临床诊断学-神经系统检查英文

Mental State
-Level of consciousness
NORMAL:
patient awake and alert, attentive to surrounding and to the examiner
DEPRESSED:
Sleepy Lethargic Stuporous-arousing only briefly in response to pain stimulation Comatose-not arousable by verbal and pain stimulation
CRANIAL NERVES
-Control of Extraocular Muscle Movements (III, IV, VI)
Extraocular muscle movements are controlled by the oculomotor (III), trochlear ( IV), and abducens (V) nerves
CRANIAL NERVES -Optic (II)
Visual Acuity-pocket card or wall chart or any reading matter such as news paper
Visual Field
Confrontation Testing-Patient and examiner stand at eye level at about arm’s length. Have the patient cover his own eye Threat Testing- applied when the patient is less than fully alert or is uncooperative
Cognitive Function
D.Aphasia:expression,reception,repeat,name,read,write E.Apraxia F.Agnosia G.exetution Other: Insight and judgment, concentration, patients mood, content of though, appropriateness of behavior, and so on.
Volitional Eye Movement-Follow my finger, just with your eyes. Tracing the Letter H
Ask about Diplopia
Nystagmus is rthythmic oscillation of the eyes
CRANIAL NERVES
-Trigeminal Nerve (V)
Facial Sensation
Corneal Reflex-Sweep a wisp of cotton lightly across the lateral surface of the eye ( out of the direct visual field) from sclera to cornea- V, VII
Motor Vtry of opening and closing of the mouth. Ask the patient to clench the teeth and then attempt to force jaw opening
Neurological examination
Sunran
SIX PARTS OF THE NEURO EXAM
Mental State & Cognitive Function Cranial Nerves Motor System Sensory System Reflexes Autonomic function
MMSE
CRANIAL NERVES
CRANIAL NERVES -Olfactory (I)
Ask the patient to identify common scents such as coffee,vanilla,etc, with eyes closed.
Do not use irritants. In testing olfactory nerve function, it is less important to determine whether the patient can correctly identify a particular odor than whether the presence or absence of the stimulus is perceived
Cognitive Function
A. Memory:instant;Short term-name three common objects, then recall them again after 5 minutes; Long term-verifiable events from the past B. Calculations: Serial sevens: count backward from 100, taking away 7 each time. Real-life problem C. Orientation to person, place, and time.
Fundus ( Ophthalmoscopic ) Examination
CRANIAL NERVES -Pupillary Reflexes (II, III)
A normal pupil will constrict in response to direct light, as a consensual response to light in the opposite eye, and to accommodation ( convergence to focus on a close object)