presented by Laura Morris
This course is part of our NCS Prep-Program. Learn more about the full prep-program here: MedBridge NCS Prep-Program.
Vestibular disorders are a unique diagnostic category, often associated with pathology that affects the peripheral vestibular system. This course highlights the central portion of the vestibular system, including anatomy and normal physiology, as a basis for understanding pathology and management central vestibular disorders.
Laura Morris, PT, NCS is a physical therapist and lecturer with 25 years of experience in the management of adults with neurologic disorders. Her clinical work focuses on vestibular disorders and mild traumatic brain injury at Elmhurst Memorial Hospital in the Chicago area. She is the Director of Communications for the Academy of Neurologic PT of the APTA. She teaches continuing education in concussion and vestibular rehabilitation both nationally and internationally. Her experience includes inpatient and outpatient care, clinical research and program development, including the launch of the fourth credentialed Neurologic PT Residency Program in Pittsburgh. Clinical practice also included vestibular and concussion rehabilitation in Pittsburgh, Pennsylvania, the Mild Brain Injury Program in Baltimore, Maryland and neurologic private practice in Alexandria, Virginia. She was re-credentialed for her as a Neurologic Clinical Specialist in 2013. She has been involved in the Academy of Neurologic PT and the Vestibular special interest group, primarily in positions involving website support. In 2005 she received the Award for Clinical Excellence in Neurology by the Neurology Section of the APTA, and in 2015 received the Service Award from the Vestibular Special Interest Group. Her contributions to the literature include book chapters and journal articles in the area of vestibular disorders and mild brain injury rehabilitation.
It is important to be able to delineate the central vestibular system from the peripheral vestibular system. The signs and symptoms of disorders of each system are unique and differentiation is necessary for efficient clinical management. This chapter addresses the normal anatomy of the central and peripheral vestibular systems. In addition, the primary structures that make up the central vestibular system will be reviewed, including the vestibular nuclei and their integration with the peripheral nervous system.
The peripheral vestibular system gives feedback to balance reflexes that help to maintain upright posture and coordinated movement. These balance reactions are coordinated via descending neural pathways to the musculature that maintains postural control. This chapter reviews the anatomy behind our postural reflexes and coordination of movement by the cerebellum.
Vestibular feedback is essential for sensory organization and conscious experience. The vestibular system also gives input into the functioning of our autonomic nervous system. This chapter reviews the cortical areas that receive vestibular input and the other areas in which ascending pathways give feedback.