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introductiontoneurology, nerves,, anatomy
- 2. WHAT IS NEUROLOGY? Neurology is the branch of medicine that deals with diseases of the nervous system.
- 4. 1.Cerebrum 2. Brain stem 3. Cerebellum Intracraniia all pa art Spinal pa art Spinal cord & Cauda equina
- 5. Cerebrum Two cerebral hemispheres Connected to: 1. each other by corpus callosum 2. brain stem by cerebral peduncles
- 6. EACH CEREBRAL HEMISPHEREDEVIDED INTO : four lobes: 1. Frontal 2. Parietal 3. Temporal 4. Occipital
- 8. Brain stem Formed of : Midbrain Pons Medulla Connected to: 1. Cerebral hemisphere by cerebral peduncles 2. Cerbellum by cerebellar peduncles
- 9. Contains: • CN 3,4 in midbrain • CN 5,6,7,8 in pons • CN 9,10,11,12 in medulla
- 10. Names of cranial nerves • • • • • • • • • • • • Ⅰ Olfactory nerve Ⅱ Optic nerve Ⅲ Oculomotor nerve Ⅳ Trochlear nerve Ⅴ Trigeminal nerve Ⅵ Abducent nerve Ⅶ Facial nerve Ⅷ Vestibulocochlear nerve Ⅸ Glossopharyngeal nerve Ⅹ Vagus nerve Ⅺ Accessory nerve Ⅻ Hypoglossal nerve
- 11. Classification of cranial nerves • • • Sensory cranial nerves: contain only afferent (sensory) fibers – ⅠOlfactory nerve – ⅡOptic nerve – Ⅷ Vestibulocochlear nerve Motor cranial nerves: contain only efferent (motor) fibers – Ⅲ Oculomotor nerve – Ⅳ Trochlear nerve – ⅥAbducent nerve – Ⅺ Accessory nerv – Ⅻ Hypoglossal nerve Mixed nerves: contain both sensory and motor fibers--- – ⅤTrigeminal nerve, – Ⅶ Facial nerve, – ⅨGlossopharyngeal nerve – ⅩVagus nerve
- 12. Sensory cranial nerves N. Name Ⅰ Olfactory Function Smell Ⅱ optic Vision Equilibrim Ⅷ Vestibular part Cochlear part Hearing Assessment Examination of smell Acuity, field & fundus Caloric and rotational chair Watch test, weber test
- 13. Motor cranial nerves N. Name Ⅲ Oculomotor Function Motor to superior, inferior and medial recti; inferior oblique & levator palpebrae superioris Assessment Ptosis, pupil, eye movements & squint Parasympathetic to sphincter papillae and ciliary muscle Ⅳ Trochlear Motor to superior oblique Ⅵ Abducent Motor to lateral rectus Ⅺ Accessory Motor to sternocleidomastoid and trapezius Ⅻ Hypoglossal Motor to muscles of tongue Look to opposite shoulder Lateral eye movement Elevaton of shoulders and neck rotation Tongue movements
- 14. Mixed cranial nerves N. Name V Trigeminal Function Muscles of mastication & sensations of face Assessment Face sensations & power of muscles of mastication VII Facial X Vagus Muscles of facial expression & taste sensation in ant. 1/3 of tongue Palatal and pharyngeal reflexes & movements of uvula XII Glossopharyng- eal Muscles of facial expression & taste sensation in ant. 1/3 of tongue Sensation and movements of Larynx, pharynx, thoracic and abdominal organs Taste in post 2/3 of tongue & gen. sensation Taste & general sensation and pharyngeal reflex
- 15. Cerebellum • Behind the brain stem • Formed of : medline vermis two cerebellar hemispheres • Composed of : outer grey matter and inner White matter
- 16. MB Pons C MO Superior peduncle connects cerebellum with midbrain. Middle peduncle connects cerebellum with pons. Inferior peduncle connects cerebellum with medulla oblongata Cerebellar peduncles
- 17. left hemisphere right hemisphere Hemispheres and vermis vermis Cerebellar hemispheres are the two bilateral structures. Vermis is the unpaired midline structure between the two hemispheres.
- 18. Spinal cord • Inside spinal canal • End at lower border of L1 • The lowest 3 segments = Conus • The above 4 segments = Epiconus • Inner grey matter and outer white matter
- 19. Cauda equina • Lumbosacral roots collection fills the lower part of the spinal canal bellow L1
- 20. Cauda equina Brachial plexus Lumbosacral plexus Cervical enlargement Lumbosacral enlargement
- 22. Peripheral nervous system • A.H.Cs • Roots • Plexuses • Peripheral nerves
- 24. Motor pathway
- 25. UMNL LMNL Tone Increased, with ‘clasp knife’ quality Decreased Clonus Present Absent Fasciculations Absent Present Muscle Wasting Absent, but disuse atrophy eventually results Present (within 2-3 weeks) Tendon Reflexes Increased. Extensor plantar reflexes. Decreased or absent. Flexor plantar reflexes. Distribution Whole limbs, with more weakness in the upper limb extensors and lower limb flexors Specific muscle groups affected (e.g. in the distribution of a spinal segment, or just the proximal muscles, etc.)