2.神经诊断1.ppt

CN VIII : Vestibulocochlear Nerve (前庭蜗神经) Double Nerves: Cochlear nerve(蜗神经): Part of the auditory system Vestibular nerve(前庭神经): Part of the vestibular system Cochlear Nerve蜗神经 Projects to cochlear nuclei蜗神经核, inferior colliculi medial geniculate Clinical Correlations Deafness Conduction deafness Sensorineural Deafness Central Deafness Tinnitus(耳鸣) Deafness Conduction deafness(传导性耳聋): Caused by an impairment in the conduction of sound through the external ear canal外耳道 Deafness Sensorineural Deafness(感音性耳聋): A loss of function in the sensory receptors in either the cochlea or the auditory nerve. Central Deafness(中枢性耳聋): Caused by the lesion in the brain stem or auditory cortex. Can be caused by a conarial tumor(松果体瘤) Tinnitus耳鸣 The false perception of a sound, or the perception of a sound that is not normally perceived, such as the pulse. 低音性-传导径路-external ear canal 高音性—sensory receptors感受器 Vestibular nerve前庭神经 First Order Neuron: Vestibular ganglion Major Connections: Projects to vestibular nuclei A false sensation of movement that is usually caused by disorders of the vestibular system, including the inner ear and/or parts of the central nervous system Often accompanied by imbalance, nausea and fatigue Clinical - Vertigo (眩晕) Clinical--Nystagmus(眼颤) Peripheral vestibular nystagmus周围性--Results from stimulation of the peripheral vestibular apparatus, usually accompanied by vertigo Central nervous system nystagmus中枢性--Occurs with the lesions in the region of the fourth ventricle. Never associated with vertigo. 垂直性眼颤—脑干被盖部病变特征 CN IX：Glossopharyngeal Nerve舌咽神经  CNⅩ: Vagus Nerve 迷走神经 Clinical Correlations Lesion often involve glossopharyngeal and Vagus Nerve同时受损 Bulbar palsy球麻痹-发音嘶哑,吞咽困难,烟部感觉丧失,咽反射消失 Pseudobulbar palsy假性球麻痹 Hypoglossal Nerve (Ⅻ,舌下神经) Clinical Correlations Unilateral Hypoglossal Nerve Lesion单侧: Deviating toward the side of nerve lesion. Ipsilateral side atrophic同侧 Fasciculations (肌束颤动) Unil