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.html
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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.jpg
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    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