Case 4 - the Vestibular System Flashcards

1
Q

what does the vestibular system do

A

detects forces generated by movement, acting as an accelerometer. translates these into a sense of balance.

provides information about the position of the head in space

allows other CNS structures to rapidly compensate for changes

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2
Q

what is the vestibular system embedded in

A

bone - membraneous labyrinth

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3
Q

where is the vestibule located

A

between the semi-circular canals and the cochlea

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4
Q

what does the vestibule contain

A

the utricle and the saccule

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5
Q

what do the saccule and utricle contain

A

equilibrium receptors called maculae

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6
Q

what is the saccule continuous with

A

cochlear duct anteriorly - vertical acceleration = lift

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7
Q

what is the utricle continuous with

A

the semi-circular ducts posteriorly - horizontal = car

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8
Q

what do the semi circular canals form

A

the dynamic system and detects angular acceleration

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9
Q

what do the otolith organs form

A

the static system and detect linear acceleration

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10
Q

what are otoconia

A

calcium carbonate crystals that form the striola which in turn rests on the otolithic membrane

rely on inertia to function by detecting changes in linear acceleration

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11
Q

where are the hair cells embedded

A

the gelatinous layer

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12
Q

what are the semi circular canals filled with

A

endolymph

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13
Q

what is endolymph

A

high K+ solution with signal transduction occurring in the ampullae

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14
Q

what are the semi circular canals sensitive to

A

pitch, roll and yaw. essential for coordination of eye movement

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15
Q

what does fluid movement do

A

displaces a gelatinous mass known as the capula

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16
Q

what does this displacement cause

A

physical strain on the hair ells

17
Q

what does physical strain on the hair cells cause

A

deflection towards the kinocilium icreases firing, deflection away from the kinocilium decreases it

this allows for very rapid detection of changes in angular acceleration of the head

18
Q

what is the signal transduction done by and what kind of transmission is it

A

mechanically gated channels and by glutamatergic transmission

19
Q

what does the vestibule-ocular reflex prevent

A

retinal slip

head rotates left and eyes rotate right

20
Q

what is nystagmus

A

an element of the VOR alternating slow eye movement with rapid saccadic movement

21
Q

what are the slow phase movements mediated by

A

vesibulo-ocular pathway

22
Q

what are the fast phase movements triggered by

A

cerebral cortex

23
Q

how to test for nystagmus clinically

A

introducing warm or cold water into the external auditory meatus. causes convection currents in the endolymph stimulates hair cells as if the head was rotating leading to nystagmus.

24
Q

what phase is present in a comatose patient

A

the slow phase but not the fast phase

this is because the cerebral cortex is not functioning but the vestibule-ocular pathway is still functioning

25
Q

what does dysfunctional slow phase imply

A

a lesion in the vestibule-ocular pathway

26
Q

what does the vestibule-spinal tract mediate

A

basic balance and postural control

27
Q

how do axons from the vestibular nuclei descend

A

ipsilaterally

28
Q

where to the vestibular nuclei sypnace

A

on lower motor neurones

29
Q

activity in the vestibular nuclei is modulated in where?

A

the cerebellum

30
Q

what does meniere’s disease do

A

increase in endolymph pressure. we don’t know what causes this increase. disrupts signal transduction and can result in tinnitus, nausea, spontaneous nystagmus

31
Q

what is benign paroxysmal positional vertigo?

A

dislodged bits of otolith stimulate the cupola in the posterior SSC causing vertigo. the Epley manoeuvre to nudge them back into the vestibule

32
Q

what treatment to use for motion sickness etc

A

anti histamines