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NeuroAnatomy & NeuroPathology Weeks 11-14 > NeuroAnatomy Lecture 12 Objectives - Vestibular System > Flashcards

NeuroAnatomy Lecture 12 Objectives - Vestibular System Flashcards

1
Q

What is the main function of the vestibular system?

A

Maintains equilibrium/postural control

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2
Q

What structures are a part of the peripheral vestibular system?

A

semicircular canals, otolithic organs (utricle/saccule), CN8

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3
Q

What structures are a part of the central vestibular system?

A

vestibular nuclei in the brainstem

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4
Q

What is the primary input to the vestibular nuclei?

A

peripheral vestibular system, visual pathways, and proproceptive/mechanosensory pathways

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5
Q

Where is the inner ear located?

A

Within the temporal bone

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6
Q

What two types of information does the inner ear process?

A

Vestibular and Auditory

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7
Q

What is the function of the semicircular canals?

A

Senses angular/rotational movement and acceleration/deceleration

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8
Q

What is the function of the Otolithic organ : Utricle?

A

senses horizontal acceleration

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9
Q

What is the function of the Otolithic organ : Saccule?

A

senses verticle movemet

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10
Q

What / Where is the Ampulla?

A

it is an enlarged area with receptors located in each semicircular canal

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11
Q

What are the receptors in the Ampulla called?

A

hair cells

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12
Q

Where do the hair cells emerge from?

A

the Crista Ampullaris

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13
Q

What are the hair cells embedded in?

A

the hair cells are embedded in a gelatinous mass known as the cupula

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14
Q

What are the hair cells connected to?

A

they are connected to CN 8

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15
Q

what is the fluid inside the semicircular canals?

A

Endolymph fluid

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16
Q

How is directional movement detected in the semicircular canals?

A

the endolymph within the semicircular canals moves and “bends” the cupula and hair cells, which stimulates an action potential in the vestibular nerve

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17
Q

which Otolithic organ do the ampullas connect to?

A

utricle

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18
Q

what are the functions of the otolithic organs?

A

detecting linear movement and acceleration/deceleration as well as head position in a static position

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19
Q

Where are the receptors of the utricle and saccule?

A

within the macula

20
Q

what is the structure of the macula?

A

hair cells are embelled in a gel-like substance with “otoliths” on top of the gel layer

21
Q

what are the otoconia?

A

they are calcium carbonite crystals, they have some weight to them

22
Q

Which otolithic organ is slightly superior?

A

the utricle is slightly superior, the saccule is slightly inferior

23
Q

what type of linear movement does the saccule detect?

A

vertical motion

24
Q

What is BBPV?

A

Benign Paroxysmal Positional Vertigo // most common vestibular disorder and cause of vertigo in adults

25
Q

What are the characteristics of BBPV?

A

acute/sudden onset of vertigo and nystagmus, symptoms last seconds up to 2 minutes

26
Q

What clinically happens during an episode of BPPV?

A

the otoliths/otoconia dislodge from the macula of the otolithic organs and travel to the semicircular canals. they can either get stuck in a canal or the cupula.

27
Q

What is Canalithiasis?

A

when otoliths accumulate in the endolymph fluid in the semicircular canal, usually near the cupula and/or free flow in the canal

28
Q

What is Cupulolithiasis?

A

when otoliths accumulate or get stuck in the cupula

29
Q

what is the most common cause of BPPV?

A

when otoliths accumulate in the posterior semicircular canal

30
Q

What are the characteristics of Canalithiasis?

A

free flowing otoliths in canal, delay of onset of symptoms, symptoms last less than 60 seconds

31
Q

What are teh characteristics of Cupulolithiasis?

A

otoliths adhered to the cupula, no delay in symptom onset, symptoms last more than 60 seconds

32
Q

What is the Dix-Hallpike Test?

A

To assess for posterior canal BPPV

33
Q

How is the Dix-Hallpike Test performed?

A

patient seated w/ head rotated to 45°, quickly brought to supine with head extended to 30°, observe for nystagmus or dizziness. // testing ear that is down

34
Q

What maneuver / treatment do you administer for a positive Dix-Hallpike test?

A

Particle Repositioning Maneuvers (PRM) (most common is Epley Maneuver) // repositioning of patient in attempt of redirecting fluid flow in posterior canal for otoliths to go back to macula.

35
Q

What are symptoms of Meniere’s Disease?

A

sensation of fullness in ears / hearing loss // tinnitus // vertigo // N/V

36
Q

What are the clinical characteristics of Meniere’s Disease?

A

slow, chronic onset // lasts for 2-3 days with gradual improvement over 2 weeks // associated with abnormal endolymph fluid pressures

37
Q

How is Meniere’s Disease diagnosed?

A

two or more definitive episodes of spontaneous rotational vertigo lasting at least 20 minutes, low-frequency hearing loss, tinnitus or aural fullness in affected ear, exclusion of other causes for above symptoms

38
Q

What is the second most common cause of vertigo?

A

Vestibular Neuritis

39
Q

What is vestibular neuritis?

A

an acute unilateral vestibulopathy, usually due to viral infection affecting vestibular nerve unlitaterally

40
Q

What are the clinical characteristics of Vestibular Neuritis?

A

general vestibular symptoms (dizziness, n/v), onset of symptoms occur about 2 weeks post infection and gradually resolve over 6 weeks - 3 months

41
Q

What are symptoms of Vestibular Neuritis?

A

complaints of imbalance, motion intolerance, headache, dizziness more easily provoked

42
Q

What is Labyrinthitis?

A

inflammation of the membranous labyrinth often due to either bacterial or viral infection – causes inflammation to both CN8 branches

43
Q

What are common symptoms of Labyrinthitis?

A

changes in hearing, dizziness, imbalance, vertigo resolving within days - weeks

44
Q

What is Perilymphatic Fistula?

A

an abnormal communication of inner and middle ear spaces leading to vertigo

45
Q

What are some symptoms of a Perilymphatic Fistula?

A

vestibular symptoms (dizziness, N/V, etc) or hearing loss

NeuroAnatomy & NeuroPathology Weeks 11-14 (5 decks)

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