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Objectives
Overview basic neuroanatomy Outline CNS and PNS examination Common neurolological deficits and
their causes
http://www.medem.com/MedLB/article_detaillb.cfm?article_ID=ZZZ0ZFP46JC&sub_cat=75
http://www.apparelyzed.com/spinalcord.html
1 - Olfactory 2 - Optic 3 - Oculomotor 4 - Trochlear 5 - Trigeminal 6 - Abducens 7 - Facial 8 - Vestibulocochlea 9 - Glossopharyngea 10 - Vagus 11 - Accessory 12 - Hypoglossal
http://library.thinkquest.org/11965/html/cyber-anatomy_ner692.html
http://www.alsa.org/images/cms/Research/Topics/disease_process.jpg
Olfactory
Have you had any change in your
sense of smell recently? if correctly identified. practice.
(Can
To complete my examination I
http://www.unmc.edu/Physiology/Mann/mann7.html
Make a H pattern with your finger. Do you see double anywhere? Look for nystagmus.
http://www.fotosearch.com/comp/LIF/LIF118/SA702031.jpg
Trigeminal Nerve
Two parts: - Sensory to face - Motor to muscles of mastication Assess sensation to face Determine if patient can open
mouth.
Facial Nerve
Must assess at least 3 muscle
groups
Raise your eyebrows Show me your teeth Puff out your cheeks
Vestibulocochlear
Grossly assess by rustling fingers at
one ear and whispering in opposite. Rhines tests
Accessory
Put hand on one cheek, push me
away, and feel sternocleidomastoid bulk on opposite side.
Hypoglossal
Stick out your tongue Look for deviation TOWARDS
affected side.
Inspection
Look for muscle wasting, scars,
abnormal movements, fasciculations.
Tone
Assess tone in upper limb by
holding hand and moving wrist. by rolling leg and looking at ankle movement, or lifting up leg by knee and dropping onto bed.
Power
Best assessed by moving joint into
neutral and moving all power groups in turn against your resistance. compare like with like. strong as you!
Reflexes
Elicit biceps, triceps and supinator
in upper limb. response.
Sensation
Place finger at a stretch from theirs. Look for intention tremor and pass
pointing.
Lower limb:
Place the heel of your right foot on Repeat for left hand side.
left knee and run foot down left shin and back to knee as fast as possible.
Patterns of disease
Upper motor neurone pathlogy
(stroke)
Cerebellar Disease
Trauma, alcohol, SOL, old age
D A N I S H P
ysdiadokinesis taxia ystagmus ntenion tremor tacatto speech ypotonia endular reflexes
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Summary
Outlined basic neuroanatomy Highlighted key aspects of
examination