The vestibular system, balance, and dizziness | Processing the Environment | MCAT | Khan Academy
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The vestibular system, balance, and dizziness | Processing the Environment | MCAT | Khan Academy


– [Voiceover] If I asked
you to list your senses, you would probably mention things like sight or sound or taste. But it turns out that
we can actually detect a lot more than that. One sense that’s really important, but not often thought about, is our vestibular system. Which is a system that is very important for our sense of balance
and spatial orientation. And while a lot of
information about balance and body position is
gained through receptors in our bodies that let us know where our limbs are in space, it actually turns out that a lot of our sense of balance and spatial awareness comes from receptors in our inner ear. So let’s take a moment to focus on our auditory system. And what I want to do is
focus on the inner ear, the part here that’s shaded in orange. And to get a better idea of
what that part looks like I’ve pre-drawn an enlarged version. And if you’re familiar
with the auditory system, part of this will probably
look familiar to you. In particular, you might be familiar with this spiraly,
snail-shaped structure here, which is referred to as the cochlea. And this is the portion of your inner ear that’s full of specialized
auditory receptors that process sound and
then transfer information about it to our brain. But what I want to focus on now are these loops on the other side, which are referred to
as semi-circular canals. So we have this anterior canal, a posterior canal, and then this lateral canal, which is also sometimes referred to as the horizontal canal. and it can be kind of hard to see this 3D structure on a 2D image, but these canals are actually
all orthogonal to each other, meaning that they are all at
right angles to each other. Let me draw some faces here to try to make this a bit clearer. So I’m gonna draw some axes on this head to try to orient us. So imagine a line that’s going from our nose to the back of our head, and we’re gonna label that the X axis. And now imagine another line that’s going from our left ear to our right ear, and we’re gonna label that one the Y axis. And here, let me add the X axis to this top picture, and the Y axis to the bottom, and I’ve put these as dotted lines to signify that they’re actually coming directly out of the screen towards us. In addition to the X and Y axes, though, we also have the Z axis. And that one goes straight up and down. And so you can see it on both images here. And each of our semi-circular canals actually lines up with one of these axes. Each of these canals
is filled with a fluid that’s known as endolymph. and when we rotate along a certain plane, it causes the endolymph to shift within that particular
semi-circular canal. And this allows us to sense what plane our head is rotating along. But because we’re also sensitive to how much of the fluid
is moving and how quickly, we also can get information about the strength of the rotation. Another part of our inner ear that gives us information relating to balance and spatial orientation are the otolithic organs, and let me write that here. And the otolithic organs include the utricle and the saccule. Which I’ve labeled here. And they help us to
detect linear acceleration and head positioning. And within these structures are crystals, actual calcium carbonate crystals, that are attached to hair cells within kind of a viscous gel substance. And if we accelerate in a direction, or say, move from
standing up to lying down, this causes the crystals to move because they are heavier than the surrounding gel environment. And when they move, they physically pull on the hair cells that
they’re attached to. Which is what triggers an action potential that carries this
information to the brain. So let me try to draw this, so that you can get a clearer
picture of what it looks like. I’m gonna erase my two faces here. And let me change my pen color. Alright, so we have a
person standing here, and within their ear, within their otolithic organs, are hair cells, and those hair cells are attached to crystals. And let me draw another
hair cell next to it. And when we’re just standing up, gravity is pushing those crystals in one direction, namely straight down. Let’s think about what
would happen if we lay down. So now we have a person
and he’s lying down, he’s all ready to go to sleep. And now because he’s
changed his orientation, these crystals are going
to shift in their position. Because of course,
gravity is still pointing in the same direction. And as they do this, they pull the hair cells along with them. And I just find this to
be really fascinating. I mean think about this, you have crystals in your ear that are physically pulled
in different directions by acceleration and gravity. That allow you to detect head positioning. Ear crystals that respond to gravity. And this is real, this is actually something that is going on in your head right as we speak. And I think this is just one of the coolest sense organs that we have. So you’ve experienced what happens when the vestibular system works, but you’ve probably also experienced what happens when it goes wrong. Because this results in things
like dizziness and vertigo. So let’s think about how this might work. And let’s think back to
the semi-circular canals. As we spin, the fluid
within them, the endolymph, moves along the direction
that we’re turning. But this liquid doesn’t
always stop spinning right when we do. And this is especially true
for spinning vigorously or for long periods of time. And think about what the
result of this might be. So you have stopped moving, but the continued
movement of the endolymph is resulting in signals
being sent to your brain that indicate that you are still moving, even after you have stopped. And this results in the
experience of dizziness. And when the fluid eventually stops moving is when the dizziness subsides. And interestingly, knowing this also helps us figure out
how we can combat dizziness. Rotating in the opposite direction of how you were originally spinning encourages the movement of the endolymph in that opposite direction. And this can help stop
the continued motion of the endolymph in the original direction by kind of cancelling it out. That’s not the only thing
that causes dizziness, though. Remember that one of the ways that we get information
about body position is by sensing the orientation of crystals in our otolithic organs
with respect to gravity. If you were in a
situation without gravity, let’s say if you were an astronaut, your otolithic organs probably
wouldn’t work very well. Because gravity won’t pull
down on them in the same way. And because of this,
concepts like up and down kind of become meaningless. And apparently this can
be really disorienting. And this is also one of the
dangers of scuba diving. Buoyancy can have the
same effect as gravity. And this can sometimes result in divers becoming really disoriented
when they’re underwater. And this is especially the case when they don’t have visual cues about which way is up
or which way is down.

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64 thoughts on “The vestibular system, balance, and dizziness | Processing the Environment | MCAT | Khan Academy

  1. bruh, i've been spinning in the opposite direction for years to get rid of dizzyness, but i just thought it was psychosomatic. I never realized that there was an actual scientific explanation for it.

  2. so in bppv are the crystals from the otolithic organs? If so how are they causing dizziness in the SC canals?  Are there hair cells in the SC canals? thanks

  3. I am kind of confused beacause if the three semicircular canals give sensory information about all possible head positions, why do we need the utricle and saccule?

  4. I suspect nerve ending misfires to be one of the culprits of PTSD and my GAD. I learned a lot at the Hough Ear Institute. Their meds didn't work well but, psychiatric meds have me sudden panic free.

  5. I don't understand why Khan Academy can explain this concept in less than 10 minutes while my professor needs 2 hours.

  6. My dizziness and vertigo got more intense, which had me fearful of even coming down from short slope. I have been utilizing this dizziness vertigo solution “Yοyο kamvuku” (Google it) for 3 days. I went out now down and up steps on a sloped side walk, no dizziness, no spinning, did not feel like I was gone to tumble. This medicine makes me happy I discovered it.

  7. I didn’t want to get beaten by unsteadiness, imbalance, and dizziness, so I searched for the procedure to my situation. The dizziness vertigo treatment “Yοyο kamvuku” (Google it) was my best choice. The symptoms I experienced were eliminated. The unstable feeling or the off balance feeling I used to have didn’t occur anymore.

  8. I didn’t want to be overwhelmed by unsteadiness, imbalance, and dizziness, so I searched for the treatment to my situation. The dizziness vertigo treatment “Yοyο kamvuku” (Google it) was my favorite choice. The symptoms I had were eliminated. The unstable feeling or the off balance experience I once had didn’t occur anymore.

  9. This specific dizziness vertigo solution “Yοyο kamvuku” (Google it) was a life saver for me personally. I was light headed with vertigo and would have devastating instances. My encounter while traveling injured me, so I never drove again. I`ve been applying this twice daily for 4 months and so far no more light-headedess, queasiness or dizziness.

  10. I was told by an ENT that my inner ear shapes are different from one another and that is why I am dizzy.
    I have been dizzy 24/7 since 1982.

  11. It is not complicated if you have good reference images. Here is good 3D model of the middle ear https://www.anatomynext.com/vestibulocochlear-nerve-cn-viii#media-1

  12. I think the body position part is more useful for blind people cause non-blind folks can see what is their body position.

  13. I have oscillipia from a nerve being burned out due to otoxicity fro vancymycn and gentamycn. ^ yr ** is moving all around 24/7. No quality left in life. Can't do ** t be able to function

  14. When a beautiful female walking by with a wink. All canals, crystals and fluids are firing. Medically, we call this "cloud 9". Shallow-minded males with rampant hormone fluctuation are most susceptible to this aberration of the inner ear functioning. Study [ 1975 : by Clubbing Disco ] shows olfactory system bombarded by Channel 5 coupled with cloud-9 syndrome often lead to unintentional one night stand resulting to what clinical psychology now called "what was I thinking" low self esteem the morning after. ( for further tangential studies refer "short gun marriages" by deep South Bible Belt publication 2010, ISBN 666 )

  15. Great resource for student! Please do note some slight errors. First, at 2:24. The Semi-Circular canals do NOT line up with the anatomical planes, as described. They are tilted up approximately 20-30 degrees, and with the HSCC (lateral canal) following Reid's Baseline, which is a line you can draw from the edge of your tragus (notch on the outer ear that you can use to plug the canal) to the lateral canthus (edge of the eye). Second: 2:58. "Otolithis" have a hard "O" for the initial "o" (and does not sound like "auto-lith", but rather like "o-toe-lith"), in medical communities in the U.S., at least. Note these are just slight things I would want my students to know. 🙂 Again, great resource. Thanks!

  16. Very confusing explanations: 
    Semicircular canals provide visual stabilization (called VOR) during day to day head motions, such as looking side to side in a grocery store. There's no VOR in the roll plane (Y axis) governed by semicircular canals. Vertical and horizontal head turns are governed by the semicircular canals, while translational VOR (forward, backward {car travel], upwards and downwards{elevator}) is governed by the utricle for eye stability in their respective orbits AND redundant body / postural positioning with the proprioceptive system.  
    No known balance contributions (known yet) are rendered by the Saccule unless it's an organ of primacy in the supine position for pre-postural infancy.  
    The video explanation of dizziness is completely wrong; rotational spin through the semicircular canals manifests in inertial LAG (endolymph is slower than initial acceleration of the spin causing the otoliths to move OPPOSITE the direction of stimulation). When the spin stops inertial lag of endolymph continues. This doesn't cause dizziness, it's the lack of management of this stimulus (inertial lag, catch up, latency) that results in the perception of dizziness. Both utricular organs and the VOR system deficits can lead to "dizziness" when their reflexive contributions AND CNS repression systems are aberrant or damaged. However, utricular input errors cause most commonly POSTURAL anomalies and imbalance, NOT primarily dizziness (exceptions: Meniere's, boat travel).
    Head motion provoked dizziness (head turns) = VOR dysfunction
    Body motion provoked dizziness (boat travel) = utricular dysfunction
    Vestibular rehab is IMPOSSIBLE if the treating professional does not understand these VERY important differences.

  17. We just evolved and this complex system appeared in our head…smh
    This was the genious of a Great, and Almighty Creator.

  18. Thank you so much for this video. I really am trying to understand THAT area, since mine got destroyed by a tumor. THANK YOU for making this easy to understand!

  19. Great info, and video. Helps me understand how my balance works now, given that my other balance systems have been understandably, and effectively destroyed, due to Neuro-Surgery for a pontine glioma (Ependymoma superior, and proximal to my brain stem), as well as an HAI (hospital acquired infection) of Serratia meningitis.

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