Vestibular system Flashcards

1
Q

How does the vestibular system work?

A
  1. Mechanical sensors detect gravity and movement
  2. CNS integrates this information and generates responses
  3. Outputs are perception and reflexes that maintain posture and gaze
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2
Q

What are examples of mechanical sensors?

A

-Canals
-Otoliths

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3
Q

What is the otolith made up of?

A

Utricle and saccule

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4
Q

How does the otolith work?

A

Hairs in different directions which detect movement and gravity
Detect linear acceleration (vertical and horizontal movement)

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5
Q

What does the utricle detect?

A

Horizontal movement

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6
Q

What does the saccule detect?

A

Vertical movement

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7
Q

What is the function of semicircular canals?

A

Rotational acceleration and angular acceleration

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8
Q

What are the 3 semicircular canals in the vestibular organ?

A

-Anterior semi circular canal
-Posterior semi circular canal
-Lateral semi circular canal

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9
Q

What are the semicircular canals connected to?

A

The ampulla which connects to the utricle

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10
Q

What is true maculae?

A

-A gelatinous matrix on which the hair cells sit
-Moves the hair cells to show movement or gravity

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11
Q

What is in the ampulla?

A

Hair cells surrounded by endolymph

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12
Q

How does the vestibular organ work?

A

Movement of the cilia which depolarises cell

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13
Q

How does the hair cell get depolarised?

A

Hairs move towards the largest cilium

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14
Q

How does the hair cell get hyperpolarised?

A

Hairs move away from the largest cilium

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15
Q

What is the pathway of the vestibular system?

A
  1. Primary afferents
  2. Vestibular nuclei in the brainstem (pons)
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16
Q

What are other functions of the vestibular system?

A

-Detect and inform about head movements
-Keep images fixed in the retina during head movements
-Balance

17
Q

What are the 2 vestibular reflexes?

A

-Vestibulo ocular reflex
-Vestibulo spinal reflex

18
Q

What is the purpose of the vestibular ocular reflex?

A

Keeps image fixed in the retina

19
Q

How does the vestibular ocular reflex work?

A

-Vestibular organ communicates with vestibular nuclei
-Vestibular nuclei communicates with abducens nuclei
-Abducens nuclei communicates with oculomotor nuclei

20
Q

What 2 things do we look at when categorising vestibular disorders?

A

-Timing and laterally

21
Q

What are the main complaints in acute and unilateral vestibular disorder?

A

-Imbalance
-Dizziness
-Vertigo
-Nausea

22
Q

What are he main complaints in slow and unilateral/bilateral loss?

A

-Imbalance
-Nausea
-NO vertigo

23
Q

How can vestibular disorders be categorised based on location?

A

-Peripheral vestibular disorders
-Central vestibular disorders

24
Q

What are examples of peripheral vestibular disorders?

A

-BPPV= crystals dislodge and move around when moving around
-Vestibular neuritis= inflammation
-Vestibular migraine
-Stroke (cerebellar)

25
Q

What are the core examinations for peripheral vestibular disorders?

A

-Eyes
-Ears
-Legs

26
Q

What are red flag symptoms for peripheral vestibular disorders?

A

-Headache
-Gait problems
-Hyper acute onset
-Hearing loss
-Prolonged symptoms (>4 days)

27
Q

How do you test for the vestibular ocular reflex?

A

-Move head in jerky movements while focusing on a spot to see if it can stay focused
-Eye cover test

28
Q

What does an eye cover test test for?

A

Vertical skew
If eye moves up and down

29
Q

What are the 4 types of vestibular disorders based on timing?

A

-Acute
-Intermittent
-Recurrent
-Progressive

30
Q

What are examples of acute vestibular disorders?

A

-Vestibular neuritis
-Stroke

31
Q

What are examples of intermittent vestibular disorders?

A

-Benign paroxysmal
positional vertigo (BPPV)

32
Q

What are examples of recurrent vestibular disorders?

A

-Migraine
-Meiners’s disease

33
Q

What are examples of progressive vestibular disorders?

A

-Schwannoma vestibular (8th nerve)
-Degenerative conditions (MSS)

34
Q

What examination is done to differentiate between acute vestibular disorders?

A

-HINTS test
-Head impulse test where you move the head quickly to see if it can stay focused on one spot and test of skew

35
Q

What does HINTS stand for?

A

-Head impulse test
-Nystagmus
-Test of skew

36
Q

What is nystagmus?

A

Jerky movement of the eye
Drifting eyes then sudden correction

37
Q

What examination is done to differentiate between intermittent vestibular disorders?

A

-Dix Hallpike test
-Hang head on bed and keep eyes open
-If their world starts spinning then its a positive sign