神经系统的评估课件.pptVIP

Neurological Assessment Anatomy of Nervous System Central Brain Spinal cord Peripheral Cranial Nerves Spinal Nerves Brain Cerebral cortex (“rind”) – gray matter Frontal Parietal Temporal Occipital Wernicke’s area – receptive aphasia Broca’s area – expressive aphasia Brain Basal ganglia: motor function Thalamus: relay station Hypothalamus: HR, BP, sleep, etc. Cerebellum: motor coordination Brain stem Midbrain Pons Medulla: respiration, heart, GI function, CN 8 - 12 Spinal Cord Nerve cell bodies arranged in “horns” Nerve pathways cross in the spinal cord Eg. Sensation of the left side of the body enters the left dorsal horn, and crosses to the right ventral horn and travels to right hemisphere Sensation Spinothalamic tract: pain, temperature, crude and light touch Posterior columms: does not cross sides; position, vibration, finely localized touch Spinal Cord Motor pathways Corticospinal (Pyramidal) tract: All go through the medulla’s pyramid Crossed Uncrossed Finer body movements Extrapyramidal Cruder movement (walking) Upper vs Lower motor neurons Peripheral Nervous System Reflex arc Deep tendon reflexes: requires Intact sensory nerve Functional synapse Motor Nerve Competent Muscle Superficial corneal, abdominal Visceral Pupillary light, accommodation Pathologic Cranial Nerves Mnemonic: “Oh Oh Oh, To Taste And Feel Very Good Veal Simply Heaven” Spinal Nerves Cervical 8 Thoracic 12 Lumbar 5 Sacral 5 1 Coccygeal Sensory in dorsal horns; motor in ventral Dermatome Functional Divisions Autonomic vs. Somatic Nervous System Sympathetic vs. Parasympathetic Primary sympathetic neurotransmitter is Norepinephrine, so sympathetic system is called “adrenergic” Primary sympathetic neurotransmitter is Acetylycholine, so parasympathetic system is called “cholinergic” History Headache Head injury Dizziness/Vertigo Seizures Tremors Weakness Incoordination History Cont Numbness or tingling Difficulty Swallowing Difficulty Speaking Environmental/occupational hazards Past Medica