Mackenzie Vestibular study guide
Mackenzie Vestibular · Work through your exam, one topic at a time.
The Mackenzie Vestibular Competency Examination is a knowledge assessment for clinicians who evaluate and treat people with dizziness, imbalance, and vestibular dysfunction - most often physical therapists, but also audiologists, occupational therapists, and other practitioners who build vestibular work into their caseload. It tests whether a candidate can reason from anatomy and pathophysiology through bedside testing and laboratory findings to a defensible plan of care, rather than simply recognizing terminology. The Mackenzie Vestibular study guide has 8 sections and about 2,408 words.
01Vestibular Anatomy and Physiology: Peripheral End Organs, Central Pathways, and VOR Logic
The labyrinth pairs three semicircular canals (horizontal, anterior, posterior) with two otolith organs (utricle, saccule). Canals sense angular acceleration; the utricle and saccule sense linear acceleration and head tilt via hair cells whose stereocilia and kinocilium define a preferred direction.
373 words, about 2 min02Vestibular Pathology and Differential Diagnosis: Peripheral versus Central Reasoning
Start with timing and triggers. Episodic triggered vertigo lasting seconds suggests BPPV; spontaneous episodes lasting minutes to hours suggest Meniere disease or vestibular migraine; acute sustained vertigo suggests vestibular neuritis, stroke, or demyelination.
318 words, about 2 min03Bedside Vestibular Examination: Oculomotor, Positional, and Head Impulse Testing
Begin with visual acuity, pupils, and alignment. Test smooth pursuit, saccades, and gaze holding.
332 words, about 2 min04Vestibular Laboratory Testing: VNG, vHIT, VEMP, and Rotary Chair
VNG includes oculomotor subtests, positional and positioning tests, and caloric irrigation. Caloric testing uses warm and cool water or air to create convection currents in the horizontal canal; it assesses low-frequency function and can show canal paresis.
307 words, about 2 min05BPPV and Canalith Repositioning: Mechanism, Testing, and Maneuvers
BPPV occurs when otoconia dislodge into a canal, most often the posterior canal. Canalithiasis causes free-floating debris with latency and fatigability; cupulolithiasis causes immediate, persistent nystagmus.
309 words, about 2 min06Vestibular Rehabilitation and Unilateral/Bilateral Hypofunction Management
Vestibular rehabilitation uses neuroplasticity through habituation, adaptation, and substitution. Habituation reduces symptoms by repeated exposure to provocative movements.
267 words, about 1 min07Central Vestibular Disorders and Concussion-Related Dizziness
Central vestibular lesions include stroke, demyelination, tumor, cerebellar degeneration, and migraine. Key exam clues are direction-changing or vertical nystagmus, impaired smooth pursuit, saccadic dysmetria, skew deviation, and normal head impulse in acute severe vertigo.
258 words, about 1 min08Professional Practice, Safety, and Documentation
Vestibular testing and repositioning carry risks: falls, neck injury, and symptom provocation. Screen for cervical spine disease, vertebrobasilar insufficiency symptoms, and recent surgery before positional maneuvers.
244 words, about 1 min