1 / 12

CENTRAL NERVOUS SYSTEM :

CENTRAL NERVOUS SYSTEM :. 1.HIGHER MENTAL FUNCTIONS: 1 . APPEARANCE 2. BEHAVIOUR 11. MEMORY 3 . COGNITIVE 12. SPEECH 4 . DELUSION 5 . EMOTIONAL STATUS 6 . GAIT 7 .HALLUCINATION. 8 . ILLUSION 9 . JUDGEMENT

riva
Download Presentation

CENTRAL NERVOUS SYSTEM :

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. CENTRAL NERVOUS SYSTEM : 1.HIGHER MENTAL FUNCTIONS: 1 . APPEARANCE 2. BEHAVIOUR 11. MEMORY 3 . COGNITIVE 12. SPEECH 4 . DELUSION 5 . EMOTIONAL STATUS 6 . GAIT 7 .HALLUCINATION. 8 . ILLUSION 9 . JUDGEMENT 10 . KNOWLEDGE( i. q)

  2. 2.SIGNS OF MENINGEAL IRRITATION: • NECK RIGIDITY • KERNIG`S SIGN • BRUDZINSKI`S SIGN 3 . CRANIAL NERVE EXAMINATION 4 . SENSORY NERVE EXAMINATION 5 . MOTOR EXAMINATION 6. GAIT

  3. CRANIAL NERVE EXAMINATION Olfactory nerve - CN I : tested easily by having the patient smell common objects such as coffee or perfume Optic nerve - CN II : • Acuity, by using the Snellen chart (near and distant vision) • Visual fields, by means of confrontation or perimetry if indicated • Color, with use of an Ishihara chart or by using common objects, such as a multicolored tie or color markers • Funduscopy

  4. Oculomotor nerve - CN III • Diplopia • Ptosis • Pupils : shape, size, direct light reflex, consensual light reflex, accomodation (distant and near) Trochlear nerve - CN IV : allows a person to view the tip of his or her nose • Downward movement is impaired Abducens nerve - CN VI : • squint (cover and uncover tests and cover – uncover test)

  5. Trigeminal nerve - CN V • Sensory : ophthalmic, maxillary, mandibular and anterior two third of the tongue • Motor : clenching of teeth (masseter and temporalis) • Corneal reflex (E: 7th and A: 5th Nerve) • Ask the patient to open the mouth (deviation on same side)

  6. Facial nerve - CN VII • Wrinkled his forehead or look up above his head • Close the eye (uprolling of the eye) • Inspect the nasolabial fold • Screw your eyes tightly shut and stop me from opening them • Blow out your cheeks with mouth closed • Taste (sweet, salt, sour and bitter) Vestibulocochlear nerve - CN VIII : • tuning fork tests (Rinne`s and Weber`s)

  7. Glossopharyngeal nerve - CN IXVagus nerve - CN X • Pharyngeal and gag reflex are unpleasant for the patient. • Assess the speech • Look the movement of the palate and uvula while the patient says ‘Aaah` Accessory nerve - CN XI : - inspect the sternocleidomastoid muscles,test the power (left : - turn the head to the right), - inspect from behind (wasting or asymmetry) and test the power (shrug the shoulder`s as you apply downward pressure)

  8. Hypoglossal nerve - CN XII • Protrude the tongue: when paralyzed on 1 side, the tongue deviates to the side of paralysis on protrusion. • Test the power (press the tongue against the inside of each cheeks in turn while you press from the outside with your finger)

  9. Motor system • Muscles :- • Bulk • Power (flexion, extension, adduction, abduction, dorsiflexion, inversion, e.t.c) • Tone • Reflexes • Coordination (finger – nose test, heel – shin test)

  10. Muscles power grading • 0 No muscles contraction visible • 1 Feeble contractions but no movement • 2 Movement with gravity eliminated • 3 Movement against gravity • 4 Movement against partial resistance • 5 Full strength Superficial reflexes • corneal, abdominal, cremasteric, and plantar (Babinski) reflexes.

  11. Deep tendon reflexes Upper limbs : • Biceps (thumb): - C5,C6 • Triceps (hold the hand): - C6,C7 • Supinator : - C5,C6 Lower limbs: • Knee jerk: -L3,L4 • Ankle jerk: - S1

  12. Sensory nerve examination Light touch (patient's eyes closed ) :- light touch with a finger, a piece of cotton wool or a piece of tissue paper Sharp touch (pinprick) :- • patient's eyes closed • With disposable pin. • hypoaesthesia (feels blunter) or hyperaesthesia (feels sharper) Temperature: touch the patient with a tuning fork Joint position sense (proprioception): Move the distal phalanx up and down Vibration sense: 128 Hz tuning fork 2-point discrimination:

More Related