II. Anatomy: Vestibular Structures
- Semicircular canals
- Monitors head rotation and spatial positioning
 - Three semicircular canals with endolymph fluid filled ampullae
- Canals lie at right angles to one another
 - One for each direction (e.g. X,Y and Z axis)
 - Fluid filled canals contain crista ampullaris
- Crista ampullaris is a sensory organ detecting sudden head rotation, acceleration and deceleration
 - Hair cells within the crista ampullaris detect fluid motion
 - Hair cells generate an impulse that is transmitted centrally via Vestibular Nerve (CN 8)
 
 
 
 - Otolithic organs
- Utricle
- Contains otoliths (small stones) that settle with position changes
 - Detects horizontal linear movement and Head Tilting
 
 - Sacule
- Smaller, more globular organ without utricle communication
 - Detects vertical linear movement (e.g. gravity)
 
 - Both Utricle and Sacule contain a Macula (sack)
- Macula contains thick, gelatinous material and otoliths
 - Otoliths (statoconia) are Calcium Carbonate crystals that move with gravity and head movement
 - Hair cells within the Macula detect static head position as well as head movement
 
 
 - Utricle
 - Perilymphatic fluid
- Surrounds vestibular apparatus (semicircular canals and otolithic organs)
 - Communicates with the perilymph of the Cochlea (from oval window to round window)
 - Communicates with perilymphatic duct (and the subarachnoid space)
 
 
III. Anatomy: Neurologic Structures
- Cranial Nerve 8 (two tracts)
 - Vestibular nucleii
- Located in the pons and Medulla and receive input from the respective tracts of Cranial Nerve 8
 - Transmit signals to the rest of the Cerebrum, Cerebellum and spinal cord
- Combines with other inputs (e.g. occiptal lobe, dorsal columns)
 
 
 - Medial Longitudinal Fasciculus and Oculomotor Nucleus
 
IV. Anatomy: Vascular Structures
- See Vertebro-Basilar CVA
 - Posterior Circulation via the vertebrobasilar system
 - 
                          Vertebral arteries
- Two arteries ascend in parallel from the subclavian artery via each transverse foramen
 - Join to form the Basilar Artery
 - Branches
 
 - 
                          Basilar Artery
                          
- Arises from the joining of the two Vertebral arteries
 - Courses anteriorly to join with the Anterior Circulation via the Circle of Willis
 - Branches
 
 
V. Anatomy: Images
- 
                          
                            
                          
                          
                            Lewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
                         - 
                          
                            
                          
                          
                            Lewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
                         - 
                          
                            
                          
                          
                            Lewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
                         - 
                          
                            
                          
                          
                            Lewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
                         - 
                          
                            
                          
                          
                            Lewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
                         - 
                          
                            
                          
                          
                            Lewis (1918) Gray's Anatomy 20th ed (in public domain at Yahoo or BartleBy)
                         
VI. References
- Goldberg (2014) Clinical Physiology, Medmaster, Miami, p. 118-9
 - Ondrejka (2014) Crit Dec Emerg Med 28(10): 11-7