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BRS NEUROLOGY > 1b// Vestibular System > Flashcards

1b// Vestibular System Flashcards

1
Q

What is the role of vestibular organ?

A

capture low frequency motion (movements)

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2
Q

What is the role of the hearing organ?

A

capture high frequency motion (sound)

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3
Q

what are the cellular origins of the hearing and vestibular organs?

A
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4
Q

What are the inputs for a vestibular system?

A

movement and gravity

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5
Q

how are movement of gravity (inputs) for the vestibular system detected?

A

mechanical sensors
(canals and otoliths)

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6
Q

What happens to the input to mechanical sensors of the vestibular system?

A

the CNS integrates this info and generates responses

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7
Q

What are the outputs of the vestibular system?

A

the outputs are perception and reflexes that maintain posture and gaze

ocular reflex
postural control

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8
Q

Describe the whole process (input and output) of the vestibular system?

A
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9
Q

Label.

A
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10
Q

Where are the utricle and saccule located? And what are they joined by?

A

in the vestibule and are joined by a conduit
the saccule is also joined to the cochlea

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11
Q

How many semicircular canals are there on each ear?

A

3 each
ant, post and lateral

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12
Q

What do the semicircular canals have on their side? And what arte they filled with?

A

an ampulla on one side, and they are connected to the utricle
filled w/fuid and respond to movement

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13
Q

What are the otolith organs and where are they located?

A

Utricle and saccule are the otolith organs. Their cells are located on the maculae, placed horizontally in the utricle and vertically in the saccule

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14
Q

Label.

A
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15
Q

What do maculae contain? (3)

A

The maculae contain the hair cells, a gelatinous matrix and the otoliths on top. These otoliths are carbonate crystals that help the deflection of the hairs.

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16
Q

What is otolith movement?

A

linear acceleration and tilt

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17
Q

What type of movement does the utricule have?

A

horizontal movement

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18
Q

What type of movement does the saccule have?

A

vertical movement

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19
Q

Where are the hair cells in the canals located?

A

in the ampulla

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20
Q

Label.

A
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21
Q

What are the orientation of the canals in the head?

A

defines 3 planes
anterior
posterior
horizontal

anterior and post canals form a 90 degree angle

lateral canals are horizontal to the other canals

therefore they work in pairs
- 6 total canals both ears

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22
Q

What is the biggest cilium in vestibular hair cells called?

A

kinocilium

23
Q

What do cilia allow? And what does head movement generate?

A

Cilia allows the cells to depolarise the cell with movement of the endolymph generated by head movement

towards the kinocilium= dfepolarisation

24
Q

What type of potential do hair cells have? And what does that have?

A

Hair cells have a resting potential which has a basal discharge to the nerve

25
Q

What happens when hairs move towards or away the kinocilium?

A

Hairs moving towards the kinocilium generates depolarization and an increase in nerve discharge.
Hairs moving away from the kinocilium generates hyperpolarization and a reduction in nerve discharge.

26
Q

Where do primary afferents end?

A

in vestibular nuclei in the brainstem (pons)

27
Q

Label.

A
28
Q

What are the functions of the vestibular system?

A

to detect and inform about head movements

balance

to keep images fixed in the retina during head movements

29
Q

What are the vestibular reflexes?

A

Vestibulo-ocular Reflex (VOR)

Vestibulo Spinal Reflex (VSR)

30
Q

What is the vestibulo-occular reflex for?

A

Keeps images fixed in the retina

31
Q

Describe the mechanism of the vestibulo-occular reflex?

A

Connection between vestibular nuclei and the oculomotor and (abducen) nuclei (CN3&6)

Eye movement in opposite direction to head movement, but same velocity and amplitude

32
Q

How can you categorise vestibular disorders?

A

timing and laterality

acute AND unilateral

slow AND unilateral or any bilateral loss

33
Q

What are the main complaints of acute and unilateral? and why?

A

imbalance, dizziness, vértigo and nausea

due to sudden asymmetry

34
Q

What are the main complaints of slow and unilateral or bilateral loss?

A

imbalance and nausea – NO vertigo

35
Q

What are the 2 types of location vestibular disorders?>

A

peripheral and central

36
Q

Where are peripheral vestibular disorders located?

A

vestibular organ and/ or VIII nerve

37
Q

What are examples of peripheral vestibular disorders?

A

Vestibular neuritis
Benign Paroxysmal Positional Vertigo (BPPV)
Meniere’s disease

38
Q

Where are central vestibular disorders located?

A

CNS (brainstem/ cerebellum)

39
Q

What are examples of central vestibular disorders?

A

Stroke
Multiple Sclerosis
Tumours

40
Q

What is the clinical approach of a vestibular disorder? main diagnoses and core exam

A

*BPPV normal gelatinous matrix dislodges, so assymetrical signalling bc the crystals are moving

41
Q

What are the red flags of vestibular disorders?

A

Headache
Gait problems
Hyper-acute onset (vascular event)
Hearing loss (e.g., blood supply to cochlea gone)
Prolonged symptoms (>4 days)

42
Q

What are the balance disorders timing classification?

A

acute
recurrent
intermittent
progressive

43
Q

What test do you do for acute balance disorders?

A

HINTS exam

44
Q

What test do you do for intermittent balance disorders?

A

Dix-Hallpike test

45
Q

What are examples of acute timing balance disorders?

A

Vestibular Neuritis
Stroke

46
Q

What are examples of intermittent timing balance disorders?

A

Benign Paroxysmal Positional Vertigo (BPPV)

47
Q

What are examples of recurrent timing balance disorders?

A

Migraine
(Meniere’s Disease)

48
Q

What are examples of progressive timing balance disorders?

A

Schwannoma vestibular (VIIIth nerve)
Degenerative conditions (MS)

49
Q

What does more dizziness most likely mean?

A

Benign Paroxysmal Positional Vertigo (BPPV)

50
Q

What is significant about migranes?

A

any movement makes it worse

51
Q

What is the HINTS exam?

A
52
Q

What is nystagmus?

A

rhythmical, repetitive and involuntary movement of the eyes aka jerking movement of the eyes

53
Q

What could support a diagnosis of Benign Paroxysmal Positional Vertigo (BPPV)?

A

The sudden and intermittent vertigo crisis which is very characteristic of this disorder.

Short lasting (minutes) spinning vertigo.

Triggered when getting up and lying down.

He does not refer to any symptoms when standing still

He does not mention any new hearing symptom accompanying the vestibular event, the hearing problems are clearly coming from previous time.

BRS NEUROLOGY (22 decks)

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