神经反射的检查-精选文档.ppt

神经反射检查西南医院神就内科罗春霞检查方法检查内容异常体征的临床意义重点:神经反射检查ExaminationoftheRelexs反射(Reflex):(包括外周感受器、传入神经、神经中枢、传出神经及外周效应器组成)的完成的。Reflex:Reflexactionisanautomaticmotorresponsethroughreflexarc,:Sensor,Afferentnerve,Nervecentre,EfferentnerveEffector神经反射:浅反射深反射病理反射Reflex:SuperficialreflexMyotasisreflexPathologicreflex浅反射:角膜反射腹壁反射提睾反射跖反射肛门反射Superficialreflex:CornealreflexAbdominalreflexCremastericreflexPlantarreflexAnalreflex角膜反射CornealreflexCornealreflex:Sensor:cornealAfferentnerve:TrigeminalnerveNervecentre:ponsEfferentnerve:FacialnerveEffector:Orbicularisoculimuscle角膜反射:感受器:角膜传入神经:三叉神经中枢:桥脑传出神经:面神经效应器:眼轮匝肌临床意义:一侧直接、对侧间接反射均消失→同侧三叉N病变;一侧直接消失,对侧间接存在→同侧面N病变。一侧直接消失间接反射消失面神经或三叉神经病变。Clinicalsignificance:onelateraldirectandcontralateralindirectreflexextinctation:ipsilateraltrigeminalnervedamage;onelateraldirectreflexandcontralateralindirectreflexextinctation:ipsilateralfacialnervedamage;onelateraldirectandindirectreflexextinctation:ipsilateraltrigeminalandfacialnervedamage腹壁反射(Abdominalreflex,AR):上腹壁反射:胸7-8;中腹壁反射:胸9-10;下腹壁反射:胸11-12。临床意义:上、中、下均消失:昏迷,急腹症或神经系统病变。一侧消失:同侧锥体束病变或脊神经损伤。Clinicalsignificance:a,Acuteabdomenandnervesystemdisease;Unilateralextinction:isolateralpyramidaltractinjuriedorspinalnervesinjuried.