Transcript 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
• 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.
Cranial nerves
NUMBER
NAME
TYPE
KEY FUNCTION
I
Olfactory
S
Smell
II
Optic
S
Vision
III
Oculomotor
M
Eye movement, pupil size, focusing lens
IV
Trochlear
M
Eye movement
V
Trigeminal
B
Sensations – head & teeth; chewing
VI
Abducent
M
Eye movement
VII
Facial
B
Face and scalp movement, salivation, tears, taste
VIII
Vestibulocochlear
S
Balance, hearing
IX
Glossopharyngeal
B
Tongue movement, swallowing, salivation, taste
X
Vagus
B
Sensory from: GI, respiratory; Motor: larynx,
pharynx, parasympathetic, abdomen and thoracic
organs
XI
Accessory
M
Head movement, accessory motor with vagus
XII
Hypoglossal
M
Tongue movement
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”
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)
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
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
Neuro Exam
– Ataxia/incoordination – cerebellum, vestibular
system, or spinal cord
– Dysmetria - cerebellar
• Hypermetria – too long movements
• Hypometria – movements too short
http://www.youtube.com/watch?v=0QOKP
FMt0Rc&feature=endscreen&NR=1
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
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
Neuro Exam – Cranial Nerves
•
•
•
•
Blind
II
No menace
Anisocoria
Atrophy of temporal muscles
• Dropped jaw
• Nares, lip pinch, cornea
II/VII
II, III
V
V
V
– Inside ear
• Lip/ear droop
• No blink
• Head tilt
VII
VII
VIII
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
Cranial nerve
• http://www.youtube.com/watch?v=S8f9GPW9IE&feature=related
Female Brain
Male Brain
Neuro Exam
• Postural reactions
– Knuckling
– Hopping
– Wheelbarrowing
– Hemiwalking
http://www.youtube.com/watch?v=IXpGX6xhJd
M
Knuckling
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
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.
Neuro Exam: Upper Motor Neuron vs. Lower
Motor Neuron signs
•
•
•
•
•
•
UMNLMN
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
Patellar Reflex
Patellar Reflex
Reflex examination
• http://www.youtube.com/watch?v=NFqFABsIa7
Q&feature=related
Pelvic Limb Withdrawal – Or Not
Panniculus Test