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Anatomy and
Physiology of
  Balance
Vestibular Hair Cells
• Type I
  (aka inner)
• Type II
  (aka outer)

     With
   Kinocilium
The Semicircular Canals
• posterior canal
  shares plane with
  contralateral
  anterior canal.

• horizontal canals
  share plane.
Stimulated by Angular Acceleration

• greatest when fulcrum
  is within head

• induces relative motion
  of endolymph

• crista is displaced by
  fluid motion
Responses of the Cristae

• All kinocilia are
  oriented in the
  same direction

• Crista in each pair
  of canals respond
  inversely to each
  other
The
   Otolithic
   Organs

Saccule: roughly
vertical orientation,
responds to acceleration components within saggital
  plane

Utricle: horizontal (+ 30 deg.) orientation
Excitation Patterns in the Utricle

                           STRIOLA

                              Anterior




Posterior
                            Medial
Cranial Nerve VIII
Vestibular Portion of C.N. VIII
 superior division: utricle, anterior part of
  saccule, and horiz & anterior canals
 inferior division: posterior part of saccule,
  and posterior canal
• to vestibular nuclei
• to cerebellum
Vestibulocochlear Nerve

• Exits temporal bone
  near its medial edge.

• Enters lateral face of
  brainstem at the level
  of the lower pons.
• Synapsing in
  (Cochlear and)
  Vestibular Nuclei
Responses of Vestibular Neurons:


• To changes in acceleration, but onset
  and fade slowly

• For most normal head movements
  firing rates are in phase with head
  VELOCITY.
Other inputs to vestibular nuclei:

•   Cerebellum: primarily inhibitory
•   Spinal cord
•   Pontine reticular formation
•   Contralateral vestibular nuclei
From the Vestibular Nuclei:
• Vestibulo-Oculomotor Pathways:
  – Direct: to oculomotor nuclei.
  – Indirect: via reticular formation to
    oculomotor nuclei (III IV and VI)
• Vestibulo-Spinal Pathways:
  – Lateral V-S-throughout spinal cord
  – Medial V-S-cervical & thoracic
  – Reticulospinal tract-via brainstem reticular
    formation
Median Longitudinal Fasciculus
• A tract linking Vest. Nuclei to
  nuclei of CN III, IV, & VI;

• Supports conjugate eye
  movement during movement of
  the head.

• Continuous with the medial
  vestibulospinal tract.

• The mlf runs near midline
  ventral to ventricle IV and the
  periaqueductal gray matter of
  the midbrain
In the brainstem
• Vestibular inputs undergo integration

• Integrated signal is combined with
  original (velocity driven) signal
• Processing to reset spatial map for eye
  musculature
Integration & “Leaky” Integration
The VOR
Central Nervous System Will
Adapt to Peripheral Damage
Eye Movements

• Saccades—rapid shift in gaze
• Pursuit—stabilize image of moving object
• Fixation—stabilize image of still object
• VOR—stabilize image during head motion
• OKN—backup for when VOR decays to
  cont’d head rotation
• Vergent movements—change depth of focus
Saccades
Pause cells inhibit
Burst Neurons
 which stimulate:
III & VI (horizontal)




  or
III & IV (vertical)
Compare, Select
    & Combine Senses


Visual   Vestibular   Somato-
System    System      Sensation




SENSORY INPUTS
     Vision
    Vestibular
  Somatosensory
SOMATOSENSORY
RECEPTORS Compare, Select
                & Combine Senses

                                   Somato-
                                   Sensation


                        Joints
                        Position
                       Kinesthesia

                       Muscles
                        Length
                        Tension
                         Skin
                         Touch
                        Pressure
VISUAL        Compare, Select
             & Combine Senses
RECEPTORS
            Visual
            System



                     Central
                     Orientation
                     Navigation

              Peripheral
             Motion-sensitive
               Body-sway
VESTIBULAR RECEPTORS

                      Compare, Select
                     & Combine Senses

                         Vestibular
                          System


Semi-circular canals
       Orientation
       Navigation


 Utricle & Saccule
   Horizontal & vertical
acceleration & deceleration
SENSORY ORGANIZATION
  Determination of Body
        Position

          Compare, Select
         & Combine Senses

Visual     Vestibular   Somatosensor
                             y
 
     Processing of inputs from the periphery
     Selection based on
          Availability Accuracy
          Value for the task at hand
Functional
  Balance:
Navigating in
    our
Environment
A Quiz
Vestibular Pathways Quiz

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1 a&p-vestib

  • 2.
  • 3.
  • 4.
  • 5.
  • 6. Vestibular Hair Cells • Type I (aka inner) • Type II (aka outer) With Kinocilium
  • 7.
  • 8. The Semicircular Canals • posterior canal shares plane with contralateral anterior canal. • horizontal canals share plane.
  • 9. Stimulated by Angular Acceleration • greatest when fulcrum is within head • induces relative motion of endolymph • crista is displaced by fluid motion
  • 10.
  • 11. Responses of the Cristae • All kinocilia are oriented in the same direction • Crista in each pair of canals respond inversely to each other
  • 12. The Otolithic Organs Saccule: roughly vertical orientation, responds to acceleration components within saggital plane Utricle: horizontal (+ 30 deg.) orientation
  • 13. Excitation Patterns in the Utricle STRIOLA Anterior Posterior Medial
  • 15. Vestibular Portion of C.N. VIII  superior division: utricle, anterior part of saccule, and horiz & anterior canals  inferior division: posterior part of saccule, and posterior canal • to vestibular nuclei • to cerebellum
  • 16. Vestibulocochlear Nerve • Exits temporal bone near its medial edge. • Enters lateral face of brainstem at the level of the lower pons. • Synapsing in (Cochlear and) Vestibular Nuclei
  • 17. Responses of Vestibular Neurons: • To changes in acceleration, but onset and fade slowly • For most normal head movements firing rates are in phase with head VELOCITY.
  • 18.
  • 19. Other inputs to vestibular nuclei: • Cerebellum: primarily inhibitory • Spinal cord • Pontine reticular formation • Contralateral vestibular nuclei
  • 20. From the Vestibular Nuclei: • Vestibulo-Oculomotor Pathways: – Direct: to oculomotor nuclei. – Indirect: via reticular formation to oculomotor nuclei (III IV and VI) • Vestibulo-Spinal Pathways: – Lateral V-S-throughout spinal cord – Medial V-S-cervical & thoracic – Reticulospinal tract-via brainstem reticular formation
  • 21. Median Longitudinal Fasciculus • A tract linking Vest. Nuclei to nuclei of CN III, IV, & VI; • Supports conjugate eye movement during movement of the head. • Continuous with the medial vestibulospinal tract. • The mlf runs near midline ventral to ventricle IV and the periaqueductal gray matter of the midbrain
  • 22.
  • 23.
  • 24. In the brainstem • Vestibular inputs undergo integration • Integrated signal is combined with original (velocity driven) signal • Processing to reset spatial map for eye musculature
  • 26.
  • 28.
  • 29.
  • 30.
  • 31. Central Nervous System Will Adapt to Peripheral Damage
  • 32. Eye Movements • Saccades—rapid shift in gaze • Pursuit—stabilize image of moving object • Fixation—stabilize image of still object • VOR—stabilize image during head motion • OKN—backup for when VOR decays to cont’d head rotation • Vergent movements—change depth of focus
  • 33. Saccades Pause cells inhibit Burst Neurons which stimulate: III & VI (horizontal) or III & IV (vertical)
  • 34.
  • 35.
  • 36.
  • 37.
  • 38. Compare, Select & Combine Senses Visual Vestibular Somato- System System Sensation SENSORY INPUTS Vision Vestibular Somatosensory
  • 39. SOMATOSENSORY RECEPTORS Compare, Select & Combine Senses Somato- Sensation Joints Position Kinesthesia Muscles Length Tension Skin Touch Pressure
  • 40. VISUAL Compare, Select & Combine Senses RECEPTORS Visual System Central Orientation Navigation Peripheral Motion-sensitive Body-sway
  • 41. VESTIBULAR RECEPTORS Compare, Select & Combine Senses Vestibular System Semi-circular canals Orientation Navigation Utricle & Saccule Horizontal & vertical acceleration & deceleration
  • 42. SENSORY ORGANIZATION Determination of Body Position Compare, Select & Combine Senses Visual Vestibular Somatosensor y  Processing of inputs from the periphery Selection based on Availability Accuracy Value for the task at hand
  • 43. Functional Balance: Navigating in our Environment

Editor's Notes

  1. The Balance System depends on a complex set of interactions between a variety of systems: Inner ears Brainstem and cerebellum Eyes Spinal cord Postural Muscles Cortices
  2. Within the temporal bone lies the bony labyrinth a maze of tunnels lined with very dense and highly calcified bone. These we know as the cochlea, vestibule, and semicircular canals. Superior/Anterior Posterior Lateral/Horizontal These approximate (although not eactly) right angles to each other. This will allow for the analysis of curvilinear motion in terms of its components within each of these planes.
  3. Within the bony labyrinth are spaces defined by soft tissue: the so-called membranous labyrinth. These divide the labyrinth into perilymphatic spaces and endolymphatic spaces. Just as in the cochlea, the endorgans for the balance half of the inner ear are contained within the endolymphatic spaces. Semicircular canals form partial circles whose diameter (if completed) would be on the order of 6.5 mm. The interior diameter of the endolymphatic tubes in the semicircular canals is up to 0.4 mm. Each of these canals has one swollen or ampulated end, which contains the endorgans. The posterior and superior canals share their non-ampulated ends in what is called the common crus.
  4. Another view-- membranous labyrinth. These divide the labyrinth into perilymphatic spaces and endolymphatic spaces. Here we have labelled the utricle and saccule, the remaining endorgans for your sense of head motion. These endorgans are found in: the Ampullae--swollen end of each semicirc the Utricle the Saccule Also visible here is the endolymphatic sac, the subject of some surgical procedures.
  5. Within each of the endorgans, the sensory transducers are hair cells just like we found in the cochlea. And they still come in two varieties, only here there is no “inner” or “outer” placement for reference. So they are labelled as Type and Type II. And they have a large cilium in addition to the sterecilia. This is known as the kinocilium. What breaks off to leave the basal body in the cochlea.
  6. Here they are (in an example from the otolithic organ).
  7. The sensory organ in both the saccule and utricle is the maccula. hair cells sit with their cilia embedded in a gelatinous membrane containing otoliths/otoconia/ stratoconia (calcium carbonate crystals). There is a curved stripe within each maccula that contains only type I (read "inner") hair cells, called the striola. The kinocilia on all of the hair cells are oriented toward the striola in the utricle and away from the striola in the saccule .
  8. To Review: The vestibular system consists of the two otolithic organs, the utricle and the saccule (which are located in the vestibule, or central portion of the labyrinth), and the semicircular canals which run off of the vestibule. superior (anterior vertical) posterior (posterior vertical) horizontal (lateral) The vertical canals share a common opening to the vestibule, the common crus, at their non-ampullated ends. Their ampullar ends as well as both ends of the horizontal canal also open into the vestibule. The Saccule: roughly vertical orientation, responding to acceleration components within a saggital plane. The Utricle: horizontal (+ 30 degrees) orientation. The macculae are primarily sensitive to linear acceleration and gravity.
  9. This chart represents the basic organization of the vestibular system. We see that the semicirc’s are primarily responding to head rotation or angular acceleration. The Saccule and Utricle are responsive to Linear acceleration and the pull of gravity. Together they form one of the three primary inputs to the central nervous system components dedicated to balance: visual// proprioception & tactile To foreshadow, the outputs of this system include: the occulomotor muscles, the spinal cord and cerebellum, and the forebrain.
  10. This chart represents the basic organization of the vestibular system. We see that the semicirc’s are primarily responding to head rotation or angular acceleration. The Saccule and Utricle are responsive to Linear acceleration and the pull of gravity. Together they form one of the three primary inputs to the central nervous system components dedicated to balance: visual// proprioception & tactile To foreshadow, the outputs of this system include: the occulomotor muscles, the spinal cord and cerebellum, and the forebrain.
  11. Smooth Pursuit: Slower, for keeping target on the fovea when there is relative movement. Controlled by the occipital cortex and are based on inputs from the retina via visual cortex. Saccadic : Fast, up to 70 degrees per .1 sec, ballistic movements which can come under voluntary control with input from the pre-frontal cortex. The pontine gaze center (within reticular formation) is involved with the initiation of these movements in the horizontal direction. VOR : to move eyes relative to head movements. Mediated via connections from the vestibular system. Accommodating Reflex : to keep target that is moving closer or farther away in focus. Mediated through the occipital cortex.
  12. This chart represents the basic organization of the vestibular system. We see that the semicirc’s are primarily responding to head rotation or angular acceleration. The Saccule and Utricle are responsive to Linear acceleration and the pull of gravity. Together they form one of the three primary inputs to the central nervous system components dedicated to balance: visual// proprioception & tactile To foreshadow, the outputs of this system include: the occulomotor muscles, the spinal cord and cerebellum, and the forebrain.