F Neurological Assessment 经系统检 NEURO
神经系统检查 Neurological Assessment 主讲人董璐
Glossary 令 palpable contraction 令 proprioceptive g. cognitive s ataxia 冷 ipsilateral
Glossary ❖ palpable ❖ contraction ❖ proprioceptive ❖ cognitive ❖ ataxia ❖ ipsilateral
需要的器具 大头针 95 874 45 E0。 电筒压舌板 棉 128H音叉叩诊锤 检眼镜
需要的器具 大头针 棉签 128 Hz音叉 叩诊锤 检眼镜 笔式电筒 压舌板
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 Functio Voluntary movement Involuntary movernent 冷 Muscle power肌力 Muscle tone肌张力 Muscle bulk肌
MOTOR SYSTEM - Motor Function Voluntary movement ❖ Muscle power 肌力 ❖ Muscle Tone 肌张力 ❖ Muscle Bulk 肌 Involuntary movement
Voluntary movement- Muscle power(BL/ yy Classic grading scores Classification 0 no contraction 今单瘫:一侧肢体 I. 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 今截瘫双下肢 3. against gravity only 4. against gravI & 交叉瘫同侧周围性脑神 resistance 经麻痹对侧肢体中枢性 5. full strengt 偏瘫
Voluntary movement - Muscle power (肌力) Classic grading scores 0 no contraction 1. palpable contraction; little visible 2. horizontally along bed surface 3. against gravity only; 4. against gravity & resistance; 5. full strength Classification ❖ 单瘫:一侧肢体 ❖ 偏瘫:一侧肢体;同侧中 枢性面瘫及舌瘫 ❖ 截瘫:双下肢 ❖ 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 bullk Decreased Atrophy萎缩 Floppy Fasciculation Flaccid 肌束颤动 Hypotonic张力减退 Normal Increased Spastic痉挛的 Rigid
Muscle Tone Decreased – Floppy – Flaccid – Hypotonic 张力减退 Normal Increased – Spastic 痉挛的 – Rigid Voluntary movement Muscle Bulk Atrophy 萎缩 Fasciculation 肌束颤动
Involuntary movement 1. hand tremor resting senile kinetic postura 2. Tetany
Involuntary movement 1. hand tremor • resting • senile • kinetic • postural 2. Tetany
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 不自主运动 患者的姿势 是否有肌肉萎缩 步态 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