79006590 1 anatomie functional a examen neurologic
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8/10/2019 79006590 1 Anatomie Functional a Examen Neurologic
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Curs neurologie
Sef lucrari Dr. Monica [email protected]
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Structura cursului
1-2 sindroame neurologice, examen neurologic 3- patologia nervilor cranieni 4-5 accidente vasculare cerebrale 6- boli demielinizante 7- boala Parkinson 8- epilepsia 9- cefaleea 10- patologia sistemului nervos periferic 11- patologia sinapsei 12- miopatii
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Stagiu
Gr. 1, 6- dr. Sabau
Gr 2, 7- dr. Comanescu
Gr. 3, 8- dr Simion Gr 4,9dr. Jurcau
Gr 5- dr. Iova Oros Andrada
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http://www.medicineamigo.com/medicine-branch/neurology/Definition-Of-Neurology.html8/10/2019 79006590 1 Anatomie Functional a Examen Neurologic
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NEUROLOGIAspecialitate ceare ca obiect de activitatediagnosticul si tratamentul
afectiunilor sistemului nervoscentral si periferic
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http://www.google.ro/imgres?imgurl=http://oameni.romportal.ro/wp-content/uploads/2010/09/Gheorghe_Marinescu_timbre_roumain.jpg&imgrefurl=http://oameni.romportal.ro/590/gheorghe-marinescu-1863-1938-biografie/&usg=__yhIVYzcIBOlpc0iBLuiQg8wkjys=&h=660&w=471&sz=249&hl=ro&start=21&sig2=jF-0Q2CIBfl2aNXuqSCoHA&zoom=1&tbnid=H3uP8zZFofEGPM:&tbnh=138&tbnw=98&ei=keHbTvmvMcPj4QTPtJCnBg&prev=/search%3Fq%3Distoria%2Bneurologiei%26start%3D20%26um%3D1%26hl%3Dro%26sa%3DN%26gbv%3D1%26tbm%3Disch&um=1&itbs=1http://localhost/var/www/apps/conversion/tmp/scratch_10//upload.wikimedia.org/wikipedia/ro/7/74/Medaille01.jpghttp://upload.wikimedia.org/wikipedia/ro/0/07/Marinescu10.jpg8/10/2019 79006590 1 Anatomie Functional a Examen Neurologic
9/74Figure 12.3
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Structuri de protectie ale creierului
Craniul
Meningele
Dura mater
Arahnoida
Pia mater
Lichidul cerebrospinal (LCR)filtrat din sange in
panzele coroidiene din ventriculii laterali, seresoarbe in sinusurile durei mater
Bariere hematoencefalica
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Sistemul motor
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Sistemul motor
Neuronul motor central
Ariile corticale
Cile de conducere intranevraxiale
Neuronul motor periferic
Nucleii motorii ai nervilor cranieni/rahidieniconin neuroniimotorii periferici. Acetia preiau impulsurile de la axonii neuronilormotorii centrali i transmit comanda musculaturii efectoare.
Cile de conducere perifericecare conin axonii neuronilor motoriiperiferici i sunt reprezentate de rdcini, plexuri nervoase i nerviperiferici.
Efectorii:muchii striai
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Ariile corticale
aria premotorie (ariile 6 i 8 Brodman, n regiuneaprefrontal) identific scopul i elaboreazschema micrii.
aria motorie primar (aria 4 Brodman, n girusulprecentral) conine neuronii motori centrali caregenereaz comanda de micare. Exist odispoziie specific somatotopic a ntregului corpn funcie de numrul de uniti motorii de la
nivelul fiecrui segment corporal care realizeazimaginea deformat a unui corp uman, aezat cucapul n jos pe girusul precentral: homunculusmotor
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Homunculus motor
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Cile de conducere
intranevraxiale
Fascicolul piramidal- conine axoniineuronilor piramidali din aria motorie.Traiectul acestor fibre este prin capsula
intern, partea anterioar a trunchiuluicerebral (piramidele pontine, bulbare), sencrucieaz imediat sub bulbul rahidian i
trec n regiunea anterioar a cordoanelorlaterale ale mduvei spinrii.
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Neuronul motor periferic
Motoneuronul 1
Corpul celular: nucleii motori
Axonul: radacini, plexuri, nervi periferici Face sinapsa cu fibrele musculare= placa
neuromotorie
Unitate motorie= un neuron motor cu toatefibrele musculare pe care le inerveaza
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Sistemele de coordonare i
control
Nucleii cenuii de la baza creierului(corpii striai):nucleul lenticular, nucleul caudat i claustrumprecum i nuclei ai talamusului) care, prin conexiunicerebrale, cerebeloase i medulare complexerealizeaz sistemu l extrapi ramidal .Acest sistemeste implicat n reglarea tonusului muscular,iniierea i susinerea micrilor i n controlul fineiii preciziei acestora.
Cerebeluleste implicat n controlul exactitiimicrilor i reglarea tonusului muscular.
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Sistemul senzitiv
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SISTEMUL SENZITIV Receptorii
Cile de conducere periferice: nervii periferici/cranieni, formati din dendriteleneuronilor senzitivi din ganglionii senzitivi ai nervilor rahidieni i nervilor cranieni
Ganglionii senzitiviconin primul neuron senzitiv. Nucleii senzitivi intranevraxiali.Al doilea neuron senzitiv Cile de conducere intranevraxialesunt reprezentate de ctre axonii
neuronilor senzitivi cile sensibilitii termice i dureroase se gsesc n cordoanele laterale, fascicolul
spino-talamic Cile sensibilitii profunde se gsesc n cordoanele posterioare, fascicolele Goll i
Burdach Sensibilitatea tactil are dou componente
epicritic, discriminativ ce urmeaz ci paralele cu ale sensibilitii profunde
protopatic, grosier ce urmeaz ci paralele cu sensibilitatea termic i dureroas.Talamus; al treilea neuron senzitivpentru toate tipurile de sensibilitate Ariile corticale senzitivereprezentate de ctre ariile 3,2,1 Brodman n
circumvoluiunea postcentral homunculus senzitiv.
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Sensibilitatea proprioceptiva
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Sensibilitatea proprioceptiva
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Sensibilitatea exteroceptiva
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Simptome neurologice
Tulburari de mers Paralizii Atrofii musculare Tulbur