Audiology Praxis Review (Vestib)
ENG stands for - Answer: Electronystagmography
VNG stands for - Answer: Videonystagmography
3 reasons to pick ENG over VNG - Answer: 1) patient has claustrophobia 2) patient has dark
areas around eyes (permanent makeup/ injury) 3) patient is under age of 6 and VNG goggles
don't fit on small head.
Upward trace deflections represent _______ eye movement - Answer: rightward
Downward trace deflections represent ______ eye movement. - Answer: leftward
T/F: The VNG/ENG evaluation is a series of subtests performed to assess portions of the
peripheral and central vestibular systems. - Answer: True
T/F The evaluation of central vestibulo-ocular pathways are restricted and evaluation of
peripheral vestibular systems is quite thorough. - Answer: False. Central evaluation is thorough.
Peripheral evaluation usually targets only horizontal semicircular canal and restricted
information from vertical canals and otolith organs.
What are the 5 main subtests during a ENG/VNG? - Answer: 1) Oculo-motor
2) Spontaneous nystagmus
3) Rapid Positioning (Dix-Hallpike)
4) Positional nystagmus
5) Caloric irrigations
VOR stands for ____________ - Answer: Vestibulo-ocular reflex
,Audiology Praxis Review (Vestib)
Which of the 5 main subtests should be evaluated by direct examination and not by post hoc
recordings? - Answer: Dix-Hallpike
What are the transducers of auditory and vestibular sensory epithelia? - Answer: The auditory
and vestibular sensory epithelia are hair cells.
What are the two types of vestibular sensory epithelia? - Answer: the cristae ampullares and
the maculae.
How do the sensory epithelia convert and send stimuli? - Answer: The cilia on each hair cell in
the vestibular system are bound together to form the ciliary tuft. When the tuft is bent towards
the kinocilium, potassium channels are opened and the hair cells are excited, releasing
neurotransmitters to activate the nerve endings on the hair cells. This propogates action
potentials along cranial nerve VIII.
Explain the differences between the two types of vestibular hair cells - Answer: Type I:
• Flask shaped
• Large synaptic endings called calyces (singular calyx)
Type II:
• Columnar shaped
• Bouton-type terminals synapsing onto their base
Explain the difference between the two types of cilia. - Answer: Stereocilia:
• 100 of these on a single cell that are each anchored in the cuticular plate
Kinocilium
• Only one per hair cell
, Audiology Praxis Review (Vestib)
• Longer than the stereocilia and has no actin
• Eccentrically located, near the cuticular plate
• Polarizes the apical surface of the hair cell
What happens when the ciliary tuft is bent in the direction of the kinocilium? - Answer: If it is
bent towards the kinocilium, potassium channels open and the hair cell is excited.
What happens when the ciliary tuft is bent away from the direction of the kinicilium? - Answer:
If it is bent away from the kinocilum, the cell is inhibited.
What movement stimulates the saccule? - Answer: The saccule is stimulated by vertical linear
acceleration.
What movement stimulates the utricle? - Answer: The utricle is stimulated by horizontal linear
acceleration or static head tilt.
Explain what makes up the otolithic membrane and how it responds to different movement. -
Answer: Crystals add weight to the otolithic membrane and enable it to respond to two types of
stimuli:
• Tilting of the head: gravity pulls on the membrane and bends the ciliary tufts
• Rapid linear acceleration or deceleration of the head: inertia delays the movement of the
heavy otolithic membrane and causes it to pull on the cilia
What does the cupula respond to? - Answer: Cupula responds to angular acceleration and
deceleration (head moves relative to the rest of the body)
What does the macula respond to? - Answer: Macula responds to linear movement (head and
body move together)
ENG stands for - Answer: Electronystagmography
VNG stands for - Answer: Videonystagmography
3 reasons to pick ENG over VNG - Answer: 1) patient has claustrophobia 2) patient has dark
areas around eyes (permanent makeup/ injury) 3) patient is under age of 6 and VNG goggles
don't fit on small head.
Upward trace deflections represent _______ eye movement - Answer: rightward
Downward trace deflections represent ______ eye movement. - Answer: leftward
T/F: The VNG/ENG evaluation is a series of subtests performed to assess portions of the
peripheral and central vestibular systems. - Answer: True
T/F The evaluation of central vestibulo-ocular pathways are restricted and evaluation of
peripheral vestibular systems is quite thorough. - Answer: False. Central evaluation is thorough.
Peripheral evaluation usually targets only horizontal semicircular canal and restricted
information from vertical canals and otolith organs.
What are the 5 main subtests during a ENG/VNG? - Answer: 1) Oculo-motor
2) Spontaneous nystagmus
3) Rapid Positioning (Dix-Hallpike)
4) Positional nystagmus
5) Caloric irrigations
VOR stands for ____________ - Answer: Vestibulo-ocular reflex
,Audiology Praxis Review (Vestib)
Which of the 5 main subtests should be evaluated by direct examination and not by post hoc
recordings? - Answer: Dix-Hallpike
What are the transducers of auditory and vestibular sensory epithelia? - Answer: The auditory
and vestibular sensory epithelia are hair cells.
What are the two types of vestibular sensory epithelia? - Answer: the cristae ampullares and
the maculae.
How do the sensory epithelia convert and send stimuli? - Answer: The cilia on each hair cell in
the vestibular system are bound together to form the ciliary tuft. When the tuft is bent towards
the kinocilium, potassium channels are opened and the hair cells are excited, releasing
neurotransmitters to activate the nerve endings on the hair cells. This propogates action
potentials along cranial nerve VIII.
Explain the differences between the two types of vestibular hair cells - Answer: Type I:
• Flask shaped
• Large synaptic endings called calyces (singular calyx)
Type II:
• Columnar shaped
• Bouton-type terminals synapsing onto their base
Explain the difference between the two types of cilia. - Answer: Stereocilia:
• 100 of these on a single cell that are each anchored in the cuticular plate
Kinocilium
• Only one per hair cell
, Audiology Praxis Review (Vestib)
• Longer than the stereocilia and has no actin
• Eccentrically located, near the cuticular plate
• Polarizes the apical surface of the hair cell
What happens when the ciliary tuft is bent in the direction of the kinocilium? - Answer: If it is
bent towards the kinocilium, potassium channels open and the hair cell is excited.
What happens when the ciliary tuft is bent away from the direction of the kinicilium? - Answer:
If it is bent away from the kinocilum, the cell is inhibited.
What movement stimulates the saccule? - Answer: The saccule is stimulated by vertical linear
acceleration.
What movement stimulates the utricle? - Answer: The utricle is stimulated by horizontal linear
acceleration or static head tilt.
Explain what makes up the otolithic membrane and how it responds to different movement. -
Answer: Crystals add weight to the otolithic membrane and enable it to respond to two types of
stimuli:
• Tilting of the head: gravity pulls on the membrane and bends the ciliary tufts
• Rapid linear acceleration or deceleration of the head: inertia delays the movement of the
heavy otolithic membrane and causes it to pull on the cilia
What does the cupula respond to? - Answer: Cupula responds to angular acceleration and
deceleration (head moves relative to the rest of the body)
What does the macula respond to? - Answer: Macula responds to linear movement (head and
body move together)
