Dizziness in orthopaedic physical therapy practice: vestibular system anatomy, vascularization, and physiology with clinical implications
Journal Title: Rehabilitacja Medyczna - Year 2005, Vol 9, Issue 4
Abstract
Dizziness is a frequent complaint in orthopaedic physical therapy and general medical practice. It can result from dysfunctions in multiple body systems relevant to balance control. Knowledge of vestibular anatomy, vascular supply, and vestibular and visual system physiology is a necessary prerequisite for the successful clinical diagnosis and management of patients complaining of dizziness. This article discusses peripheral and central vestibular anatomy and relevant afferent and efferent pathways with emphasis on the vestibuloocular, vestibulo-spinal, and vestibulo-collic reflex circuits. The article also provides information on vestibular system vascularization and vestibular and relevant visual system physiology including a discussion of the contribution to gaze stabilization by the vestibuloocular and cervico-ocular reflex circuits, the smooth pursuit and saccadic systems, and the optokinetic response. The basic science information provided is made clinically relevant by discussing specific clinical implications for evaluation and management of patients with a main complaint of dizziness clarifying the need for comprehensive multi-system evaluation in this patient group.
Authors and Affiliations
Peter Huijbregts, Paul Vidal
Keywords
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