There

 are  3  primary  reflex  pathways  from  the  vestibular   end  organ: Vestibulo-­‐
ocular   reflex  ( VOR)  – generates  eye  m ovements  that  enable   clear  vision   while  
the  head   is  in  m otion
Vestibulospinal reflex  ( VSR)  – generates  compensatory   body   movement   in  
order   to  m aintain  head   and  postural  stability  and  m aintain  balance
Vestibulocollic reflex  ( VCR)-­‐ acts  on   the  neck   musculature   to  stabilize  the  head

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For the  purpose   of  this  section   we  w ill  consider   the  VOR  as  a  three-­‐neuron   arc.  The  
primary  purpose   of  the  VOR  is  to   elicit  rapid  compensatory   eye  m ovements  that  
maintain  stability  of  images  on  the  fovea  during  head   motion.   In  the  case  of  the  
horizontal  S CC,   primary  vestibular  afferents  from  the  horizontal  S CC   synapse  in  the  
ipsilateral  vestibular  nuclei.  

Some  of  the  secondary   vestibular   neurons   have  axons  that  decussate  and  synapse   in  
the  contralateral  abducens nucleus
Others  w ill  continue   to  ascend   ipsilaterally to  the  oculomotor   nucleui .  
Motoneurons from  the  abducens nucleus   and  the   medial  rectus  subdivision   of  the  
oculomotor   nucleus   then  synapse  at  the  neuromuscular   junction   of  the  lateral  rectus  
and  m edial  rectus  m uscles,  w hich  w ill  then  contract   the  m uscles.

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Vestibular  structures   send  information  about   head  m ovement to  the  vestibular  
nuclei.  Compensatory   eye  m ovements   result  by  innervation   of  the   extra-­‐ocular  eye  
muscles.

VOR  allows  for  gaze  stabilization  during  active  head   movement.

VOR  eye  m ovement   must  be   equal  and  opposite   to  head   movement.
It  is  m easured  in  terns  of  gain  and  phase

So  .  .  .  F or  each  degree   of  head   movement  there   must  be   a  correspondingly   equal  

degree  of  eye  m ovement   (gain  should   be  1:1)  Or  you   will  see  it  as  negative  one.   (gain  
=  eye  velocity   /  head   velocity;   eyes  m ove  -­‐20  degrees  one   direction   if  head  m oves   20  
degrees  in  the  opposite   direction)            If  there  is  not  close   to  equal  gain,  the   eyes  have  
to  m ake  compensatory   saccadic  m ovements   to  catch  up.

Phase  describes   relationship  of  w hen  the  eyes  have   moved  relative  to  head  
movement.   The  eye  m ovement  should   be  exactly   opposite,   or  180  degrees  out   of  
phase  w ith  head  m ovement.

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As  a  review  .  .  .  

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In  someone   with  normal  vestibular  function.   With  no  head   movement,  the   static  rate  
of  firing  w ill  be  equal between   the  structures.    If  there  is  acceleration,  an  asymmetry  
in  neural  firing  w ill  exist  at  the   level  of  the   vestibular  nuclei  due   to  the  paired  
excitatory  /  inhibitory   action.    In   the  case  of  the   VOR,  asymmetry  in  neural  firing  
produces   a  corresponding   equal  and  opposite   eye  m ovement   to  m aintain  gaze  during  
active  head  m ovement.

You   can  see,  in  the   first  picture  the   head  is  turning   to  the  right,  w hich  is  resulting  in  
the  VOR  activating,  m oving  the   eyes  slowly  to   the  left  and  then   a  rapid  saccadic  
movement   will  reset  
The  eyes  back   to  the  right.  The  second   picture,   where  the  peripheral   system  has  been  
damaged  causes  the   same  signal  to  reach  the   brain  as  if  the   head  w as  turning   to  the  
right,  w hich  w ill  result  in  the  VOR  being  activated,  m oving  the   eyes  slowly  to   the  left  
and  beating  back   to  the  right.  

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Any  dysfunction   in one  or   more  of  the  peripheral   sensory   modalities  or   in  the   CNS  
integration  of  the  inputs  or   with  the  m otor  control   responses   will  likely  cause  some  
form  of  abnormal  equilibrium  function.

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The  purpose   of  the  VSR  is  to  m aintain  posture   and  center   of  gravity  over   ones   base  
of  support.    ( COG  over   BOS)  

The  limbs  ipsilateral to  the  direction   of  acceleration  are  extended,   whereas  those  
contralateral  to   the  acceleration  are  contracted

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Vestibulo-­‐spinal  R eflex
The  VSR  consists  of  several  reflexes  and   volitional  m ovements
To   maintain   a  correct   center   of   gravity  over   the   b ase  of   support  
requires  accurate  and  timely   information   from  all   the  sensory  
modalities,   integration   b y the  CNS   &   a  correct   motor   response.
Disruption   of  dysfunction  in  any  aspect  of  the  input-­‐‑central  
processor-­‐‑output   continuum   may   cause  an   equilibrium   disorder

Output:  antigravity  muscles

Ventral:   Abdominals,   Quadriceps,   Tibialis Anterior
Dorsal:   Paraspinals,  Hamstrings,   Gluteus  Maximus,  &  
Gastrocnemius

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