神经系统疾病常见症状与定位_00002.ppt

The 六节Aesthesio-system Distribution of sensory (Mark level) △ mammary papilla plan -----T4 △ nave plan---T10 △ Groin plan ---T12,L1 △ upper limb radialis桡侧---C5--7 △ forearm,hand ulnaris---C8,T2 △ cohort股前---L1—3 see fig Distribution of sensory (Mark level) △ leg anterior---L4--5 △ sole of foot，post-cohort股---S1--2 △ circum-anus and Sella area鞍--S3--5 That are help for localized diagnosis Anatomy of sensory pathways Two main pathways ▲ The dorsal colmn pathway ▲ The spinothalamic pathway inter-or extra- spinal cord lesion neck -tumor in spinal cord， in early of the lesion ▽ inter ----- damage from C---T--L--S and ‘saddle area’ reserved ▽extra----- S--L--T—C and ‘saddle area’ damaged. [clinical classification] Kind of Lesion Locus of Lesion Kind of lesion 1.excitative symptom (1) hypersthesia:light flick, very pain (2)dyseshtesia:no-pain excitat,feel pain (3) hyperpathia: high sensory liminal value , pain prolonged, thalamic damage. Kind of lesion (4) paresthesia:disorder of sensory。 (5) pain 1) local pain 2) radiating pain : from waist to leg, e.g. ischium N. 3) spreading pain : 4) Referred pain:cardiac angina _left shoulder pain Kind of lesion 2.anti-symptom *completely sensory loss ---- all kinds of sensory loss below the level of lesion *part abruption sensory loss-----just some kinds of sensory loss below same damage part . such as, pain loss, but other sensory conservancy。 Locus of lesion 1,End-brush pattern ：Multifocal neuropathy, symetry damage of all extreminities ,for example diabetes disease, B12 deficiency,”glove-and-stocking” sensory loss 4.Conduct band pattern 1) Complete transected damage of spinal cord: Impairment of all sensory modalities below the level of the lesion of the spinal cord 5.Crossign pattern Wallenberg syndrome-- cerebellar posterior and inferior artery had obs