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Localization in neurology 1

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Localization in neurology 1

  1. 1. Localization in Neurology- 1 Anatomical & pathological correlation
  2. 2. Brain functions
  3. 3. Extrapyramidal system  Afferent-  Caudate nucleus  Globus pallidus  Efferent-  Putamen  Substantia nigra  Subthalamic nucleus
  4. 4. Cerebellum  Coordination  Vermis- axial & Lobes- I/L appendicular  3 peduncles  Superior- midbrain- efferent  Middle- pons- afferent  Inferior- medulla- afferent
  5. 5. Blood supply of brain  Internal carotid  MCA  ACA  Subclavian artery  Vertebral artery-2 Ant. spinal artery-1 PICApost. spinal artery-2  Basilar artery-1 AICA SCA PCA  Circle of Willis  AC-ACA-MCA-PC-PCA
  6. 6. Blood supply
  7. 7. Blood supply
  8. 8. Venous drainage of brain
  9. 9. Blood supply to spinal cord  Anterior 2/3rd - ASA  Posterior 1/3rd - PSA
  10. 10. Cranial n. nuclei  Midbrain III, IV  Pons V-VIII  Medulla IX-XII
  11. 11. Motor pathways
  12. 12. Sensory pathways
  13. 13. Spinal tracts
  14. 14. Tracts  Motor-  Corticospinal- cross at medulla Medial Lateral- C.T.L.S  Sensory-  Spinothalamic- pain & temperature- cross at spinal level Medial Lateral- C.T.L.S  Posterior column- touch, position, vibration- cross at medulla Medial Lateral- S.L.T.C
  15. 15. Motor & sensory units
  16. 16. Autonomic nervous system  Sympathetic Thoraco-lumbar  Parasympathetic Cranio-sacral (III, VII, IX, X cranial n. have parasympathetic nuclei)
  17. 17. ANS  Involuntary, independent  Located outside cerebrospinal axis  Most organs have both S & PS supply; adrenal, hair follicles, sweat glands, blood vessels- S supply only  Lateral horn  Ganglia  Organ pregang. fibres postgang. fibres all Ach S-NE, PS-Ach  Central regulation- frontal lobe, limbic system, hypothalamus
  18. 18. CNS- pathology  Vascular- infarct or hemorrhage  Infection- myelitis or encephalitis  Abscess  Meningitis  Trauma  Demyelination  Degenerative  Tumor/SOL  Congenital or hereditary  Nutritional  Metabolic  Toxins/Poisoning  Psychogenic
  19. 19. Practical localization  Is CNS involved?  At what level- cerebral cortexmuscle?  What system(s) is/are involved?  Consciousness, language, vision  Motor function, coordination  Pain/temperature, proprioception/vibration  Process- focal/multifocal/diffuse?  Lateralization- Left/Right/bilateral?  Onset, progression & course?
  20. 20. Practical pathology  Onset-  Acute- vascular/electrical  Subacute- demyelinating/inflammatory  Chronic- structural/degenerative  Course-  Self-limiting- vascular  Paroxysmal- electrical/demyelinating  Progressive- compressive/degenerative  Circumstances-  Preceding viral infection- demyelinating  Preceding trauma- structural  Peripartum- venous thrombosis etc.

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