Physiology of Body

Equilibrium & Balance

SYED TOUSIF AHMED

Centre of gravity

To balance the centre of gravity must be above the support point.

Physiology Of Body Balance

Physiology Of Body Balance

Balance:
Balance: ability to control equilibrium Foot position affects standing balance
Is defined as : THE ABILITY TO MAINTAIN THE EQUILIBRIUM OF THE BODY.

Equilibrium
o Is defined as : Physics. The state of a body or physical system at rest or in un accelerated motion in which the resultant of all forces acting on it is zero and the sum of all torques about any axis is zero. There are 2 types of balance
Static Dynamic

Neuromuscular Synergies

Musculoskeletal Components

Body Schema

BALANCE
Sensory Systems Reactive Mechanisms

Proactive Mechanisms (external)

Anticipatory Mechanisms (internal)

Balance and Orientation Pathways

Systems regulating body balance

Humans use three systems:

CNS
1- Cerebral cortex 2- Brainstem 3- Cerebellum
Muscle commands 1-

1- visual

2- Vestibular 2-

3- Proprioceptive

The Cerebellum
11% of brain mass Dorsal to the pons and medulla Controls fine movement coordination Balance and equilibrium Muscle tone

Anatomy of the Cerebellum

Two hemispheres connected by vermis Each hemisphere has three lobes
Anterior, posterior, and flocculonodular

Foliatransversely oriented gyri Arbor vitaedistinctive treelike pattern of the cerebellar white matter

Anterior lobe
Cerebellar cortex Arbor vitae

Cerebellar peduncles Superior Middle Inferior Medulla oblongata (b)

Flocculonodular lobe

Posterior lobe Choroid plexus of fourth ventricle

Figure 12.17b

Cerebellum

Cortico cerebellum

Vestibulo cerebellum

Spinocerebellum

Vestibulocerebellum

controls tone & movements of muscles involved in equilibrium & posture, by receiving impulses from vestibular apparatus.

Spinocerebellum
coordinates mainly movements of distal parts of limbs, such as the fast ballistic movements (in association with cerebrocerebellum), & also coordinates saccadic eye movements. It receives impulses from proprioceptors in muscles, tendons & joints, tactile receptors,

visual receptors & auditory receptors.

Corticocerebellum
coordinates timing & planning involved in fast
sequential movements like writing, running, talking etc. It perform its function by the intensive

to & fro connection with the cerebral cortex

(cerebro-cerebello-cerebral connections)

Granule cell axons ascend to the molecular layer, bifurcate and form parallel fibers that run parallel to folia forming excitatory synapses on Purkinje cell dendrites. Cerebellar cortex also has several types of inhibitory interneurons: basket cells, Golgi cells, and stellate cells. Purkinje cell axon is only output of cerebellar cortex, is inhibitory and projects to the deep nuclei and vestibular nuclei. Deep nuclei axons are the most common outputs of the cerebellum (excitatory).

Cerebellar Cortical Circuits

Cerebellar Output Pathways

Lesions of lateral cerebellum affect distal limb coordination. Medial lesions affect mainly trunk control, posture, balance, and gait. Cerebellar deficits occur ipsilateral to the lesion because cerebellar outputs go to the contralateral side and then motor pathways decussate back to the original side (double cross-over). Vermis lesions do not cause unilateral deficits because medial muscle groups typically receive bilateral UMN inputs.

Static Equilibrium
1) keep the body in a desired position,

Static equilibrium The equilibrium is maintained in a FIXED POSITION, usually while stood on one foot. maintenance of body posture relative to gravity while the body is still.

Dynamic Equilibrium 2) move the body in a controlled way .

Dynamic equilibrium The equilibrium must be maintained while performing a task which involves MOVEMENT e.g. Walking the beam. maintenance of the body posture (mainly the head) in response to sudden movements. Tracking a moving object.

Vestibular Reflexes
Vestibulo-cervical:
Helps to maintain stability of the head during movement of the torso.

The vestibular labyrinth

The Vestibular Apparatus

Components
a. Three semicircular canals (SCCs)
Anterior Posterior Lateral

b. Utricle and Saccule c. Vestibular nerve and nuclei

Vestibular receptors
there are five receptor organs housed in each of the two vestibular labyrinths: 1. hair cells in the utricle Detect linear accelerations along any axis 2. hair cells in the saccule 3. hair cells in the 4. hair cells in the 5. hair cells in the
Detect anterior vertical semicircular canalangular accelerations horizontal semicircular canal about any posterior vertical semicircular canal axis

the displacement of hair cells due to the forces of gravity and inertia transduce mechanical stimuli into receptor potentials

Stimulus to the vestibular sensory organs

Mechanism of Stimulation
Deflection of stereocilia towards kinocilium =Stimulation Deflection of stereocilia away from kinocilium = Inhibition

Vestibular receptors

Static Equilibrium
Inside the vestibule are two chambers :
utricle and saccule.

Regions of hair cells and supporting cells called maculae. Otoliths ear rocks

The Utricle and Saccule

Present in the vestibule of the labyrinth Utricle is vertically oriented Saccule is horizontally oriented

Sensory hair cells are embedded in the maculae of the utricle and saccule
Hair cells are covered by a membrane called otolithic membrane

Maculae

The Semicircular Canals

1. Fluid filled

2. Each canal has a dilated end = Ampulla

3. The ampulla houses the sensory hair cells which are covered by a gelatinous material a. Ampulla b. Cristae = hair cells c. Cupulae = gelatinous material

the vestibular labyrinth

Anterior

Anatomy: Maculae of Utricle or Saccule Physiology: Linear acceleration of head

Otolithic membrane

Hair cell

Vestibular pathways
the vestibulo-ocular reflex is an example of a reflexive eye movement that exists between semicircular canals and nuclei controlling extrinsic eye muscles

Vestibulo-Ocular Reflex (VOR)

STIMULUS = Head movement
Center

Efferent = oculomotor nerves Effector = Extra-ocular muscles

Afferent = vestibular nerve

Sensory = Vestibular HC

Vestibulo-ocular Helps maintain stability of visual field Leads to physiologic nystagmus

Vestibular pathways
1st order sensory neurons:
- dendrites surround base of hair cells in vestibule and semicircular canals - cell bodies located in the vestibular ganglion - the vestibular ganglion lies in a swelling of the vestibular nerve within the internal auditory meatus - about 20,000 axons join to form vestibular nerve, which joins cochlear nerve to form vestibulocochlear nerve - vestibular nerve portion projects to the ipsilateral complex of four major vestibular nuclei in the dorsal part of the pons and medulla - axons of 1st order sensory neurons synapses with 2nd order sensory neurons (interneurons) in the vestibular nuclei

Vestibular pathways

Vestibular pathways
2nd order sensory neurons in vestibular nuclei
-

integrate signals from vestibular organs with those from o spinal cord o cerebellum o visual system project to 3rd order sensory neurons in o the ventral nuclei of the thalamus o oculomotor nuclei o reticular centers occupied with skeletal movement o spinal centers occupied with skeletal movement o vestibulocerebellum

Vestibular processing areas

3rd order sensory neurons
in the ventral thalamus send axons to synapse with neurons in vestibular area (Brodmanns area 2V and 3a) of the primary somatosensory cortex the cortex uses the information from the vestibular apparatus (acceleration and angular rotation) to generate a subjective measure of selfmovement and the external world

THE END