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Neurology and Neuroscience > Vestibular System > Flashcards

Vestibular System Flashcards

1
Q

The vestibular system includes what three inputs?

A

visual
proprioceptive
vestibular information

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2
Q

What are the main outputs of the vestibular system?

A

reflexes to maintain a stable posture and stable gaze

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3
Q

Where is the vestibular organ located?

A

posterior area of the inner ear

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4
Q

What important structures are located in the vestibule? What are they joined by?

A

utricle
saccule
joined by a conduit

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5
Q

Name the three semicircular canals on each ear.

A

anterior
posterior
lateral

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6
Q

What do the semi circular canals have on one side? What are they connected by?

A

ampulla

utricle

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7
Q

where does the vestibular organ sit in the skull?

A

superior projection of right bony labyrinth in the temporal bone on the base of the skull

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8
Q

the plane of the anterior semi circular canal meets the plane of the posterior semi circular canal at what angle?

A

90 degrees

perpendicular

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9
Q

the planes of the anterior + posterior semi circular canals determine what?

A

which structure will be stimulated with a specific head movement

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10
Q

list types of cilia the vestibular hair cells have

A

kinocilium (biggest)

stereocilia

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11
Q

function of cilia

A

allows the cells to depolarise with movement of the endolymph generated by head movement

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12
Q

what is the utricle?

A

larger of the two fluid-filled cavities forming part of the labyrinth of the inner ear

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13
Q

what is the saccule?

A

smaller of the two fluid-filled cavities forming part of the labyrinth of the inner ear

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14
Q

list the otolith organs

A

utricle

saccule

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15
Q

define otolith

A

each of three small oval calcareous bodies in the inner ear, involved in sensing gravity and movement

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16
Q

where are the cells of the utricle and saccule located?

A

on the maculae

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17
Q

how are the cells oriented in the utricle?

A

horizontally

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18
Q

how are the cells oriented in the saccule?

A

vertically

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19
Q

the maculae contain?

A

hair cells
gelatinous matrix
otoliths on top

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20
Q

function of otoliths

A

are carbonate crystals that help the deflection of the hairs

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21
Q

where are the hair cells in the canal located?

A

ampulla

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22
Q

name the liquid in the canal

A

endolymph

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23
Q

endolymph is rich in?

A

potassium

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24
Q

where is the crista?

A

in the ampulla

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25
Q

what is the crista?

A

the sensory organ of rotation

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26
Q

function of the crista

A

sense angular acceleration and deceleration

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27
Q

the hair cells are surrounded by the matrix called?

A

cupula

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28
Q

do the semi circular canals have otoliths?

A

no

29
Q

describe the orientation of the lateral canals to the anterior and posterior canals

A

horizontal to the other canals

the planes of the anterior and posterior canals meet at 90 degrees

30
Q

primary afferents to the vestibular organ end in?

A

vestibular nuclei and in the cerebellum

31
Q

vestibular nuclei have projections to?

A

spinal cord
nuclei of the extraocular muscles
cerebellum
centres for cardiovascular + respiratory control

32
Q

list the four main vestibular nuclei

A

superior
lateral
medial
inferior

33
Q

information that travels to the superior and lateral vestibular nuclei then goes to the?

A

ventroposterior nucleus > vestibular cortex

34
Q

list reflexes the vestibular system is responsible for

A 
vestibulospinal reflexes (posture)
vestibulocerebellar reflexes (coordination/monitoring)
vestibulo-ocular reflexes (eye movements in compensation for head movements)
35
Q

what area is the vestibular cortex in?

A

not anywhere specific, many inputs and integrators are involved, many cortical areas

36
Q

where is the main processing centre of the vestibular cortex?

A

in the parietal lobe

in the parieto-insular vestibular cortex

37
Q

in terms of processing of sensory information, what are the primary and adaptive processors?

A

primary > vestibular nuclear complex

adaptive > cerebellum

38
Q

list the three main functions of the vestibular system

A

to detect and inform about head movements
postural control
to keep images fixed in the retina during head movements

39
Q

how many potentials do hair cells have? name them

A

3: resting, excitation, inhibition

40
Q

resting potential of the hair cells

A

basal discharge (neural firing rate) to the nerve

41
Q

excitation of the hair cells

A

deflection of the hair cells towards the kinocilium > increased nerve discharge > depolarisation

42
Q

inhibition of the hair cells

A

deflection of the hair cells away from the kinocilium > reduced neural firing rate > hyperpolarisation

43
Q

otolith movement

A

linear acceleration and tilt (backward and forwards)

44
Q

the utricle is sensitive to movements in what plane?

A

horizontal

45
Q

the saccule is sensitive to movements in what plane?

A

vertical

46
Q

the semicircular canals are sensitive to what movement?

A

angular acceleration

47
Q

how do the semicircular canals detect movement?

A

movement moves endolymph > cupulla displacement > displaces hair cells > depolarisation or hyperpolarisation

48
Q

what is the output signal on the vestibulocochlear (VIII) nerve?

A

velocity

49
Q

semicircular canals on both sides of the head work together in what pairs?

A

both laterals work together

anterior canal from one side works with the posterior canal on the other side (vice versa)

50
Q

what is the vestibulo-ocular reflex?

A

helps keep the image fixed in the retina despite head movement (head moves, eyes stay still)

51
Q

what is the vestibulo-spinal reflex?

A

postural control

avoidance of falls compensatory body movement according to head position

52
Q

what nuclei are involved in the vestibulo-ocular reflex?

A

vestibular

oculomotor

53
Q

connections from nuclei in vestibulo-spinal reflex?

A

vestibular nuclei > motor neurons > limb muscles (lateral tract) or neck/back muscles (medial tract)

54
Q

assessment of the vestibular system

A 
anamnesis (history)
posture and gait
cerebellar function
eye movements
symptoms and impact assessment
55
Q

list vestibular tests

A

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

56
Q

imaging used to assess the vestibular system

A

CT scan

MRI

57
Q

main symptoms of balance disorders?

A

dizziness

vertigo

58
Q

balance disorders can be categorised based on?

A

location of the affected structure

evolution of signs and symptoms

59
Q

peripheral vestibular disorders are located where?

A

labyrinth and/or VIII nerve

60
Q

central vestibular disorders are located where?

A

CNS (brainstem/cerebellum)

61
Q

list examples of conditions leading to central vestibular disorders

A

stroke
MS
tumours

62
Q

list examples of conditions leading to peripheral vestibular disorders

A

vestibular neuritis
Benign Paroxysmal Positional Vertigo (BPPV)
Meniere’s disease
Unilateral and Bilateral vestibular hypofunction

63
Q

name categories for evolution of signs and symptoms of balance disorders

A

acute
intermittent
recurrent
progressive

64
Q

list conditions with an acute evolution

A 
Vestibular Neuritis (‘labyrinthitis’)
Stroke
65
Q

list conditions with an intermittent evolution

A

Benign Paroxysmal Positional Vertigo (BPPV)

66
Q

list conditions with a recurrent evolution

A

Meniere’s Disease

Migraine

67
Q

list conditions with a progressive evolution

A 
Schwannoma vestibular (VIIIth nerve)
Degenerative conditions (MS)
68
Q

what are other reasons, apart from vestibular dysfunction, for dizziness?

A 
heart disorders
presyncopal episodes
orthostatic hypotension
anaemia
hypoglycaemia
psychological
gait disorders

Neurology and Neuroscience (15 decks)

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