上海交通大学：《诊断学》课程PPT教学课件（英语版）Chapter 19 NEUROLOGICAL EXAMINATION

NEUROLOGICAL EXAMINATION Dr Lu Qinshi Dept Neurology, Ren Ji Hospital Shanghai Second Medical University Te:63260930-2217 Email:ginchilu(@hotmail.com

NEUROLOGICAL EXAMINATION Dr. Lu Qinchi Dept. Neurology, Ren Ji Hospital Shanghai Second Medical University Tel: 63260930-2217 Email: qinchilu@hotmail.com

IMPORTANTCE Despite recent advances in neuroscience and the continuing development of sensitive diagnostic procedures, the essential skill required for the diagnosis remains the clinical neurologic examination o Most neurologic diagnosis can be made on the basis of the history alone

IMPORTANTCE! ⚫ Despite recent advances in neuroscience and the continuing development of sensitive diagnostic procedures, the essential skill required for the diagnosis remains the clinical neurologic examination ⚫ Most neurologic diagnosis can be made on the basis of the history alone

SIX PARTS OF THE NEURO EXAM o Mental state cognitive Function ● Cranial nerves o Motor system Sensory System ● Reflexes

SIX PARTS OF THE NEURO EXAM ⚫ Mental State & Cognitive Function ⚫ Cranial Nerves ⚫ Motor System ⚫ Sensory System ⚫ Reflexes

MEnTAL STATE& COGNITIVE FUNCTION

⚫MENTAL STATE& COGNITIVE FUNCTION

Mental State Cognitive Function Level of consciousness(Mental State) ● NORMAI: patient awake and alert, attentive to surrounding and to the examiner ● DEPRESSED: Sleepy Lethargic Stuporous-arrousing only briefly in response to pain stimulation Comatose-not arousable by pain stimulation

Mental State & Cognitive Function -Level of consciousness( Mental State) ⚫ NORMAL: – patient awake and alert, attentive to surrounding and to the examiner ⚫ DEPRESSED: – Sleepy – Lethargic – Stuporous-arrousing only briefly in response to pain stimulation – Comatose-not arousable by pain stimulation

The Glasgow coma scale en Spontaneously To verbal command No response Best motor response To verbal command Obeys To pair simulus Localises pain Flex Extension No response Best verbal response Orientated b 432165432154321 Ite Incomprehensible sounds No response

Mental State Cognitive Function Cognitive function check list o A. Orientation to person, place, and time o B Commom knowledge such as who is the president” o C Memory: Short term-name three common objects. then name them again after 5 minutes: Long term-verifiable events from the past

Mental State & Cognitive Function -Cognitive function check list ⚫ A. Orientation to person, place, and time. ⚫ B. Commom knowledge such as “ who is the president” ⚫ C. Memory: Short term-name three common objects, then name them again after 5 minutes; Long term-verifiable events from the past

Mental State Cognitive Function Cognitive function check list o D. Calculations: Serial sevens: count backward from 100, taking away 7 each time. Real-life problem ●E. Abstract though:“ How is an apple different from -or the same as- an orange o FOther: Insight and judgment, concentration verbal fluency, patients mood, content of though, appropriateness of behavior, and so on

Mental State & Cognitive Function -Cognitive function check list ⚫ D. Calculations: Serial sevens: count backward from 100, taking away 7 each time. Real-life problem ⚫ E. Abstract though: “ How is an apple different from –or the same as – an orange ⚫ F.Other: Insight and judgment, concentration, verbal fluency, patients mood, content of though, appropriateness of behavior, and so on

Mental State Cognitive Function Language functioning check-up ● Broca’ s Aphasias ● Wernicke's Aphasias o Conductional Aphasias

Mental State & Cognitive Function -Language functioning check-up ⚫ Broca’s Aphasias ⚫ Wernicke’s Aphasias ⚫ Conductional Aphasias

CRANIAL NERVES

⚫CRANIAL NERVES