神经系统检查35724幻灯片.pptVIP

Neurological Assessment Glossary palpable contraction proprioceptive cognitive ataxia ipsilateral 需要的器具 Six Parts of Neuro Exam Mental State Cognitive Function Cranial Nerves Motor System Sensory System Reflexes MOTOR SYSTEM - Motor Function Voluntary movement Muscle power 肌力 Muscle Tone 肌张力 Muscle Bulk 肌 Involuntary movement Voluntary movement - Muscle power (肌力) Classic grading scores 0 no contraction palpable contraction; little visible horizontally along bed surface against gravity only; against gravity resistance; full strength Classification 单瘫:一侧肢体 偏瘫:一侧肢体;同侧中枢性面瘫及舌瘫 截瘫:双下肢 交叉瘫:同侧周围性脑神经麻痹;对侧肢体中枢性偏瘫 Voluntary movement Muscle Tone Decreased Floppy Flaccid Hypotonic 张力减退 Normal Increased Spastic 痉挛的 Rigid Involuntary movement hand tremor resting senile kinetic postural Tetany (三)共济运动: 主要评估小脑功能 任何一个动作的完成都必须有一定的肌群参加，如主动肌、对抗肌、协同肌和固定肌等。这些肌群的协调一致主要是靠小脑的功能。此外，前庭神经、视神经、深感觉、锥体外系均参与作用，动作才能协调和平衡，在小脑和前述结构发生病变时．协调动作出现障碍，称为共济失调。 英文？ Ataxia – cerebellum function Ataxia is the shaky and unsteady movements that result from brains failure to regulate posture, strength and direction of movements, most often caused by disease activity in cerebellum. Motor Coordination Gait Cerebellum: coordinating fine-tuning m. (ipsilateral ) Finger-to-Nose Finger -to- Finger Rapid Alternating Movements Heel-Knee-Shin Romberg Romberg’s test quick, excellent screen proprioceptive feedback neuropathy spinal cord disease Sensory Function Sensory Function 检查注意点： 感觉包括痛觉、温度觉、触觉及深感觉检查 检查时应由感觉障碍区向健侧逐步移行， 如感觉过敏也可由健侧向障碍区移行。 遇病人意识欠佳又需检查时、则只能依赖所行刺激引起病人的表情变化，受刺激肢体的回缩等现象粗略估计病人的感觉障碍。 Sensory Function Small-fiber Spinothalamic Function Temperature Sensation Superficial Pain Sensation Light Touch Sensation Large-fiber Dorsal Column Function Vibration Sense Joint Position Sense Sensory Function （一）浅感觉 主要有皮肤、粘膜  的痛觉和触觉 触觉有障碍－后索病变 温觉有障碍－脊髓丘脑侧索损伤 均有障碍－－神经根病变 Sensory Function （二）深感觉 包括关节觉、震 动觉 （三）复合感觉 包括皮肤定位