vestibular
what canal is the dix hall pike and sidling test, testing?
PSCC
if there is a cerebellar lesion, what side is involved?
ipsilateral
what is the metabolic cascade?
influx of CA++ and outflow of K+
where is balance in the ICF model?
activity (what's causing balance to be off goes in body structure)
what level are the quads and achilles reflexes?
quads- L2-4
achilles- S1-2
what is Menderes disease caused by
poor endolymph reabsorption causing swelling
what is the predictor of recovery from cerebellar stroke?
better progenies if deep cerebral nuclei are NOT involved
what is the cadence for VOR and visual motion sensitivity for concussion?
VOR- 180 bpm
visual motion- 50 bpm
what are the anatomic components of balance
UMN lesion sx
paresis/paralysis, spasticity, spasms, (+) babinski, clonus, increased DTRs
your patient complains of feeling imbalanced and unsteady, they are not experiencing spinning. what type of dizziness are they experincing?
disequilibrium
what is an intention tremor
occurs during the end portions of visually guided movement toward a target
-gets better with eyes closed
when should the buffalo concussion test be stopped?
-exhaustion (RPE 17)
-symptom limited (>3 VAS)
-HR >90% of age-predicted max
-pt request to stop
what are the specific limits of stability?
anterior sway- 8
lateral sway- 16
posterior sway- 4
what is positive and negative babinski
(+) splaying toes
(-) flexion of toes
What is the difference between cupulothiasis and canalithiasis
cupulothiasis: otoconia exits utricle and adheres to cupula, nystagmus does NOT fatigue
canalithaisis: otoconia are free floating in the endolymph of SCC. nystagmus will fatigue
what are the clinical signs if the lateral zone is damaged?
dyssynergia (impairment of multipoint movements)
decomposition of movement
what is joint position error testing
tests proprioception of C-spine
laser on head, point laser to bullseye thingy, rotate head to one side and turn back to neutral
normal: < or equal to 4.5 degrees error
SPLATT
sx prior to fall
previous falls
location of fall
activity- what they were doing during fall
time of fall
trauma
what is 2 on the modified ashworth scale?
more markedly increase in tone throughout ROM but affected part moved easily
you have a patient that has complained of diplopia, shows lack of coordination, has abnormal smooth pursuit and has a purely vertical nystagmus- what is your diagnosis/next steps?
CNS involvement- refer out!!!!
name 3 of the tests for cerebellar function
tone
finger to nose
alternating pronation-supination
static position
heel to knee
foot or toe tapping / hand or finger tapping
mass grasp
finger opposition
5 D's and 3 N's
diplopia, dysphasia, dysarthria, dysmetria, drop attacks
nausea, nystagmus, numbness
internal vs external perturbations
internal- inside body
external- outside body
what is the jedrasski's maneuver
having someone pull hands or feet apart to elicit a reflex