introduction to neurology
DESCRIPTION
Introduction to neurology lecture data show for 5th year studentTRANSCRIPT
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Introduction toIntroduction to
Neurology Neurology
Prof. Mamun SarhanProf. Mamun SarhanHead of NeurologyHead of Neurology DepartmentDepartment
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WHAT IS NEUROLOGY?
Neurology is the branch of medicine that deals with diseases of the nervous system.
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Major divisionsMajor divisions
NervousNervousSystemSystem
CentralCentral nervousnervous systemsystem
PeripheralPeripheralnervousnervoussystemsystem
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1.Cerebrum 2. Brain stem 3. Cerebellum
Intracranial part
Intracranial part
Spinal part
Spinal part
Spinal cord &
Cauda equina
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Cerebrum
Two cerebral hemispheres Connected to:
1. each other by corpus callosum
2. brain stem by cerebral peduncles
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EACH CEREBRAL HEMISPHEREDEVIDED INTO :
four lobes: 1. Frontal
2. Parietal
3. Temporal
4. Occipital
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Brain stem
Formed of :
Midbrain
Pons
Medulla
Connected to:
1. Cerebral hemisphere
by cerebral peduncles
2. Cerbellum by cerebellar
peduncles
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Contains:
• CN 3,4 in midbrain
• CN 5,6,7,8 in pons
• CN 9,10,11,12 in medulla
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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
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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
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Sensory cranial nerves
N. Name Function Assessment
Ⅰ Olfactory Smell Examination of smell
Ⅱ optic Vision Acuity, field & fundus
Ⅷ Vestibular part
Equilibrim Caloric and rotational chair
Cochlear part
Hearing Watch test, weber test
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Motor cranial nervesN. Name Function Assessment
Ⅲ Oculomotor Motor to superior, inferior and medial recti; inferior oblique & levator palpebrae superioris
Ptosis, pupil, eye movements & squint
Parasympathetic to sphincter papillae and ciliary muscle
Ⅳ Trochlear Motor to superior oblique Look to opposite shoulder
Ⅵ Abducent Motor to lateral rectus Lateral eye movement
Ⅺ Accessory Motor to sternocleidomastoid and trapezius
Elevaton of shoulders and neck rotation
Ⅻ Hypoglossal Motor to muscles of tongue Tongue movements
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Mixed cranial nervesN. Name Function Assessment
V Trigeminal Muscles of mastication & sensations of face
Face sensations & power of muscles of mastication
VII Facial Muscles of facial expression & taste sensation in ant. 1/3 of tongue
Muscles of facial expression & taste sensation in ant. 1/3 of tongue
X Vagus Sensation and movements of Larynx, pharynx, thoracic and abdominal organs
Palatal and pharyngeal reflexes & movements of uvula
XII Glossopharyng-eal
Taste in post 2/3 of tongue & gen. sensation
Taste & general sensation and pharyngeal reflex
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Cerebellum
• Behind the brain stem
• Formed of : medline vermis
two cerebellar hemispheres
• Composed of :
outer grey matter and inner
White matter
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MBMB
PonsPons CC
MOMO
Superior peduncle connects cerebellum with midbrain. Middle peduncle connects cerebellum with pons. Inferior peduncle connects cerebellum with medulla oblongata
Cerebellar peduncles
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lefthemisphere
righthemisphere
Hemispheres and vermis
Cerebellar hemispheres are the two bilateral structures.Vermis is the unpaired midline structure between
the two hemispheres.
vermis
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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
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Cauda equina
• Lumbosacral roots collection fills
the lower part of the spinal canal
bellow L1
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Cauda equinaBrachial plexusLumbosacral plexusCervical enlargementLumbosacral enlargement
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Peripheral nervous system
• A.H.Cs
• Roots
• Plexuses
• Peripheral nerves
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Medulla
motor cortex
internal capsule
Uppermotorneuron
Lowermotorneuron
anterior horn cell
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Motor pathway
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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.)
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Thank You!!!