Vestibular

Question 1

Role of vestibule-ocular network

Answer 1

Stabilises images on retina + produces eye movement opposite ti head movement (VOR)

Question 2

Role of vestibule-spinal network

Answer 2

Relevant for muscle tone + produces postural adjustments of head and body

Vestibulospinal reflexes= senses falling/tripping–> contracts limbs for postural support

Vestibulocollic reflexes= acts on neck musculature to stabilise head if body moves

Vestibule-Ocular reflexes= stabilises visual image during head movement

Question 3

Role of vestibular-thalamic-cortical network

Answer 3

Conscious perception of motion + spatial orientation

Question 4

Describe Senses

Answer 4

• (-) low vestibular registration = may crave activities involving movement
• (+) hypersensitivity = avoid climbing, concerns on playground, avoid quick movements or sudden position changes
• Subjective: can gain info from sensory profile
• Observation: interacting with environment – may not explore, avoid movements, or be moving/rocking all the time

Question 5

Describe engages

Answer 5

(-) avoids/dislikes = eg. Motion sickness while travelling

• (+) over seeks = may want to always be moving/spinning and not want to stop
• P/E: balance and posture evaluation, vestib evaluation, clinical tools and tests CTSIB

Question 6

Describe Nominates

Answer 6

• (-) unable to perceive stimulus timing = difficulties with activities like jumping, rolling, or things that need vestibular perception of head movement
• (+) unable to perceive sensory intensity = perceives too little or too much intensity

Question 7

Describe symmetry

Answer 7

• (-) extinction = child experiencing unilateral glue ear (stuff stuck in ear), experiencing postural difficulties due to reduced registration/perception of vestib info
• (+) localized hypersensitivity = vestib neuritis, dizziness, nausea

Question 8

Describe adjust

Answer 8

• (-) poor/delayed position adjustments = does not keep eyes and head aligned to horizon
• (+) excessive position adjustment – child locking

Question 9

Describe tunes

Answer 9

• (-) under responds to stimuli = no effective protective ext of UL
• (+) over responds = exaggerated protective extension of UL to very small perturbation

Question 10

Describe overrides

Answer 10

• (-) unresolved sensory conflict = unable to suppress feeling they are moving although stationary
• (0) detects sensory conflict appropriately

Question 11

Describe Normal

Answer 11

• (-) unsafe – accidental injury, risky, poor control

- (+) too safe – fear avoidance, low experience

Question 12

Reaction to rotation

Answer 12

Ability: Maintain PC + display normal post-rotatory nystagmus after spinning in both direction

• Rotations stim horizontal semicircular canals – detect accel or deceleration. On abrupt stop of rotation, horiz SCC continue to be stimulated until equilibrium returned
• Normal post-rot nystag = opposite to direction of body rotation, lasts for 4+ beats of nystagmust

Typical:

• 1mo = few beats of normal nystag + head lift with neck/trunk ext
• 2y = normal nystagt + some  in postural trunk extensor tone
• 4y = normal nystag, can posturally lean into spine and maintain control of body, readjustment once rot stop

Atypical: prolonged nystagmust > 20s, abnormal eye movement, fine shimmer, incorrect direction of nystag, instability or falling, overexaggerated tonal response