上海中医药大学：《健康评估》课程教学资源（PPT课件）神经系统检查 Neurological Assessment（主讲：董璐）

Neurological 神堡冤统检查 Assessment 主 NEURO 人重路

Glossary palpable ÷contraction proprioceptive cognitive *ataxia ipsilateral

Glossary v palpable v contraction v proprioceptive v cognitive v ataxia v ipsilateral

需要的器具 大头针 95 874 2043 笔式电筒 压舌板 棉签 128Hz音义 叩诊锤 检眼镜

Six Parts of Neuro Exam 1.Mental State 2.Cognitive Function 3.Cranial Nerves 4.Motor System 5.Sensory System The Reflex Tester..... It's a kick in the chin! 6.Reflexes

Six Parts of Neuro Exam 1. Mental State 2. Cognitive Function 3. Cranial Nerves 4. Motor System 5. Sensory System 6. Reflexes

MOTOR SYSTEM-Motor Function Voluntary movement Involuntary movement ÷Muscle power肌力 ÷Muscle Tone肌张力 Muscle Bulk肌

MOTOR SYSTEM - Motor Function v Muscle power 肌力 v Muscle Tone 肌张力 v Muscle Bulk 肌

Voluntary movement-Muscle power ( Classic grading scores Classification 0 no contraction 。单瘫：一侧肢体 1.palpable contraction; little visible 偏瘫：一侧肢体；同侧中 2.horizontally along bed 枢性面瘫及舌瘫 surface ·截瘫：双下肢 3.against gravity only; 4.against gravity ÷交叉瘫：同侧周围性脑 resistance; 神经麻痹；对侧肢体中 5.full strength 枢性偏瘫

Voluntary movement - Muscle power (肌力) 0 no contraction 1. palpable contraction; little visible 2. horizontally along bed surface 3. against gravity only; 4. against gravity & resistance; 5. full strength v 单瘫:一侧肢体 v 偏瘫:一侧肢体;同侧中 枢性面瘫及舌瘫 v 截瘫:双下肢 v 交叉瘫:同侧周围性脑 神经麻痹;对侧肢体中 枢性偏瘫

Voluntary movement Muscle Tone Muscle Bulk Decreased Atrophy萎缩 Floppy Fasciculation -Flaccid 肌束颤动 -Hypotonic张力减退 Normal Increased -Spastic痉挛的 -Rigid

Decreased – Floppy – Flaccid – Hypotonic 张力减退 Normal Increased – Spastic 痉挛的 – Rigid Voluntary movement Atrophy 萎缩 Fasciculation 肌束颤动

Involuntary movement 1.hand tremor resting senile kinetic postural 2.Tetany

Involuntary movement • resting • senile • kinetic • postural

录像 米不自主运动 米患者的姿势 米是否有肌肉萎缩 米步态 米肌张力 嘱患者放松 伸、屈患者的腕、肘、肩关节 。 伸、屈患者的膝、踝关节

录像 ã 不自主运动 ã 患者的姿势 ã 是否有肌肉萎缩 ã 步态 ã 肌张力 • 嘱患者放松 • 伸、屈患者的腕、肘、肩关节 • 伸、屈患者的膝、踝关节

Gait and Balance Assessment