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Balance requires :
Normal
functioning
vestibular system
Input from visual
system
Input from
proprioceptive
system
Vestibular Apparatus
Membranous and
bony labyrinth
Vestibular nerves
Vestibular nuclei
Labyrinth
5 distinct end organs
3 semicircular canals:
superior, lateral,
posterior
2 otolith organs:
utricle and saccule
Saccule
Lies in the spherical
recess on the medial
wall of the vestibule
Connected:
anteriorly to the
cochlear duct by the
ductus reuniens
posteriorly to the
endolymphatic duct
via the
utriculosaccular duct
Utricle
Semicircular canals
lateral or horizontal,
superior or anterior,
and posterior or
inferior
They are oriented at
right angles to each
other
Semi-circular canals
One end of each canal is dilated to form
the ampulla, which contains a saddleshaped ridge termed the crista
ampullaris, on which lies the sensory
epithelium.
The nonampulated ends of the superior
and posterior canal form the crus
commune or common crus.
All canals merge into the utricle.
Macula
Sensory epithelium of
utricle and saccule
project into the
overlying statoconial
membrane.
The statoconial
membrane is
comprised of 3 layers:
1.
2.
3.
Macula
Orientation of two
maculae. The
utricular macula is in
the horizontal plane,
and the saccular
macula is in the
vertical plane
Morphological polarizations of the stereociliary bundles in the maculae of the (A) utricle
and (B) saccule. The on direction of stereo ciliary deflection is indicated by the arrows.
In the utricle (A) hair cells are excited by stereo ciliary deflection toward the striola
(curving central zone). In the saccule (B) hair cells are excited by stereo ciliary deflection
away from the striola.
Otolithic Organs
Crista
consists of a crest of sensory epithelium supported on a
mound of connective tissue, lying at right angles to the
longitudinal axis of the canal.
A bulbous, wedge-shaped, gelatinous mass called the
cupula surmounts the crista.
Cilia of the sensory cells project into the cupula.
The cupula extends from the surface of the cristae to the
roof and lateral walls of the membranous labyrinth,
forming a fluid-tight partition
Crista
A, The cupula spans the lumen of the ampulla from the crista to
the membranous labyrinth.
B, Head acceleration exceeds endolymph acceleration. The
relative flow of endolymph in the canal is therefore opposite to
the direction of head acceleration. This flow produces a
pressure across the elastic cupula, which deflects in response.
Schematic drawing of
the two types of
sensory cells in the
mammalian labyrinth
showing fine
structural organization
of type I and type II
sensory cells and
their innervation
The superior
division supplies
the cristae of the
superior and lateral
canals, the macula
of the utricle, and
the anterosuperior
part of the macula
of the saccule.
Vestibular nuclei
(first-order neurone)
Most afferent fibers from the hair cells terminate
in the vestibular nuclei, which lie on the floor of
the fourth ventricle.
Afferent pathways to
the vestibular nuclei
Efferent connections
of the vestibular
nuclei
PROJECTIONS FROM
THE VESTIBULAR NUCLEI
Extend to the cerebellum, extraocular nuclei, and
spinal cord.
The cells of the superior vestibular nucleus project in
an ascending direction to the nuclei of the extraocular
muscles (III and IV). This projection almost, if not
entirely, reaches the ipsilateral eye nuclei by way of
the medial longitudinal fasciculus.
The lateral vestibular nucleus has been shown to be
the sole source of fibers to the vestibulospinal tract.
These fibers terminate near the anterior horn cells of
all the spinal cord levels and mediate trunk and limb
muscle reflexes.
Cerebral cortex
The vestibular area in the cerebral
cortex has not been defined by using
anatomical methods.
Electrophysiologic studies indicate that
the projection area is in the temporal
lobe near the auditory cortex.
Cerebral cortex
Functional MRI and PET studies implicate the
insula as another possible cortical projection of
the vestibular system.
These pathways appear to integrate vestibular,
proprioceptive, and visual signals to provide a
conscious awareness of body orientation
Cerebellum
Midline cerebellum plays a pivotal role in modulating the
final motor activity triggered by the VOR and VSR
Some primary vestibular neurons pass directly to the
cerebellum, in particular the flocculonodular lobe and the
vermis.
Direct and indirect vestibular input reach the cerebellum,
which in turn produces an inhibitory influence via
Purkinje cell activity to fine tune ocular and postural
movements and assure appropriate interaction among
vestibular , visual, and proprioceptive cues
Semicircular canals
afferents
Majority of semicircular canals
input synapses in the medial and
superior vestibular nuclei
Macular afferents
VOR
The principal function of the VOR is the
control of eye position during transient
head movements to maintain a stable
visual image
Canal physiology
Saccadic system
Provides the fast component during the
production of jerk nystagmus
Reposition a visual target of interest onto
the fovea with a single rapid eye motion
Cortical activity, pontine reticular formation
and vestibulo-cerebellum participate in
modulating saccadic eye movement
Myototoic reflex
Is stimulated by an externally generated
pull on a muscle, causing stimulation of
tendon and muscle stretch receptors
Is mediated through spinal cord pathways
Regulate muscle force, thereby
maintaining stability at a joint
Volitional movement
Mediated at all levels, including cortical
sensory and motor areas
Responsible for learned, purposeful
movements, and balance stabilizing
responses