（优质医学）颅神经解剖及功能定位.ppt

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Light-near dissociation, refers to a condition where the light reflex is absent or abnormal but the near response is intact. There is no clinical condition in which the light reflex is present and the near response is absent. Millard Gubler syndrom： 同侧展、面神经周围性瘫, 对侧肢体瘫。 Foville syndrome：病灶侧外展神经麻痹，双眼向病灶侧凝视麻痹，对侧肢体瘫。 * 图p37 * 延髓： Wallenberg‘s syndrome：同侧Ⅸ、Ⅹ颅神经麻痹，交叉性感觉障碍，同侧共济失调，同侧霍纳征。 Jackson syndrome：病灶侧周围性舌下神经瘫，对侧肢体瘫。见于延髓前部橄榄体内侧病变。 * 图p35 * * * * * * * * * * * * * * * * * * * * * * * An optic nerve with mild swelling (papilledema). Note the pathologicC-shaped halo of edema surrounding the optic disk (Grade I papilledema). * Grade I papilledema, Another example of an optic nerve with mild papilledema. * Grade II papilledema. The halo of edema now surrounds the optic disc. * Grade IV papillededema. With more severe swelling in addition to a circumferential halo, the edema covers major blood vessels as they leave the optic disk (grade III) and vessels on the disk (grade IV). A subretinal hemorrhage is present at 7 oclock. * * Pseudopapilledema. A patient with an elevated optic nerve present since birth. There is no halo, no major vessel covering a small nerve with abnormal vessel branching and tortuosity. Pseudopapilledema is apparent optic disc swelling that simulates papilledema but is usually secondary to an underlying benign process. * 《Clinical manifestation》 * Cochlear nerve lesion: 耳鸣、听觉过敏及听幻觉: 听力减退或丧失: * 传导性耳聋与感音性耳聋的鉴别诊断 正常 传导性耳聋 感音性耳聋 听力 正常 减退 减退 Rene test 气导骨导（阳性） 骨导气导（阴性） 气导骨导（弱阳性） Weber test 正中位 偏向病侧 偏向健侧 病变部位 声音传导装置(鼓膜、听骨等) 迷路及听神经纤维至听觉中枢(颞横回) * * Vestibular nerve lesion： 1. 眩晕 Vertigo: 眩晕是一种自身或外界物体的运动幻觉。 平衡三联：视觉系统