Last edited: 8/22/2021
56. NEUROLOGY - CN VIII : VESTIBULAR PATHWAY
Neurology - CN VIII: Vestibular Pathway
OUTLINE
I) CN VIII: VESTIBULOCOCHLEAR NERVE
II) CN VIII IN THE BRAIN
III) REVIEW QUESTIONS
I) CN VIII: VESTIBULOCOCHLEAR NERVE
Figure 1: CN VIII Breakdown
STATIC EQ: via the macula within the utricle & saccule
DYNAMIC EQ: via the cristae ampularis within the
semicircular ducts (specifically the ampulla)
(A) NERVE COMPONENTS
Figure 2: Nerve Components
• Spiral Organ of Corti – gave off spiral ganglion and
helps to form the cochlear branch
• Other branches coming from:
o Ampulla, macula, and utricle – individual nerve fibers
that make up the vestibular branch of CN VIII
Both branches form CN VIII and then exits through the
Internal Acoustic Meatus (Canal).
CN VII Facial Nerve will also exit through the internal
acoustic meatus
What Happens Next?
The vestibular branch will take its central processes and go
to a specialized structure within the medulla – the vestibular
nucleus.
Neurology - CN VIII : Vestibular Pathway
Medical Editor: Dr. Christina Perry
II) CN VIII IN THE BRAIN
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Figure 3: Vestibular Nuclei
Vestibular Nuclei – composed of 4 components:
o Superior, Lateral, Medial, and Inferior Vestibular
Nuclei
o Information comes into the medulla to the vestibular
nuclear complex
 From here, information can go to any of 4
destinations
(A) DESTINATION 1: VESTIBULOSPINAL TRACT
(1) Lateral and Medial Vestibular Nuclei
These control the descending motor pathways
o Lateral = trunk and limb movements
o Medial = head and neck movements
As it comes down, it comes through the ventral (anterior)
funiculus
It then gives axons ipsilateral to the ventral (anterior) gray
horn
Figure 4: Vestibulospinal Pathway
The lower motor neurons (LMN) are stimulated and then
exit the ventral ramus and out through the root and then
travel to specific muscles.
Provide proper tone to extensor muscles and head and
neck muscles with response to linear or rotational
acceleration.
Figure 5: Knee Joint
LMN going to the extensor muscles – which comes from
the lateral vestibular nucleus.
o Need to maintain posture and resist gravity for
balance
NEURO PHYSIOLOGY: Note #56. 1 of 2
 (B) DESTINATION 2: CEREBELLUM (D) DESTINATION 4: THALAMUS

Figure 8: Thalamus Pathway

Fibers coming from superior vestibular nucleus and
traveling to the thalamus to the Ventroposterior Medial
Figure 6: Cerebellar Pathway Nucleus (VPM)
Fibers will move into the cerebellum via the inferior It can then go to the internal capsule – come out through
cerebellar peduncle. the corona radiata and project to specific areas in the
From there, it will go to the cerebellum – more CNS (cerebrocortex)
specifically, the flocculonodular lobe (vestibulo- o Believed to go to the:
cerebellum) 1. Lateral Postcentral Gyrus
Fastigial Nucleus  can send connections outwards to 2. Insular Cortex
the vestibular nuclei and can influence the vestibulospinal 3. Temporoparietal Cortex
tract
o Cerebellum can take information from proprioceptors III) REVIEW QUESTIONS
and tell us where our body is in space and modulate CN VIII is formed by the vestibular and cochlear
vestibulospinal movements branches and exit the skull through this:
a. Jugular foramen
(C) DESTINATION 3: PONS b. Foramen rotundum
c. Internal acoustic meatus
d. Superior orbital fissure

True or False: The Oculomotor Nerve (CN III)

controls both horizontal and vertical movements of
the head:
a. True
b. False

This lobe of the cerebellum receives signals from

the vestibular nuclei via the inferior cerebellar
peduncle:
a. Anterior lobe
b. Medial lobe
c. Posterior lobe
d. Flocculonodular lobe
Figure 7: The Pons Pathway
Fibers coming from this nucleus travel via the
Medial vestibular nucleus crosses over to the ventroposterior medial nucleus (VPM) up to the
contralateral CN VI nucleus. thalamus:
o It can then cross over and give stimulation to different a. Medial Vestibular Nucleus
nerves b. Lateral Vestibular Nucleus
Horizontal movements = controlled by CN III and CN VI c. Inferior Vestibular Nucleus
Vertical movements = controlled by CN III and CN IV d. Superior Vestibular Nucleus

Table 1: Cranial Nerves and their Innervations Lower motor neurons (LMN) are stimulated in the
CRANIAL NERVE DESTINATION ventral gray horn via signals descending through
this pathway:
CN III
Medial Rectus Muscle a. Vestibulospinal tract
Oculomotor
b. Spinothalamic tract
CN IV c. Rubrospinal tract
Superior Oblique Muscle
Trochlear d. Corticospinal tract
CN VI
Lateral Rectus Muscle CHECK YOUR ANSWERS
Abducens
This connection is done via the left and right Medial
Longitudinal Fasciculus
o Purpose is to control eye movements and gaze *Remembering ocular muscles and their innervations*
fixation during vertical and horizontal movements  Use this pneumonic:
VOR (Vestibulo-Ocular Reflex) LR6SO4AO3
Paramedian Pontine Reticular Formation
LR6 = Lateral Rectus innervated by CN VI
o Example: When we move our head to the right, our
SO4 = Superior Oblique innervated by CN IV
eyes will go to the left (controlled via medial and
AO3 = All Others (superior, medial, and inferior recti
lateral rectus)
muscles + inferior oblique) innervated by CN III
o Can stimulate or inhibit movement depending on
which way we are rotating (controlled via contralateral
paramedian pontine reticular formation)

2 of 2 NEURO PHYSIOLOGY: Note #56. Neurology - CN VIII : Vestibular Pathway