Senses – Vision included (final) Flashcards
What is the physical manifestation of sound intensity?
Difference in pressure between compressed and rarified patches within the medium.
L9a #6
Give the medium of conduction for:
- ) Outer ear
- ) Middle ear
1.) Outer ear = Conduction through AIR
2.) Middle ear = Conduction through BONE
L9a #10
What are the conducting and neural components of the ear?
Conducting: Outer and middle ear
Neural: Inner ear – Cochlea and Spiral ganglion
L9a #9
What is the modiolus and what does it contain?
Modiolus is the bony core of the cochlea, it contains the beginnings of CN VIII (vestibulocochlear nerve).
L9a #14
What comprises the bony labyrinth and membranous labyrinth of the cochlea and what fills them?
Bony labyrinth: Scala vestibuli and scala tympani (perilymph-filled).
Membranous labyrinth: Scala media (endolymph-filled).
L9a #16
When the stapes pushes on the oval window, which cochlear cavity/compartment is first to feel the perturbation in fluid?
Scala vestibuli —> Directly connected to the oval window.
L9a #16
Where are the scala vestibuli and scala tympani continuous with one another?
A point at the apex of the cochlea called the Helicotrema
L9a #17
- ) Give the relative Na+ and K+ ionic concentration within perilymph. What other bodily fluid does it resemble in composition?
- ) What feature of perilymph makes it ideal for its role in sound transduction?
- ) What additional structural feature aids #2?
1.) High Na+ and Low K+. Composition similar to CSF.
2.) Perilymph is INCOMPRESSIBLE
3.) Bony labyrinths (outside of cochlea) are also incompressible.
L9a #17
- ) The stereocilia of hair cells project into what?
2. ) What are they embedded in?
1.) Endolymph of the scala media
2.) Embedded in the Tectorial membrane
L9a #19
Concerning the auditory hair cells, what are their names “inner” and “outer” in relation to? Explain.
In relation to their relative distance from the modiolus (bony core of the cochlea).
Inner hair cells: Closer to the modiolus.
Outer hair cells: Further from the modiolus
L9a #19
- ) What characteristics of hair cells movement/displacement are responsible for Amplitude/Intensity and Frequency?
- ) What do these characteristics translate into in terms of sound qualities?
1.) Amplitude/Intensity: Degree of hair cell displacement.
Frequency: How quickly/repeatedly they are moved.
2.) Amplitude/Intensity = Loudness
Frequency = Pitch
L9a #20
What are the inner and outer hair cells best for detecting?
Inner hair cells: Frequency detection.
Outer hair cells: Amplitude detection.
Mnemonic: “IF Only” —> Inner = Frequency
L9a #21
What amplifies the signal created by hair cells (2)?
Signal amplified by ionic content of endolymph and by outer hair cells.
L9a #20 and 22
Describe the two portions of the basilar membrane in terms of stiffness/width and frequency detection
Base: Narrower and more rigid/stiff; detects high frequencies.
Apex: Wider and more compliant; detects low pitches.
Higher frequencies detected at the entrance and exit points for the perilymph-containing scala (near the round and oval windows)
L9a #22, p.289 Haines
Where does the basilar membrane vibrate (in general terms)?
Where the frequency finds a sympathetic response.
L9a #22
What is the frequency range of the basilar membrane?
20-20,000 Hz
L9a #22
What is found in the spiral ganglion?
Cell bodies of the first order neurons in the auditory pathway.
The only neurons in the PNS for audition
Describe the neurons of the auditory pathway in terms of:
- ) Neuron type
- ) Their processes (where they are and what nerves they form).
1.) Bipolar neurons
2.)
(i) Central processes: Collectively the cochlear/acoustic nerve.
Comprises part of CN VIII
(ii) Peripheral processes: Collectively the auditory nerve. Synapse with hair cells
L9a #25
- ) Which cochlear compartment contains the organ of corti?
2. ) What are the hair cells in the organ of corti innervated by?
1.) Scala media
2.) Peripheral processes of the bipolar neurons.
L9a #25-26
- ) What does the Weber test evaluate?
- ) What implement is used for the test and how?
- ) Damage to which structures gives positive test (2)?
- ) What findings constitute a positive test?
1.) Evaluates for Sensorineural hearing loss i.e. differentiates between conductive and sensorineural hearing loss.
2.) Use a tuning fork (vibrating at 256 or 512 Hz) place somewhere ALWAYS ON THE MIDLINE, e.g. middle of forehead, above upper lip (under nose), or on top of head equidistant from ears.
3.) Auditory nerves or hair cells
4.) Normal ear hears sound better (normal patient has equal volume in both ears).
L9a #28
- ) What does the Rinne test evaluate?
- ) What implement is used for the test and how?
- ) What findings constitute a positive Rinne test?
- ) Affected patient?
1.) Conductive hearing loss (air or bone conduction).
2.) Tuning fork (vibrating at 512 Hz) on skin overlying mastoid process (bone conduction) and outside ear (on the pinna – air conduction) Note time until tone is no longer detected at each site.
3.) Detection outside ear > Detection on initial mastoid site
-Positive Rinne test is a NORMAL PATIENT!
4.) Detection on initial mastoid site > Detection outside ear
L9a #29
How is hearing loss measured on an audiogram?
Measured as the volume needed to detect a sound at a particular frequency.
L9a #38
What is the decibel range of human speech?
20 to 50-60 dB
L9a #39
What five spoken letters require the greatest volume to be heard/distinguished?
E, N, O, U, G mnemonic —> ENOUGh
L9a #39
What decibel level heard for 8 hours per day is likely to cause hearing loss?
≥ 85 dB
L9a #39
- ) Noise-induced hearing loss (a ______ cause) is characterized by hearing loss at ___________.
- ) What type of pain and/or visible trauma is evident?
- ) __________ with each exposure
1.) -A progressive cause
-Select frequencies
2.) No pain or visible trauma
3.) Accumulates with each exposure
L9a #40
- ) What is the term for age-related hearing loss?
- ) What range of detection is the first to go/most severe (in terms of pitch/frequency and position on basilar membrane)
- ) Give (i) two primary and (ii) three secondary symptoms
1.) Presbyacusis
2.) Higher pitches/frequencies (base of basilar membrane).
3.) (i) Loss of directionality, difficulty understanding speech. (ii) Hyperacusis (sensitivity to volumes or frequencies), tinnitus, vertigo.
L9a #42
What are three criteria for cochlear implants?
1.) Severely hard of hearing (particularly in the low frequencies).
2.) People who lost their hearing (i.e. beyond their critical period) and have DAMAGED HAIR CELLS (i.e. not congenital, because in that case, the correct neural framework never would have had a chance to be set up).
3.) Children BEFORE they have passed through the critical period for audition (i.e. retain some neuroplasticity for audition).
L9a #43
Where are cochlear implants placed?
On the auditory nerve
L9a #43
Where is a neural hearing implant placed?
Directly in the space of the cochlear nuclei (where it electrically stimulates the neurons in the cochlear nucleus).
Not a effective as a cochlear implant at this point
L9a #47
Describe the ascending auditory pathway starting with the termination of the 1st order cochlear nerve fibers. Give CNS level/location for each of the FIVE components (one of them is an dual route, so there are technically FOUR levels).
1.)
(a) Cochlear nuclei (medulla-pons): Only auditory nuclei that does not receive binaural input.
AND
(b) Superior olivary nucleus (pons): Input from ventral cochlear nuclei. There are two of them –medial and lateral olivary nuclei.
2.) Inferior colliculus (midbrain)
3.) Medial geniculate nucleus (thalamus)
4.) Auditory cortex (cerebral cortex)
L9a #49, p.205 BRS
- ) The inferior colliculus is part of the ______ of the ________.
- ) In other words, it is the _______ component of the ___________ in the _________.
1.) Part of the TECTUM (aka roof plate) of the midbrain.
2.) Caudal component of the quadrigeminal plate in the midbrain (#55).
L9a #49
- ) What are the external manifestations of the posterior acoustic striae and where are they?
- ) What is unique about this pathway?
- ) This is part of what set of pathways?
1.) Striae medullares on the surface of the rhomboid fossa (dorsal medulla).
2.) It bypasses the superior olivary nucleus and goes straight to the inferior colliculus.
3.) Medullopontine pathways
L9a #50
- ) Where does the Medial Superior Olivary Nucleus receive inputs from?
- ) What is its main function?
1.) Receives inputs from left side OR crossing input from the right side.
2.) Measures time difference/difference in how quickly the SAME sound message reaches the superior olivary nucleus, i.e. helps LOCALIZE SOUND.
Mnemonic —> Medial = Minutes (of time difference —> localize)
L9a #52
What is the function of the Lateral Superior Olivary Nucleus?
Measures the difference in SOUND INTENSITY (loudness) between the two ears.
Mnemonic —> Loudness = Lateral
L9a #52
The superior olivary nucleus is the first place for what?
First place where there is a mixing of information of one side versus the other (i.e. first place where there is BINAURAL INFORMATION).
L9a #52
Describe how the stapedius muscle is activated (i.e. connections). What is this for?
Cochlear nuclei —> Superior olivary nuclei (bilaterally) —> Facial nucleus —> Facial nerve to stapedius.
Connections to dampen loud sounds for hair cell protection
L9a #53
Define lemniscus
2nd order crossing fibers
L9a #54
Describe the lateral lemniscus, i.e. what type of fibers, and where to/from
2nd order fibers from cochlear nuclei directly to the CONTRALATERAL inferior colliculus.
L9a #54
What is the common organizational pattern of tones in the superior olivary complex, the trapezoid body, and the inferior colliculus?
Low tones = Lateral
High tones = Medial
L9a #63-64
- ) What are the afferents and efferents for the medial geniculate nucleus (give laterality)?
- ) What is its function, i.e. what information does it carry (4)?
1.) Afferent: Ipsilateral inferior colliculus, ipsilateral auditory cortex.
Efferent: ipsilateral Auditory cortex
2.) Carrying frequency, intensity, and binaural (FIB) information to cortex (BUT…the first place to have binaural information is the superior olivary nucleus).
L9a #59
The vestibular system detects ______ and ______ of the _______.
Detects position and movement of the head.
L9b #7
- ) Describe the adaptation speed of the vestibular system and why it must be this way
- ) Firing rates of neurons change in response to what?
1.) Rapidly adapting because it detects changes over time.
2.) In response to movement
L9b #7
Which two parameters of position and movement does the vestibular system detect?
Attitude and acceleration
L9b #7
Endolymph is a fluid designed to facilitate _________.
Synaptic transmission
L9b #9
Bending of the cupula within the ampulla is caused by a change in ________.
Angular acceleration.
L9b #10
The two otolith organs are designed to detect __________.
Linear acceleration.
L9b #11
Describe the two otolith organs in terms of their macule orientation, hair cell orientation, and what they respond to. How are the otoliths oriented to one another?
-Utricle: Horizontally-oriented macule, vertically-oriented hair cells. Responds to movement parallel to the ground.
-Saccule: Vertically-oriented macule, horizontally-oriented hair cells. Responds to vertical movements (against or with gravity).
Oriented at right angles to one another
L9b #11
- ) Within the otoliths, movement of the ________ imparts the sense of motion (i.e. transduces signal).
- ) The region of otolith organs containing hair cell receptors is called what?
1.) Kinocilia
2.) Macula
L9b #12
- ) What type of hearing loss is associated with Meniere’s disease?
- ) What hearing would be used?
- ) The initial hearing loss occurs in ______ frequencies.
- ) What does the audiogram look like in advanced stages?
1.) Sensorineural (not conductive)
2.) Weber test
3.) Lower frequencies, but continues to middle and high frequencies as the disease progresses.
4.) Becomes flat or falling.
L9b #17
- ) What is the 1˚ pathophysiological feature of Meniere’s disease?
- ) Where is pressure transmitted?
- ) What are the four principal symptoms?
1.) Hydrops –increased endolymph fluid and pressure in the endolymphatic sac.
2.) To the Cochlear duct, because endolymph is incompressible.
3.) Pressure/feeling of fullness in the ear, tinnitus, recurring vertigo, hearing loss
L9b #16, 21
The pressure/swelling associated with Meniere’s disease distorts what four structures?
1.) Reissner’s membrane
2.) Scala media
3.) Semicircular canals
4.) Otolith organs
Both 1-2, and 3-4 go together
L9b #21
- ) Where are the cell bodies for the bipolar vestibular neurons found (two names)?
- ) Describe the connection between the two
1.) Vestibular ganglia (VG), aka Scarpa’s ganglion
2.) Peripheral processes from the bipolar neurons extend from the hair cells in the end organs (otoliths or semicircular canal) to the cell body in the VG.
L9b #24
Name the two vestibular ganglia and which vestibular receptors they control.
Superior VG: Anterior and horizontal semicircular canals, and utricle.
Think “everything in front of you —> Anterior + Horizontal x2
Inferior VG: Posterior semicircular canal and saccule.
Posterior and vertical
L9b #24
- ) Where are the second order neurons of the vestibular system located?
- ) Where do they receive direct innervation from?
1.) Four vestibular nuclei located in the lateral medulla.
2.) Receive direct innervation from the 1st order neurons in vestibular (spiral) ganglia.
L9b #29
3rd order neurons of the vestibular system receive projections from the _________.
Vestibular nuclei.
L9b #31
- ) How do projections from the 2nd order neurons in the vestibular nuclei ascend to reach their 3rd order nuclei (i.e. where do they travel)?
- ) What are the two end-locations for ascending vestibular nuclei projections?
- ) What are two other non-ascending end-locations (one is a descending pathway)
1.) via the MLF (medial longitudinal fasciculus).
2.) Oculomotor muscles (particularly CN III and VI; responsible for lateral eye movements) and Thalamus.
3.) Cerebellum, and spinal cord (via lateral and medial vestibulospinal tract).
L9b #31
For the lateral vestibular tract:
- ) Origin
- ) Structures it passes through (2)
- ) Termination
- ) What it regulates
1.) Lateral vestibular (Dieter’s) nucleus.
2.) Anterior funiculus and inferior vestibular nuclei
3.) Ipsilateral anterior horn on α and γ motor neurons.
4.) Regulates position-related musculature (anti-gravity muscles), i.e. extensors + back and lower limb muscles.
L9b #31
For the medial vestibular tract:
- ) Origin
- ) Structures it passes through (1)
- ) Termination
- ) What it regulates
1.) Medial vestibular nucleus
2.) Anterior funiculus
3.) Bilateral anterior horn on α and γ motor neurons of CERVICAL and THORACIC cord.
4.) Regulates HEAD POSITION-related musculature.
L9b #32
- ) Where is the primary vestibular region in the cortex, i.e. what site of cortex receives most vestibular input?
- )
Area 3 (related to the face), and places where vestibular input mixes with other modalities. L9b #33
Vestibulo-ocular reflex (VOR) requires that the vestibular nuclei be connected to what two things?
CN III (oculomotor) and CN VI (abducens) L9b #35
Be able to explain the “Testing Vestibular Function” on #35 of L9b
poop (L9b #35)
- ) Describe the ocular effects of pouring cold vs warm water into a persons ear canal.
- ) What is this procedure called?
- ) How does this relate to nystagmus?
1.) Cold water = eyes turn in the direction of the ear into which cold water was poured.
Warm water = eyes turn in the direction opposite of the ear into which warm water was poured.
2.) Caloric test of vestibulo-ocular reflex.
3.) With nystagmus, there is the same effect, but…
The eyes move slowly in the initial direction as detailed above, then quickly move back in the opposite direction.
L9b #36