神经系查体333(最新整理版).pptxVIP

great clinicians could pinpoint a lesion in the nervous systemwith often astounding accuracy. Today, with the availability of modern imaging techniques, the neurologic examremains a critical way in the clinical decision-making process. All these questions can quickly be answered by a carefully performed neurologic exam;病史采集及神经系统 查体;病史采集;一、现病史;一、现病史;对下列症状必须作重点询问;对下列症状必须作重点询问;对下列症状必须作重点询问;对下列症状必须作重点询问;二、既往史;三、个人史;四、家族史;In addition, we will briefly discuss which neuroanatomic systems are tested by each part of the neurologic exam, so that its functional and practical relevance will be better appreciated.;需要的器具;The neurologic examis part of the general physical examination. Thus, the neurologic examshould always be preceded by and interpreted in the context of a more general examination including vital signs, heart, lungs, abdomen, etc.;The neurologic examination is always performed and recorded in a sequential and uniformmanner in order to avoid omissions and to facilitate the subsequent analysis of case records.;一. 意识及精神状态;1. 意识状态检查;1. 意识状态检查;２．记忆,思维,情感,智能;３．言语;二．颅神经（cranial nerve）;I – 嗅神经 (olfactory nerve);.;II – 视神经－眼底检查;Test Extraocular Movements Stand or sit 3 to 6 feet in front of the patient. Ask the patient to follow your finger with their eyes without moving their head. Check gaze in the six cardinal directions using a cross or H pattern. Pause during upward and lateral gaze to check for nystagmus. [6] Check convergence by moving your finger toward the bridge of the patients nose. Test Pupillary Reactions to Light Dimthe roomlights as necessary. Ask the patient to look into the distance. Shine a bright light obliquely into each pupil in turn. Look for both the direct (same eye) and consensual (other eye) reactions. Record pupil size in mmand any asymmetry or irregularity;IV – 滑车神经;VI – 外展神经 (abducent nerve);眼睑运动;Test Temporal and Masseter Muscle Strength Ask patient to both open their mouth and clench their teeth. Palpate the temporal and massetter muscles as