_examination前庭功能检查课件

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1、VestibularExaminationANATOMY&FUNCTIONCarmenCasanovaAbbottPT,PhDLectureObjectivesDiscussvestibularstructureasitrelatestovestibularfunctionwhenexaminingadizzypatient.DiscusssignsandsymptomsassociatedwithvestibulardisordersDifferentiatebetweenperipheralandcentralvestibular

2、pathologyDiscusscomponentsofaphysicaltherapyvestibularexamination.VestibularSystemFunctionProvidesinformationconcerninggravity,rotationandaccelerationServesasareferenceforthesomatosensory&visualsystemsContributestointegrationofarousal,consciousawarenessofthebodyviaconne

3、ctionswithvestibularcortex,thalamusandreticularformationAllowsfor:gaze&posturalstabilitysenseoforientationdetectionoflinear&angularaccelerationVestibularAnatomyPeripheralsensoryapparatusdetects&relaysinformationaboutheadangular&linearvelocitytocentralprocessingsystemori

4、entstheheadwithrespecttogravityCentralprocessingsystemprocessesinformationinconjunctionwithothersensoryinputsforpositionandmovementofheadinspaceMotoroutputsystemgeneratescompensatoryeyemovementsandcompensatorybodymovementsduringhead&posturaladjustmentsPeripheralApparatu

5、sMembranousLabyrinthSemicircularcanals(SSC)OtolithorgansNetter‘97SemicircularCanalsAngularaccelerationAmpullacontainssensoryepitheliumSSCCoplanarPairingSpatialarrangementofthe6SSCcause3coplanarpairingsR&Llateral,LanteriorandRposterior;lposterior&Ranterior;R&LhorizontalA

6、llowsforaPush-Pullarrangementofthetwosides(e.g.,asheadturnsright,rightSSCwillincreasefiringrate&theleftSSCwilldecreasefiringrate)Advantagessensoryredundancycommonmoderejection/noiseassistincompensationforsensoroverloadInhibitoryCutoffDepolarizationoftheipsilateralhairce

7、llsoccursduringangularheadmovementsHyperpolarizationofcontralateralhaircellsoccursatthesametimeHaircellsareonlyabletohyperpolarizetowhattheywereatrest=cutoffofinhibitoryinfluencesfromthemovementgoingintheoppositedirectioneveniftheipsilateralhaircellscontinuetospikehighe

8、rfiringratesPurves2001OtolithsUtricleandsacculeOtolithsensorystructuresMaculaeOtolithicmembraneOtoconiaMovemen