By Robert T. Ross
A vintage number of time-proven actual suggestions for the exam of the apprehensive approach, written via certainly one of North America's most beneficial neurologists. With uncomplicated prose and various important illustrations, the writer describes intimately trustworthy bedside exam options that might pinpoint the positioning of a lesion within the frightened approach and result in a solution of the matter. The options conceal a large choice of troublesome areas, together with the visible pathways, the sensory process, higher motor neurons, cranial nerves, the cerebellar method, top and decrease limbs, reflexes, the corticospinal approach, problems of speech, and difficulties of stance, gait, and stability.
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Extra resources for How to Examine the Nervous System
Note the lens number (the difference is the amount of papilledema). The normal eye is shown in cross-section in Figure 3–1A, and the disc area is shown in more detail in Figure 3–1B. 5 mm in diameter and, seen with the ophthalmoscope, looks like those in Figures 1–3 and 1–4. The disc edges are of different elevations at various points on the circumference of the nerve head. The physiological cup is a true depression in the nerve head. There is no retina overlying the nerve head, hence the normal blind spot.
Histories vary from helpful to misleading. The presbyopic patient complains he cannot get far enough from his newspaper to read it. ) The patient with pigmentary retinal degeneration will often forget to mention the progressing night blindness, an extremely important symptom. Another patient with an inattention left hemianopia has no complaints and is being examined only at the insistence of, for example, his wife or the motor vehicle licensing authorities. Typically, in the past months he has been driving with the left side of his car over the dividing line into oncoming traffic.
With the images side by side, the greatest separation occurs when the patient looks to the left. The outside image will vanish when you cover the right eye. Superior Rectus The superior rectus (one of two eye elevator muscles) cannot do its principal job of elevation with the eye in the primary position because the long EYE MOVEMENTS, DIPLOPIA, AND CRANIAL NERVES 3, 4, AND 6 / 51 axis of the muscle is not parallel to the anteroposterior axis of the eye (Figure 4–2A). 1. The superior rectus is supplied by the third cranial nerve.
How to Examine the Nervous System by Robert T. Ross