CHAPTER VIII. EXAMINATION OF THE NERVOUS SYSTEM. Anatomy; Normal and Pathological Physiology. 1. The Cortico-muscular Tract (the Pyramidal Tract). 2. The Sensitive or Centripetal Tracts. 3. Centres and Tracts of the Special Senses. 4. Remarks upon the Vessels Supplying the Brain. Symptomatology and Methods of Examination. Examination of the Seat of Disease. The Spinal Column. The Peripheral Nerves and their Surroundings. Examination of the Condition of the Mind. Disturbances of Sensation. 1. Sensory Irritation to Peripheral Irritation. (a) Sensibility of the Skin. (2) Deep Sensibility. The Knowledge of Form (Stereognosis). 2. Sensible Phenomena of Irritation and Pain from Pressure upon Nerves. 1. Paresthesia. 2. Spontaneous Pain. 3. Distribution of the Sensory Cutaneous Nerves. Disturbances of Motility. 1. Paralysis. 2. Disturbance of the Nutrition and Tone of the Muscles. 3. The Reflexes. 1, Skin Reflex. 2, Tendon Retlexds (parlosteal, hadlal téllex). 4. Electrical Examination of the Nerves and Muscles. Regarding the Physics, and the Instruments Employed. Methods of Examination and their Physiological Results upon the Living Human Body. General Methods, and Explanation of the Terms Employed in Galvanic Examinations. Method of amination in Detail. Normal Condition. 1. Points of Stimulation. 2. What to Observe in Determining the Electrical Reaction. Paradic Current. Galyanie Current. FOR 452 452 459 460 483 488 489 495 497 501 501 CONTENT XV 1. The Reaction of Degenerntion (EaR). (a) Complete EaR. see (2) Partial EaR. Varieties of EaR: (c) Mixed Electrical Reaction. 2. Myotonic Reaction (Erb). 8. Diagnostic Value of the Electrical Condition. 4. Mechanical Excitability of Muscles and Nerves. 5. Codrdination and Ataxia. 6. Spasms of the Voluntary Muscles, their Innervation, their Function, and the Diseases that Disturb Them. Disturbances of Speech (Lalopathy). I. Dysarthria and Anarthria. II. Aphasic Disturbances, Disturbance of Graphic Communication (of Mimicking and Singing). Mode of Procedure in Teste for Aphasic Disturbances. Sense Organs. Disturbances of the Vegetative System in Nervous Diseases. General Phenomena. 2. Disturbances of the Respiratory Apparatus. 3. Disturbances in the Circulatory Apparatus. 4. Disturbances of the Digestive Apparatus. 5. Disturbances of the Urinary Apparatus. 6. Disturbances of the Genital Apparatus. 7. Disturbances of the Skin. Bones and Joints. The Diagnostic Value of the Symptoms in Nervous Diseases. APPENDIX. 1. Laryngoscopie Examination of the Larynx. Paralysis of the Muscles of the Larynx. 2. Examination with the Ophthalmoseope. 3. Bacteria which come under Consideration in the Diagnosis of Internal Diseases.
Key Takeaways
- The chapter covers detailed methods for examining and diagnosing neurological issues, including sensory and motor disturbances.
- Electrical examination techniques are described in detail to assess the condition of nerves and muscles.
- Disturbances of speech and other senses are examined as indicators of nervous system disorders.
Practical Tips
- Learn to recognize signs of paralysis or muscle weakness early, which can be critical for survival in emergency situations.
- Understand the importance of sensory testing (like stereognosis) to quickly assess a patient's neurological status.
- Use simple electrical tests to check nerve and muscle function when basic equipment is available.
Warnings & Risks
- Be cautious with electrical examinations, as improper use can cause injury or harm.
- Do not rely solely on these historical techniques; modern diagnostic tools should be used in conjunction.
- Ensure thorough training before attempting any of the described methods to avoid misdiagnosis or complications.
Modern Application
While many of the specific electrical examination techniques have evolved, the fundamental principles of neurological assessment remain crucial. Understanding basic sensory and motor function can help in triage situations where modern equipment is not available.
Frequently Asked Questions
Q: What are some key signs of nerve damage described in this chapter?
The chapter describes several key signs, including paresthesia (abnormal sensations), spontaneous pain, and disturbances in the distribution of sensory cutaneous nerves. These can indicate nerve damage or disorders.
Q: How does the chapter suggest examining the condition of the mind during a neurological examination?
The chapter advises observing the patient's mental state and behavior to assess any disturbances, as changes in mental function can be indicative of nervous system issues.
Q: What are some methods for testing reflexes mentioned in this chapter?
The chapter details skin reflex tests and tendon reflex tests (parlosteal and hadlal téllex) as methods to assess the condition of nerves and muscles. These can provide valuable information about nerve function.