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BRAIN POWER!

BRAIN POWER!. “ Any fool can know. The point is to understand.” -Albert Einstein Chapter 8. DISEASES OF THE NERVOUS SYSTEM. CHAPTER 8. Neurological Diseases. PNS. Anatomy of the Nervous System. Central Nervous System (CNS) Brain, spinal cord

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BRAIN POWER!

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  1. BRAIN POWER! “Any fool can know. The point is to understand.” -Albert Einstein Chapter 8

  2. DISEASES OF THE NERVOUS SYSTEM CHAPTER 8

  3. Neurological Diseases PNS

  4. Anatomy of the Nervous System • Central Nervous System (CNS) • Brain, spinal cord • Peripheral Nervous System (PNS-Links CNS to body) • Cranial nerves (from brain) • Peripheral nerves (from spinal cord) • Autonomic nervous system controls smooth muscle and cardiac muscle • Parasympathetic vs. Sympathetic Nervous system • Somatic (voluntary) system – skeletal m.

  5. Cranial nerves

  6. Mneumonics • Olfactory, Optic, Oculomotor, Trochlear, Trigeminal, Abducens, Facial, Vestibulocochlear, Glossopharyngeal, Vagus, Accessory, Hypoglossal • “Oh, Oh, Oh, To Touch And Feel Various Girl's Very Angelic Hands” • “Some Say Marry Money, But My Brother Says Big Business Makes Money”

  7. Neurological Exam • Observe • Attitude, mentation (alert, lethargic, coma, etc), Gait • Agitation, anxiety • Seizures • Posture (Higher center) • Upright or sternal • Head tilt (vestibular?VIII) • Wide based stance (ataxia, weakness)

  8. Neuro Exam • Gait • Walking and running on flat, non-slippery surface • Walk slowly back and forth with turns and circles • Proprioceptive deficits (knuckling)-spinal cord defect • Paresis (weakness)/paralysis (no movement) – cerebral cortex, brainstem, spinal cord or peripheral spinal nerves or muscles • Circling/pacing – • Tight circling with head tilt – vestibular (VIII) • With dementia – ipsilateral cerebral cortex

  9. Posterior Paresis • Reflexes present or exaggerated • in the rear legs if lesion is between • T3-L3 • Reflexes are • diminished or • absent in the rear legs if lesion is between • L4-S2

  10. Neuro Exam http://www.youtube.com/watch?v=0QOKPFMt0Rc&feature=endscreen&NR=1 • Ataxia/incoordination – cerebellum, vestibular system, or spinal cord • Dysmetria - cerebellar • Hypermetria – too long movements • Hypometria – movements too short

  11. Neurologic Exam • Cranial Nerves • - I (S) Olfactory: ether /alcohol on cotton—will pull away • - II (S) Optic: follow moving objects; drop cotton ball • - III (M), IV (M), VI (M) Oculomotor, trochlear, abducent: look up, down, sideways • - V (B) Trigeminal: sensory to face, motor to muscles of mastication, weakness in jaw muscles

  12. Neurologic Exam • VII (M) Facial: unilateral droop; drool; no menace • VIII (S) Vestibulocochlear: balance (nystagmus, head tilt); hearing • IX (B), X (B), XI (M) Glossopharyngeal, Vagus, Accessory: swallowing; muscle atrophy • XII (M) Hypoglossal: loss of tongue movement; unilateral atrophy

  13. Neuro Exam – Cranial Nerves • Blind II • No menace II/VII • Anisocoria II, III • Atrophy of temporal muscles V • Dropped jaw V • Nares, lip pinch, cornea V • Inside ear • Lip/ear droop VII • No blink VII • Head tilt VIII

  14. Neuro exam – Cranial Nerves • Nystagmus VIII • Deafness VIII • Difficulty swallowing IX, X • Loss of gag reflex IX, X • Laryngeal paralysis IX, X • Weakness, asymmetry of tongue XII

  15. Cranial nerve http://www.youtube.com/watch?v=S8f9-GPW9IE&feature=related

  16. Female Brain

  17. Male Brain

  18. Neuro Exam http://www.youtube.com/watch?v=IXpGX6xhJdM • Postural reactions • Knuckling • Hopping • Wheelbarrowing • Hemiwalking

  19. Knuckling

  20. Neuro Exam • Muscle Tone • Atrophy – occurs slowly from disuse • Rapidly from nerve damage • Lower Motor Neuron signs – decreased reflexes and muscle tone (spinal cord) • Upper Motor Neuron – reflexes & muscle tone increased (brain) • Test by flexing/extending joints

  21. Neuro exam – Spinal Reflexes Thoracic limb withdrawal – pinch toe Patellar – strike patellar ligament – extension of stifle Pelvic limb withdrawal – pinch toe Sciatic – Strike between greater trochanter and ischium – flexion of stifle and hock Cranial tibial – strike cranial tibial m just below proximal end of tibia – flex hock Perineal – pinch perineum/anus – anal sphincter contraction, tuck tail Panniculus – stimulate skin over dorsum just lateral to vertebral column – twitch of cutaneous trunci m.

  22. Neuro Exam: Upper Motor Neuron vs. Lower Motor Neuron signs UMN LMN Muscle tone N or I D Spinal reflexes N or I D Motor fxn Spastic Flaccid Muscle atrophy Mild Severe disuse neuro Bladder Tense Flaccid

  23. Patellar Reflex

  24. Patellar Reflex

  25. Reflex examination http://www.youtube.com/watch?v=NFqFABsIa7Q&feature=related

  26. Pelvic Limb Withdrawal – Or Not

  27. Panniculus Test

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