PENGANTAR NEUROLOGI

PENGANTAR NEUROLOGIDr FUAD HANIF SpS M.KESSMF NEUROLOGI RSUD BANJAR

BATASANNEUROLOGI ADALAH ILMU YANG MEMPELAJARI TENTANG PERSARAFAN, BAIK YANGFISIOLOGIS MAUPUN PATOLOGIS.

SKEMA PEMERIKSAAN PENYAKIT SARAFSKEMAANAMNESAPEMERIKSAAN FISIK

PEMERIKSAAN PENUNJANGGEJALA TUMPANG TINDIHDIAGNOSA KLINISDIAGNOSA LOKALISASIDIAGNOSA ETIOLOGIDIAGNOSA BANDING

CARA PEMERIKSAANSSP (SUSUNAN SARAF PUSAT)TERLETAK DIDALAM TULANG SEHINGGA TIDAK DAPAT DI INSPEKSI, PALPASI, DAN AUKULTASI SECARA LANGSUNG, MELAINKAN DENGAN PEMERIKSAAN KHUSUS (TEKNIK STIMULUS RESPONS)

URUTAN PEMERIKSAANANAMNESAALLO-ANAMNESAHETERO-ANAMNESA

PEMERIKSAAN FISIKSTATUS PRAESENSI : vital signSTATUS INTERNA

ETIOLOGY IN NEUROLOGIC DISORDERS :

TRAUMA : HEAD / SPINE TRAUMAVASCULAR : STROKEINFECTION : ENCEPHALITIS, MENINGITISTUMOURDEGENRATIVE PROCESS : PARKINSON, DEMENTIAIDIOPATHIC : EPILEPSY

STATUS NEUROLOGIRANGSANG MENINGEALSARAF OTAKPEMERIKSAAN MOTORIKPEMERIKSAAN SENSORIKPEMERIKSAAN REFLEKSPEMERIKSAAN KOORDINASIPEMERIKSAAN FUNGSI LUHUR

ANAMNESAKELUHAN UTAMARIWAYAT PENYAKIT SEKARANGRIWAYAT PENYAKIT DAHULU

PEMERIKSAAN FISIKKESADARANTEKANAN DARAHNADIRESPIRASITEMPERATUR

PEMERIKSAAN NEUROLOGISDIPERIKSA RANGSANGAN MENINGEALPEMERIKSAAN MELIPUTI :TANDA KAKU KUDUKTANDA KERNIGTANDA LASEQUETANDA BRUDZINSKI

PEMERIKSAAN SARAF OTAKSARAF YANG DIPERIKSANERVUS I (OLFAKTORIUS)NERVUS II (OPTIKUS)NERVUS III, IV, VINERVUS V (TRIGEMINUS)NERVUS VII (FASIALIS)NERVUS VIII (VESTIBULOCOCHLEARIS)NERVUS IX (GLOSSOFARINGEUS)NERVUS X (VAGUS)NERVUS XI (ASESORIUS)NERVUS XII (HIPOGLOSUS)

Cranial Nerves

Nuclei of Cranial Nerves

Motoric Cranial Nerves Nuclei

Sensoric Cranial Nerves Nuclei

CN V (TRIGEMINAL) SENSATION OF FACE, OPEN/CLOSE JAW, MASTICATION, CORNEAL REFLEX)

CN VII (FACIAL) FACIAL MOVEMENT AND EXPRESSION, TASTE OF ANTERIOR TWO THIRD OF TONGUE, BLINKING REFLEX

Central 7th palsyPeripheral 7th palsy

CN VIII (VESTIBULO-COCHLEAR) BALANCINGSENSE OF HEARING

CN IX (GLOSSOPHARYNGEAL) AND CN X (VAGUS)

ELEVATION OF PALATE/UVULA, GAG REFLEX

CN XI (SPINAL ACCESSORY) HEAD MOVEMENT, SHOULDER SHRUG/ELEVATIONCN XII TONGUE MOVEMENT

MOTOR SYSTEM

MUSCLE BULKMUSCLE TONUSMUSCLE POWER/STRENGTHFASCICULATION

SENSORY SYSTEM

SUPERFICIAL SENSORY MODALITIES : PAIN PERCEPTION, TEMPERATURE DISCRIMINATION, LIGHT TOUCH

DEEP SENSORY MODALITIES : VIBRATION SENSE, POSITION SENSE

CORTICAL FUNCTION : TWO-POINT DISCRIMINATION (EXTINCTION), STEREOGNOSIS

REFLEXES

PHYSIOLOGIC REFLEX [MUSCLE STRETCH (DEEP) REFLEX] : BICEPS, TRICEPS, BRACHIORADIAL, KNEE JERK (KPR), ANKLE JERK (APR)

SUPERFICIAL REFLEX : ABDOMINAL SKIN REFLEX, CRESMATERIC, ANAL, BULBOCAVERNOUS

PATOLOGIC REFLEX : BABINSKI, CHADDOCK, HOFFMANN TROMMER, REGRESSION

SUBSPECIALTIES IN NEUROLOGY

NEUROPEDIATRIC OR DEVELOPMENTAL NEUROLOGYNEURO-RADIOLOGYNEURO-PHYSIOLOGYNEURO-PSYCHOLOGYNEURO-ANATOMYNEURO-REHABILITATIONCEREBRO-VASCULAR DISEASE (CVD)CNS INFECTIONEPILEPSYPERIPHERAL NERVENEURO-OPHTHALMOLOGY

SIGN AND SYMPTOMS IN NEUROLOGICAL DISEASES

Due to location HemisphereCentral Nerves System Medulla spinalisCerebralCerebellumBrain sectionCervicalThoracalLumbosacral NucleusPeripheral nerves system Ganglion Nerve root

SYMPTOMS & SIGNS

Cardinal symptomsGeneral cerebral disordersHigh intracranial pressureIntoxicationMetabolic disordersFocal cerebral disordersDisturbances of ARAS / brain stemConsciousness

Causes of decreased LOC Intra-cranialExtra-cranialDiffuseMeningitis, EncephalitisFocal Stroke, Tumour, AbscessHeparRenalLungsDiabetesIntoxicationLumbal punctureCT-ScanLaboratory

Cardinal symptomsMeningeal irritation : - Infection- Haemorrhage- Radix irritation

Motor dysfunction : - centralCerebral : hemiparese, hemiplegy- Vascular- Infection- SOL- Degenerative processMedullar : segmental paralyticUpper motor / centralHypertonic / spasticHyperreflexiaPathological reflex

- PeriferCranial nerveSegmental :- Myotomal- Radiculopathy- NeuropathyLower motor :Hypotonic / flacidHypo / areflexia

Sensoric dysfunction : ExteroceptivePainTemperatureTouchProprioceptiveVibrationDeep painPositionCerebralCorticalThalamicMedullarRadicularOrganic

Autonomic :SymphaticParasymphaticRegulation of blood pressure, respiration, micturation, bowel habit, sweating

Equilibrium :Central :CerebellumPosterior medulla spinalisPeripheral :Vestibular

Higher Cortical Dysfunction :Cognitive dysfunction NeurobehaviourMemoryImmediateRecentLong term memoryLanguageVerbalNon verbalDyslexiaDysgraphiaOrientationTimePlacePerson

PraxisCalculationInsightExecutive functionVisuospatialEmotion

Higher Cortical Dysfunction :Degenerative DementiaVascular StrokeSOL Intracranial tumorNeurotransmitter Psychiatric disorder

Symptoms :Memory problemExecutive dysfunctionLanguage dysfunction, aphasiaDisorientationDisinhibitionBehaviour disturbancesDispraxia

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