Transcript Neurophysiology Chapter 13

Neurophysiology
Chapter 12
Perry C. Hanavan, Au.D.
Basal Ganglia (Nuclei)
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Equilibrium of Neuron
Myelin Sheath and Node of Ranvier
Synaptic Junction
Neurotransmitters
Neuromuscular Junction (Motor Unit)
Muscle Fiber Components
Muscle Spindle
Muscle Spindle Function to Control
Muscle Length
Cranial Nerve-
How to test the nerve-
If the nerve is diseased
or damaged-
1 (one)-to the nose
Can the patient smell strong herbs?
Patient cannot smell anything and may not be
able to taste food very well.
2 (two)-to the eyes
Can the patient count your fingers and tell you
how many you are showing?
Patient loses sight in one or both eyes with no
cataracts or injury.
3 (three), 4 (four), and 6 (six)-to the muscles
that move the eyes, the eyelids and the
pupils
Can the patient open their eyes, look up and
down and to each side? Do they
complain of seeing double? Are the
pupils the same size? They should be.
Shine a light in the patient’s eye and their
pupils should get small. In a dark room,
their pupils should be larger.
Patients may have a droopy eyelid or a very
large pupil that does not get smaller even
when you shine light on the eye. If one
pupil is bigger than the other, one of the
eyes may have an injured nerve. Patients
may complain of double vision.
If the double vision is from a cranial nerve
problem, it will get better when you cover
one eye!!
Sometimes you may see that one eye is not
moving very well. This can be a cranial
nerve problem too.
5 (five)-to the face to feel
Touch the patient’s face lightly with soft cloth
on each side. Can they feel the soft touch
on both sides?
Patients may have numbness on one side of
the face, maybe only in one small area.
Sometimes people can get terrible pains
in the face without any other problem.
7 (seven)-to the face to move J
Ask the patient to close their eyes. Ask them to
smile. Ask them to raise their eyebrows
as though they are surprised.
The patient may have a weak face on one side
that looks very droopy. They may not be
able to smile on one side or close one
eye. They may have saliva (spit) dripping
out of their mouth.
The eyebrows on the same side as the weak
face will also be weak if this is a cranial
nerve problem.
How to test the nerve-
If the nerve is diseased
or damaged-
8 (eight)-to the ear for hearing and balance
Test the patient’s hearing. Ask them a
question but do not let them watch your lips
move. In children, have someone call their
name softly from across the room.
Patients may complain of hearing loss.
Children with poor hearing may not complain
of hearing problems, but may speak normally
for their age.
Some problems with cranial nerve 8 cause
patients to feel as though they are spinning or
to hear ringing in their ears. Patients may feel
unstable and have problems walking. They
may stumble as if they are drunk.
9 (nine) and 10 (ten)-to the back of the mouth
and throat
Ask the patient to open their mouth and say
"AAAHHH". Watch the palate. It should go up
on both sides. If you have a tongue blade (no
sharp edges!) or a cotton swab, you can
lightly touch the back of the patient’s throat by
the palate. They should gag. Watch the
patient take a sip of water.
The patients may choke when drinking water.
Their palate may go up only on one side.
They may not gag when you touch the back
of their mouth.
11 (eleven)-to the shoulders
Ask the patient to shrug their shoulders.
One shoulder may be too weak to shrug
12 (twelve)-to the tongue
Ask the patient to open his mouth but keep
the tongue inside. Examine the tongue while
it sits quietly in the mouth. Ask the patient to
stick out their tongue straight out.
The tongue may be weak and wasted on one
side. When they try to stick out their tongue, it
may go off to one side.
Cranial Nerve-
Cranial Nerves
• Cranial Nerves function
• CN Table
• Cranial Nerve Summary
Brodmann’s Area Map of Brain
Cerebral Aneurysm Repair
• CAR with clip
• Drs. Payner and
Cohen-Gadol,
neurosurgeons at
Goodman Campbell
Brain and Spine
Intracranial Blood Vessel Block
• Stroke treatment
• Developed by Dr.
Jeffrey Saver's group
at UCLA Stroke Center
• Covidien Solitaire FR
Revascularization
Device
• Restore circulation and
remove clots using a
single device
Head Trauma
• Tumor Locator