How to Examine the Nervous System by Robert T. Ross

By Robert T. Ross

A vintage choice of time-proven actual suggestions for the exam of the frightened process, written via one in all North America's most useful neurologists. With basic prose and diverse worthy illustrations, the writer describes intimately trustworthy bedside exam ideas that might pinpoint the site of a lesion within the worried process and bring about a solution of the matter. The concepts hide a wide selection of troublesome areas, together with the visible pathways, the sensory approach, top motor neurons, cranial nerves, the cerebellar process, top and reduce limbs, reflexes, the corticospinal procedure, issues of speech, and difficulties of stance, gait, and stability.

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How to Examine the Nervous System

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Extra resources for How to Examine the Nervous System

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6. Occipital lobe: Monocular temporal crescent, field, or scotomatous defect, in anterior occipital lobe lesions (Figures 2–9 and 2–10). a. Central, congruous scotomas, in lesions of the tip of the occipital pole (Figure 2–8). b. Hemianopic with macular sparing; bilateral lesions will leave the patient with tubular vision, that is, all blind but for 10 degrees around fixation, or all central and peripheral loss. 7. The more posterior the lesion, the more likely are the areas of field defect in the two eyes to be congruous and macular vision spared.

Stay in the binocular field (Figure 4-1). Rule1 In the analysis of any diplopia, put the eyes in the position that causes the greatest separation of the two images. For example, let us assume that the separation is greatest on looking up and to the left. Rule 2 Discover from which eye the false image is coming. The false image is the nonmacular, less distinct, image. It is always the outside image; that is, if the diplopia is lateral with two images side by side, the image farther away from the midline is the false one.

There is a sudden onset of visual loss, sometimes followed by increasing and progressive visual failure over 5–7 days. Altitudinal (inferior) field defects are common. Funduscopy examination shows a swollen disc, hemorrhages near the disc edge, and cotton-wool spots. A macular star is common with vasculopathies. The other eye is commonly involved within weeks or months of the first eye. Anterior Ischemic Optic Neuropathy Retinitis Pigmentosa The most common symptom of retinitis pigmentosa (RP) is night blindness.

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