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46 Cards in this Set

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Why is knowing the anatomy of the vestibular system so important?

- Anatomy dictates how the ear works
- That dictates the physiology of how the ear works
- No way to have a disorder of the ear that doesn't mirror the anatomy
What bony part of the skull is the vestibular system within?
Temporal bone
Temporal bone
What are the two nerves of the vestibular system?
Superior and Inferior Vestibular Nerves = Vestibular nerve
Do not deal with the Cochlear nerve (auditory)
What are the structures of the vestibular system?
- Two nerves
- Two otolith organs
- Three semicircular canals
- Two nerves
- Two otolith organs
- Three semicircular canals
Which structure is highlighted in blue?
Which structure is highlighted in blue?
Superior or Anterior Semicircular Canal
Superior or Anterior Semicircular Canal
Which structure is highlighted in blue?
Which structure is highlighted in blue?
Lateral or Horizontal Semicircular Canal
Lateral or Horizontal Semicircular Canal
Which structure is highlighted in blue?
Which structure is highlighted in blue?
Posterior Semicircular Canal
Posterior Semicircular Canal
Which structure is highlighted in blue?
Which structure is highlighted in blue?
Utricle
Utricle
Which structure is highlighted in blue?
Which structure is highlighted in blue?
Which structure is highlighted in yellow?
Which structure is highlighted in yellow?
Superior Vestibular Nerve
Superior Vestibular Nerve
What does the superior vestibular nerve innervate?
- Superior/anterior semicircular canal
- Lateral/horizontal semicircular canals
- Utricle
- Part of Saccule
- Superior/anterior semicircular canal
- Lateral/horizontal semicircular canals
- Utricle
- Part of Saccule
What condition affects the superior vestibular nerve?
What condition affects the superior vestibular nerve?
Vestibular Neuronitis (spares the inferior vestibular nerve)
- Therefore affects the superior/anterior and the lateral/horizontal semicircular canals
Vestibular Neuronitis (spares the inferior vestibular nerve)
- Therefore affects the superior/anterior and the lateral/horizontal semicircular canals
Which structure is highlighted in yellow?
Which structure is highlighted in yellow?
Inferior Vestibular Nerve
Inferior Vestibular Nerve
What does the inferior vestibular nerve innervate?
- Posterior sememicircular canal
- Saccule
- Posterior sememicircular canal
- Saccule
What stimulates the inferior vestibular nerve?
BPPV
What fluid is inside of the semicircular canals?
Endolymph
Endolymph
How does the endolymph in the semicircular canals help detect motion?
- Endolymph has inertia
- Turn head - fluid doesn't want to move
- Pushes against the cupula which moves the hair cells
- Endolymph has inertia
- Turn head - fluid doesn't want to move
- Pushes against the cupula which moves the hair cells
Which of the semicircular canals can detect movement such as shaking your head or doing a pirouette?
Horizontal semicircular canal
Horizontal semicircular canal
Which semicircular canal detects movement around the vertical axis?
Horizontal/lateral semicircular canals
Horizontal/lateral semicircular canals
Which of the semicircular canals can detect movement such as nodding your head?
Posterior semicircular canals
Posterior semicircular canals
Which semicircular canal detects when you move your head side to side (bringing right ear to right shoulder, left ear to left shoulder)?
Superior Semicircular canals
Superior Semicircular canals
What are the semicircular canal pairings?
- R anterior w/ L posterior (RALP)
- R posterior w/ L anterior (LARP)
- R lateral w/ L lateral
What are the otolith organs?
Utriculus and Sacculus
How is the movement of hair cells different in the otolith organs (utriculus and sacculus) compared to the semicircular canals?
- In the semicircular canals, the movement is due to the inertia of the fluid
- In the otolith organs, the movement is due to otoconia inertia (otoconia = tiny calcium carbonate crystals within the gelatinous fluid)
- In the semicircular canals, the movement is due to the inertia of the fluid
- In the otolith organs, the movement is due to otoconia inertia (otoconia = tiny calcium carbonate crystals within the gelatinous fluid)
Which organs detect linear movement?
- Sacculus - in the vertical plane (up/down and front/back)
- Utriculus - in the horizontal plane (side-to-side and front/back)
Which movements are considered linear acceleration?
Up/down
Front/back
Left/Right
(as in riding an elevator or moving sidewalk)
Which movements are considered angular acceleration?
- Nodding
- Shaking head no
- Side to side (ear to shoulder)
Where does your vestibular system send the information regarding linear and angular acceleration?
To the eyes, neck, spine, and extremities
What is the most important vestibular reflex? What is its function?
- Vestibular Ocular Reflex (VOR)
- Maintains eye position during motion
- Extremely fast responses
If your vestibular ocular reflex (VOR) is not working properly, what sensations will you feel?
Sensation of dizziness and nausea
How do you test the vestibulocular reflex (VOR)? What are you looking for?
- Head thrusts where they are told to look at a certain point and stay looking at it(also the temperatures)
- When the function of the right balance system is reduced quick head movement to the right cannot be sensed properly anymore
- No compensatory eye movement is generated, and the patient cannot stay fixated on the point
What are the minor vestibular reflexes?
- Vestibulocolic reflex
- Vestibulspinal reflex
What is the vestibulocolic reflex?
Coordinates neck position and movement with head motion and eye motion
What is the vestibulospinal reflex?
Coordinates body position with head and eye movement
What happens during a vestibular reflex?
- Both ears send signals to brain
- Brain compares both sides and determines plane, speed, and degree of movement
- Brain tells eyes how to adjust
When is there information being sent from your vestibular system to your brain?
Always - there is a baseline level of activity
If your brain is receiving baseline level of information from each vestibular system, what do the eyes do?
If your brain is receiving baseline level of information from each vestibular system, what do the eyes do?
Stay looking straight ahead
Stay looking straight ahead
If you have higher activity on R side and lower than baseline activity on the L side, which way did you turn? Which way will your eyes reflexively turn?
- Turned right (more activity on that side)
- Eyes turn left
- Turned right (more activity on that side)
- Eyes turn left
If you lose function on one side of your vestibular system, what will your brain think? What will your eyes do?
- It thinks that the intact side has higher activity than the harmed side
- Eyes will turn towards harmed side
- They will feel dizzy until brain figures out that one side is dead; then it will determine a new "baseline" so to speak
- It thinks that the intact side has higher activity than the harmed side
- Eyes will turn towards harmed side
- They will feel dizzy until brain figures out that one side is dead; then it will determine a new "baseline" so to speak
What happens to a person's eyes when they are dizzy?
Nystagmus
How do you name a nystagmus?
Based on the fast direction of motion
- L/R or Up/Down
- Clockwise/Counterclockwise
When there is a problem with the semicircular canals, what is the fast direction of motion in the resulting nystagmus?
Towards the more active canal (because other side is dead or because it is being stimulated inappropriately)
Which way will the eyes deviate if R horizontal canal is more active
Which way will the eyes deviate if R horizontal canal is more active
Towards the Right side (more active canal)
Towards the Right side (more active canal)
If the right superior canal is more active than the left posterior canal, which way will the eyes deviate?
Jerk towards the R side and down
Jerk towards the R side and down
If the right posterior canal is more active than the left superior canal, which way will the eyes deviate?
Towards the R side and up
Towards the R side and up
What is Alexander's Law?

Gaze in direction of the fast phase of nystagmus increases the amplitude and frequency