Professional Documents
Culture Documents
6.8
Auditory Pathways
Outline
I.
Auditory
and
Vestibular
system
II.
Auditory
System
A. External
Ear
B. Middle
Ear
C. Inner
Ear
III.
Central
Auditory
Pathway
IV.
Vestibular
System
A.
Inner
Ear
(Labyrinth)
B. Vestibular
Functions
of
the
ear
Macula
Objectives:
Define
function
of
the
cochlear
system
and
receptors
for
hearing
Tracing
the
pathway
of
sound
from
the
environment
to
the
sense
organ
for
hearing
Describing
the
origin,
course,
and
termination
of
the
cochlear
nerve
Tracing
the
central
auditory
pathway
from
the
organ
of
Corti
until
the
nerve
impulse
reaches
the
auditory
cortex
Role
of
the
olivocochlear
bundle
of
Rasmussen
in
sound
perception
Pathways
of
auditory
reflexes
Differentiating
between
conductive
and
sensory
deafness
Explaining
tinnitus,
Rinnes
&
Webers
test
Function
of
the
vestibular
system
Parts
of
Static
labyrinth
vs
kinetic
labyrinth
Location
of
the
receptors
for
vestibular
control
Origin,
course,
and
termination
of
the
vestibular
nerve
Describing
the
role
of:
MLF,
medial
vestibulospinal
tract,
lateral
vestibulospinal
tract
in
the
maintenance
of
equilibrium
Connections
of
the
vestibular
apparatus
with
the
cerebellum
Define:
vertigo
and
nystagmus
Tests
for
vestibular
function
Clinical
manifestations
of
disturbances
in
vestibular
apparatus
Air-filled
cavity
Two
parts:
o Tympanic
cavity
proper
o Attic/
epitympanic
recess
Page 1 of 8
Resembles
a
snail
Contains
helicotrema
which
is
the
apical
connection
between
the
scala
vestibuli
and
scala
tympani.
It
is
also
the
base
of
cochlea
Turns
at
its
conical
central
axis
called
modiolus.
2
and
turns
Consists
of
three
parallel
filled
channels:
o Scala
vestibuli
(w/
perilymph)
o Scala
tympani
(w/
perilymph)
o Scala
media
or
cochlear
duct
(w/
endolymph)
*Perilymph
is
similar
to
CSF
while
endolymph
is
similar
to
intracellular
fluid.
Vestibular
membrane
divides
scala
vestibuli
into
another
space
called
scala
media
or
cochlear
duct
RG,
SOPIE,
KEIFER,
TASIE,
FILLE,
ELIZ,
MAY,
JANNA
J
Page 2 of 8
(N2)
trapezoid
nuclei
superior
olivary
nuclei
(contralateral
and
ipsilateral)
Lateral
Lemniscus
Lateral
Lemniscus
(contralateral)
(ipsilateral)
(N3)
Inferior
colliculus
Inferior
colliculus
(N4)
MGB
MGB
Primary
auditory
complex
(BA
41
&
42)
Page 3 of 8
2.
Vestibular/Membranous
Labyrinth
Consists
of
the
saccule,
utricle,
semicircular
ducts,
cochlear
duct
Where
the
peripheral
receptors
of
the
vestibular
system,
the
vestibular
hair
cells,
are
located
Contains
endolymph
2
swellings
within
the
vestibule
o Utricle
o Saccule
3
semicircular
canals
within
the
vestibule
o Anterior
o Lateral/Horizontal
o Posterior
Page 4 of 8
C.
Macula
Figure
6.
Striola
Figure
4.Movement
of
stereocilia
RG,
SOPIE,
KEIFER,
TASIE,
FILLE,
ELIZ,
MAY,
JANNA
J
Figure 5. Macula
Page 5 of 8
o React
to
rotational
acceleration
or
angular
movement
(kinetic
equilibrium)
o Covered
with
a
gelatinous
capsule,
the
cupula
Extends
almost
to
the
roof
of
the
ampulla
Has
the
same
specific
gravity
as
the
endolymph,
therefore,
it
cannot
sense
the
effect
of
gravity
RG,
SOPIE,
KEIFER,
TASIE,
FILLE,
ELIZ,
MAY,
JANNA
J
E.
Vestibular
Pathways
Afferent
fibers
of
the
vestibular
nerve
have
their
cell
bodies
in
the
vestibular
ganglion
(of
Scarpa)
Axons
of
bipolar
cells
of
the
vestibular
ganglion
pass
through
the
internal
auditory
canal
and
reach
the
upper
medulla
in
company
with
the
cochlear
nerve
o Most
of
the
fibers
of
the
vestibular
nerve
bifurcate
into
ascending
and
descending
branches
and
terminate
in
the
vestibular
nuclei,
which
are
clustered
in
the
lateral
floor
of
the
fourth
ventricle
o Inferior
vestibular
nucleus
(descending
spinal)
Receives
input
from
the
semicircular
ducts
and
from
the
utricle
and
the
saccule
Nucleus
projects
into
the
ascending
medial
longitudinal
fasciculus
(MLF)
o
Superior
vestibular
nucleus
(of
Bechterew)
Receives
input
chiefly
from
the
cristae
of
semicircular
canals
Neurons
project
into
the
ascending
part
of
the
MLF,
where
they
participate
in
vestibuloocular
reflexes
o Medial
vestibular
nucleus
(of
Schwalbe)
Receives
input
chiefly
from
the
cristae
of
semicircular
canals
Neurons
project
into
the
ascending
part
of
the
MLF,
where
they
participate
in
vestibuloocular
reflexes
o Lateral
vestibular
nucleus
(of
Deiter)
Receives
input
chiefly
from
the
macula
of
the
utricle
Neurons
project
to
the
ascending
portion
of
the
MLF
and
to
the
spinal
cord
through
the
lateral
vestibulospinal
tract
Page 6 of 8
1. Conjugate
Eye
Movement:
in
response
to
head
movement
&
position
of
head
in
space
Vestibular
nuclei
via
MLF
(crossed
and
uncrossed)
Nuclei
of
CNs
III,
IV,
VI:
EOMs
(conjugate
eye
movement)
and
Nucleus
of
CN
XI
and
anterior
horn
cells
of
cervical
spinal
cord
(medial
vestibulospinal
tract:
maintains
the
position
of
the
head)
2. Maintain
upright
posture
Lateral
vestibular
nucleus
Lateral
vestibulospinal
tract
of
spinal
cord
to
sacral
level:
extensor
muscles
of
the
trunk
and
limits
3.
Fastigial
nuclei
of
the
cerebellum
0
0
- Vestibulocerebellar
fibers
(1
and
2 )
enter
cerebellum
via
juxtarestiform
body
(a
portion
of
the
inferior
cerebellar
peduncle).
Uncrossed
efferent
fibers
from
the
fastigial
nucleus
of
the
cerebellum
project
to
the
brainstem
also
through
the
juxtarestiform
body.
Secondary
vestibulocerebellar
fibers
Fastigial
nuclei
&
cortex
of
cerebellar
vermis,
sends
efferent
fibers
to
Lateral
vestibular
nucleus:
facilitating
influences
on
extensor
muscle
tone
via
vestibulospinal
tract
4. Reticular
formation
of
brainstem
o Vomiting
center
(group
of
reticular
neurons
in
medulla
near
dorsal
motor
nucleus
of
vagus)
Parasympathetic
motor
impulses
to
thoracic
&
abdominal
viscera
Connections
from
vestibular
nuclei
to
the
vomiting
center
probably
account
for
the
vomiting
associated
with
motion
sickness
o RAS
(Reticular
Activating
System)
or
Reticular
centers
Vestibuloreticular
connections
to
the
RAS
may
alert
individual
to
sleep
(rocking
chair
for
babies)
5. MGB
(Medial
geniculate
body)
o Vestibular
influences
project
rostrally
via
the
MGB
to
a
vestibular
cortical
area
near
the
auditory
cortex
o Related
to
objective
sensations,
e.g.
dizziness
associated
with
the
vestibular
system
Page 7 of 8
1.
2.
Rotation
test
0
Subject
will
sit
on
a
rotating
chair
with
head
tilted
30
forward
which
will
then
be
stopped
after
10-12
rotations
Induces
nystagmus,
which
lasts
about
30
seconds
in
neurologically
normal
persons
Caloric/Thermal
Test
Subject
will
be
tested
on
both
sides
0
Lying
down
with
head
tilted
forward
about
30
or
sitting
with
0
head
tilted
backward
60
to
bring
the
horizontal
SCC
into
a
vertical
plane
Ear
will
be
irrigated
with
warm/cold
water
which
will
cause
a
convection
current
on
endolymph
which
will
stimulate
the
hair
cells
and
cause
nystagmus
COWS
direction
of
nystagmus
o Cold
on
Opposite,
warm
on
Same
Side
Reference:
2014A
trans
Lansang
Notes
Snell
Moore
Berne
&
Levy
Everybody
is
a
genius.
But
if
you
judge
a
fish
by
its
ability
to
climb
a
tree,
it
will
live
its
whole
life
believing
that
it
is
stupid.
--
Albert
Einstein
"If
you
don't
go
after
what
you
want,
you'll
never
have
it.
If
you
don't
ask,
the
answer
is
always
no.
If
you
don't
step
forward,
you're
always
in
the
same
place."
J
CLINICAL
CORRELATIONS
A.
Nystagmus
Persistent
stimulation
of
hair
cells
in
cristae
ampullaris
will
draw
eyes
slowly
to
one
side
until
a
limit
is
reached
then
jerk
quickly
to
opposite
side.
(involuntary
back
and
forth,
up
and
down
rotational
movement
of
the
eyeball)
its
direction
is
designated
according
to
the
direction
of
the
fast
component
which
is
the
basis
for
tests
in
vestibular
function
this
results
from
a
lesion
of
the
vestibular
system,
its
peripheral
and
central
connection
and
also
from
lesions
in
brainstem
and
cerebellum
this
can
also
be
caused
by
chronic
visual
impairment
or
toxic
substances
if
unbalanced:
o Unilateral
damage
to
the
vestibular
nuclei
or
their
connections
tonic
deviation
of
the
eyes
to
one
side
+
vertigo
+
nystagmus
o Destruction
of
the
vestibular
receptors
or
section
of
the
nerve:
(-)
tonic
deviation
Fast
case:
nystagmus
diagnosis
o Ex.
Lesion
on
R
o Caloric/thermal
test:
Cold
water-direction
of
nystagmus
is
opposite
the
lesion
Warm
water-direction
of
nystagmus
is
to
the
same
side
B.
Vertigo
Sensation
of
whirling,
dizziness
due
to
disturbance
of
equilibrium
Stimulation
or
damage
to
the
vestibular
end
organ
(prolonged
or
excessive
stimulation
of
vestibular
apparatus
-
motion
sickness)
RG,
SOPIE,
KEIFER,
TASIE,
FILLE,
ELIZ,
MAY,
JANNA
J
Page 8 of 8