Professional Documents
Culture Documents
NERVUS SYSTEM
CENTRAL NERVUS SYSTEM PERIPHERAL NERVUS SYSTEM
The Cranial Nerves ( I XII) The Spinal Nerves (C8, T12, L5, S5, Co1)
Central Connection
1. Transverse fibers 1. Corpus Callosum 2. Commisura ant & post 2. Association fibers 1. Short 2. Long: fasc. longitudinalis 3. Projection fibers 1. Corticospinal, cortico bulbar etc.
NEUROANATOMY
Ascending: Spinothalamic, spinocerebellar, Spinoolivary, gracillis, cuneatus
BG T BG T
Cortico bulbar (UMN) Cranial Nerves (LMN) III, IV, V, VI, VII, IX, XII
Cortico spinal tract (UMN) -Lateral crossed (80%) -Anterior uncrossed (10%) Spinal nerve C8, T12, L5, S5, Cc1 Spinal cord (LMN)
FUNCTIONAL NEUROLOGY
Sensory Cortex Assoc. Cortex Motor Cortex
Thalamus
Brainstem
Upper M.N
Spinal Cord
Reflex
Central Nervus Sistem 1. Otak 2. Ascending: Spinothalamic, spinocerebellar, Spinoolivary, gracillis, cuneatus 3. Descending: corticospinal, rubrospinal, olivospinal, vestibulospinal,tectospi nal, reticulospinal, fasc interfasicularis 4. Medula spinalis (C8,T12,L5,S5,Coc1)
2. 3.
Tujuan Khsus
Kompetensi dalam Pemeriksaan syaraf kranial I XII Pemeriksaan reflex syaraf kranisl Pemeriksaan MBO (mati batang otak) Menginterpretasi dan menganalisa hsl pemeriksaan
Metode
1. 2. 3. 4. Presentasi oleh instruktur Demonstrasi oleh instruktur Pelatihan mhs dengan bimbingan Latihan mhs mandiri
Spinal Nucl N V
Contra lateral 1. Pars superior N. VII 2. N. XII Bilateral: Other cranial nuclei
OLFACTORY NERVE
Symptoms & Signs and Tests S&S Anosmia Parosmia Cacosmia Test Each nostril test separately. (tobacco, coffee)
S&S
OPHTAHALMIC NERVE
1. Visual acuity 2. Visual field 3. Diplopia (coloured glass) 4. Color blindness (RBG)
Tests
1. Visual acuity (snellen, jaeger, jari 1/60) 1. Perimetri (Goldman), confrontation 1. Color blindness 2. Light reflex 3. Funduscopy
Test Motor status; smile, whistle,etc EMG. Reflex; cornea, conjuntival and lid. Sensosy Status. Taste (sweet, salty, sour, bitter), Facial asymitry
Cranial nerve VIII : ACOUSTIC NERVE (Composite Sensory Nerve) Symptoms and signs Cochlear Tinnitus Deafness Hearing scotomas Supra nucl dis Vestibular Vertigo NystagmusTests Tests Hearing acuity Weber (lateralisasi), Rinne, Swabach, Bing. Otoscopic Audiometry Caloric test Hallpike Electric test Dix Hallpike Prinsip: konduksi udara lebih baik dari konduksi tulang. Gunakan garpu tala frekuensi 256 Weber : garpu tala di vertex, normal tak ada suara. Suara terdengar (lateralisasi) di telinga dengan gangguan konduksi. Rinne : garpu tala di mastoid sesudah suara tak terdengan pindahkan kedepan liang telinga. Bila tidak mendengar suara pasien menderita gangguan konduksi. Swabach : bandingkan konduksi tulang pasien dengan normal. Taruk garpu tala di mastoid orang normal sampai suara hilang kemudian pindahkan ketelinga pasien masih terdengar > pasien menderita gangguan konduksi. Bings test : garupu tala di vertex kemudian tutup satu telinga lateralisasi ketelinga ditutup bila tak terdengar > gangguan syaraf.
Tests Shrug shoulder, deviation on bending chin downward against resistance. Muscle atrophy, Shoulder drop etc. Electromyography