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 Somatosensory


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