神经系统体查与腰椎穿刺 课件.ppt

神经系统体查与腰椎穿刺Neurological Examination and Lumbar Puncture;outline;神经系统体格检查;神经系统体格检查;神经系统体格检查;神经系统体格检查;神经系统体格检查;神经系统体格检查;神经系统体格检查;神经系统体格检查;神经系统体格检查;神经系统体格检查;神经系统体格检查;神经系统体格检查;神经系统体格检查;神经系统体格检查;神经系统体格检查;神经系统体格检查;神经系统体格检查;神经系统体格检查;神经系统体格检查;神经系统体格检查;意识障碍检查;意识障碍检查;意识障碍检查;意识障碍检查;意识障碍检查;意识障碍检查;意识障碍检查;意识障碍检查;意识障碍检查;意识障碍检查;精神状态和高级皮质功能检查;精神状态和皮质功能;精神状态和皮质功能;精神状态和皮质功能;精神状态和皮质功能;精神状态和皮质功能;精神状态和皮质功能;Type of Dysphasia;精神状态和皮质功能;精神状态和皮质功能;精神状态和皮质功能;精神状态和皮质功能;精神状态和皮质功能;颅神经检查;颅神经检查;颅神经检查;颅神经检查;颅神经检查;颅神经检查;颅神经检查;颅神经检查;Papilledema. Note swelling of the disc, hemorrhages, and exudates, with preservation of the physiologic cup ;Optic Atrophy. Note the chalky white disc with discrete margins. Optic atrophy is a late finding with increased intracranial pressure. ;颅神经检查;Note extra-ocular muscle palsies and horizontal or vertical nystagmus.;The limitation of movement of both eyes in one direction is called a conjugate lesion or gaze palsy, and is indicative of a central lesion it can be either supranuclear (in cortical gaze centers) or nuclear (in brain stem gaze centers). Disconjugate lesions internuclear ophthalmoplegia (INO). isolated impairment of adduction of one eye, nystagmus is often present ipsilateral median longitudinal fasciculus (MLF) lesion. Gaze-evoked nystagmus (nystagmus that is apparent only when the patient looks to the side or down) may be caused by many drugs, including ethanol, barbiturates, and phenytoin (Dilantin). Ethanol and barbiturates (recreational or therapuetic) are the most common cause of nystagmus ;Ocular bobbing is the rhythmical conjugate deviation of the eyes downward. characteristic of damage to the pons. Downbeat nystagmus indicate a lesion compressing on the cervicomedullary junction ;颅神经检查;颅神经检查;颅神经检查;The Weber test(256Hz). Normally, the sound is heard in the center of the head or equally in both ears. conductive hearing loss the vibration will be louder on the affected;The Rinne test place the butt on the mastoid eminence firmly. Tell