Term
-1818 ___ reported that “swinging” was a popular treatment for mental illness
-1820 ___ one of the first researchers credited with establishing research on vestibular system
-1830 ___ relationship between SSC stimulation and eye movement |
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Definition
| Hayner; Purkinje; Flourens |
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Term
-1849 DuBois-___ and 1903 ___ corneoretinal potential; 5 types of eye movements described as the reactive compensatory eye movement provoked by rotating subject in dark with fast phase in direction of rotation
-1907 ___ rotary chair testing |
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Definition
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Term
Original Test:
-Head tilted forward ___ degrees to bring horizontal SCC in plane of rotation
-Chair rotated ___ times over 20 seconds and then stopped
-Duration of post-rotary nystagmus measured in seconds by ___ observation
-___ information about horizontal SCC function |
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Definition
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Term
Original Test and Difficulties:
-Consisted of two movements: ___ and ___
-Difficulties: ___ effects of visual suppression and poor control of ___ applied stimulus |
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Definition
| Clockwise (CW) and Counterclockwise (CCW); Inconsistent; manually |
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Term
| What are the 3 types of rotation used? |
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Definition
| Barany, constant, and sinusoidal |
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Term
| Rotation where you stop abruptly |
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Definition
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Term
| As frequency of motion is increased, fluid tends to remain stationary due to inertia – relative motion between the fluid and the canal deflect the hair cells resulting in a motion signal to the nervous system |
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Definition
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Term
At very ___ frequencies, fluid moves as the canal moves resulting in no relative motion and no motion signal sent to the
CNS |
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Definition
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Term
-Changes in physical characteristics of the canal and fluid will alter the ___ cutoff frequency
-Smoother surface on inner walls of canal would allow for freer motion ___ or ___ cutoff frequency
-More dense fluid will ___ its mass and resistance to motion
-Reduced fluid density will ___ low cutoff frequency |
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Definition
| low; reducing or decreasing; increase; increase |
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Term
Rotational Chair vs Caloric Testing:
-RC ___ better by patients
-Rotational stimulus more ___
-___ test frequencies
-___ isolate one ear |
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Definition
| tolerated; physiologic; Multiple; Cannot |
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Term
Reasons for Conducting RC:
-Want more information about different ___ of movement
-When VNG suggests ___ ___ ___ (no spontaneous nystagmus) despite a unilateral weakness and ongoing complaints
-When caloric results are ___ deg/sec bilaterally, rotation test is used to define extent of bilateral weakness
-When ___ testing cannot be performed |
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Definition
| speeds; unilateral compensated disorder; <10; caloric |
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Term
| Why might caloric testing not be performed? |
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Definition
| When there is an asymmetry in anatomy (mastoid bowl), OM, perforation. When you can't accurately compare ears to each other. Outer/middle malformations. |
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Term
Reasons for Conducting RC:
-When ___ is required to follow natural progression of patient’s disease (Meniere’s Syndrome, vestibular schwannoma)
-For determination of ___ of treatment (chemical ablation of one or both vestibular systems) |
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Definition
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Term
| -Low frequency rotation, ___ Hz and slower, able to detect unilateral peripheral vestibular deficits and ___ with caloric results. Can track ___ in function over time › -Useful to test at very ___ frequencies like a caloric test does (0.004 Hz) and high frequencies like ___ head motion (0.5 to 5.0 Hz) |
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Definition
| 0.16; agrees; changes; low; normal |
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Term
Effect of Age:
-Increase in ___ of nystagmus with increase in age
-Decrease in ___ of nystagmus with increase in age |
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Definition
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Term
VOR:
-___ phases are vestibular in origin
-___ phases are central in origin as the eyes are re-centered in an attempt to maintain a stable image as patient is rotated |
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Definition
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Term
-___– relationship of slow-phase eye motion compared to motion of the rotational chair
-___– comparison of the velocity of the chair to the slow-phase eye velocity of the patient |
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Definition
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Term
Directional Preponderance:
-Discard fast phase of eye movement to construct a ___ phase sine wave
-Compare slow phase sine wave to ___ sine wave |
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Definition
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Term
Measurement Parameters:
-___– greatest clinical significance for documenting peripheral dysfunction; timing relationship between vestibular part of VOR and head motion
-___– measurement of eye movement that compensates for head movement (eye velocity/chair velocity)
-___– difference between maximum left beating and right beating eye velocities divided by total of left and right beating maximum slow phase eye velocities |
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Definition
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Term
| Allows rapid measurement of gain and time constant of VOR rotating in both directions; quick impulsive movements |
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Definition
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Term
Pediatric Testing:
-Rotational chair often most ___ and best ___ for testing children
-Can sit on ___ ___ in chair
-Use of ___ goggles if tolerated |
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Definition
| efficient; tolerated; parent’s lap; VNG; |
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Term
Pediatric Testing: Norms are different
-___ amplitude but ___ saccades for a given stimulus
-As child ages, amplitude of slow phase ___ and more ___ saccades are generated |
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Definition
| Larger; fewer; decreases; frequent |
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Term
Patient Setup:
-Head should be tilted down approximately ___ degrees so that horizontal SCC ___ to the floor and ___ to axis of rotation
-Secured in chair with some type of ___
-Feet, knees, head, arms, and torso ___
-Instructed to keep head ___
-DO NOT suggest ___ or ___ |
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Definition
| 30; parallel; perpendicular; seatbelt; secured; stationary; nausea; claustrophobia |
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Term
Patient Preparation:
-No ___ 24 hours prior to testing
-Avoid ___ 2 hours before testing
-If patient has been on medications continuously for at least __ weeks, do not withdraw
-Discuss with prescribing ___ prior to suggesting discontinuation of medication for 24 to 48 hours prior to test
-If patient has ___, should follow physician instructions regarding eating
-Obtain good ___ ___ prior to test |
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Definition
| alcohol; food; 8; physician; diabetes; night sleep |
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Term
| What is the room preparation like? |
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Definition
-No light leaks for rotary chair enclosure or for goggles
-Lights outside test enclosure should be turned off to avoid light leakage
-If patient can see at all some measures are invalidated |
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Term
Test Battery:
-Patient calibration: ___ eye movement target at +/- 10
degrees from midline or ___ ___ test target at about 0.16 Hz
-Spontaneous nystagmus test: Patient stares at fixation light in dark enclosure for __ seconds, then stares with fixation light off for __ seconds – patient must be alerted when fixation is ___ |
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Definition
| Saccadic; smooth pursuit; 10; 30; absent |
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Term
Test Battery: Sinusoidal harmonic acceleration test
-Head tilted down approximately __ degrees
-Test begins at ___ Hz for an average of at least __ cycles (300 seconds or 5 minutes for 0.01 Hz)
-If phase, gain, and symmetry are normal at 0.01 Hz, skip ahead to ___ through ___ Hz |
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Definition
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Term
Velocity step or trapezoidal rotary chair testing:
-Measures ___ rate of nystagmus following an abrupt angular acceleration or deceleration
-Calculated as time required for nystagmus to attenuate to __% of maximum peak slow phase velocity
-Use acceleration rate of ___ degrees/second squared to a peak velocity of ___ deg/sec |
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Definition
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Term
Visual fixation suppression testing:
-Slow phase eye velocity produced by harmonic acceleration with patient in ___ compared to slow-phase eye velocity when patient is rotating and ______________ that moves with chair
-Ability to ___ nystagmus induced by rotation is a sign that the connections between the midline cerebellum and the vestibular nuclei are intact |
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Definition
| dark; fixating on laser target; attenuate |
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Term
Optokinetic Testing:
-Best done in enclosure with ___ ___–best environment to produce patient’s sensation of turning
-Chair facing ___ the door to limit visual cues of door frame |
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Definition
| rotational chair; opposite |
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Term
OKAN – optokinetic after nystagmus:
-Perseveration of OKN/OPK after lights have been turned ___
-Indication of a normal functioning central vestibular ___ ___ ___ |
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Definition
| off; velocity storage mechanism |
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Term
Advantages of Whole Body Sinusoidal Harmonic Acceleration Testing:
-Useful when VNG shows no ___ ___ yet patient shows a ___ ___ on caloric test and is symptomatic
-Can track progression of ___ impairment and treatment
-Can track process of ________ compensation for peripheral vestibular system impairment |
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Definition
| spontaneous nystagmus; unilateral weakness; disease; CNS |
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Term
More Advantages:
-Can determine if there is residual ___ frequency peripheral “drive” in cases of BW
-___ graded stimuli can be delivered in a short period of time
-Rotation stimulus is unrelated to ___ features of the external ear or temporal bone so a more exact relationship between stimulus and response is possible |
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Definition
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Term
Disadvantages:
-Cannot evaluate independently the left and right ___ SCCs
-Instrumentation is costly ($___-___) |
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Definition
| horizontal; 80,000 to $100,000 |
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