Vestibular system

Monday, 16 August 2021 7:34 AM

Inner ear consists of bony labyrinth. Inside the bony

labyrinth is the system of coiled tubes – the
membranous labyrinth. It consists of cochlea (organ
for hearing) and vestibular apparatus (organ for
equilibrium).
Vestibular apparatus is composed of:
1. Utricle & saccule, and
2. Three semicircular canals
1. Utricle & saccule: (otolith organs)

[Figure: It shows the maculae in the utricle and the

saccule; their orientation is with respect to an
upright position of the head. There are calcium
carbonate crystals into which the stereocilia are
embedded.]
- Detect orientation of head with respect to gravity,
and maintain balance during linear acceleration.
- Inside them, there is sensory organ called macula.
Macula inside utricle is horizontal. Utricle plays the
role in equilibrium when there is horizontal linear
acceleration
macula inside saccule is vertical; saccule play the
role in equilibrium when there is verticle linear
acceleration.
- Maculae are covered by a gelatinous layer. It
contains calcium carbonate crystals –
otoconia/statoconia. [Due to the presence of these
crystals, the maculae are also referred to as otolith
organs.] Otoconia have 2.5 times higher specific
gravity.
- Maculae have hair cells. Stereocilia projecting from
hair cells are embedded in the gelatinous layer at
the top. Sides and bases of the hair cells synapse
with vestibular nerve fibers. Length of the stereocilia
goes increasing to one side; the longest cilium at one
end is called kinocilium. Due to the higher specific
gravity of the otoconia, they cause bending of
stereocilia on linear acceleration.
- When stereocilia bend toward the kinocilium, hair
cell is depolarized; when they bend in the other
direction, hair cell is hyperpolarized. These changes
lead to changes in the discharge rates of the
afferent vestibular nerve fibers.
-

[Figure: It shows the event of linear acceleration.

As the head is thrust forward, the stereocilia bend
in the opposite direction due to the inertia of the
otoconia.]

1. Semicircular canals: (3 in each labyrinth; a

horizontal, an anterior vertical, and a posterior
vertical)

[Figure: It shows one end of a semicircular

canal.]
- One end of each canal is dilated, called the ampulla.
The crest inside the ampulla is called crista
ampullaris. There are hair cells oriented in all
directions inside the crista.
- At the top of the crista, there is a gelatinous
structure – cupula.
- Canals are filled with endolymph.
- Angular rotation of the head causes movement of
the canal, but the endolymph does not move
initially, due to inertia. This causes bending of cupula
in the opposite direction. It leads to change in the
discharge rate in the afferent vestibular nerve fibers.
Summary: (differences in functions of utricle &
saccule and the semicricular canals)
1. Utricle & saccule maintain the equilibrium when
the head is stationary and when there is linear
acceleration. Semicircular canals maintain
equilibrium during angular rotation.
2. Semicricular canals perform a predictive function
(this ability is not there with utricle & saccule.)
During an acceleration of the body, if there is going
to be a sudden, sharp turn, semicircular canals can
make the adjustments about 1 to 2 seconds in
advance, thereby help maintain the body’s balance.
Vestibulo-ocular reflex: (Nystagmus)
• As the head rotates in a particular direction, say left,
bending of the cupula in the left horizontal canal
causes increase in the discharge of vestibular nerve
fibers. The eyes slowly deviate in the opposite
direction (right, in this case), to maintain visual
fixation. As they reach the extreme of the orbit, they
quickly return to the center, to have a new fixation
point. Then, again slowly deviate in the opposite
direction. The oscillatory, jerky movement thus
caused is called nystagmus.
• During rotation, slow movement is in the opposite
direction and fast component is in the same
direction (of head rotation). Slow movement is
caused by vestibular impulses; fast movement is
triggered by brain stem center. (vestibular nuclei →
medial longitudinal fasciculus → sending signals to
oculomotor nuclei). Direction of the nystagmus:
denoted by fast component.
• As the rotation continues, endolymph catches up
the speed of the canal. No more bending of the
cupula now, and the nystagmus will cease.
• When the rotation stops suddenly, endolymph
continues to move for some time in the same
direction due to its inertia. Now the cupula will bend
in the opposite direction (as compared to rotational
bending). This time the slow and fast movements
will be opposite. If the rotation was to left, slow
movement will now be to the left and fast
movement will be to the right. This is post-rotatory
nystagmus.
• When the head is upright – horizontal nystagmus.
When the head is tipped sideways (leaning on
shoulder) – vertical nystagmus. When the head is
flexed forward – rotatory nystagmus.
• Caloric nystagmus: When warm or cold water is
instilled in the ear, it sets up convection currents in
the endolymph. This causes bending of cupula,
leading to nystagmus. The famous mnemonic to
denote this nystagmus is “COWS” (cold opposite,
warm same). It means, cold water will cause
nystagmus in the opposite direction, and warm
water in the same direction. Warm water in the left
ear will cause fast component to the left (“warm
same”), which means it will cause slow rotation of
eyes to the right.
• Spontaneous nystagmus: (unilateral
labyrinthectomy or vestibular nerve lesions)
At rest, the vestibular apparatus has a
normal tonic discharge. This steady
discharge of both sides has equal and
opposite action on skeletal muscles and
eyes. Due to steady tonic discharge in the
left vestibular apparatus, eyes deviate to
right. And, discharge in the right apparatus
deviates eyes to the left. These effects
cancel out each other so that the eyes have
a normal straight gaze.
If the vestibular apparatus is destroyed on
left side, then due to steady discharges in
the right, eyes will slowly deviate to the left
side and quickly return to the right. Thus a
spontaneous nystagmus will be observed.
• Motion sickness/sea sickness: It results from a
mismatch between vestibular, visual, and
proprioceptive inputs.
• Vertigo: Abnormal stimulation of the vestibular
system results in the sensation of vertigo.