感觉系统症状1.pptVIP

SENSORY MODALITY Figure 10-3: Two-point discrimination SENSORY MODALITY Figure 10-6: Lateral inhibition DORSAL COLUMN DAMAGE dorsal column pathway Left spinal cord injury Loss of sense of: touch proprioception vibration in left leg DORSAL COLUMN DAMAGE Sensory ataxia Patient staggers; cannot perceive position or movement of legs Visual clues help movement 由于传导痛觉、温度觉的传入纤维在进入脊髓后→在进入水平的 1-2个节段内更换神经元并交叉到对侧；而传导轻触(- 压)觉的传入纤维在进入脊髓后分成上行和下行纤维，分别在多个节段内更换神经元并交叉到对侧，因而发生上述痛、温觉受损而触觉保留现象。 3.头面部的感觉传导路： Facial sensory pathway 触觉、本体感觉的传入冲动 ↓ 三叉神经主核、中脑核中继换元 痛觉、温度觉的传入冲动 ↓ 三叉神经脊束核中继换元 发出第Ⅱ级纤维→越至对侧→三叉丘系→丘脑后内侧腹核 SENSORY SYNDROMES 1. Peripheral nerve: according to the distribution area of the affected nerve Polyneuropathy: glove – stocking distribution, more pronaunced distaly, more on the lower extremities Dorsal root ganglia or radicular laesions: segmental, localised to dermatomes SENSORY SYNDROMES 2. Spinal cord: -complete cord lesion -hemisection of spinal cord : Brown – Sequard syndrome -central cord lesion (Syringomyelia, dissociated sensory loss: loss of pain and temperature, preservation of proprioception) -posterior tract lesion (funicular myelosis: loss of proprioception, ataxia) -conus laesion (sensory loss of sacral area, “saddle anaesthesia) Brain stem: Wallenberg syndrome Thalamus: Dejerine – Roussy syndrome (contralateral hemihypaesthesia, ataxia, pain) Sensory cortex: contralateral hemihypaesthesia SENSORY SYNDROMES – SPINAL GANGLION SENSORY SYNDROMES – FUNICULAR MYELOSIS SENSORY SYNDROMES SENSORY SYNDROMES SENSORY SYNDROMES SENSORY SYNDROMES 谢谢 感觉神经系统症状 郑州大学第一附属医院神经内科 苗 旺 GENERAL PROPERTIES OF SENSORY SYSTEMS Figure 10-4: Sensory pathways 1. SENSORY RECEPTORS A: Free nerve endings (pain, temperature) B: Pacinian corpuscle (pressure) C: Meissner’s corpuscle (touch) D: Muscle spindle (stretch) A B C D SENSORY RECEPTOR TYPES Figure 10-1: Sensory receptors Ruffinis endings respond to tension and stre