Introduction to EPC II_Neurologic Exam Lecture (PowerPoint)

Introduction to EPC II_Neurologic Exam Lecture (PowerPoint)...

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Introduction to EPC II 2011 January 24, 2011 Melanie Hagen, MD FACP
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Course Website https:// medinfo.ufl.edu/courses/php/content.php?nav =1&courseid=719
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Course Instruction Highlights Attendance at panels is required Need 70/100 on grading rubric Videorecording reviews Must pass CSE 1 REAP papers Tutoring available Communication Physical exam Mobile Clinic Projects from Preceptorship
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The Neurologic Exam from Bates’ Guide to Physical Examination  and History Taking 10 th  edition edited by Melanie Hagen, MD EPC II 2011
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Common or Concerning Neurologic  Symptoms Headache : Have you had any headaches? Dizziness or vertigo : Have you had any dizziness or loss of balance? Generalized, proximal, or distal weakness : Have you noticed any weakness in your arms or legs? Numbness, abnormal or loss of sensations : Have you had any numbness or tingling?
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Loss of consciousness, syncope, or near- syncope : Have you passed out or fainted or felt like you might? Seizures : Have you ever had a seizure or made abnormal movements you could not control? Tremors or involuntary movements : Do you have an shaking or tremulousness?
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The Nervous System: Key Principles As you examine the patient, remember three important questions: Is the mental status intact? Are right- and left-sided findings the same, or symmetric ? If findings are asymmetric or otherwise abnormal, does the causative lesions lie in the central nervous system or the peripheral nervous system?
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Organize your thinking into  categories: Mental status, speech, and language You’ll learn this in Human Behavior Cranial nerves Motor system Sensory system Reflexes
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What disease processes can effect  Cranial Nerve Function? Stroke Tumor Neuromuscular disease Amytrophic lateral sclerosis Bulbar atrophy
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Testing the Cranial Nerves CN I Olfactory CN II Optic Occlude each nostril, test different smells Test visual acuity inspect fundi Screen visual fields by confrontation We will learn about this when we do the Eye Exam
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CN II-III Optic, Oculomotor CN III, IV, VI – Oculomotor Trochlear, Abducens Inspect size and shape of pupils, test and reactions to light and near response Test extraocular movements in 6 cardinal directions of gaze; check convergence
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CN V Trigeminal Ask patient “Please clench your teeth” Palpate temporal and masseter muscles Ask patient “Does it feel the sharp (or dull) on each side when I touch you here, here, here . . .” Forehead Cheek Jaw Let patient know, “I am going to touch your eye lightly with this cotton swab”
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Assess face for asymmetry, tics, abnormal movements. Ask patient to:
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This note was uploaded on 07/01/2011 for the course BMS 6016 taught by Professor Hagen during the Spring '11 term at University of Florida.

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Introduction to EPC II_Neurologic Exam Lecture (PowerPoint)...

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