NEUROLOGICAL EXAMINATION

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??? ?????????
??? ?????????
?????????1
NEUROLOGICAL EXAMINATION
???????????????????? ???????????????????? Professo
r?Doctor director ?Neurologist
???(? 7 ?)
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???????????????????
?????????????????????
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????????Content of neurological examination

• ?????? (Higher functions)
• ??? (Cranial nerves)
• ???? (Motor system)
• ????(Sensory system)
• ???? (Reflexes)
• ?????? (Autonomic nervous system)

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TOOLS for the NEURO EXAM

• Reflex Hammer
• Tuning Fork 512 Hz (128Hz)
• Pocket Vision Card ( newspaper )
• Pen Light ( Ophthalmoscope)
• Cotton or tissue paper
• Wooden Tongue Depressor
• Stethoscope

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??? ????Consciousness state
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1.Consciousness state

• ??(somnolence)
• Sustained in a sleep state to be awakened, the
  correct answer questions and to meet physical
  examination, but after the cessation of
  stimulation to sleep
• ???????????????????????????,???????????
• (2) ??(stupor)
• Loudly shouting or more strong pain stimulation
  can wake up, wake up after the facial expression
  at a loss, vague answers to simple questions, do
  not meet inspection, immediately after the
  cessation of stimulating people into deep sleep.
• ?????????????????,??????,??????????,??????,???????
  ?????

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(3) ??(coma) 1) ??? ????, ????(), ??\?\??\??
???(), ??????? On a coma loss of
consciousness, the pain reaction (), corneal \-\
cough \ tendon swallowing reflex (), no change
in vital signs 2) ??? ????(?), ???, ???()
??????, ??\?????? In a coma pain response
(?), Sizhi Tan, pathological sign () light
reflection, and so weaken, respiratory \
circulation stability 3) ??? ????, ????,
??????, ???? ??, ???\???(?),
??\??\?????? Deep coma eyes fixed, dilated
pupils, scattered, light reflection, and so
disappear, limbs, flaccid paralysis, tendon
reflexes \ pathological sign (?), respiratory \
circulation \ body temperature regulation
obstacles
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• 2. ??????(Special Consciousness state)
• ???(delirium)?????????????????????
• ?????????,?????????????????????
• With the level of awareness, attention,
  orientation, perception, emotion,
• and so smart and a great disorder, with more than
  Jire, anxiety, terror,
• as hallucinations and paranoia, and other
  regions
• ???(confusion)?????,?????????,?????
• ????????????????
• A slow onset, the orientation of not more
  serious obstacles,
• time orientation relative obviously indifferent
  performance,
• sleepiness, attention deficiencies

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????
3.?????

• ???? ??????(??) (?3-2)
• ????????????,?????????,
• ????????????,????????,
• ????????????????,???????

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• (2) ???(Kernig)? ??, ?\????????, ????????,
  ??????lt135o?()
• ??-Kernig???(?????????\??????)
• (3) ?????(Brudzinski)?? ?????
• ???\????(???, ?3-2)
• ?????????, ???????(???)

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????
????
3. ?????
???(Kernig)?
?????(Brudzinski)??
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• ????24?????(??????Kernig??Brudzinski?)(18?)

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• (1)?????????(6?)?????????????,?????????,???????
  ?????,????????,????????????????,???????(4?)???????
  ????(2?)???????????,?????????????

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• (2)Kernig???????(6?)?????????????,?????????????,?
  ????????,?????????????,???????????,???????????????
  ?,?????(4?)?????????(2??????????135???,?????,?????
  ??????

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• (3) Brudzinski???????(4?)??????????????,?????,???
  ???,??????????,???????,????????,?????????????(2?)?
  ????????(2?)??????,??????????????

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• (4) ??(2?)(2?) ?Kernig??Lasegue?(??????)?????????
  ??(1?) ????????,???????,???????????135,?????????
  ?????,?????????,????????????70,?????????????????
  ??? ?????????????????????(1?) ???????????

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??????(autonomic function)??
1. ????

• ?????
• ??(??\??\??
• \??\????\??)
• ??(??\??\??
• \??\??\??\??)
• ??(??\??)
• ??\??\???

???(Raynauds disease) ?? ?? ??
??
??
?????
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??????(autonomic function)??
1. ????
????

• ?????
• ??\??\????
• \????????

?????(hair nail)

• ???
• ?????????
• \?????

??(sweat)
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??????(autonomic function)??
2. ???????

• ??
• ????
• ????\??\???
• ??\???????(??\?
• ?\????\???\???\?
• ????)
• ???????????

???
???
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??????(autonomic function)??
3. ??????

• ????? ??????????
• ?????(???????)??
• ????????, ???????, ?????
• ???????
• ???710s???, ?????

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??????(autonomic function)??
3. ??????

• ???????
• ?????????????, ??
• ???????, ???????--
• ??
• ??????????--?????
• ????
• ???????, ????????
• --???????????????
• ??

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??????(autonomic function)??
3. ??????

• ??????
• ???????1min??
• ???gt1012?
• ???????????gt1012?/min
• ???????????

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??????(autonomic function)??
3. ??????
???
????

• ?????(????)
• ??????
• ??????
• ?????????10mg
• ???????????
• ??????,?????
• ????????????
• ??????
• ?\?\??? C8T1??
• ?? T28
• ?? T512
• ???? T10L3

????(perspiring test)????
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4 ?????????????
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???\????????
??????? ??????\??\???\???\??? ?????? ????? ??
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1. ???(Aphasia)??
?????? ?\?\?\? ??????? ????\???\??\??\??\??
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1. ???(Aphasia)??
??????????????? (Aphasia Battery of Chinese,
ABC?) ????????(????)??
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1. ???(Aphasia)??
1. ????(speech expression)

• ?????????????
• ??
• ????\????
• ??????
• ???????
• ???????
• ????, ????
• ????
• ???????????

?????(?????????,WBC) ????????,??????
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1. ???(Aphasia)??
2. ???(comprehension).

• ??????????, ? ???
• ?????????
• ????????????\???
• ????????
• ?????\??????????,
• ????????????/????

????????, ?? ??\??\??\????????
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1. ???(Aphasia)??
3. ??(repetition)

• ???(???\??\??)
• ????(??\????)
• ???(???\??)
• ??(???????)
• ??(????)
• ????(??????????????)
• ????????, ??????\????\
• ???????\???????

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1. ???(Aphasia)??
4. ??(naming)

• ????????????\
• ??\??????????
• ????????????
• ??????????...(?)
• ????????

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1. ???(Aphasia)??
5. ??(reading)

• ??????
• ?????????(????????)

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1. ???(Aphasia)??
6. ??(writing)

• ????\??\????
• ????(??????)
• ??\??--??????

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2. ???(Apraxia)??
???????????? ????, ??????
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2. ???(Apraxia)??

• ????
• ???\??\??????????
• ???????????
• ???\??\??\?????
• ??????(??????\????)
• ?????(???\??????)
• ????????\????, ??????

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3. ???(Agnosia)??
(1) ????
? ??????????, ????????\ ?????????? ?
????????????? ? ???????????????????,
??????\??????
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3. ???(Agnosia)??
(2) ????

• ???????
• ???\??????????
• ?????, ?????????

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3. ???(Agnosia)??
(3) ????

• ????, ????????

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??!