Last edited: 9/6/2021

1. SEMICIRCULAR CANALS | CRISTAE AMPULLARIS | BPPV

Special Senses | Semicircular Canals | Cristae Ampularis | BPPV Medical Editor: Dr. Christina Perry

OUTLINE II) INSIDE THE SEMICIRCULAR CANALS

I) SEMICIRCULAR CANALS OVERVIEW REMEMBER: the VESTIBULE contains the outer bony
II) INSIDE THE SEMICIRCULAR CANALS labyrinth which is composed of perilymph fluid (high in
III) INSIDE THE AMPULLA Na+ and low in K+)
IV) INSIDE THE CNS o It contains a special structure inside of it called the
V) VERTIGO & BPPV inner membranous labyrinth which consists of
VI) REVIEW QUESTIONS endolymph (low in Na+ and high in K+)
VII) REFERENCES
NEW: the SEMICIRCULAR CANALS contain the outer
bony labyrinth composed of perilymph
I) SEMICIRCULAR CANALS OVERVIEW
o Inside is the inner membranous labyrinth called the
semicircular ducts which are composed of endolymph
o Special detector (sensory epithelium) located in the
ampulla called the cristae ampularis

III) INSIDE THE AMPULLA

Figure 1: Overview of inner ear structures

Cochlea – role with sound transduction and sound waves
Vestibule – via macula within the utricle and saccule and
their response to linear acceleration and horizontal/
vertical axis and head tilting
Semicircular canals – there are 3 that are oriented in
three different planes (x, y, and x axis) and help to orient
with rotational/angular acceleration
o Dynamic equilibrium*

Figure 3: Inside the ampulla – right side

When the head is rotated to the right, the endolymph will
stay stationary in the ducts due to inertia, but the
semicircular canal will continue to rotate with head
o Results in the endolymph pushes on the cristae
ampularis structure and bends
Hair cells lie under the ampullary cupula – these have
stereocilia that extend into the cupula
o Under the hair cells are afferent nerve terminals that
connect to Scarpa’s (vestibular) ganglion and travels
to the central nervous system
Figure 2: Canal orientation
(1) HORIZONTAL/LATERAL SEMICIRCULAR CANAL
This canal is 25˚ above the horizontal plane

(2) ANTERIOR/SUPERIOR CANAL

This canal is 41˚ anterolateral to the sagittal plane

(3) POSTERIOR CANAL

This canal is 56˚ posterolateral to the sagittal plane

The canals are located 90° from each other and allows
for them to pick up rotations and angular accelerations.

Figure 4: Hair cell depolarization

Semicircular Canals | Cristae Ampullaris | BPPV SPECIAL SENSES: Note #1. 1 of 4

When the cupula bends, the stereocilia beat together
toward the kinocilium and open the channels to allow
Ca2+ and K+ into the cell
The cations rush in  cell depolarization
Ca2+ accumulate and cause synaptoproteins on these
vesicles to fuse with the cell membrane  exocytose
chemicals and release glutamate
o Glutamate will stimulate the afferent nerve terminal
and send action potentials down the peripheral
process to the pseudo-unipolar ganglion and then
down the central processes to the CNS
Ex) If we rotate to the right, inertia causes the
endolymph to push on the ampullary cupula causing the
stereocilia to beat toward the kinocilium
o If they beat toward the kinocilium, it’s going to
stimulate action potentials to Scarpa’s ganglion and
then into the CNS
Figure 5: Ampullopedal movement
When we rotate to the R, the fluid stays stationary due to
inertia  semicircular canals still rotate
Figure 6: Ampullofugal movement
If the endolymph flows away from the cupula, it is called
ampullofugal movement
Figure 7: Hair cell hyperpolarization
2 of 4 SPECIAL SENSES: Note #1.
Stereocilia beat away from the kinocilium, the Ca2+ or K+
will not move into the cell
The cell will then hyperpolarize, and glutamate will not be
released
The afferent nerve terminals will not be stimulated  very
little to no action potentials will be sent to Scarpa’s
ganglion or into the CNS
IV) INSIDE THE CNS
The vestibular branch of CN VIII Vestibulocochlear n. will
exit the skull through the internal acoustic
meatus/canal (IAC) and travel to the medulla
From there, it will travel and synapse on the vestibular
nuclear complex – mainly the medial vestibular nucleus
If the hair cell depolarized, it will stimulate the medial
vestibular nucleus on that side, however, if the hair cell
was hyperpolarized and no action potentials were
created, then the vestibular nucleus on that side will be
inhibited
Figure 8: Stimulating/Inhibiting vestibular nuclei
Medial vestibular nuclei will then cross to the
contralateral side of the medulla to the contralateral
nucleus of CN VI Abducens n.
Action potentials that were sent to the medial vestibular
nucleus will then stimulate the contralateral CN VI nerve
nucleus and send signals to the ipsilateral lateral rectus
Figure 9: CN VI pathway stimulation
The contralateral CN VI nucleus action potentials can
cross again to the contralateral side to the oculomotor
nucleus and stimulate that pathway. This will stimulate
the medial rectus muscle on the contralateral side
Semicircular Canals | Cristae Ampullaris | BPPV

Figure 10: CN III nucleus pathway stimulation
This is what happens with head rotation:
o Head rotates to the left  gaze is stabilized
o The left eye adducts; the right eye abducts
o This is a result of the vestibulocochlear reflex (VOR)
When we run, the image we see is not jumbled or
bounding up and down, it is stabilized.
Due to the semicircular canal, the utricle and the
saccule because they allow for gaze stabilization
On the side where the hair cell hyperpolarized and
inhibited action potentials to the CN VIII nucleus, it also
inhibited potentials to the ipsilateral lateral rectus
muscle as well as the contralateral CN III nucleus
When we rotate our head to the right, the eyes will beat
fast to the left  they will then move back to the right
Frontal eye field is an area on the cerebral cortex that will
send an action potential down to a nucleus in the pons
called the paramedian pontine reticular formation
If we inhibit the left CN VI nerve nucleus from the
paramedian pontine reticular formation, the action
potentials via the right medial longitudinal fasciculus to
the lateral rectus will be inhibited
Action potentials to the right CN III nucleus will also be
inhibited
o Ex) Rotate head to the R  eyes beat to the left 
medial rectus contract on the R eye and lateral rectus
contracted on the L eye
Semicircular Canals | Cristae Ampullaris | BPPV
Figure 11: Eye movements
Eyes beating in the opposite direction is called
saccadic movement
When the eyes beat to both sides, it is called
vestibular nystagmus
o Occurs naturally
o Turning head to right side will activate right
semicircular canals
V) VERTIGO & BPPV
Vertigo = the feeling or sensation that your head and/or
body is rotating and moving around without an actual
stimulus
The otoconia (crystals) in the macula become dislodged
and stuck in the semicircular canals
o The most common canal for the otoconia to become
lodged in is the posterior semicircular canal
 This is called posterior BPPV (benign paroxysmal
positional vertigo)
 Diagnosed via the Dix-Hallpike maneuver
 Eyes will bounce around (rotational nystagmus)
This will then cause action potentials inside the ducts to
go to the CNS which tells us that we are moving/rotating
o This will produce nystagmus
Treatment for posterior BPPV is done with the Epley’s
maneuver
If the otoconia get stuck in the anterior semicircular
canal, it is called anterior BPPV
o Dix-Hallpike maneuver will cause vertical nystagmus
If the otoconia get stuck in the lateral semicircular
nystagmus, it is called lateral semicircular canal BPPV
o Deep head hanging maneuvers will cause horizontal
nystagmus
SPECIAL SENSES: Note #1. 3 of 4
 VI) REVIEW QUESTIONS
T/F: Three semicircular canals work to determine
changes in static equilibrium and linear movement
a. True
b. False

Describe what happens inside the ampularis when

the head is first turned to the R
a. The endolymph will push on the cristae ampularis
b. Glutamate stimulates the afferent nerve terminals
c. Endolymph will stay stationary due to inertia
d. The cell will depolarize

When the stereocilia beat together toward the

kinocilium the hair cell will ________ and allows Ca2+
and K+ into the cell which will then cause a release of
this neurotransmitter
a. Hyperpolarize, Dopamine
b. Hyperpolarize, Glutamate
c. Depolarize, Serotonin
d. Depolarize, Glutamate

T/F: If the endolymph flows away from the cupula, it

is called ampullofugal movement
a. True
b. False
During gaze fixation, when the head is rotated to the
left, the left eye will _____ and the right eye will ______.
a. Abduct, abduct
b. Abduct, adduct
c. Adduct, adduct
d. Adduct, Abduct

This sensation or feeling happens when the brain

senses that the environment around us is moving or
spinning
a. Dizziness
b. Vertigo
c. Meclizine
d. BPPV

This canal is the most common one to have

otoconia become lodged in it, thus creating BPPV
a. Horizontal
b. Lateral
c. Anterior
d. Posterior

This diagnostic test can be performed to determine

if someone has posterior BPPV which can then be
treated by this maneuver
a. Dix-Hallpike, Epley’s maneuver
b. Dix-Hallpike, deep head hanging maneuvers
c. Epley’s maneuver, Dix-Hallpike maneuver
d. Deep head hanging maneuver, Epley’s maneuver

CHECK YOUR ANSWERS

VII) REFERENCES
● Wikimedia Commons. (2017, August 3). Vertigo. Retrieved from
Wikimedia Commons:
https://upload.wikimedia.org/wikipedia/commons/thumb/9/91/Vertigo
.png/768px-Vertigo.png

4 of 4 SPECIAL SENSES: Note #1. Semicircular Canals | Cristae Ampullaris | BPPV