Vestibular System Flashcards
- Components of the vestibular system
- Peripheral receptor apparatus
- Central vestibular nuclei
- Vestibuloocular network
- Vestibulospinal netwoark
- Vestibulothalamocortical network
Function of the peripheral receptor apparatus
- Inner ear
- Transducing head motion/position
- Location/Function of central vestibular nuclei
- Integrating and distributing info that controls motor activity and spatial orientation
- Located in brainstem
- Location/Function of vestibuloocular network
- Location-vestibular nuclei
- Control of eye movements
- Function of vestibulospinal network
- Coordinates head movements, axial muscles, postural reflexes
Function of vestibulothalamocortical network
- Conscious perception of movement-spatial orientation
- The vestibular labyrinth has _ separate receptor structures
- What are the two components of the labyrinth?
- 5
- 3 semicircular canals
- 2 otolith organs
-
Bony labyrinth
- Shell that houses fluid-filled membranous labyrinth
-
Membranous labyrinth
- Connecting tubes and prominences houses vestibular receptors
- Space between membranous and bony labyrinth contains _ fluid (similar to CSF)
- Space withinthe membranous labyrinth is filled with _
- Different ionic concentrations between the two fluids is maintained by _ in the membranous labyrinth and endolymphatic sac
- Perilymph
- Endolymph
- Secretory cells
- What are semicircular canals responsible for sensing?
- What innervates them?
- Rotational head movements/angular accelerations
- Vestibular ganglion/Scarpa (primary afferent fibers)

- What are otolith organs sensitive to?
- What innervates them?
- Translational head movements/linear acceleration
- Vestibular ganglion/Scarpa’s ganglion (primary afferent fibers)

What is the blood supply to the labyrinth?
- Labyrinthe a (branch off AICA)
- Enters temporal bone thru internal auditory meatus
- Stylomastoid a. (semicircular canals)
- Not primary supply
- Membranous labyrinth
- Enlargements of ends of ducts= _
- Receptors in the _ are oriented horizontally/longitudinally
- Receptors in the _ are oriented vertically
- Ampulla (contains sensory receptors for the semicircular canals))
- Utricle
- Saccule (ball sacs are vertical #madisonfacts)
- _ (the fluid of the membranous labyrinth) is drained into the _ via small ducts
- Sinus communicates through the endolymphatic duct with the _ (located adjacent to the dura mater)
- Endolymph, Endolymphatic Sinus
- Endolymphatic sac
- Saccule of the membranous labyrinth is connected to the cochlea via _
- Ductus reuniens
- (Family reunion between the saccule and the cochlea)
- Meniere’s Disease
- Increase in endolymph volume-abnormal distension of membranous labyrinth
- Symptoms
- Fluctuating hearing loss
- Vertigo
- Positional nystagmus
- Nausea
- Unpredictable attacks of auditory and vestibular symptoms (vomiting, tinnitus, inability to make head movements or stand passively)
- Treatment
- Diuretic and salt restricted diet-reduces hydrops
- Implantation of shunt to drain swollen endolymphatic sac
- What is the long sensory hair cell called?
- Kinocilium
- What are the two types of vestibular sensory receptors?
- From where do they receive their input?
- Type I
- Chalice shaped
- Surrounded by afferent termina (nerve calyx)
- Type 2
- Cylindrical
- Innervated by synaptic buttons
- Both receive synapses from vestibular efferents that control receptive sensitivity
- Ampulla
- Hair cells embedded in _ that extends across base
- Type I cells occupy _ region
- Type II cells occupy _ region
- Enveloped in _
- Crista
- Central
- Peripheral
- Cupula (gelatinous structure)
- How does transduction of signals from the ampulla (semicircular canals) work?
- Rotational head movements produce angular accelerations
- Endolymph is displaced
- Pushes cupula to one side or the other
- Displace steriocilia in same direction
(Remember that you are stimulating one side but inhibiting the other)
- Macula
- Hair cell stereocilia extend into _ membrane covered by _ (more dense than surrounding endolymph and not displaced by normal endolymph movements)
- Otolith membrane covered by otoconia (carbonate crystals)
- How does transduction of signals in the macula work?
- Changes in head position relative to gravity and linear accelerations(forward/backward/upward/downward) displace the otoconia
- Displacement of otoconia bends underlying hair cell stereocilia (activating or inhibiting signal based on the direction of movement)
- Functions of the vestibular nuclei
- Targets of the vestibular nuclei
- Functions
- Positional movement information processing
- Control of visual and postural reflexes
- Target
- Oculomotor nuclei
- Vestibulocerebellum
- Contralateral vestibular nuclei
- SC
- Reticular formation
- Thalamus
- Location of:
- Superior vestibular nucleus
- Medial vestibular nucleus
- Lateral vestibular nucleus
- Inferior vestibular nucleus
-
Superior vestibular nucleus
- Superolat central pons
-
Medial vestibular nucleus
- Lateral floor of 4th ventricle
-
Lateral vestibular nucleus
- Lateral to medial (shocker)
- Contains Deiters cells
-
Inferior vestibular nucleus
- Lateral to medial
- Extends thru medulla

- Afferents from semicircular canals (ampulla) project to what vestibular nuclei (primarily)?
- Afferents from otolith organs (maculae) project to what vestibular nuclei?
- Afferents from the saccule project to _ nucleus and influence vertical eye movements
- Superior, medial
- Lateral, medial, inferior
- CONTRALATERAL OCULOMOTOR
- _ fibers go through juxtarestiform body (part of inferior cerebellar peduncle) and send projections to _ and _ nuclei of the cerebellum (and terminate as mossy fibers)
- Vestibular nuclei send _ projections to fastigal and dentate nuclei
- Primary vestibulocerebellar fibers (from fastigal)
- Dentate and fastigal
- Secondary vestibulocerebellar
- What afferent fibers arise from all vestibular nuclei?
- What nuclei are they more prominent in?
- What is their function?
- Vestibulovestibular nuclei
- Superior and medial
- Reciprocal connections w/ contralateral nucleus
- What afferent vestibular fibers arise from all levels of the spinal cord?
- Which vestibular nuclei do they provide input to?
- Spinovestibular
- Proprioceptive input to medial and lateral vestibular nuclei
- Besides the spinal cord, cerebellum and other vestibular nuclei, where else can vestibular nuclei neurons receive input from?
- Reticular formation
- Raphe nuclei
- Thalamus
- Cortical regions
- Vestibuloocular reflex
- Compensatory (equal in magnitude and opposite direction)
- Any direction or speed of head movement (we talked about horizontal)
- Can the vestibuloocular reflex be suppressed?
- Yes-for example when you are focusing on a moving target (catching a football while running a route)
- MOA of the Vestibuloocular reflex
- Primary afferents from horizontal semicircular canals project to specific neurons in medial and lateral vestibular nuclei
- Send axons thru MLF to contralateral abducens nucleus
- Abducens motor neurons send excitatory stimulus via CN VI to ipsilateral lateral rectus m.
- Abducens interneurons send excitatory impulses to the contralateral oculomotor nucleus to innervate medial rectus m.
A second set of vestibular neurons send excitatory signals to ipsilateral oculomotor nucleus (medial rectus m.)
A third set of vestibular neurons carry inhibitory signals to ipsilateral abducens nucleus

- Nystagmus (how does it work?)
-
Slow phase
- Vestibuloocular reflex sending signals to your eyes to look opposite the direction that your head is turning (EX: Looking to the right when turning head left)
- Eventually eyes reach a limit of how far they can turn
-
Fast phase
- Eyes rapidly spring back to central position
- Then will move in the same direction as head (EX: Turning head to left, eyes will look left)
- Another slow phase begins
- Continuation of slow and fast phases=nystagmus
- What test can you use to test for nystagmus?
- Caloric test
- Introducing warm or cold water to the external auditory canal
- Warm water-nystagmus beats to same side
- Cold water-nystagmus beats to opposite side
- COWS nystagmus mnemonic
- Unilateral lesions of the vestibular pathway result in a reduced of absent nystagmus _
- IPSILATERALLY
LVST (lateral vestibulospinal tract)
Neuron location
Where are projections going (are they ipsilateral or contralateral)
Where do they travel through
Where do they terminate
Overall Function
- Neurons in lateral and vestibular nuclei
- Projects to all levels of ipsilateral SC
- Anterorostral-cervical cord
- Posterocaudal-lumbosacral cord
- Fibers go through lateral medulla and anterior funiculus of SC
- Terminate on alpha and gamma motor neurons and interneurons in laminae VII to IX
- Coordination of postural control
- MVLT
- Nuclei location
- Receives input from?
- Where do fibers descend?
- Where do fibers terminate?
- Functions?
- Nuclei-primarily medial vestibular (some lateral and inferior)
- Vestibular receptors, cerebellum, PCMLS in SC
- Fibers descend thru MLF
- Terminat in lamina VII to IX of cervical spinal cord
- Neck flexion and extension (stabilize neck in vestibulocolic reflex)
What part of the thalamus do vestibular nuclei send projections to?
- VPL
- VPI
- Sensory and vestibular stimulation (some)
- Some specific to vestibular stimulation
- Anterior pulvinar (dorsal to VPL)-also receives inputs
- What cortical regions does the vestibular system send projections to?
- Area 2v and 3a (Primary somatosensory cortex)
- 2v-whole body motion
- 3a-head and body
- Area 7 (Parietal cortex)
- Spatial coding
- Body motion in space
- Lesions-agnosia-confusion of spatial awareness
- Insular areas of lateral sulcus and PIVC (parietoinsular vestibular cortex)
- PIVC lesions-episodes of vertigo, unsteadiness, and loss of perception for visual vertical
- Prefrontal cortex and superior central gyrus
- Related to frontal eye field
- Saccades and smooth pursuit eye movements
- Dizziness
- Nonspecific-may or may not involve feelings of movement
- Not necessarily vestibular in origin
- Vertigo
- Illusion of body motion (spinning/turning) when no motion is happening
- Subjective-patient experiences sensation of moving while things aren’t
- Objective-sensation of objects moving while patient is still
- Benign Paroxysmal Positional Vertigo
- Episodes of vertigo w/ changes in body position (turning in bed, getting up in morning, bending over, rising from bent position)
-
Otoconial crystals from utricle separate from otolith membrane and lodge in cupula of semicircular canal (cupulolithiasis)
- Produces abnormal cupula deflections when head changes position relative to gravity
Vestibular Schwannoma
Benign tumor originating from Schwann cells of vestibular root
Usually @ cerebellopontine angle where it impinges on structures in internal acoustic meatus (CN VII, CN VIII, Labyrinthe a.)
Hearing loss, gait difficulties, tinnitus
- Vestibular Neuritis
- Edema of vestibular n or ganglion (from viral infection (EX: HSV, URI, cold, flu)
- Symptoms
- Vertigo
- Nausea
- Vomiting
- No hearing loss