1. The document discusses the 12 cranial nerves, their names and functions.
2. It describes how the cranial nerves exit from the bottom of the brainstem through various holes in the skull to innervate their target structures.
3. The nerves are involved in senses such as smell, vision, and hearing as well as motor functions like eye movement, facial expressions, and tongue movement.
1.picture of tongue
2. Cadaveric picture of tongue
3. Introduction of tongue
4. function of tongue
5. presenting parts
6. parts of tongue
7. diagram of tongue
8. Base of tongue
9. Dorsal surface of tongue
10. Papillae
11. Histology of papillae
12. Ventral surface of tongue
13 ventral surface
14. lateral margin of tongue
15. root of tongue
16. Muscles of tongue
17.Muscles diagram
18. Genioglossus
19.Hyoglossus
20. Superficial relation of hyoglossus
21. Deep relation of hyoglossus
22.Styloglossus
23.Palatoglossus
24.Intrinsic muscles of tongue
25.Muscles altering the shape of the tongue
26.Nerve supply of tongue
27.Sensory nerve supply of tongue
28.motor supply- diagram
29. sensory supply- diagram
30. Taste sensation part
31. Lymphatic Drainage
32.Pecularities of lymphatic drainage
33. Applied Anatomy
34. Tongue Tie
35.Bifid tongue
36. Lingual thyroid & Thyroglossal cyst
37.glossitis
38.Carcinoma of the tongue
39. Identify the structures
40. Thank you
This presentation contains the detailed description about the courses, branches and supply of the Trigeminal Nerve, contains variations of maxillary nerve & Mandibular Nerve, and the detail about trigeminal Neurolgia and its managements
Prakruty is a Sansakrit language word and means for Constitution of human body charesteristics and their recognition through sign and symptoms. This is very necessary when Ayurveda treatment is given. This is one of the basic fundamentals of Ayurvedic Medical science. How a physician will be able to detect the Prakruty, is dependent upon the signs of the body. In this slide show the reader will find the glimps of the different functions and signs to recognise the prakruty.
1.picture of tongue
2. Cadaveric picture of tongue
3. Introduction of tongue
4. function of tongue
5. presenting parts
6. parts of tongue
7. diagram of tongue
8. Base of tongue
9. Dorsal surface of tongue
10. Papillae
11. Histology of papillae
12. Ventral surface of tongue
13 ventral surface
14. lateral margin of tongue
15. root of tongue
16. Muscles of tongue
17.Muscles diagram
18. Genioglossus
19.Hyoglossus
20. Superficial relation of hyoglossus
21. Deep relation of hyoglossus
22.Styloglossus
23.Palatoglossus
24.Intrinsic muscles of tongue
25.Muscles altering the shape of the tongue
26.Nerve supply of tongue
27.Sensory nerve supply of tongue
28.motor supply- diagram
29. sensory supply- diagram
30. Taste sensation part
31. Lymphatic Drainage
32.Pecularities of lymphatic drainage
33. Applied Anatomy
34. Tongue Tie
35.Bifid tongue
36. Lingual thyroid & Thyroglossal cyst
37.glossitis
38.Carcinoma of the tongue
39. Identify the structures
40. Thank you
This presentation contains the detailed description about the courses, branches and supply of the Trigeminal Nerve, contains variations of maxillary nerve & Mandibular Nerve, and the detail about trigeminal Neurolgia and its managements
Prakruty is a Sansakrit language word and means for Constitution of human body charesteristics and their recognition through sign and symptoms. This is very necessary when Ayurveda treatment is given. This is one of the basic fundamentals of Ayurvedic Medical science. How a physician will be able to detect the Prakruty, is dependent upon the signs of the body. In this slide show the reader will find the glimps of the different functions and signs to recognise the prakruty.
Cranial nerve assessment..Simple and Easy to perform for medics and Physiothe...pawan1physiotherapy
Cranial Nerve Assessment is a crucial step in neurological assessment. By following the simple theoretical aspects it can be made on your fingertips....here is an try to make the stuff easier for you....
Psoriasis Ayurvedic Treatment Centre in Punjab, IndiaDr. Amit Dutta
Welcome to Dr. Amit Dutta’s :: AYUR - SUDHA ::: Advanced Ayurveda Skin Treatment Centre, a new kind of SKIN CARE organization. This site has information on Ayurveda and skin diseases, which is very good for your health and a leading Ayurvedic Medicine. Ayurveda is very popular in India and now is getting popular around the world. Herbs play a big part in Ayurveda, as does meditation.
Super Speciality Ayurveda Centre , FOR SKIN DISEASES is a Holistic Centre devoted to Ayurvedic Treatment & research run by highly qualified group of professionals.
AYUR SUDHA :: Super Speciality Ayurveda Centre
67 A , Guru Ravidass Nagar, Nr. Guru Ravidass Chowk
Jalandhar , Punjab , India
+91.98033.56060
+91.98030.39369
info@ayursudha.com
ayur.sudha@ymail.com
www.ayursudha.com
www.dramitdutta.com
www.ayursudha.ca
Training Program for Panchakarma Assistant
(20-24/05-2024)
Department of Panchkarma, Gurukul Campus
Uttarakhand Ayurved University, Haridwar, Uttarakhand
Training Program for Panchakarma Assistant
(20-24/05-2024)
Department of Panchkarma, Gurukul Campus
Uttarakhand Ayurved University, Haridwar, Uttarakhand
Technoayurveda’s Practical SOP Panchakarma - 2nd edition
by Ayurmitra Prof Prasad KSR & Prof Meena S Deogade
High lights: 4 sections, 38 Chapters, A4 size 272 + 18 Pages Full color
Detailed Explanation, SOP formats with appropriate illustrations
Paper: 70 GSM Maplitho (Text) 300 GSM Art Card (Cover)
Pages: 292 (Text) 4 Pages (Cover)
Print: 4-color (1-sided & inner side no print) (Text and Cover)
Size: 8.25 x 10.75 inches
Finish: Matte Lamination for Cover & Back, Perfect-binding for book with side-stitching
More Details of the Book at - https://technoayurveda.com/practical-sop-panchakarma/
Ayurmitra Nadi Bhishak Jyotisha Vaidya Prof Dr KSR Prasad explanation on Ayur-Jyotisham (Ayurveda Astrology) on the basis of Nakshatra Vriksha and Unique method of technoayurveda developed Cosmic anatomy and Cosmic Energy Garden - Jyotisha (Nakshtra) Vana.
Virechana Introduction, Seasonal administration and Agni intervention Guest lecture by Ayurmitra Nadibhishak, Jyotisha Vaidya Dr KSR Prasad at GAC Varanasi
Ayurmitra & Nadi Guru
Prof KSR Prasad (Technoayurveda)
9290566566/9503227966 / technoayurveda@yahoo.com
Lifestyle is a combination of determining intangible or tangible factors – the diseases generates because of are Lifestyle disorders
Jariatric (Geriatric) Psychological Trauma Management Through Ayurveda by Ayurmitra, Nadi Bhishak Prof KSR Prasad on 20-02-2021 @ SHRI HINGULAMBIKA AYURVEDIC MEDICAL COLLEGE AND HOSPITAL KALABURGI, KANATAKA
Selection of Bahya Snehana Techniques in Panchakarma by Ayurmitra, Nadi Bhishak, Prof KSR Prasad (Technoayurveda), Professor & Head, Panchakarma, LN Ayurved College, Bhopal, MP, 9290566566/9503227966 - technoayurveda@yahoo.com at eAyurshala Web Learning Ayurved Academy online lecture series on *Keraliya Panchakarma, 21st October 2020
Role of Vamana & Virechana in Lifestyle disorders by Ayurmitra Nadi Bhishak Prof KSR Prasad (Technoayurveda) in National Webinar On Role of Panchakarma in Lifestyle Disorders
On 15-09-2020 @ 2PM Panchakarma Dept, Govt PG Ayurveda College, Varanasi
Ayurmitra Nadi Bhishak Prof KSR Prasad (Technoayurveda) lecture on Precautionary measures & post COVID
management through Panchakarma
All Panchakarma are done even in COVID and
post COVID situations as per Ayurveda principles
following precautions
Viruddha Ahara referred in terms of food to food interactions or food processing interactions develops Toxicity because of antagonism. - by Ayurmitra Nadi Guru Prof KSR Prasad (Technoayurveda) 9290566566/9503227966 ‐ technoayurveda@yahoo.com
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
NVBDCP.pptx Nation vector borne disease control program
Cranial nerve exmination
1. To
CLINICAL ANATOMY OF CRANIAL NERVES
By
y
Dr . Giridhar M Kanthi
Prof & Head
Dept of Basic principles
S D M College of Ayurveda. Udupi
8/23/2011 Dr G M Kanthi Prof S D M C A Udupi 1
2. “ You have I nose & II eyes ”
“ h & ”
I ‐ Olfactory n. & II ‐ Optic n.
I ‐ Olfactory n & II ‐ Optic n
8/23/2011 Dr G M Kanthi Prof S D M C A Udupi 2
4. The cranial nerves all exit from the bottom surface of the brain and brainstem
and exit the skull through various holes (foramina) to reach their targets
targets.
Cranial Nerve 1 Smell
Cranial Nerve 2 Vision
Cranial Nerve 3 Eye movement
Cranial Nerve 4
Cranial Nerve 4 Eye movement
Eye movement
Cranial Nerve 5 Facial sensation
Cranial Nerve 6 Eye movement
Cranial Nerve 7 Facial movement
Cranial Nerve 8 Hearing and balance
Cranial Nerve 9
C i lN 9 Organs and Taste
O dT t
Cranial Nerve 10 Organs and Taste
Cranial Nerve 11 g
Shoulder shrug & head turn
Cranial Nerve 12 Tongue movement
8/23/2011 Dr G M Kanthi Prof S D M C A Udupi 4
6. Olfactory Nerve C N I
CN II
C N IV
C N IV
C N III
C N V
C N VI
C N VII
C N VII
C N VIII
C N IX
C N X
C N XI C N XII
7. 1. One I ‐ Olfactory
I On
II Old 2. Of
2 Of II ‐ Optic
III Olympus 3. Our III – IV – VI ‐ Extraoculars
IV Towering 4. Trained
4 T i d III – Oculomotor
V Trigeminal
V Tops 5. Teacher IV – Trochlear
6. Asked
6 Asked VII
VII ‐ Facial VII ‐
VII Abducent
VI A
VI A
VII Finn 7. For VIII ‐ Vestibulocochlear
VIII And
VIII And 8. A
8 A
IX ‐ Glossopharyngeal,
IX German 9. Good
X ‐ Vagus
X Viewed
X Viewed 10. Vehicle
10. Vehicle
XI Astounding 11. And XI: Accessory
XII Hops 12. Horse
XII: Hypoglossal
XII H l l
8/23/2011 Dr G M Kanthi Prof S D M C A Udupi 7
8. Extraocular muscles
“ LR 6 ‐ SO 4 ‐ Rest 3 "
“ LR 6 SO 4 R 3"
LR 6 Lateral Rectus ‐‐> VI abducens
SO4 Superior Oblique ‐‐> IV Trochlear
Remaining 4 eyeball movers ‐‐> III oculomotor
8/23/2011 Dr G M Kanthi Prof S D M C A Udupi 8
10. I ‐ Olfactory
Fore brain
II ‐ Optic
II O ti
III – Oculomotor
Mid brain
Mid b i
IV – Trochlear
V Trigeminal
V Trigeminal
VII ‐ Abducent
Pons
VII ‐ Facial
VIII ‐ Vestibulocochlear
IX Glossopharyngeal,
IX ‐ Glossopharyngeal
X ‐ Vagus
Medulla
XI: Accessory
y
XII: Hypoglossal
8/23/2011 Dr G M Kanthi Prof S D M C A Udupi 10
11. Some
I Some (Sensory)
Says
II Say (Sensory)
Marry
III Marry (primarily Motor)
Money
IV Money, (primarily Motor)
But V But (Both)
My VI My (primarily Motor)
Brother VII Brother (Both)
Says VIII Says
VIII Says (Sensory)
IX Big (Both)
Bad
X
X Bras
Bras (Both)
Business
XI Matter (primarily Motor)
Marry
XII More (p
(primarily Motor)
y )
Money
8/23/2011 Dr G M Kanthi Prof S D M C A Udupi 11
12. Summary of the Cranial Nerves
I ‐ Smell
II ‐ Vision ‐ Visual acuity, visual fields and ocular function
II, III ‐ Pupillary reactions
III, IV, VI ‐ Extra‐ocular movements, including opening
III IV VI E t l t i l di i
of the eyes & eye movement
of the eyes & eye movement
p
ptosis (III nerve) and pupil reaction to light (II & III nerve)
( ) p p g ( )
8/23/2011 Dr G M Kanthi Prof S D M C A Udupi 12
13. Paralysis of ( III ) oculomotor nerve
Results
Partial ptosis
Dilation of pupil
Loss of accommodation
Diplopia
Lateral squint
8/23/2011 Dr G M Kanthi Prof S D M C A Udupi 13
14. V ‐ Facial sensation, movements of the
jaw, and corneal reflexes
VII ‐ Facial movements and gustation
VIII ‐ Hearing and balance
8/23/2011 Dr G M Kanthi Prof S D M C A Udupi 14
15. IX, X ‐ Swallowing, elevation of the palate, gag reflex and
gustation
V, VII, X, XII ‐ Voice and speech
XI ‐ Shrugging the shoulders and turning the head
XII ‐ Movement and protrusion of tongue
XII M t d t i ft
8/23/2011 Dr G M Kanthi Prof S D M C A Udupi 15
16. Olfactory Nerve – Cranial Nerve 1
The olfactory nerve is essentially responsible for the sense of smell.
It courses along the base of the frontal lobes and perforates through
the base of the skull and rests inside the roof of the nose.
Recently, these nerves have received additional interest because of their
potential for involvement in the harvest of naturally existing stem cells.
8/23/2011 Dr G M Kanthi Prof S D M C A Udupi 16
17. Olfactory Nerve
Olf N
Olfactory Bulb
Olfactory Tract
Test each nostril with essence bottles
of coffee, vanilla, peppermint.
8/23/2011 Dr G M Kanthi Prof S D M C A Udupi 17
18. Evaluate the potency of the nasal passages bilaterally
Inform to close the eyes
Cranial Nerve I
place a small bar of soap near the patent nostril
ask the patient to smell the object
This part of the exam is often omitted
unless their is a reported history suggesting head
trauma or toxic inhalation.
t t i i h l ti
Very little localizing information can be obtained
8/23/2011 Dr G M Kanthi Prof S D M C A Udupi 18
19. The olfactory nerve is essentially responsible for the sense of smell.
Gather some items with distinctive smells
(for example, cloves, lemon, chocolate or coffee).
Test each nostril with essence bottles of coffee, vanilla, peppermint.
C. N I. video
8/23/2011 Dr G M Kanthi Prof S D M C A Udupi 19
20. 8/23/2011 Dr G M Kanthi Prof S D M C A Udupi 20
21. Cranial Nerve II
Using an ophthalmoscope,
Observe the optic disc
Retinal vessels a d fovea
e a esse s and o ea
Note the pulsations of the optic vessels
Check for a blurring of the optic disc margin
Change in the optic disc's color form its
normal yellowish orange
y g
8/23/2011 Dr G M Kanthi Prof S D M C A Udupi 21
22. The initial change in the ophthalmoscopic examination
in a patient with increased intracranial pressure
is the loss of pulsations of the retinal vessels.
This is followed b bl i of th optic di margin
Thi i f ll d by blurring f the ti disc i
and possibly retinal hemorrhages.
p y g
8/23/2011 Dr G M Kanthi Prof S D M C A Udupi 22
23. Cranial Nerve II
Visual acuity by using a
pocket visual acuity chart
Visual acuity
Evaluate the visual fields,
color vision, and optic disc appearance
visual fields
8/23/2011 Dr G M Kanthi Prof S D M C A Udupi 23
24. Observe the diameter of the pupils in a dimly
Cranial Nerves II and III
light room.
Shine the penlight light into one eye at a time
and check both the direct and consensual light
responses i each pupil.
in h il
Note the symmetry between the pupils.
Test for pupillary constriction
Note their size and possible asymmetry
asymmetry.
8/23/2011 Dr G M Kanthi Prof S D M C A Udupi 24
26. Ptosis is the lagging of an eyelid.
The ptosis from a III nerve palsy is of greater
severity than the ptosis due to a lesion of the
sympathetic pathway,
Anisocoria is a neurological term indicating
that one pupil is larger than another.
8/23/2011 Dr G M Kanthi Prof S D M C A Udupi 26
27. 8/23/2011 Dr G M Kanthi Prof S D M C A Udupi 27
31. 8/23/2011 Dr G M Kanthi Prof S D M C A Udupi 31
32. A problem with the oculomotor nerve might result in
double vision when looking at near object and cause
trouble when reading.
trouble when reading.
The trochlear nerve is responsible for internal rotation of the eye.
A problem with this nerve often is noticed by the patient as they
have trouble walking down stairs.
abducens nerve is responsible for moving each eye temporally – or
away from the nose. A problem with the sixth nerve results in double
f th A bl ith th i th lt i d bl
vision on looking at distant objects.
8/23/2011 Dr G M Kanthi Prof S D M C A Udupi 32
34. Trigeminal Nerve ‐ Cranial Nerve 5
The trigeminal nerve is one of the largest cranial nerves.
It also has many functions.
The entire sensation from the face, the forehead, the cheeks,
and the jaw are returned to the brain from the three different
divisions of this nerve.
8/23/2011 Dr G M Kanthi Prof S D M C A Udupi 34
35. 8/23/2011 Dr G M Kanthi Prof S D M C A Udupi 35
36. 8/23/2011 Dr G M Kanthi Prof S D M C A Udupi 36
37. Trigeminal Nerve ‐ Cranial Nerve 5
Three different divisions of this nerve.
1. Opthalmic br. ‐ Sensory to Fore head, air sinus, Eyeball (ciliary, eyelids)
side & tip of nose, and lacrimal gland
2. Maxillary br. ‐ Middle cranial fossa, pterygopalatine fossa,
Imfraorbital canal, and Face
3. Mandibular br. ‐ t
3 M dib l b pterygoid, lingual, mylohyoid, and diagastricz
id li l l h id d di ti
8/23/2011 Dr G M Kanthi Prof S D M C A Udupi 37
38. Cranial Nerve – V
Test for ‐ Jaw power
Trigeminal
Sensation of face
Corneal and jaw reflexes
Corneal and jaw reflexes
1. Palpate the masseter muscles
2. Note masseter wasting on observation
3. Ask the patient to open their mouth against
resistance applied by the instructor at the base
of the patient's chin.
8/23/2011 Dr G M Kanthi Prof S D M C A Udupi 38
39. 4. Test gross sensation –
Tell the patient to close their eyes and say "sharp" or
"dull" when they feel an object touch their face
"d ll" h th f l bj t t h th i f
5. Ask the patient to also compare the strength
p p g
of the sensation of both sides
6. Touch the patient above each temple, next
to the nose and on each side of the chin
h d h id f h hi
7. Test the corneal reflex ‐ look for the eye to blink
8/23/2011 Dr G M Kanthi Prof S D M C A Udupi 39
40. Trigeminal Nerve ‐ Cranial Nerve 5
• Corneal reflex: patient looks up and away.
• Touch cotton wool to other side.
• Look for blink in both eyes, ask if can sense it.
• Repeat other side [tests V sensory, VII motor].
•F i l
Facial sensation: sterile sharp item on forehead, cheek, jaw.
ti t il h it f h d h k j
• Repeat with dull object. Ask to report sharp or dull.
• If abnormal, then temperature [heated/ water‐cooled tuning fork],
light touch [cotton].
light touch [cotton].
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41. Trigeminal Nerve ‐ Cranial Nerve 5
• Motor: pt opens mouth, clenches teeth (pterygoids).
• Palpate temporal, masseter muscles as they clench.
• Test jaw jerk:
Test jaw jerk:
Dr's finger on tip of jaw.
Grip patellar hammer halfway up shaft and tap Dr's finger lightly.
Usually nothing happens, or just a slight closure.
If increased closure, think UMNL, esp pseudobulbar palsy.
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43. Cranial Nerve VII – Facial
1. inspect the face during conversation and
rest, noting any facial asymmetry
2. Drooping, sagging or smoothing of normal
2 D i i hi f l
facial creases.
3. Ask the patient to raise their eyebrows,
smile showing their teeth,
Branches of the facial nerve
"Ten Zombies Bought My Car“
Temporal, Zygomatic, Buccal, Masseteric, Cervical
Temporal Zygomatic Buccal Masseteric Cervical
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45. Auditory Nerve ‐ Cranial Nerve 8
Another name for the auditory nerve is the vestibulo‐cochlear nerve.
It is so called this because it serves 2 purposes.
The hearing or sound information is transmitted back to the
brain through the cochlear nerve.
b i h h h hl
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46. The balance information is transmitted through the vestibular
g
portion of the nerve.
There is a fairly well known tumor although misnamed
called an Acoustic Neuroma which arises from this nerve.
ll d h h f h
It is misnamed because this commonly benign tumor actually arises from
It is misnamed because this commonly benign tumor actually arises from
the vestibular nerve and is not a nerve tumor as the name implies.
Vestibular test
Vestibular test
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47. Cranial Nerve VIII ‐ Auditory
Rinne's test
The Rinne’s test compares air conduction to
bone conduction.
bone conduction
Perform an otoscopic examination of both
Eardrums to rule out a severe otitis media
Occlusion of the external auditory meatus
Occlusion of the external auditory meatus
Perforation of the tympanic membrane
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48. Cranial Nerve VIII ‐ Auditory
Assess hearing
A h i
1. By instructing the patient to close their eyes,
Vigorously rub your fingers together very near
to the ear.
to the ear.
2. The sound was the same in both ears, or
louder in a specific ears
3. If there is lateralization or hearing
abnormalities perform the Rinne and Weber Tests
Weber’s test
The Weber test is a test for lateralization
Th W b t t i t t f l t li ti
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53. • Rinne's test: Air vs. Bone Conduction
• 512/ 1024 Hz [256 if deaf] vibrating fork on mastoid behind ear.
Ask when stop hearing it.
• When stop hearing it, move to the patients ear so can hear it.
• Normal: air conduction [ear] better than bone conduction [mastoid].
• If indicated, look at external auditory canals, eardrums.
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54. Cranial Nerves IX and X
The functions of the glossopharyngeal and the vagus nerve
are too many to list. In essence, these two nerves take to and
from the brain information regarding swallowing, taste, voice,
organ function, heart rate, abdominal function, etc.
In fact, vagus means wandering in Latin.
In fact vagus means wandering in Latin
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56. Glossopharyngeal and Vagus Nerve ‐ Cranial Nerve 9,10
The vagus nerve actually starts from the brain and is continuous all
the way through and even reaches the intestines.
Since there are so many functions of this nerve,
the signal from the body also have to be returned to many
parts of the brain through the same nerve as well.
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57. Interestingly, it was discovered that this nerve
could serve as a conduit through which to treat epilepsy – or seizures.
A neurosurgeon can surgically wrap and electrode around this nerve and
connect it to a pacemaker device which can then be used to treat epilepsy
t it t k d i hi h th b d t t t il
in some patients
in some patients
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59. Cranial Nerves IX and X - Glossopharyngeal & Vagus
Soft palate elevation,
Ask the patient to swallow and note any
Deviation & Gag reflex
difficulty doing so.
difficulty doing so
Note the quality and sound of the patient's
voice. Is it hoarse or nasal ?
observe the soft palate, uvula and pharynx.
observe the soft palate uvula and pharynx
The soft palate should rise symmetrically,
the uvula should remain midline
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60. •Pt says "Ah": symmetrical soft palate movement.
Pt "Ah" t i l ft l t t
Gag reflex [sensory IX, motor X]:
Gag reflex [sensory IX motor X]:
• Stimulate back of throat each side.
Stimulate back of throat each side.
• Normal to gag each time
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62. Accessory Nerve ‐ Cranial Nerve 11
The accessory nerve is responsible for turning the head,
nodding yes and no, and shrugging the shoulders. Specifically,
it controls the muscles called the sternocleidomastoid and the trapezius.
Since this nerve controls head turning and is a cranial nerve – as
opposed to a spinal nerve, the motion of turning the head is
typically preserved in patients who injure their spinal cords
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64. Cranial Nerve XI - Accessory
Shoulder elevation & turning of neck
with head (trapezius and sternomastoid)
Evaluated by looking for wasting of the
trapezius muscles by observing
i l b b i
Ask the patient to turn their head to
the side as strongly as they possibly
h d l h bl
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66. Hypoglossal Nerve ‐ Cranial Nerve 12
Hypoglossal Nerve ‐ Cranial Nerve 12
The hypoglossal nerve is responsible for the complex movements of the
The hypoglossal nerve is responsible for the complex movements of the
tongue. There is some help from the vagus nerve but three of the four
main tongue muscles are controlled from the hypoglossal nerve.
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67. Cranial Nerve XII – Hypoglossal
yp g
The hypoglossal nerve controls the intrinsic
musculature of the tongue
l t f th t
Tongue function; wasting / fasciculation
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68. Cranial Nerve XII – Hypoglossal
Note is their deviations of the tongue from midline,
Note complete lack of ability to protrude the tongue
Note is there the tongue will be protruded
g p
from the mouth and remain midline.
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71. Dr . Giridhar M Kanthi. B S A M; DHA; Ph.D
Prof & Head
Dept of Basic principles
S D M College of Ayurveda. Udupi. 574 118
Karanataka
Residence – Hudco Colony
L I G 39
Manipal – 576 104
Cell – 9448888378
Land line - 08202570417
E mail – girisha_k @yahoo.com
girishakanthi@gmail.com
giridhar@webduniya.com
giridhar@webduniya com
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