informal tests of the systems involved in balance coupled with an accurate case history, can –help...

19

Informal Tests of the Systems Involved in Balance • Coupled with an accurate case history, can – Help identify potential source of complaint – Help rule out certain etiologies – Help prevent provoking further problems during testing.

Upload: tamsin-sharon-kelly

Post on 05-Jan-2016

212 views

Category:

Documents

0 download

Report

Download

Embed Size (px):

TRANSCRIPT

Page 1: Informal Tests of the Systems Involved in Balance Coupled with an accurate case history, can –Help identify potential source of complaint –Help rule out

Informal Tests of the Systems Involved in Balance

• Coupled with an accurate case history, can– Help identify potential source of complaint– Help rule out certain etiologies– Help prevent provoking further problems

during testing.

Page 2: Informal Tests of the Systems Involved in Balance Coupled with an accurate case history, can –Help identify potential source of complaint –Help rule out

Ocular Range of Motion/Gaze Stability

• Move a target (18” from nose)35-40 degrees Left and Right.30-35 degrees Up and Down.25-30 degrees DiagonallyPausing 15-20 second

• Volitional Saccades

Page 3: Informal Tests of the Systems Involved in Balance Coupled with an accurate case history, can –Help identify potential source of complaint –Help rule out

Frenzel lens exam:

• Lenses magnify pt’s eyes

• Reduce visual fixation

Page 4: Informal Tests of the Systems Involved in Balance Coupled with an accurate case history, can –Help identify potential source of complaint –Help rule out

Monocular Eye Cover

• Looking for vertical shift in gaze

• Suggests abnormality in otolithic organs/pathways.

Page 5: Informal Tests of the Systems Involved in Balance Coupled with an accurate case history, can –Help identify potential source of complaint –Help rule out

Vertebral Artery Test

1. Avoid Basilar Stroke. 2. Differential diagnosis.

Rationale

Procedure 1. Sitting or Supine. 2. Patient turns head. 3. Hyper-extension of neck and posterior head pitch.

Page 6: Informal Tests of the Systems Involved in Balance Coupled with an accurate case history, can –Help identify potential source of complaint –Help rule out

Vertebral Artery Screening

Page 7: Informal Tests of the Systems Involved in Balance Coupled with an accurate case history, can –Help identify potential source of complaint –Help rule out

Passive Head Rotation

• screening for bilateral weakness.

Page 8: Informal Tests of the Systems Involved in Balance Coupled with an accurate case history, can –Help identify potential source of complaint –Help rule out

Halmagyi Head Thrust

• rapid isolated unidirectional screening for low VOR gain on side turning towards.

Page 9: Informal Tests of the Systems Involved in Balance Coupled with an accurate case history, can –Help identify potential source of complaint –Help rule out

Copyright restrictions may apply.

Della Santina, C. C. et al. Arch Otolaryngol Head Neck Surg 2002;128:1044-1054.

Passive head thrust test results for a healthy subject

Page 10: Informal Tests of the Systems Involved in Balance Coupled with an accurate case history, can –Help identify potential source of complaint –Help rule out

Copyright restrictions may apply. Della Santina, C. C. et al. Arch Otolaryngol Head Neck Surg 2002;128:1044-1054.

Passive head thrust test results unilateral vestibular deficiency (UVD)

Page 11: Informal Tests of the Systems Involved in Balance Coupled with an accurate case history, can –Help identify potential source of complaint –Help rule out

Head Shake

• “No” movement vigorously for 15-20 secs then examine with Frenzel lenses. Nyst usually away from lesion side.

Page 12: Informal Tests of the Systems Involved in Balance Coupled with an accurate case history, can –Help identify potential source of complaint –Help rule out

Pneumatic Otoscopy

• Looking for Hennebert’s sign.

Page 13: Informal Tests of the Systems Involved in Balance Coupled with an accurate case history, can –Help identify potential source of complaint –Help rule out

Post-Rotary Nyst

• in swivel chair

Page 14: Informal Tests of the Systems Involved in Balance Coupled with an accurate case history, can –Help identify potential source of complaint –Help rule out

Hallpike Maneuver

• Detection of BPPV

• Does not require equipment

• Similar to first steps of Epley

Page 15: Informal Tests of the Systems Involved in Balance Coupled with an accurate case history, can –Help identify potential source of complaint –Help rule out

VSR/Postural Control

• Past-Pointing – arms out pointing with index fingers to examiners hands, then up and back to examiner’s hands 2 to 3 times w/ eyes open and several times with eyes closed. Both arms move toward weaker ear.

Page 16: Informal Tests of the Systems Involved in Balance Coupled with an accurate case history, can –Help identify potential source of complaint –Help rule out

Romberg

• -- eyes closed, feet together.

• Tandem (Sharpened) Romberg – eyes closed heel to toe.

Page 17: Informal Tests of the Systems Involved in Balance Coupled with an accurate case history, can –Help identify potential source of complaint –Help rule out

Modified CTSIB

• eyes open firm surface

• eyes closed firm surface

• eyes open compressible surface

• eyes closed compressible surface

Page 18: Informal Tests of the Systems Involved in Balance Coupled with an accurate case history, can –Help identify potential source of complaint –Help rule out

Fukuda

• 50 steps in place with eyes closed. Rotate toward weaker labyrinth.

Page 19: Informal Tests of the Systems Involved in Balance Coupled with an accurate case history, can –Help identify potential source of complaint –Help rule out

Casual Gait

• walking 15 feet, with eyes open.

• With and without head turns.

Measuring the informal economy: From employment in the informal sector to informal employment Working Paper

The Informal Sector...Informal employment 60.4 percent of informal workers works in the informal sector, while the rest (39.6 percent) works in the formal sector under informal arrangements,

Self-Help Groups and Income Generation in the Informal ... Self-Help Groups and Income Generation in the Informal Settlements of Nairobi Eliana La Ferrara1 Bocconi University and IGIER

Informal Lectures on Formal Semantics - Randy M Informal Lectures on... · This note is a review of the book Informal Lectures on Formal Semantics, Informal Lectures on to help

Measuring Informal Sector and Informal Employment National Workshop on Informal Employment and Informal Sector Data Collection: Strategy, Tools and Advocacy

ESSAYSONINFORMAL CREDITINTERMEDIATION …1.4 Cross Market Analysis of Deposit and Loans of selected MFIs in ... informal credit activities in Ghana coupled with their interrelationship

Informal reports, Guidelines for writing informal reports

Liberalization, Informal Sector and Formal-Informal Sectors

Informal Workers in Formal and Informal Enterprises in ...conference.iza.org/conference_files/Statistic_2017/abraham_r25068.pdf · Informal Workers in Formal and Informal Enterprises

INFORMAL FALLACIES The aim of this tutorial is to help you learn to recognize and resist fallacious arguments

A coupled simulation architecture for agent-based/geohydrological modelling … · 2019-02-08 · While these coupled modelling methods can help capture the complex behaviors of social-ecological

Rio de Janeiro - ucl.ac.uk · Urban Slums Reports: The case of Rio de Janeiro, Brazil also concentrate the highest rates of informal activity coupled with a lack of infrastructure

The Informal Sector and Informal Employment in Bangladesh

Informal & Formal Words List A Informal Formal

Unit 4 – Informal Logic/Deductive Reasoning Informal Languagemath.rice.edu/~rusmp/curriculum/geometrymodule/PDFdocuments/R… · Unit 4 – Informal Logic/Deductive Reasoning Informal

Informal Fallacies “A Short Catalog of Informal Fallacies”

How informal learning can help you in the deliverables of your H2020 project?h2020 ubium

Help as Knowledge Management: Taking Care of Scarce Resources through Informal Encouragement JD Eveland, Ph.D. December 11, 2000

Beef to School Informal Procurement (RFQ) Template · Web viewThis document is a template to help you create a Request for Quotes (RFQ) using the informal procurement procedure to

1 MEETINGS Formal Formal Informal Informal. 2 Informal Meetings Informal Meetings Impromptu Impromptu Very short notice Very short notice Ideal for discussing

10-Does Informal Finance Help Formal Finance Evidence from ... Informal Finance... · A strand of literature shows the existence of informal finance alongside formal systems. Recent

buildsomething.com : DIY Project Ideas, Free Plans ......Shandy, so an informal entertainment buffet, coupled with a functional potting bench would serve us well. This project was

Informal Reasoning 1/9. Agenda Introduce Informal Reasoning Reflect on Informal Reasoning END GOAL: Is informal reasoning reliable?

Informal and Formal Bidding Process Steps Informal …dfl.hancockcollege.edu/2016Accreditation/Evidence/StandardIII/III.D... · Informal and Formal Bidding Process Steps Informal

Liberalization, Informal Sector and Formal-Informal Sectors' Relationship

Housing Conditions, Sustainability and Self Help in … Colonias/Uploads for... · · 2010-09-20Housing Conditions, Sustainability and Self Help in Rancho Vista and Redwood Informal

DOES WEALTH INEQUALITY HELP INFORMAL INSURANCE?

Tracing the Urban Informal: Mutual Self-Help to ExNihilo

Measuring the Informal Economy: From Employment in the Informal Sector to Informal Employment

Improving the Public’s Ocean Science Literacy What Can Informal Science Education Do to Help?

An Informal Approach To Solving Problems · Vol. 36, No. 8 • $10.00 ctlawtribune.com An Informal Approach To Solving Problems ‘Ombuds’ help organizations deal with conflicts,

The Informal Sector and Informal Employment in Indonesias3.amazonaws.com/zanran_storage/ · THE INFORMAL SECTOR AND INFORMAL EMPLOYMENT IN INDONESIA . BPS-STASTICS INDONESIA 2010

Informal Economy Literature Review - Aspen Institute...In this literature review, the terms informal economy, informal work, informal sector, and informal economic activity are used

Informal Sector Versus Informal Contracts in Nairobi, Kenya

Measuring the informal economy from employmeent in the informal sector to informal employment