Cranial 讲义.ppt

Topical Diagnosis in Neurology Neuroanatomy The nervous system(NS) is composed of the central NS(CNS) and the peripheral NS (PNS). PNS consists of 31 pairs of spinal nerves(8p. cervical n.,12p. Thoracic n, 5p. Lumbar n. 5p.sacral n. 1 coccygeal n.) and 12 pairs of cranial nerves. CNS consists of the brain and the spinal cord. Topical Diagnosis in Neurology Neuroanatomy The brain consists of the paired cerebral hemispheres, the diencephalon (thalamus), the brain stem and cerebellum. The brain stem consists of the midbrain, pons and medulla. The cerebral hemispheres consists of the frontal, parietal, temporal, occipital lobe. The nervous system includes motor system. Somesthetic system and autonomic system. Cranial Nerves I. Olfactory N. II. Optic N. III. Oculomotor N. IV. Trochlear N. V. Trigeminal N. VI. Abducens N. VII. Facial .N VIII. Vestibulocochlear IX. Glossopharyngeal N. X. Vagus N. XI. Accessory N. XII. Hypoglossal N. In patient’s attempts to smile or bare teeth, mouth draws to unaffected side.Patient cannot wink, close eye, or wrinkle forehead on affected side . The Somesthetic System The Somesthetic System is responsible for sensory appreciation. Sensation may be divided into (1) cutaneomucosal sensation (pain, temperature and touch-pressure) (2) deep sensation (sense of vibration and joint position) (3) cortical sensation (stereognosis, two-point discrimination) The Somesthetic System The peripheral receptors include the skin, connective tissue, muscles, joints, and organs (olfaction, vision, and hearing). The Somesthetic System includes the peripheral receptors ,peripheral nerves, sensory root (posterior root), the central sensory tracts (spinothalamic tract and dorsal columns), the thalamus, and the sensory cortex. The localizing diagnosis of the Somesthetic lesions: 1.Peripheral nerve Widespread peripheral disorders in the distal symmetrical extre