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临床诊断学-神经系统检查英文课件.ppt

发布:2019-02-10约5.35千字共111页下载文档
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A.Muscle Strength The classic grading system scores as follows: 5, full strength; 4, movement against gravity and resistance; 3, movement against gravity only;2, movement horizontally along the surface of the bed;1,palpable contraction but little visible movement; 0, no contraction 运动系统 B.Muscle Tone Decreased( floppy, flaccid, hypotonic) Normal Increased( Spastic vs. Rigid) CRANIAL NERVE -Glossopharyngeal(IX) Vagus(X) Test the function of the palate, pharynx, and larynx 1.Palatal elevation- say “ah” 2.Gag reflex ( afferent IX, efferent X)- gently touch each side of the posterior pharyngeal wall with a cotton swab 3.Sensory function-lightly touch each side of the soft palate with the tip of a cotton swab 4. Voice quality-listen for hoarseness or “breathiness”, suggesting laryngeal weakness CRANIAL NERVE -Accessory (XI) Sternocleidomastoid- press a hand against the patient’s jaw and have the patient rotate the head against resistance. Pressing against the right jaw tests the left sternocleidomastoid and vice versa Trapezius-have the patient shrug shoulders against resistance and assess weakness CRANIAL NERVE -Hypoglossal (XII) Tests for hypoglossal nerve function include the following 1.Atrophy or Fasciculations-with the patient’s tongue resting in the floor of the mouth, first inspect for atrophy or fasciculations. Then ask the patient to protrude the tongue, and observe for deviation to the weak side 2. Subtle Weakness-have the patient push the tongue into each cheek against external resistance(opposite hypoglossal m.) 3. Subtle Dysarthria- Ask the patient to repeat difficult phrases Sensory Function Motor Function 运动系统 Neurological examination Sunran SIX PARTS OF THE NEURO EXAM Mental State Cognitive Function Cranial Nerves Motor System Sensory System Reflexes Autonomic function Mental State -Level of consciousness NORMAL: patient awake and alert, attentive to surrounding and to the examiner DEPRESSED: Sleepy Lethargic Stuporous-arousing only briefly
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