AnatomyandPhysiology-Ch16 (1)
Chapter Overview
Title: The Neurological Exam
Content Source: OpenStax Anatomy and Physiology
Neurological Exam
Health care professionals can quickly assess neurological functions using the neurological exam.
Inspection of Oral Cavity:
Inspect for signs of infection.
Tests associated with cranial nerves linked to the oral cavity.
Image credit: U.S. Department of Defense.
Central Nervous System (CNS) Relations
Major Sections of the Neurological Exam:
Mental Status Exam
Cranial Nerve Exam
Sensory Exam
Motor Exam
Coordination Exam (including Gait Exam).
Hemorrhagic Stroke
Types of Hemorrhage:
(a) Accumulation of blood in cerebrum leading to disfiguration (e.g., lateral ventricles).
(b) CT scan example showing intraparenchymal hemorrhage in parietal lobe.
Image credit: James Heilman.
Brodmann’s Areas of the Cerebral Cortex
Background:
Illustrated by Korbinian Brodmann based on cytoarchitecture.
Areas correspond to functional differences in the cerebral cortex.
Types of Cortical Areas
Types of Processing Regions:
Primary Areas:
Initial processing for sensory information or origins of motor commands.
Association Areas:
Adjacent to primary areas; further processing modality-specific input.
Multimodal Integration Areas:
Combine information from different modalities (e.g., spatial processing).
Language Function Areas
Broca’s and Wernicke’s Areas:
Integral for language processing.
Connected through deep white matter from posterior temporal lobe to frontal lobe.
Visual Acuity Assessment
The Snellen Chart:
Measures visual acuity using lines of decreasing size of Roman letters.
The smallest letters perceptible at 20 feet indicate normal acuity; larger letters indicate reduced acuity (e.g., 20/200 vision).
Pituitary Tumor Effects
Location:
Pituitary gland located in sella turcica beneath optic chiasm.
A tumor can press on optic fibers, leading to "tunnel vision" (only central visual field is perceived).
Eye Movement Mechanics
Saccadic Eye Movements:
Rapid eye movements for visual stimulus tracking or examination (e.g., studying a face).
Concentration on facial features.
Vestibulo-Ocular Reflex
Functionality:
Links head movement with eye fixation on visual targets, coordinating vestibular input with eye movement nuclei via the medial longitudinal fasciculus (MLF).
Accessory Nerve Functionality
Innervation:
Accessory nerve controls the sternocleidomastoid and trapezius muscles.
Functions include opposing roles in head flexion/extension and synergistic actions in lateral flexion.
Spinal Fiber Tracts
Locations of Major Tracts:
Lateral corticospinal tract
Anterior corticospinal tract
Dorsal column
Spinothalamic tracts
Dermatomes
Definition:
Topographic regions of the skin corresponding to spinal nerve sensory endings.
Demonstrates nerve distribution within the skin.
Cerebellar Connections
Cerebellar Peduncles:
Three main connections: ICP, MCP, SCP.
ICP arises from the medulla, MCP from pons, SCP projects into the midbrain.
Major Regions of the Cerebellum
Divisions:
Midline region (vermis and flocculonodular lobe).
Hemispheres (lateral regions).
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