Term
| Info vestib system provides (3) |
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Definition
angular velocity,
linear acceleration,
orientation of head in relation to gravity |
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Term
| Info from vestib nuclei goes to... |
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Definition
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Term
| 3 sections of vestibular anatomy |
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Definition
peripheral (sensory input),
central processor,
mechanism for motor output |
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Term
| Components of peripheral vestibular system (3) |
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Definition
bony labyrinth,
membranous labyrinth,
hair cells |
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Term
| Components of bony labyrinth (3) |
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Definition
semicircular canals (3),
cochlea,
vestibule |
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Term
| Perilymph within bony labyrinth communicates with CSF in subarachnoid space via... |
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Definition
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Term
| Sensory organs of membranous labyrinth (5) |
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Definition
semicircular canals (3),
otolith organs (2) |
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Term
| Semicircular canals used to detect... |
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Definition
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Term
| Otolith organs used to detect... |
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Definition
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Term
| Communication between endolymph and perilymph |
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Definition
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Term
| Location of hair cells (2) |
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Definition
crista ampullaris (ampullae of SCCs),
maculae (in otolith organs) |
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Term
| Number of stereocilia in one hair cell |
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Definition
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Term
| Large cilium in hair cell = |
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Definition
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Term
| Location of macula in saccule |
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Definition
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Term
| Location of macula in utricle |
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Definition
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Term
| Gelatinous membrane which covers hair cells in ampulla |
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Definition
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Term
| Nerve impulse frequency increases on the side that you're turning TOWARD / AWAY FROM |
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Definition
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Term
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Definition
| atop gelatinous membrane covering macula of otolith organs |
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Term
| Specific gravity of otoconia is HIGHER / LOWER than that of gelatinous material |
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Definition
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Term
| In acceleration, hair cells bend TOWARD / AWAY FROM kinocilium |
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Definition
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Term
| Specific gravity of cupula is HIGHER / LOWER than that of surrounding endolymph |
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Definition
| EQUAL; is not sensitive to gravity |
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Term
| Which sense organs detect head tilt? |
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Definition
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Term
| Important spatial arrangements of semicircular canals (3) |
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Definition
perpendicular to one another,
planes on each side conform to each other,
planes nearly parallel those of ocular mm |
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Term
| Semicircular canal "coplanar pairs" (3) |
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Definition
R/L lateral
R post, L ant
R ant, L post |
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Term
| "Push-pull" configuration of semicircular canals = |
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Definition
| head rotation >> hair cells on side of rotation are excited, cells on opposite are inhibited (due to coplanar alignment) |
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Term
| Main areas of central processing branch of vestib system (2) |
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Definition
vestibular nuclei,
vestibulocerebellum |
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Term
| 1ยบ site for info processing from peripheral system = |
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Definition
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Term
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Definition
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Term
| Vestib nuclei send info UP / DOWN |
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Definition
| some send up, some send down |
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Term
| Info sent up from vestib nuclei goes to ... |
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Definition
vestib cortex (via thalamus),
cranial nuclei III/IV/VI (extraocular mvmt, VOR) |
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Term
| Infor sent down from vestib nuclei goes to ... |
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Definition
| LMNs (to maintain balance) |
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Term
| Damage to vestib cortex >> |
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Definition
loss of awareness of "upright",
unilat pusher syndrome |
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Term
| "Vestibular nuclei ______ information from multiple sensory sytemst" |
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Definition
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Term
| Pathways from vestib nuclei (7) |
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Definition
MLF,
vestibulospinal tracts,
vestibulocollic pathways,
vestibulothalamocortical,
vestibuloautonomic,
vestibulocerebellar |
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Term
| Pathway from vestib nuclei via MLF goes to... |
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Definition
| extraocular nuclei, superior colliculus (VOR) |
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Term
| Pathway from vestib nuclei via vestibulospinal tracts (med & lat, reticulospinal/tectospinal) goes to... |
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Definition
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Term
| Pathway from vestib nuclei via vestibulocollic pathway goes to... |
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Definition
| XI nuclei (influence head position) |
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Term
| Pathway from vestib nuclei via vestibulothalamocortical goes to... |
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Definition
| cortex (conscious awareness of head position/mvmt |
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Term
| Pathway from vestib nuclei via vestibuloautonomic goes to... |
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Definition
| reticular formation (influence N&V) |
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Term
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Definition
| flocculonodular lobe; part of cerebellum that receives info from vestib apparatus |
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Term
| Fxns of vestibulocerebellum |
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Definition
influence eye mvmt (adjust gain of VOR),
influence postural activity (VSR) |
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Term
| Vestib system component responsible for inhibiting VOR when person tries to turn eyes WITH head (doll's eye) |
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Definition
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Term
| Lesion of vermis of cerebellum >> |
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Definition
gait ataxia,
trunk instability |
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Term
| 2 primary reflexes of vestib system motor output |
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Definition
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Term
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Definition
head tilted to one side; otoliths/canals stimulated
vestib nn/nuclei activated
impulses transmitted to cord via lat/med vestibulospinal tracts
>> prox mm contractions to counteract change in COM |
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Term
| Major vestib system disorders (4) |
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Definition
BPPV,
vestib neuritis (aka acute unilat vestibulopathy),
Meniere's disease,
bilat vestib disorders |
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Term
| Most common cause of vertigo = |
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Definition
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Term
| BPPV vertigo episode lasts... |
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Definition
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Term
| BPPV does NOT produce (3) |
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Definition
loss of hearing,
"fullness" in ear,
tinnitus |
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Term
| Gender more prone to BPPV |
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Definition
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Term
| BPPV usually self-limiting in __[timeframe]___ |
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Definition
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Term
| PT test used to eval suspected BPPV |
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Definition
| Dix-Hallpike positioning test |
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Term
| Positive Dix-Hallpike test = |
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Definition
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Term
| Major theories behind pathophysiology of BPPV (2) |
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Definition
cupulolithiasis,
canalithiasis |
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Term
| Mechanism of influence in cupulolithiasis |
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Definition
| otolith incr specific gravity of cupula >> cupula sensitive to gravity |
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Term
| Mechanism of influence in canalithiasis |
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Definition
| otolith sinks to lowest point in canal >> causes endolymph to move w head mvmts |
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Term
| Vestibular neuritis aka... |
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Definition
| acute unilateral vestibulopathy |
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Term
| Etiology of vestib neuritis |
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Definition
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Term
| Mechanism of pathology in vestib neuritis |
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Definition
| TONIC activity from one vestib apparatus is lost >> symptoms |
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Term
| Length of time S/Sx persist in vestib neuritis |
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Definition
48-72 hrs;
gradual return to normal within 6 wks |
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Term
| S/Sx of vestib neuritis (5) |
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Definition
Acute onset of PROLONGED, severe rotational vertigo, exacerbated by head mvmt;
imbalance;
nausea;
nystagmus *toward good ear*;
NO hearing loss |
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Term
| Nystagmus in vestib neuritis IS / IS NOT present when patient is fixating gaze |
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Definition
| nystagmus is NOT present while pt is fixating |
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Term
| Results of caloric testing in vestib neuritis pt |
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Definition
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Term
| Mech of recovery in vestib neuritis |
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Definition
central compensation of vestib tone balance (help by using habituation/accommodation ex),
peripheral restoration of labyrinthine fxn |
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Term
| Unilat vestib deafferentiation syndrome = |
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Definition
| complete deafferentiation/destruction of a labyrinth |
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Term
| Vestib condition involving attack/remissions |
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Definition
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Term
| Immediate/early S/Sx of Meniere's dz attack |
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Definition
fullness in ear,
tinnitus,
hearing loss |
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Term
| Delayed S/Sx of Meniere's dz attack (after 30 min - 24 hr) |
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Definition
rotational vertigo,
postural imbalance,
N&V |
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Term
| Length of symptoms in Meniere's |
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Definition
Worst symptoms: 24 hrs
Ambulatory in 2-3 days |
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Term
| Pattern of Meniere's attacks over first year |
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Definition
| Incr in frequency over first year, then decr |
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Term
| Pathophys of Meniere's dz |
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Definition
| incr in endolymphatic fluid pressure in inner ear (endolymphatic hydrops) >> distention of otolith organs & ampullae |
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Term
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Definition
No known PT interventions;
once imbalance problems are in remission, habituation & balance ex may be initiated |
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Term
| Rx of the cause of Meniere's dz |
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Definition
| NO treatment for the cause; just the sequelae |
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Term
| Causes of bilat vestib disorders (6) |
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Definition
meningitis,
labyrinthine infection,
Paget's dz,
bilat tumors,
meds,
autoimmune disorders,
etc. |
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Term
| Rx of bilat vestib disorders |
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Definition
Medical (accommodation is impossible);
vestibular suppressants (in case of vertigo);
corticosteroids (if autoimmune) |
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Term
| Onset of acoustic neuroma |
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Definition
| gradual onset (months, years) |
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Term
| Location of acoustic neuroma |
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Definition
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Term
| S/Sx of acoustic neuroma (4) |
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Definition
hearing loss,
imbalance,
tinnitus,
NO fullness in ear |
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Term
| Acoustic neuroma usually UNILAT / BILAT |
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Definition
| unilateral (unless neurofibromatosis) |
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