II Cranial nerves 1. Smell 2. Vision-field, acuity, abnormal eye movement 3. Pupil size, reactions 4. Fundi 5. Ocular movement, squint, nystagmus, ptosis, sun-set sign 6. Jaw movement, jaw jerk, facial sensation corneal reflex 7. Ear examination hearing vestibular function 8. Paltal movement, gag reflex 9. Rotate head, elevate shoulders extend neck 10. Tongue-protrusion atrophy fasciculation, percussion-myotonla 回复旦大学上海医学院儿科学系
II. Cranial nerves 1. Smell 2. Vision-field, acuity, abnormal eye movement 3. Pupil size, reactions 4. Fundi 5. Ocular movement, squint, nystangmus, ptosis, sun-set sign 6. Jaw movement, jaw jerk, facial sensation & corneal reflex 7. Ear examination, hearing, vestibular function 8. Paltal movement, gag reflex 9. Rotate head, elevate shoulders, extend neck 10. Tongue-protrusion, atrophy, fasciculation, percussion-myotonia
III Motor Functions 1. Observe spontaneous posture movement Lying, sitting, standing, walking, running, climbing descending, grasping, manipulation 2. Muscle bulk, consistency 3. Muscle tone- fasciculation myotonia 4. Muscle power, joint by joint 5. Ataxia -Truncal while sitting standing Limds: Reaching Finger-nose, Heel-knee Rapid alternating movements 6. Involuntary movement-Chorea, athetosis, dystonia tremor, myoclonus at rest and on movement 回复旦大学上海医学院儿科学系
III. Motor Functions 1. Observe spontaneous posture & movement: – Lying, sitting, standing, walking, running, climbing & descending, grasping, manipulation. 2. Muscle bulk, consistency 3. Muscle tone – fasciculation, myotonia 4. Muscle power, joint by joint 5. Ataxia – Truncal while sitting & standing – Limds: Reaching, Finger-nose, Heel-knee Rapid alternating movements 6. Involuntary movement – Chorea, athetosis, dystonia tremor, myoclonus, at rest and on movement
VI ensation 1. Superficial: touch pain, temperature 2. Proprioceptive: position - joint vibration 3. Cortical: stereognosis, graphesthesia, 2 point discrimination, texture, shape, weight 4. Special: hearing( and comprehension),taste, Sight( and comprehension ), smell 5. Sensori-motor co-ordination 回复旦大学上海医学院儿科学系
VI. Sensation 1. Superficial: touch, pain, temperature 2. Proprioceptive: position – joint, vibration 3. Cortical: stereognosis, graphaesthesia, 2 point discrimination, texture, shape, weight 4. Special: hearing( and comprehension), taste, Sight ( and comprehension ), smell 5. Sensori–motor co-ordination
V Reflexes 1. Tendox reflexes 2. Superficial -anal, plantar 3. Clonus 4. Babinski, Gordon, Chaddock, Oppenheim, Hoffmann 5. Meningeal irritation -stiff neck, Kerning/ Brudzinsk signs 回复旦大学上海医学院儿科学系
V. Reflexes 1. Tendox reflexes 2. Superficial – anal, plantar 3. Clonus 4. Babinski, Gordon, Chaddock, Oppenheim, Hoffmann 5. Meningeal irritation – stiff neck, Kerning/Brudzinsk signs
1. Infectious Disease of cns ◆ Clinical Findings: fever, malaise, hypothermia headache mental status, seizures focal deficits meningeal irritation(+)/a bulging fontanelle Babinski, Gordon, Chaddock, Oppenheim(+) Laboratory Findings CSF/EEG /CT mri (+ Differential microbes viral, bacterial, tuberculous, cryptococcus Ce ebrospirel fluid drawn trom botcon two wcrtchrso Metnig's sign bnkmncts nsc sian ADAM PADAM 國)复旦大学上海医学院儿科学系
Clinical Findings: – fever, malaise, hypothermia – headache, mental status, seizures, focal deficits – meningeal irritation(+) / a bulging fontanelle Babinski, Gordon, Chaddock, Oppenheim (+) Laboratory Findings: CSF / EEG / CT & MRI (+) Differential microbes: – viral, bacterial, tuberculous, cryptococcus…… 1. Infectious Disease of CNS