4.图解神经科查体.pptVIP

Coordination * Romberg Test Meningeal irritation neck stiffness * Meningeal irritation Kernigs test * Lasegues Test Meningeal irritation Brudzinskis test * Gait Parkinson’s * rising from the sitting position * The Examination of a Comatose or Stuporous Patient Glascow Coma Scale I. Motor Response 6 - Obeys commands fully 5 - Localizes to noxious stimuli 4 - Withdraws from noxious stimuli 3 - Abnormal flexion, i.e. decorticate posturing 2 - Extensor response, i.e. decerebrate posturing 1 - No response II. Verbal Response 5 - Alert and Oriented 4 - Confused, yet coherent, speech 3 - Inappropriate words, and jarbled phrases consisting of words 2 - Incomprehensible sounds 1 - No sounds III. Eye Opening 4 - Spontaneous eye opening 3 - Eyes open to speech 2 - Eyes open to pain 1 - No eye opening Glascow Coma Scale = I + II + III. A lower score indicates a deeper coma and a poorer prognosis. * Thank you! * Knee flexion L5 and S1 the sciatic nerve * Ankle dorsiflexion L4 and L5 the peroneal nerve * Ankle plantar flexion S1 and S2 the tibial nerve * move the large toe up towards the patients face L5 * The Sensory System Examination Pain sensation (pin prick) Light touch sensation (brush) Position sense Stereognosia Graphesthesia Extinction. * Pain and Light Touch Sensation * The corresponding nerve root for each area 1. posterior aspect of the shoulders (C4)2. lateral aspect of the upper arms (C5) 3. medial aspect of the lower arms (T1)4. tip of the thumb (C6)5. tip of the middle finger (C7)6. tip of the pinky finger (C8)7. thorax, nipple level (T5)8. thorax, umbilical level (T10)9. upper part of the upper leg (L2)10. lower-medial part of the upper leg (L3)11. medial lower leg (L4)12. lateral lower leg (L5)13. sole of foot (S1) * Position Sense * vibratory sensation * Stereognosia * Graphesthesia * Extinction * Deep Tendon Reflexes 4+ Very brisk, hyperreflexive, with clonus 3+ Brisker or more refl