신경학적 검사 NEUROLOGIC EXAMINATION

목차

♣ 일반적 접근

1. Mental status exam.

2. Cranial nerve exam.

3. Motor

4. Sensory fxn.

5. Reflex

6. Cerebellum

7.Gait & Station

본문내용

fasciculation (-)
wasting & fasciculation (+)
4. Sensory fxn.
1) Examination
- light touch
- pinprick & temperature
- deep pressure
- vibration
- joint position
- cortical sensation:sensory extinction
two point discrimination(parietal lobe lesion시 이상)
stereognosis(integrative fxn of parietooccipital location)
topognosis
barognosis
graphism(parietal lobe lesion시 이상)
5. Reflex
☞ reflex는 5개의 등급으로 나누어져 있다.
0 : 무반응
1 : 약간 활동성이 감소된 상태
2 : 평균 정상
3 : 평균보다 빠른 상태
4 : 매우 빠르고 과도 활동성의 성격을 띈다.
1) stretch or tendon reflex
- brachioradialis reflex(C5,6 radial)
- biceps reflex(C5,6 musculocutaneous)
- triceps reflex(C7,8 radial)
- finger jerk(C8,T1, median)
- Knee jerk(L3,4, femoral)
- ankle jerk(S1,2, tibial)
- jaw jerk(pons,mandibular branch of trigeminal)
2) Superficial reflex
- abdominal reflex->upper(T7-10), lower(T10-12)
- cremasteric reflex(L1,2)
- plantar reflex(S1,2)
3) Release reflex
- grabellar reflex
- snout reflex (뇌 양측 추체로의 장해)
- sucking reflex (전두엽 장해,양측 대뇌의 광범위한 장해)
- grasp reflex (전두엽 장해)
- rooting reflex
★ Extensor plantar reflexes (pathologic reflexes)
① Babinski
② Gonda
③ Oppenheim
④ Gordon
⑤ Chaddock
6. Cerebellum
1) Cbll dysfxn
- hypotonia - nystagmus
- ataxia - dysmetria
- intention tremor - dysdiadochokinesia
- dysarthria - rebound phenomenon
2)Exam.
- finger to nose test : effectively block a mild degree tremor
특징) pasting pointing with pt's index finger repeatedly
overshooting the target
intention tremor
terminal tremor
- heel to shin test
7.Gait & Station
1)abnormal gait
- waddling gait
- steppage gait
- sensory ataxia
- cerebellar incoordination
- parkinsonian gait
- spastic gait
- choeic gait
- dystonia musculorum deformans
- frontal gait
- senile gait
- hysterical gait
2)Exam
- tandem gait
- Romberg test :(+) -peripheral neuropathy
post. column ds

키워드

신경,   검사,   mental,   의식,   자극,   혈액,   두통,   혈압