing oscillopsia
D)Positional nystagmus reducing oscillopsia

Question 21

The patient was given Brandt-Daroff exercises for benign paroxysmal positional vertigo.After the first day,the patient reports increased dysequilibrium and nausea for about 45 minutes after completion of the exercises.What should the therapist tell the patient?

A)Stop performing all the exercises until further examination.
B)Decrease the repetitions so there is no facilitation of symptoms.
C)Perform the exercises more slowly,but more often each day.
D)Increased symptoms after the exercises is normal and to continue.

Question 22

What might the interventions for benign paroxysmal positional vertigo do to improve the patient's symptoms?

A)Remove debris from the semicircular canals through repositioning.
B)Facilatate habituation of the central nervous system to movement.
C)Stimulate the patient's vestibular system to decrease vertigo.
D)Develop the use of visual cues for the patient to prevent the onset.

Question 23

Which of the following symptoms should alert the therapist that the patient might have a central versus a peripheral vestibular pathology?

A)Positional nystagmus with slow and fast phases
B)Vertigo that is suppressed by visual fixation
C)Diplopia lasting longer than 2 weeks after onset
D)Hearing loss and sensation of fullness in the ears

Question 24

The therapist has the patient move the head horizontally while maintaining focus on a stable target.What is the purpose of this intervention?

A)To improve gaze stability with head motion
B)To develop balance strategies with head motion
C)To facilitate habituation to horizontal head motion
D)To increase visual acuity during head motion

Question 25

The therapist observes that the patient demonstrates pendular nystagmus.What might this indicate?

A)The patient has peripheral vestibular pathology.
B)The patient has central vestibular pathology.
C)The patient has bilateral vestibular hypofunction.
D)The patient has unilateral vestibular hypofunction.

Question 26

Which of the following would be an appropriate intervention for a patient with bilateral vestibular hypofunction?

A)Habituation exercises to facilitate tolerance to head movement
B)Walking program progressing to different surfaces and environments
C)High-intensity aerobic exercise to increase endurance for activity
D)Exercises in which the head and a target move in opposite directions

Question 27

What would be a reasonable expectation for recovery for a patient with central vestibular hypofunction?

A)The patient should expect full recovery.
B)Aggressive therapy will improve outcomes.
C)Recovery may take up to 2 months.
D)The patient may have residual symptoms.

Question 28

A patient presents with vertigo,spontaneous nystagmus,complaints of oscillopsia with head movement,and dysequilibrium following a viral infection.What is the most likely problem?

A)Malignant paroxysmal positional vertigo
B)Benign paroxysmal positional vertigo
C)Bilateral vestibular hypofunction
D)Unilateral vestibular hypofunction