Vestibular system Flashcards

1
Q

What are the three main inputs of the vestibular system?

A

Proprioceptive
Vestibular information
Visual

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2
Q

What are the two main outputs of the vestibular system?

A

Ocular reflex

Postural control

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3
Q

Where is the vestibular organ located?

A

Within the posterior area of the inner ear

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4
Q

which cells are located within the vestibular organ?

A

Hair cells

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5
Q

What two structures are joined by a conduit in the vestibule?

A

The utricle and saccule

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6
Q

What is the utricle?

A

The utricle detects linear accelerations and head-tilts in the horizontal plane.

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7
Q

What are the three semi-circular canals?

A

Anterior
Posterior
Lateral

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8
Q

Which structure connects the semi-circular canals with the utricle?

A

Ampulla

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9
Q

Which bone is the vestibular organs located in?

A

Petrous part of the temporal pone.

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10
Q

What term refers to the biggest cilium on vestibule hair cells?

A

Kinocillium

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11
Q

What is the function of stereocilia on vestibular hair cells?

A

Cilia allows the cells to depolarise the cell with movement of the endolymph generated by head movement. Cilia are orientated to a particular side, deflection will induce cellular depolarisation in response to endolymph movement

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12
Q

What are otoliths?

A

The otoliths (statoconia) are small calcium carbonate crystals which put pressure on the cilia, inclining them, thereby stimulating the sensory hair cells.

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13
Q

Where are the utricle and saccule cells located?

A

In the maculae

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14
Q

How are utricle cells organised?

A

Horizontally

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15
Q

Which otolith organ cells are organised vertically?

A

Saccule

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16
Q

What is the maculae?

A

Contains the hair cells, a gelatinous matrix and the otoliths.

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17
Q

Where are the hair cells located within the semi-circular canals?

A

In the ampulla, the rest of the canal contains endolymph

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18
Q

What fluid comprises the semi-circular canals?

A

Endolymph (High in potassium ions)

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19
Q

Which structure within the ampulla contains hair cells?

A

The crista

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20
Q

Which structure surrounds the crista ampularis?

A

The cupula

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21
Q

What function is performed by the cupula?

A

Helps hair cell movement, facilitated by endolymph movement

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22
Q

What angle is formed between the anterior and posterior canals?

A

90 degrees

23
Q

Where are the vestibular nuclei located?

A

Rostral medulla

24
Q

Which nuclei is receives primary afferents?

A

Vestibular nuclei

25
Q

What four projections arise from the vestibular nuclei?

A

1) Spinal cord
2) Nuclei of the extraocular muscles
3) Cerebellum
4) Centres for cardiovascular and respiratory control

26
Q

Which vestibular nuclei are concerned with vestibulospinal reflexes?

A

Lateral, medial and inferior nuclei

27
Q

How many vestibular nuclei are there?

A

Superior, lateral, medial and inferior

28
Q

Which vestibular nuclei are concerned with the vestibulocerebellar reflex?

A

Inferior

29
Q

Which vestibular nuclei are concerned with the vestibulo-ocular reflex?

A

The inferior nuclei

30
Q

Where is the main vestibular cortex located?

A

In the parietal lobe (Parieto-insular vestibular cortex)

31
Q

What are the three main vestibular system functions?

A

To detect and inform about head movements

Postural control

To keep imaged fixed in the retina during head movements

32
Q

What are the three vestibular hair cell potentials?

A

Resting
Excitation
Inhibition

33
Q

What is the relationship between neural firing rate in the right and left ear?

A

There is an antagonistic relationship (Inhibition v excitation)

34
Q

Which otolith organ is concerned with horizontal linear acceleration?

A

Utricule

35
Q

Which otolith organ is concerned with vertical movement?

A

Saccule

36
Q

How is angular acceleration inputted?

A

The endolymph within the semi-circular canals exerts pressure onto the cupula, inducing hair cell displacement, subsequent information is transmitted to the brainstem and integrated within.

The output signal is via the vestibulocohclear nerve (velocity)

37
Q

What are the semi-circular canal pairs?

A

Both laterals
Left anterior with right posterior
Left posterior with right anterior.

38
Q

What are the two main vestibular reflexes?

A

The vestibulo-occular reflex

The vestibulo spinal reflex

39
Q

What is the vestibulo-occular reflex?

A

The vestibulo-ocular reflex (VOR) is a reflex acting to stabilize gaze during head movement

40
Q

Which nuclei are connected within the VOR?

A

The vestibular and oculomotor nuclei.

41
Q

How are eye movements coordinated in the VOR?

A

Eye movements in the opposite direction to head movement, with same velocity and amplitude.

42
Q

What is the VSR?

A

Postural control, avoidance of falls and compensatory body movement according to hed movement

Motor neurones to limb muscles (lateral tract)

Motor neurones to neck and back muscles (medial tract)

43
Q

What is the initial assessment of the vestibular system?

A

Anamnesis

44
Q

What is Anamnesis?

A

A patient’s account of their medical history

45
Q

What are the four main clinical vestibular assessments?

A

Caloric test
Video head impulse test (vHIT)
Vestibular evoked myogenic potential (VEMP)
Rotational test

46
Q

What is the main balance disorder?

A

Vertigo

47
Q

How is vertigo categorised?

A

Based on location of the affected structure and evolution of signs and symptoms

48
Q

What is vertigo?

A

Vertigo is the sensation that the environment is spinning around relative to oneself.

49
Q

What are the main peripheral vestibular disorders concerned with the larbyrinth or VIII nerve?

A

Vestibular neuritis

Benign positional vertigo (BPPV)

Meniere’s disease

Unilateral and bilateral vestibular hypofunction

50
Q

What is BPPV?

A

Benign paroxysmal positional vertigo (BPPV) is a peripheral vestibular disorder that manifests as sudden, short-lived episodes of vertigo elicited by specific head movements.

51
Q

Which semi-circular canal is typically associated with the migration of otoliths in the endolymph?

A

Posterior semi-circular canal

52
Q

What is a vestibular schwannoma?

A

A benign cerebellopontine angle tumour that grows from the superior vestibular component of the vestibulocochlear nerve, usually presenting with unilateral sensorineural hearing loss.

53
Q

What is the evolution of Meniere’s disease?

A

Recurrent

54
Q

Which common balance disorder presents intermittent symptoms?

A

Benign paroxysmal positional vertigo