NPTE - (5) Neuroanatomy - Balance, Vestibular, Test & Measures Questions and Answers Already
Passed Graded A+
Balance can be broken down into three components - Answers1. Vestibular
2. Somatosensory
3. visual
Describe somatosensory input for the balance system - AnswersSomatosensory receptors are located in
the joints, muscles, ligaments, and skin to provide proprioceptive info regarding length, tension,
pressure, pain, and joint position. Proprioception and tactile input from ankles, knees, hips, and neck
provide balance info to the brain
What kind of test can be done to test the somatosensory system - AnswersExamination of pressure and
vibration
Observation of a patient when changing the surface they are standing on
Example: slopes, uneven surfaces, standing on foam
Describe visual input for the balance system - AnswersVisual receptors allow for perceptual acuity
regarding verticality, motion of objects and self, environmental orientation, postural sway and
movement of head/neck
-children rely heavily on this system for maintenance of balance
What kinds of tests can be done to test the visual system - AnswersExamination of quiet standing with
eyes open; observing balance strategies to maintain center of gravity with and without visual input
-assessment of potential visual field cuts, hemianopsia, pursuits saccades, double vision, gaze control,
and acuity is necessary
Describe the vestibular input system for balance - AnswersVestibular system provides the CNS with
feedback regarding the position and movement of the head with relation to gravity.
-the labyrinth consists of three semicircular canals filled with endolymph and two otolith organs
-semicircular canals respond to movement of fluid with head motion
-otoliths measure the effects of gravity and movement with regard to acceleration/deceleration
What kinds of tests can be done to test the vestibular system - AnswersExamination of balance with
movement of the head
-Dix-hallpike maneuver, bithermal caloric testing, assessment for nystagmus. Head thrust sign, testing of
the vestibulocular reflex
,List the 4 automatic postural strategies - Answers1. Ankle strategy
2. Hip strategy
3. suspensory strategy
4. Stepping strategy
Describe the ankle strategy - Answers-first strategy to be elicited by a small range and slow velocity
perturbation when the feet are on the ground
-muscle groups contract in a distal to proximal fashion to control postural sway from the ankle joint
Describe the hip strategy - Answers-elicits greater force challenge or perturbation through the pelvis and
hips
-hips will move in the opp direction of the head in order to maintain balance
muscle groups contract in a proximal to distal fashion in order to counteract the loss of balance
Describe the suspensory strategy - Answers-used to lower the center of gravity during standing or
ambulation in order to better the control of the center of gravity
-examples of this often include knee flexion and squatting
-this strategy is often used when both mobility and stability are required during a task (such as surfing)
Describe the stepping strategy - AnswersElicited through unexpected challenges or perturbations during
static standing or when the perturbation produces such a movement that the COG is beyond the BOS.
-the LE step and/or UE reach to regain a new BOS
Describe vertigo - AnswersSense of movement and rotation of oneself or the surrounding environment
with a typical spinning sensation
What are the two types of vertigo - AnswersPeripheral and central vertigo
What are the characteristics of peripheral vertigo - Answers-Episodic and short duration
-autonomic symptoms
-precipitating factor
-pallor, sweating
-nausea and vomiting
-auditory fullness (fullness within the ears)
, -tinnitus
What are the characteristics of central vertigo - Answers-Autonomic symptoms less severe
-loss of consciousness can occur
-neurological symptoms presents including:
1. Diplopia
2. hemionpsia
3. Weakness
4. Numbness
5. Ataxia
6. dysarthria
What is the cause/etiology of peripheral vertigo (6) - Answers1. Benign paroxysmal positional vertigo
(BBPV)
2. menieres disease
3. Infection
4. Trauma/tumor
5. Metabolic disorders (diabetes mellitus)
6. Acute alcohol intoxication
What is the cause/etiology of central vertigo (6) - Answers1. Meningitis
2. Migraine headache
3. Complications of neurologic origin post ear infections
4. Trauma/tumor
5. Cerebellar degeneration disorders (alcoholism)
6. Multiple sclerosis
Describe benign paroxysmal positional vertigo - Answers-repeated episodes of vertigo that occur
subsequent to changes in head position
-BPPV only lasts a few seconds and is typically noted while in the recumbent position
Passed Graded A+
Balance can be broken down into three components - Answers1. Vestibular
2. Somatosensory
3. visual
Describe somatosensory input for the balance system - AnswersSomatosensory receptors are located in
the joints, muscles, ligaments, and skin to provide proprioceptive info regarding length, tension,
pressure, pain, and joint position. Proprioception and tactile input from ankles, knees, hips, and neck
provide balance info to the brain
What kind of test can be done to test the somatosensory system - AnswersExamination of pressure and
vibration
Observation of a patient when changing the surface they are standing on
Example: slopes, uneven surfaces, standing on foam
Describe visual input for the balance system - AnswersVisual receptors allow for perceptual acuity
regarding verticality, motion of objects and self, environmental orientation, postural sway and
movement of head/neck
-children rely heavily on this system for maintenance of balance
What kinds of tests can be done to test the visual system - AnswersExamination of quiet standing with
eyes open; observing balance strategies to maintain center of gravity with and without visual input
-assessment of potential visual field cuts, hemianopsia, pursuits saccades, double vision, gaze control,
and acuity is necessary
Describe the vestibular input system for balance - AnswersVestibular system provides the CNS with
feedback regarding the position and movement of the head with relation to gravity.
-the labyrinth consists of three semicircular canals filled with endolymph and two otolith organs
-semicircular canals respond to movement of fluid with head motion
-otoliths measure the effects of gravity and movement with regard to acceleration/deceleration
What kinds of tests can be done to test the vestibular system - AnswersExamination of balance with
movement of the head
-Dix-hallpike maneuver, bithermal caloric testing, assessment for nystagmus. Head thrust sign, testing of
the vestibulocular reflex
,List the 4 automatic postural strategies - Answers1. Ankle strategy
2. Hip strategy
3. suspensory strategy
4. Stepping strategy
Describe the ankle strategy - Answers-first strategy to be elicited by a small range and slow velocity
perturbation when the feet are on the ground
-muscle groups contract in a distal to proximal fashion to control postural sway from the ankle joint
Describe the hip strategy - Answers-elicits greater force challenge or perturbation through the pelvis and
hips
-hips will move in the opp direction of the head in order to maintain balance
muscle groups contract in a proximal to distal fashion in order to counteract the loss of balance
Describe the suspensory strategy - Answers-used to lower the center of gravity during standing or
ambulation in order to better the control of the center of gravity
-examples of this often include knee flexion and squatting
-this strategy is often used when both mobility and stability are required during a task (such as surfing)
Describe the stepping strategy - AnswersElicited through unexpected challenges or perturbations during
static standing or when the perturbation produces such a movement that the COG is beyond the BOS.
-the LE step and/or UE reach to regain a new BOS
Describe vertigo - AnswersSense of movement and rotation of oneself or the surrounding environment
with a typical spinning sensation
What are the two types of vertigo - AnswersPeripheral and central vertigo
What are the characteristics of peripheral vertigo - Answers-Episodic and short duration
-autonomic symptoms
-precipitating factor
-pallor, sweating
-nausea and vomiting
-auditory fullness (fullness within the ears)
, -tinnitus
What are the characteristics of central vertigo - Answers-Autonomic symptoms less severe
-loss of consciousness can occur
-neurological symptoms presents including:
1. Diplopia
2. hemionpsia
3. Weakness
4. Numbness
5. Ataxia
6. dysarthria
What is the cause/etiology of peripheral vertigo (6) - Answers1. Benign paroxysmal positional vertigo
(BBPV)
2. menieres disease
3. Infection
4. Trauma/tumor
5. Metabolic disorders (diabetes mellitus)
6. Acute alcohol intoxication
What is the cause/etiology of central vertigo (6) - Answers1. Meningitis
2. Migraine headache
3. Complications of neurologic origin post ear infections
4. Trauma/tumor
5. Cerebellar degeneration disorders (alcoholism)
6. Multiple sclerosis
Describe benign paroxysmal positional vertigo - Answers-repeated episodes of vertigo that occur
subsequent to changes in head position
-BPPV only lasts a few seconds and is typically noted while in the recumbent position
