复旦大学：《耳鼻咽喉科学》课程教学资源（PPT课件讲稿，英文版）Evaluation of vestibular function

Evaluation of vestibular function Chunfu dai m,d ph. d

Evaluation of vestibular function Chunfu Dai M.D & Ph.D

球囊上交通支 上半规管 上半规管 上骨壶腹 外(侧)骨壶腹 耳蜗 球囊主要神经 前庭窗 前庭神经节 后半规管 总脚 外半规管 后半规管 蜗顶 单脚 后骨壶腹蜗窗 前庭 耳蜗螺旋神经节 图241内耳全貌 Stapes Semicircular Vestibular

Balance is a highly integrated network vestibular system -rotatory stimulation and linear acceleration Information proprioceptive system -information input from the feet, ankle, hip and neck ocular system-visual perception of spatial orientation is supplied by the central nervous system -integrated these information and translated to fine motor movements

Balance is a highly integrated network ◼ vestibular system -rotatory stimulation and linear acceleration Information ◼ proprioceptive system - information input from the feet, ankle, hip, and neck ◼ ocular system - visual perception of spatial orientation is supplied by the ◼ central nervous system - integrated these information and translated to fine motor movements

Static balance test i Romberg test, useful in patients with an acute unilateral labyrinthine lesion Mann test: the patient stands heel to toe rather than with feet together Static posturography

Static balance test ◼ Romberg test: useful in patients with an acute unilateral labyrinthine lesion ◼ Mann test: the patient stands heel to toe rather than with feet together ◼ Static posturography:

Dynamic balance test Dynamic posturography Co-ordination function test I Point nose test Alternative movement Finger point

Dynamic balance test ◼ Dynamic posturography ◼ Co-ordination function test: ◼ Point nose test ◼ Alternative movement ◼ Finger point

Nystagmus u Nystagmus Slow phase: hypoactivity Quick phase: hyperactivity Direction: quick movement of eye Plane: horizontal, rotary, vertical Degree: I: quick phase side II: quick phase side and look forward III: quick phase side, slow phase side and look forward

Nystagmus ◼ Nystagmus ◼ Slow phase: hypoactivity ◼ Quick phase: hyperactivity ◼ Direction: quick movement of eye ◼ Plane: horizontal, rotary, vertical ◼ Degree: ◼ I: quick phase side ◼ II: quick phase side and look forward ◼ III: quick phase side, slow phase side and look forward

Ocular dysmetria test; Brainstem or cerebellum lesion Smooth pursuit test Brainstem or cerebellum lesion Optokinetic nystagmus Lesion in central never system Gaze nystagmus a Lesion in central nerve system

◼ Ocular dysmetria test: ◼ Brainstem, or cerebellum lesion ◼ Smooth purpsuit test: ◼ Brainstem or cerebellum lesion ◼ Optokinetic nystagmus ◼ Lesion in central never system ◼ Gaze nystagmus ◼ Lesion in central nerve system

Caloric test: Horizontal semicircular canal a Temperature: 44 and 30 Stimuli duration: 40s Rotation test

◼ Caloric test: ◼ Horizontal semicircular canal ◼ Temperature: 44 and 30 ◼ Stimuli duration: 40s ◼ Rotation test

VANG SI JUN EENT Fistula sign Fistula was blocked by granuloma or cholesteatoma Dead labyrinth Hennebert sign u Tullio phenomeno

◼ Fistula sign ◼ Fistula was blocked by granuloma or cholesteatom ◼ Dead labyrinth ◼ Hennebert sign ◼ Tullio phenomeno

(1) gaze (fixation) test, (2) ocular pursuit test, (3)optokinetic test, (4) static positional test, (5) dynamic positioning test, and (6) bithermal caloric test

◼ (1) gaze (fixation) test, (2) ocular pursuit test, (3) optokinetic test, (4) static positional test, (5) dynamic positioning test, and (6) bithermal caloric test