11 - Vestibular System: Peripheral Receptors and Central Pathways Flashcards

1
Q

What is the function of the vestibular apparatus?

A

Maintain upright posture, adjust head position in response to changes in posture, coordinate eye movements with each other, and coordinate eye movements to compensate for head movements.

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2
Q

What is linear acceleration? What is angular acceleration?

A

Linear: head movement along a single place

Angular: head rotation in a single plane or simultaneous change in velocity and direction

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3
Q

What does the bony labyrinth contain?

A

Semicircular canals, cochlea, and the vestibule of the inner ear.

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4
Q

Describe the anatomy of the vestibular apparatus?

A

Bony labyrinth with membranous labyrinth inside.

Between the bony labyrinth and the membranous portion is perilymph. Inside the membranous labyrinth is endolymph.

Sensory receptors are in the macula of the utricle, in the macula of the saccule, and the semicircular canals with crista ampullaris.

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5
Q

The maculae in the utricle and saccule detect what? How do they do this?

A

Linear acceleration.

Specialized spots of epithelium that contain sensory hair cells (mechanoreceptors) called maculae.

Hair cells project into the otolythic membrane (gelatinous) and when the membrane moves the cilia deflect towards the true cilium called the kinocilium resulting in depolarization of the cell.

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6
Q

What is the appearance of a macula hair cell?

A

They have bundles of surface projections called stereocilia arranged in rows that abut a taller kinocilium.

These are all covered by the gelatinous otolythic membrane.

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7
Q

The macula in the utricule lies in the _____ plane, while the macula in the saccule lies in the ______ plane.

A

Utricle: horizontal

Saccule: vertical

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8
Q

What are the sterocilia and kinocilium bundles polarized towards? What type of movements is this involved in?

A

A ridge that cuts across the macula.

Deflection towards kinocilium results in polarization while deflection away from kinocilium results in hyperpolarization.

Involved in front to back and side to side movements (lineear acceleration).

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9
Q

What are tip links? What is their function?

A

Proteins on the top of stereocilia that link them to kinocilium.

When inclined in one direction, the tip link is pilled like a slinky, which causes it to open ion channels, resulting in depolarization of hair cells.

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10
Q

A pattern of differential hair cell signaling across the maculae is transmitted to the brainstem via _____. What is this process called?

A

CN 8.

This pattern of cells firing gives information to the brain and is called called population coding.

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11
Q

What are ampullae? What does each contain?

A

Enlarged ends of the semicircular canals (single is ampulla).

Each ampulla contains a ridge of sensory epithelium called the crista ampullaris.

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12
Q

If you cross-sectioned an ampulla, what are the regions that you would see? What happens in this region during movement?

A

Top surface ridge of sensory epithelium called crista ampullaris embedded in a gelatinous material called the cupula.

The epithelium is composed of hair cells that have stereocilia and movement of fluid in the canal (endolymph) causes a wave in which the whole ridge will be pushed by the cupula which acts as a sail.

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13
Q

The _______ is the location of sensory epithelium that’s covered by gelatinous material called _____.

A

Crista ampullaris

The cupola

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14
Q

What is the physiology of the vestibular apparatus? How does endolymph move in response to movement?

A

Rotation of the heads means rotation of the bony labyrinth, which sets up movement of the endolymph within the membranous labyrinth.

Endolymph moves in opposite direction of head turn and delfects cupula and stereocilia towards the kinocilium which causes depol of hair cells.

This sends signals through the vestibulocochlear nerve to get info about movement to the brain.

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15
Q

Semicircular canal detects ______ in speed of head rotation.

A

CHANGES.

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16
Q

The three se circular canals on each side of the head about approximately perpendicular and and in functional pairs that work in concert. What are these groups?

A

Right and left horizontal canals.

Right superior and left posterior.

Right posterior and left superior.

17
Q

How does peripheral sensory information get from the vestibular apparatus to the brain? What are the two ganglion? Where do these neurons synapse?

A

CN 8 bipolar neurons have cell bodies in the vestibular ganglion and have dendrites that connect to spots of the epithelium macullae or the hair cells in the crista ampullaris.

In cochlea, CN8 also has bipolar neuron cell bodies in the spiral cochlear ganglion.

Central processes terminal in the inferior pons and superior medulla on vestibular nuclei.

18
Q

What is the function of central vestibular pathways? How does the body respond to vestibular information?

A

Regulate contraction of axial musculature to keep you upright.

The body responds to vestibular information with muscle contraction.

19
Q

What are the four vestibular nuclei?

A

Caudal Pons:

  • superior vestibular nucleus
  • lateral vestibular nucleus

Rostral Medulla:

  • Medial vestibular nucleus
  • Inferior vestibular nucleus
20
Q

What is the function of the lateral vestibulospinal tract (LVST)?

A

Use sensory information about body position coming from the vestibular system that detects linear and angular acceleration in order to maintain balance and posture.

21
Q

What is the pathway of the lateral vestibulospinal tracts?

A

Input to the vestibuar nuclei in the pons and medulla (and cerebellum) from the vestibular division of CN8.

Projects from Vestibular nuclei unilaterally to all levels of the sp cd because it does axial musculature

Communicates with motor neurons in ventral horn and projects to extensor muscles that keep us upright.

There’s one on each side and they are ipsi.

22
Q

What is the function of the medial vestibulospinal tract (MVST)?

A

Adjusts head position in response to postural changes, coordinates eye movements with each other, reflexively coordinates eye movements to compensate for heat movements (vestibuloocular reflex [VOR]).

23
Q

What is the path of the medial vestibulospinal tract?

A

Projects bilaterally and only goes to the cervical level of the cord because it’s innervating lower motor neurons that are turning the head (SCM).

Also projects upwards and across to other regions of the pons and midbrain nuclei that move the extraocular muscles (CN3, 4, and 6)

24
Q

How does the MVST coordinate eye movements with each other?

A

The vestibular nuclei sends sensory input regarding head movement to the contralateral abducens nucleus.

Each abducens nucleus is in communication with the contralateral oculomotor nucleus via the medial longitudinal fasciculis.

This allows the eyes to be yoked together resulting in conjugate horizontal gaze.

25
Q

What is the vestibuloocular reflex (VOR)? What is an example of when this reflex in important?

A

The MVST reflexively coordinates eye movements to compensate for head movements.

When your head is moving while you run, information is sent to the vestibular nuclei in the pons and medulla, which sends information to the ocular nuclei to compensate for the bouncing so that your gaze remains steady.

26
Q

What is the central pathway for the Vestibuloocular reflex (VOR)?

A

Neuron 1: sensory neurons with cell bodies in the vestibular ganglion detect head movement and send signal to vestibular nuclei.

Neuron 2: neurons in vestibular nu. project to brainstem nuclei that control extraocular muscles.

Neuron 3: Neurons whose cell bodies are in extraocular muscle nuclei project to extraoc. muscles to cause contraction, moving eyes in order to maintain foveation.

27
Q

What is Nystagmus? What can it be caused by and what are the names for it?

A

Rhythmic oscillations of the eyeballs.

May be caused by rotation of the head (rotary nystagmus), observing a moving object when the head is stationary (optokinetic nystagmus), or temperature-generated convection currents in semicircular canal endolymph (caloric nystagmus).

28
Q

What results from application of warm water in the left ear canal? What is this called?

A

Warmed endolymph “rises” stimulating head turning toward the left and induces a left-beating nystagmus.

Caloric Nystagmus.

29
Q

What results from application of cold water into the left ear canal?

A

The cooled endolymph “sinks” simulating head turning toward the right and induces a right-beating nystagmus.

Caloric Nystagmus.

30
Q

Vestibuloocular reflex plays a role in the diagnosis of brain death. In a comatose patient, caloric stimulation is used to induce VOR. When happens if slow phase of nystagmus is present? Absent?

A

Present: the central vestibular pathways are working, indicating brainstem circuitry is intact.

Absent: brainstem is not functioning (the eyes will NOT drift).

31
Q

Why is the FAST phase of nystagmus always ABSENT in a comatose patient?

A

Because the cerebral cortex is not correcting the gaze.

32
Q

How do you use VOR to diagnose brain death? What is a normal response? What response indicates brain death?

A

Oculocephalic maneuver:
-head abruptly rotated laterally; this stimulates inertial flow of endolymph in the opposite direction to head rotation.

Normal: reflexive deviation of the eyes to the opposite side of the head turn

Brain death: no eye movement in response to head movement

33
Q

Your patient is unstable when standing upright- he leans toward his right and veers toward the right if he attempts to walk unassisted. You examine him to see if he has a peripheral vestibular injury. You would expect the injury to be on his ______ side.

A

Right.

Unilateral peripheral vestibular injury results in a loss of vestibular nuclei activity on the ipsi side. Consequently, the intact side is unopposed. Reduced activity of the LVST on the injured side results in leaning or falling towards the lesioned side.