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Neuroscience > Vestibular System > Flashcards

Vestibular System Flashcards

1
Q

What are the 5 components of the vestibular system?

A
  • Peripheral receptor apparatus
  • Central vestibular nuclei
  • Vestibulo-ocular network
  • Vestibulospinal network
  • Vestibulo-thalamo-cortical network
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2
Q

What are the 2 portions of the peripheral vestibular labyrinth?

A
  • Bony labyrinth

- Membranous labyrinth

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3
Q

In what bone is the bony labyrinth found?

A

Petrous portion of temporal bone

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4
Q

Where is the peripheral vestibular labyrinth located in relation to the cochlea?

A
  • Posterior and lateral
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5
Q

Where is the membranous labyrinth found? What is it?

A
  • A membrane of simple epithelium (the membranous labyrinth) is found within the bony labyrinth
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6
Q

Where is perilymph found?

A

Between the bony and membranous labyrinth

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7
Q

Where is the endolymph found?

A

Inside the membranous labyrinth.

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8
Q

What are the 5 portions of the membranous labyrinth?

A
  • Utricle
  • Saccule
  • 3 semicircular canals
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9
Q

What structures make up the static labyrinth?

A
  • Utricle

- Saccule

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10
Q

What type of structures are the utricle and saccule?

A
  • Otolith organs
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11
Q

What are the 3 semi-circular canals?

A
  • Anterior
  • Horizontal
  • Posterior
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12
Q

What are the 3 functions of the static labyrinth?

A
  • Monitor absolute position of head in space (posture/ balance)
  • Maintain eye position
  • Perception of linear acceleration and deceleration
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13
Q

Which otolith organ pertains to horizontal movement?

A

Utricle

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14
Q

Which otolith organ pertains to vertical movement?

A

Saccule

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15
Q

Which labyrinth pertains to pitch and roll of the head?

A

Static

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16
Q

Which labyrinth pertains to yaw of the head?

A

Dynamic

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17
Q

What is the name of the specialized region within the otolith organs?

A

Macula

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18
Q

Describe the structure of the macula.

A
  • Epithelial cells “hair cells” with special cilia called stereocilia and a single kinocilium on their apical surfaces
  • Hairs extend upward into gelatinous substance containing otoconia (calcium carbonate crystals)
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19
Q

If the otoconia bend away from a kinocilia, what is the effect?

A
  • Decreased Afferent Activity
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20
Q

If the otoconia bend towards the kinocilia, what is the effect?

A
  • Increased afferent activity
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21
Q

What is the linear vestibulo-ocular reflex?

A
  • Eyes are remain positioned as the head tilts (??)
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22
Q

What is a striola?

A

Structural land mark of small otoconia that define a narrow trench that divides each otolith organ.

23
Q

How are the kinocilia arranged in reference to the striola in the utricle, and the saccule?

A

Utricle: Towards striola
Saccule: Away from striola

24
Q

What is the tonic labyrinthine reflex for supine?

A
  • Extension of UE and LE
25
Q

What is the tonic labyrinthine reflex for prone?

A
  • Flexion of UE and LE
26
Q

What is the tonic labyrinthine reflex for side lying?

A
  • Extension of limbs touching floor

- Flexion of limbs off floor

27
Q

What is the trendelenburg position?

A
  • Patient supine, but the body tilted so that the head is below the LE
28
Q

What is the tonic labyrinthine reflex for the trendelenburg position?

A
  • UE extension

- LE flexion

29
Q

Which semi-circular tubule is the commonly used?

A

Horizontal

30
Q

What are the 2 functions of the dynamic labyrinth?

A
  • Track rotation of the head in space

- Perception of angular acceleration/ deceleration

31
Q

How are the right and left semi-circular canals aligned?

A
  • Right anterior canal aligned with left posterior canal
  • Right posterior canal aligned with left anterior canal
  • Semicircular canal mirror images of one another
32
Q

What is the expansion at the end of each semicircular tubule called?

A

The ampulla

33
Q

How are the semicircular canals oriented in relation to the horizontal?

A

Canted 30 degrees

34
Q

What is the name of the sensory epithelium in the ampulla? (not sure if this is accurate)

A

Crista

35
Q

What is the name of the gelatinous door that splits the ampulla into 2 compartments?

A

The cupula

36
Q

How does the endolymph function within the vestibular system?

A
  • Endolymph has a high specific gravity, meaning it remain in place while structures around it move
  • As the head rotates, endolymph will come into contact with the cupula on the side the head is rotating towards, facilitating the vestibular system
  • Endolymph will also move away from the contralateral side pulling liquids out of the the ampulla causing inhibition
37
Q

What are the 2 components of nystagmus?

A
  • Saccade

- Slow component of eyes coming by to neutral to maintain fixation

38
Q

What reflex causes saccades?

A
  • Vestibulo-ocular
39
Q

Describe the vestibulo-ocular reflex.

A

(Ipsilateral refers to side which the head is turning towards)
- Endolymph facilitates vestibular nuclei on ipsilateral and side, and inhibits vestibular nuclei on the contralateral side
On ipsilateral side:
- Lateral vestibular nucleus facilitates ipsilateral oculomotor nucleus
- Medial nucleus facilitates contralateral abducens nucleus
- CN VI sends a projection to ipsilateral oculomotor nucleus through medial longitudinal fasciculus
- CN VI facilitates the contralateral lateral rectus muscle through contralateral abducens nerve
- CN III through facilitation from the ipsilateral lateral vestibular nucleus and contralateral abducens nucleus activates ipsilateral rectus muscle

On contralateral side:
- Ipsilateral medial rectus and contralateral lateral rectus are inhibited through the same pathways

40
Q

What is post rotatory nystagmus test?

A
  • Pt seated at chair with head tilted 30 degrees
  • Pt rotated 10 - 12 times
  • Endolymph will be rotating in direction opposite to the rotation of the head
  • Pt stopped
  • Endolymph reverses direction of flow
  • Slow component of nystagmus will be in the direction of the rotation, fast component will be opposite
  • Since nystagmus is named by the fast component, nystagmus will be opposite to the direction of rotation
  • In normal patients, nystagmus should stop within 20 - 30 seconds
41
Q

What semicircular canals are tested by the post rotatory nystagmus test?

A

Horizontal

42
Q

What is the Caloric test? What pathologies will it test?

A
  • Flex head 30 degrees
  • Irrigate external auditory canal with 20 - 30 mL of ice cold water
  • Fast component of nystagmus should occur away from the irrigated side
  • Supratentorial or memtabolic lesion will cause only the slow component to occur
  • Unilateral brain stem disease will cause no reaction
43
Q

What is the Doll’s Eye Maneuver? What is indicated by a positive test?

A
  • Head briskly turned to one side or another or tilted up and down
  • Eyes should turn opposite the direction of the head turn
  • Brain stem lesions are implicated if the eyes move with the head or stay still
44
Q

What type of movements increase tone?

A

Phasic, quick movements

45
Q

What type of movements decrease tone?

A

Slow, rhythmic movements

46
Q

What autonomic responses can be affected by the vestibular system?

A
  • Blood pressure
  • Respiration
  • Heart rate
  • Body temperature
  • Peristalsis
47
Q

What nervous system is stimulated by quick movements?

A

Sympathetic

48
Q

What are the 4 most common symptoms of vestibular disease?

A
  • Vertigo
  • Instability
  • Nystagmus
  • Nausea
49
Q

What are the 2 most common vestibular pathologies?

A
  • Vestibular neuritis

- Benign Paroxysmal Positional Vestigo

50
Q

What is vestibular neuritis?

A

Inflammation of the vestibulocochlear nerve

51
Q

What is Benign Paroxysmal Positional Vertigo (BPPV)?

A
  • Otolith pieces slip into SSCs

- These particles can create fluid waves that displace the cupula causing dizziness, vertigo, and nystagmus

52
Q

Which canal is typically affected by BPPV?

A
  • Posterior
53
Q

What area of the brain causes nausea?

A
  • Area postrema

Neuroscience (33 decks)

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