SANDA NICA USN Stele ‘NEUROLOGIE VOLUMULI ~ EXAMINAREA NEUROLOGICAssi imp @ peimanentarigoaregtiniid,bazata peo biblograte Selectata dn oratura lemahonala de specastate Recomand aceasta carta tuluor sludentior din facut de ina cin Romani, do si medilorrezident terior raurotgi “A nu ar feb daca 91 mec! cu al mul ani de expariant crica foto din cand in ind Prof, Dr. Ovidiu Bajenaru Progedintele Soeietati de Neurologie din Romania ee CUPRINS. | ANAMNEZA $1 INSTRUMENTELE NECESARE EXAMINARI NEUROLOGICE 1. Anamneza 12 nstrumentele necesare examinaril neurologice IL ATITUDINI PARTICULARE §1 SEMNE MENINGEALE 114. Atudin’ particu 112. Semnete meningealo IM. SISTEMUL MOTOR $1 MOTILITATEA 4. Calle motitati L4.1. Cale piramidale 1.13. Nuclei Bazal sau corpus striatum AA, Substantia nigra WI15. Nucloulsubtatamic alli Luys Examinarea motiitai voluntare 2.4 Migeaale active UL2.1.4; Membr superior 2.12. Membrul inferior 2.13. Musevlatura cervicals 12.4 Museulaturatrunchilui 5! abdomen 12.1.6. Museulatura centutlcoxo = femurale 12.416. Museulatura contut seaputo humo 1122. Fora segmentara 1.2.3. Probote de parext 13, Examinares motitsilrflexe 3.1. Reflexele osteo ~ tendinoase 32 Clonusul 1.3.3: Relexsle cutanate 3.4. Reflexe patologice 1.4. Tonusul muscular 1.41. Examinarea tonusului muscular 1.4.2: Tonusul museular de postura 4.3: Tonusul muscular de seyune 5. Conclast LS. Sindromul de NMC 132. Singromal de NMP .5.3, Orientare In fata unui paciont cu deficit motor |W. MISCARI INVOLUNTAREV. EXAMINAREA MERSULUL Vi EXAMINAREA SENSIGILITATIL Vi. Notiuni de anatomie VL2. Examinarea sensibility Via" Examinares sensibility suporficisle 1¥VL2.2. Examinares sonsibiltatitprotunde L3 Inertia neviticn VL. Inervatiaragieuara LB. Sindroame medulare ‘Vi. Notun! de anatomio VL82. Notiuni de fiziologie Visa, Examinarea clinies Vi5.4. Considerai einice Vis. Sindroml tlamic YLT. Sindrom cortical pari Vil EXAMINAREA CEREBELULU! VVl4. Nojlunl de anatomie ViL2_ Examinarea functor cerebelulul Vika, Sindromul cerebelos Vil, NERVII CRANIENT VILA. Nervul ofactiv( prechea F-2) ‘Vt. Notun! de snatomie UIIL1.2,Notiuni de fziotogie UVIlI43. Examnarea clinics #simulul otfactiv IlL1&. Considerati clince VL2. Nervul optic (perechea a i-a) ‘V2.1: Nofiant de anatomic VIZ Nofluni de fiologie ‘iIL2.3, Examnarea clinica 3 analizorul ‘Vill22.1 Examinarea pupilelor ‘Vill22.2' Examinarea acuta vizuale Vil2'3.3: Examinarea cémpululvizual ‘ill2.34, Examinarea fundulul de och ‘.24: Consideraielinice \L3. Neri eran I 1, UL ‘Vil3.1, Nerv oculomotor comun ( porechea ata} ‘VIlL3.1.4. Notun’ ee anatomic \Vil.3.1.2. Notiun’ de fizologie i134, Constderaticlinies \V.42. Nervi telear(perechea a V-2) Vill'3.2.1. Notun’ de anatomis Vil'3.22; Nojuni de fiologie 102 102 $08 409 110 0 10 Mt 42 42 13 13 4s 15 118 119 420 11 24 126 126 $30 +0 13 131 101 Vi2.2.2. Considerai clinica VIIL3.3. Nervul abducens (perechea a Vi-e) ‘Vil.3.3.1 Notun! de anatomic. VIN33.2' Notun de fzologie V3.3. Consigeraticlniee VIIL3.4. Examinarea clinics 3 oculomotriit il Nervultrigemen perechea a V-a) Vil4.1. Notiuni de anatomie VIILA2: Considerati clinice VIlLA3. Examinarea ciniea ‘i, Nervul facial perech ‘VinLS.1. Nofiuni de anatomie VIIL52: Considerati clinico VIILS3. Examinarea ciniea vay wi ‘VIIL6.1-Notiuni de anatomic VIlL82: Consideraticlinice VIlL62.1. Sindromul vestibular prieric VilL62.2. Sindromul vestibular central V6.3. Examinarea clinics VL. Nervul glesofaringian porochea 9 1X2) \i7.1; Notiuni de anatorn WILT.2: Consideraticlinice VIIL7.3: Examinarea clinics VILB. Nervul vag (perechiea a Xa) V3.1: Notiuni de snatomie Vi.8.2: Consideratl cline Vil.8.3. Examinares elinies WLS. Nervul accesor (spinal) (perochea a XLa ) V9.1: Notiuni de anatom VilL9.2: Consideratielinice VILO'3. Examinarea clinics ‘Vil10, Nerval hipogtes (perechea a Xit-a) VIIL10-4. Notun! de anatomic VN10.2: Considerati clinica ‘Vil10;3, xaminarea clinics 1K EXAMINAREA LIMBAJULUI Der. tania 1X2. Examinarea pacientulul cu tulburat de ima) X. EXAMINAREA PRAXIEL Xa. Examinare X2,Aspacteclinice XI. SISTEMUL NERVOS VEGETATIV 101 132 433 135 1m i 17 138 19 444 13 145 6. Nervul acustico-vestibula(porechea a Vil-a) 147 iar 149 450 151 151 154 184 156 197 7 159 199 160 160 161 462 163 163 463 164 165, 468 70 170 m mX14. Sistomul nervos vegetativ simpatic 17 X12. Sistomul nervos vegetatv parasimpatic a4 XiL EXAMINAREA PACIENTULUI CU TULBURAR! SFINCTERIENE. 178 XILT. Notiuni de anatomie 176 XIL2.Notiuni de faiologie 178 XiL3. Considerati clinics 179 Xil, PACIENTUL CU TULBURARI ALE STARI OE CONSTIENTA +20 Xl. Examinarea pacientulul cu tulburérl ale str de congtienta 180 XilL2. Cauze comune pentru starea do coma 186 XII. Hipertensiunea intracraniang 487 il.31. Angajarea uncala 487 XilL3.2: Angajarea central 188 XIV, SINTEZA EXAMINARII NEUROLOGICE 189 ILIOGRAFIE 101 ( |. ANAMNEZA SI INSTRUMENTELE NECESARE EXAMINARII NEUROLOGICE LA, ANAMNEZA In neurologic, poate mal mul cain ate specialty, stones bolls! anlecedontetepaciantuli ne pot aventa in agnosie Secret Lune! ‘anamneze coreete este acala daa ne tanstorina ie fu Aascultar. Esta imporant sane farm gi de prezumpia ca, ind int Sservieu de neurcogie, pacientul rebuie obligato $8 ab o suerint newroogea. ‘Pentru un examen neurologic complet, pier rebue sf lreaz, conglient, cooperant, intro camer lngtts, bine lumina Inalata corespuncaior, cu posbtatea de a f dezbracal(pistands intimate}. Pacientul bus examinat complet, deoarece puter oi ‘Semne neurologice la care rune agteptam si care pot contribu | iagnostc, ‘Anamneza cupinde mei male etope ~ "Dalele personale le pacinnulu: virsta, ccupata, dac este" drepteci sau stangaci(omisfera sting ‘pordoneazd baju la tot dreptach $i Ia 70% dite. Siangacl sau amoidexi), Motvele intend, Antecedente personal, Antecedents faa. Condi de viata i de munca, © store bet PPecientul rebuie lassi s8 se exptime singur (pe cét posi acd nu_are tubburai de. limbaj sau ‘de exprmare). Sa desc Simptomele cu proprile cuvini gi cu et mal multe amanunta post dar fara ase lerde In delat exhaustive Ca umaro, dupa identiicarea_simptomelor, trebuie s: lati din timpulanamneze! ummatoaree aspects + De cand s.a nal simpiomatoiogia 1 care a fost modu ot ‘2parije (brutal sau gradat) si evalua acess ens progresivitate sa nu? + Daca simptomele apar cu intermitent, ot dureaza acuzele¢ are este trecventa de aparie sau dacd sunt siabio = constants IntiExisterta aller simptome asoctate principalelr acuze Factor care precipita sau ameioreaza stoma Ce investiga sau elecvat pnd la momenta actual Ce tratamante a mai urrat cue efecteeupra simptomelor In cees ce privesto aniocendentole personale, este de preferats8:ne bazim. po eat posi pe cocumente mediate anterioare aro 38 atest forte afectun: decorate de paciert. sie imporiant 8 cuneagtom medicamentele pe care le lua pacientul pan Slocbunile deca Antecedenele familie Webule stent cautate, mai ales c& 0 ‘ulime de bol neurolegice degenerative au un substrat genetic. De Aasemenea, o multtodine Ge factor de rise pent patologia vascular ‘au 9 incarcatura familala (disiphdemile, label zaharal, hiperensiunea aera ec) In o8ea ce prvasto conte de viea 94 munca, nu frebule nealjte intrebirie "despre expunerea Ia dle factor tox Profesional De asemenea trebule frut cont 8, impact socal a aleciunlor neurdogice, soldat de mute ot cu handcapun dete de hoglal este fearie mare, paGenti racestand super psiiloge penny inigrarea i socatate eviron izle sociale, Concluit Anamneza reprezinia pared ea mai importants a ‘amend cine. ¥ Ea trebule s6_ne sles consinim ipotezele de agnostic, prin” inlogtares date in. conoxtl ‘anlecedenislr personal famille ale pacionu 12. INSTRUMENTELE NECESARE EXAMINARIL NEUROLOGICE Clocanul do retlexe care poste f dota cu un ae bant gi cu 0 Peru penru examinarea sensible dueroase gate, ¢ ‘Ac bont pent examinarea sensbitath durroase, Priuta sau vats pentu examinarea senebita ace Diapazon periry examinarea sensistat visatr Offalmoscop penifu examinareafundulut de och, far tunis poate sor gla examinorea reflex foleator, Lanter pentru examinarea refx fotomotor Spun sau all substan odorzanta penitu examinaree slate Examenul se incepe prin examinaroa generals: este observa pacionul in tmp ce se objne anamneza, Examinatorul va incepe pit 50 prezenta, evaluind in acolay imp, rosie, staroa de congtonta¢ acter Se apreciaza_aspectul general al pacentulu: igiena 51 aspecta vestimentar(adocvattemperaturs medi, vrs, statusula social), Sevoteaza + Groutalea, Inalimoa, constiuja (cagecte, obez smart + Difericle postri paricuare (opistotonus, toca ‘sau mode involutare (Kemer, mica ample, ce cculoate), daca ext + Some vial: pull (palpareaartoroorpeiforie dele toate membrole) si alra.veninculars. auscutaie corduls qr aterelor caroiée, temperatura, tensune arterial, resp + Examinarea Serer de niale meningeal.Il, ATITUDINI PARTICULARE $I SE’ VE MENINGEALE 11, ATITUDINI PARTICULARE Anum pall neuciogice detemind atte panicle, care no aula ofrtarea sagnostu nea la prima inspec 8 > Hemipareza spastic (el mai fecvent dup ecu vasculre eretra) Wombrul superior slo in asi, cu antebrat in enone gun rena pe bo er eget sur ‘Membr inferior eso fn exes, pci avn tend ean fese pane oat ima, Aceast poss ‘otomind mera carci, cost of aeestr Pode. Packngon 7 botrata uncd Mars cu pa! mi, gil fr balansul blr. “Faces hpomimi sat'amime (8a) up or. 7 Pacintul nu poate meontine © atudine stabi datos ‘ut multitude de mia volutre, tl dezordonato Sinan ote next Memes supericre sunt exensie, adduct 5 tale intra \ Hlembele feroare sunt n extensi ai inter. > laltiatea rn doco Membelesuperiare sunt in fx, embyele eferoare sunt textes gota iter. Alun Blnavul este ghemuita In cecas de puyed uti ata, cu aparia une solioe antic. > Tosicolis ~7 Capul oso Incl ata, ey babi rica faa oat ‘pr parca opus 12, SEMNELE MENINGEALE Semnolo meningesle se obin grin manera de eongaie ‘8escinior noe spinah care dn saul ue provocate, cues | limtates migeari do foxe In fegiunes cereals sou de exten | ‘vel mabe neroare, Examinaea cine asermeler meningeal se fects cu aclnttn cub dersa cu membre iferoere nesters Redoarea de cea roprezins corvacts muscu cele Ingo do cutee la marevele da mabizare volts. sou pasa cle a incercarea de a atinge tracele cu bara, In condi tae "dain paroase de un procasinfesios(mankige bacterero se ale) seu de moctiearea medull Ghnse norma (singe In sesh Subarahnoiian)| Examinatorltncearcd 68 fcteze capl paienubi pe trace. Se ‘constalaimposbitea fle caput, dita neputind ange tracle Trebuie 8 menfonim c8 imposibilttea fest capulln. Inseam obigatoru exstenja ial meningeene: aut redoar dt ‘eal gn azul una Fac ale cpanel caves, sia carer 50 poate face ric fx nl extensla caput (inl nu eee inde) S2v, mal frecyent ‘eainia Tn paces mecca, prin modest spondlozice ale colon! comical Putem gs font pacer ¢Il, ATITUDINI PARTICULARE $1 SEMNE MENINGEALE 14, ATITUDINI PARTICULARE -Anunitepstigl neuroasce detemiad atin part care Ta chentaren ogress nc ols pia nepec 8 > Hamjaacza spas (smal event pac vascare 7 hoi spar tn adda, eu ater n Sori Ugoard pone pe, eps tnt fete peste pees Mantel fer exe nextel, ond avin ei {toa rin nexe planar gral ntoma, Aceosla pote ‘licrmina eet carci, Cont ct pace > Boala Parkinson Hos opal gil aloe ej. 1 Peles npcnane sa mim i) cp ar. 7 pacer nu poate mentine 0 aitusne sabi datos na ulin de mie ilu, ol ezordonate > Rinna orn decerebrare tomtele supercars sint nextel, astuc x aie Marble roaresunn exon rae its > Risittes orn dosorteare Psrachaless exer embrala spare sit in Membr irate stn exrsie ta tema Aine Blnevull eso oho, n cocoy de pug. > piscooats werebrale uae eae, apaia ne colo ats Capi este fncint atara, ou rb lel flare reparea epics 112, SEMNELE MENINGEALE Semele meningale se chin prin marewa do slongt ‘acini never spa care dln eauzn due provecate, due Frarea migeardo feo Ih repuneacervesla rau de elon ‘lu mendelrnoroare pacentl in decstdrsal. ov membres extrso Redoares do ceafa ropes contacts rates © Ineoya de cere ta munavrele nase vourard ae pas (ate ncorearea do 8 stnge tract cu barb ncaa ‘aascinfer nerves do un procos cts (menngla bacerens ‘rate tau de rodiicaren madi chime nomal (esnge Th se ‘oernnaan) xaminctonlIcaar $8 tectze cal aan po trace, CotetaaInposbtatn fxelcapll, bala nepund singe tat € yal on Tebsle 28 menjensm 28 impesbaiee Basal eapus Inogarnd obligato extona a meningsen: exis recoar (ald aa nor oct le odour cave, sue cat Se poate fool nla nit extol cap (gt hu oso Saul rover rants fn preciea madeala, "pen med ‘pondinsc ln cabana earicala.Putem get Ia unt poset ‘esoare do tp opoctona, co aeemanea pani fexie = Pe ‘worse, car buen une aun ra stesa paces iteSem Kerig Keri: pacer se fn decubt desl oorcarea de ‘rod0e flea nsounra & gonunchiu antl). + Kari 2: point ind in cab coal co oops Neca pe cn 30 exrnstonl nesses exis gra cn Gel, cace ce pobre eee a Unto a exer ub ca — ‘emul Braden 1 Gradzines 1: ssamiatou|inoearca a elactice ex capi Fea gambebr pe ceape a acestra pe abdomen, Ge. ao | Reh ‘+ Bradzinai 2 foctares fee pas »coopeal pe edomen, Gatamin sia gombel 9 conpon a celak mom eso, Meninglaml Sterns teotte redare de ceoll, SISTEMUL MOTOR $I MOTILITATEA Sistomut moter ssigcd motietitea oman fd const mat mls subiteme, ive caro exit rach SV ARILE MOTOR “CORTICALE (ARILE MOTOR 1 PREMOTORI ARIA MOTORIE SUPLMENTARA) ‘CAILE MOTILITATH (SISTEMUL PIRAMIOAL) ‘SUBSISTEMUL EXTRAPRAMIOAL { SUBSISTEMUL CEREBELOS 1 SuasisTEMUL VESTIBULAR Moliaies rprecisponbliaten oo migare, co sigur plese orgasm sua stor segment ae sia Motliten ‘ee dermal mata ot gc volute, comandate 3 scour corebrala cu un scophine tabs, Comana scula motor peach din scoartaprecental. & ‘abu frontal (aria motor pimara = ara 4 Brodmann, undo 8 homuncull met aria premotore = aria © Brodmann, roto suptmntar), Oaed ext Inert cata ete miors Inelron go ead acest ivenper na Se mal pose sles igen voto. ufarea mig eur, ca ampludne, teed sa on ‘col arse. car, i une So aspech conta 5 ‘eiecalzor. posta va da parc pa a slog, PAREZA = ttre migseor ran anu tno ‘+ monopareza = scares ampltuaini vera su fot do rome misao a un mombus (monopreed brah eau reap). ‘+ hemiparezh = scidores ampli, viezel sau a fet de tecle a mace in matte do com (ati ls meu ‘peor, cael er) + paraparcea = scares ampliuded, viexe sau fate de 4 ttraparezd = sfoarea ureter pat monde PLEGIE = ps tal mio ante cu acl vate a a ‘+ monoplaie = abenie mic: la ue mtu (ranoeie Ural eau curl senge sa coat) manu supetor, ct cx) igen marl err, + ote branaia™ aoeena mcr fname mere ‘alo WeaealReseareh Counel Seale) us grave ‘= ilu fa oo ages rete poss 41='sunt pes serach vol Wile, sau pe cae le vider ia paar muse Sr cre hu depaceac Segrant imearese edu fs 2 eso posbl migcares aca, dr 8 aiming gave tb pln pot 3 migcirea act se poate exocta gi imgovaqava, aru 9 npn ne feast dpa exit 4s migcen civ ee pooa conn revi uel reat deren ed. ' ana musty este renal, pact poate exes migra conan meus do rama 4. CAILE MOTLITATH 19, CALE PIRAMIDALE cORTICO SPINAL) Cle pads sunt alate dn fro (oxo cu rine Soars cereal n cele paride Set nauronul ator contre utente)" aria piscetaia a lebutonaunde Sea omuncuitsid moo ares asodars fre nari peta ydn ‘tia matone superar, lo so tarrind In nase molt a nal {canlrisau Th caulale moto dn eaten antercre (neuron ‘motor peri = NMP) ate mace spin. Cle pram ou al ous tact unl corico bulbar, care mega. Mule plot Etaion 9 afl crtce spinal, care merge le eae area dt mradwa sin a remand cnet cleric prom Piramidale (NMC) dn sceara coreba (oss Bez) Je undespt un tect descndent. ected pen bratul posterior al ‘spell ntore spp fafa anteroar a truncal earebral. In ecunenlt cera Seip porunea mise pour scar, Ih farts tecs pte fheele pontine transerate ese? Goodadn Fess nurerose, ara vel butar doin sper 9 remind ‘opines peamideleranatcae, care grooming pe ala arena ¢ (hihuur La nvetl etme moor bua, Se Sosace tn dos + oul sa neulgact pa ia medina forind decusaia Pramdala sso tact corveo-pinal tral Fasclelupramidal nerucgat cae conne cea mat tare parte aber srmte S08) + fafa recus (w10% ange rae arial) ‘bow mau dest deve tata cortee Spinal veil fascleull praia ree). Fle tachi peamical ct so ieucyeazd sol la vl made prin comiur nf anieroer, der ota fa veh ‘hotter eepmerte media La veil save Room fe sapsd ‘ale dons novon ae, sian mara dn com antonor NMP). '.Troctal cots bubar est nun 9 fasleul goncuat, oni of, ups cobonrs a scoata ebrla, {oe pth enunchit eapeuel interne La nv pecuneulda cereba ocups Elnomsn inter plo pedunedor, fr intl sy pin roti! crea et fe spre nue de origme at ner maton ftenen Unele fre de a nivel posure crea emoacs wn ‘Gere! dens, cave salud tarwnael modal te Are In elt eri Scrot I ZV precum gin cau exaoae Tor ete fale sro oaul-etslogi Celle thre fortnebubare mary ere nucle motors pon, VX, XI i at ae icin sa mac conmcospos sae al ci motor el a gdseso i unchl cerebral Sau comnele Snteriare ale maduvel spi, de" undo pleacd eri canton, feapodiy spina, ee Srgseleslcton ee asguré macarea, Ent Sota de retro ere owe motonesront gar iB ‘Motoneuront ata au acpie recs ye rele mace sunt de du falta fai cae neweasd Trae muscle St Corres apes, erin doar in Unpol contvacil alfa tone,corr pe negro oe eo em re eut ntr erial ce acneech og uu nme ieee ora tacsty canes eta ema es cea meee fee mera Sune’ de manen er (xem: unt moo mich ol 46 fre see cireersieead ti ends oie washerenante cota Bohs iaepenmoencmase tak ocean earner icate vmod athe deco aa etc 14.2, CAILE EXTRAPIRAMIDALE res ren cre nt pena eee ees sooth ages mia awa Sergei sea enone wc Sis ate gee Ea ca 9 ad ‘Raut mde in trl raven, rnd malar rit ay seo aae acted ee ‘Sores tat pons ep ciceaneeeteaes = * Sp cuss cows, substnja oeagr i ructoul rth anna enienci er omecat cata sri yaaa rae ttl iain eit geome’ re cocriars laaais vice sien aa ae eu crs og stot coral Se eco o acal null au lr ean reer, dot poe Gea nve medulr, draelenaarsaaupra aie corikle mle bude dep eodback. otal sat, cu mules de lgbur sl conesun or unt eel do ‘il utes Find sistomol aor expan jana 2 505 Serena de stom moto ama ‘hgh mucel su coneyunt cu cone corral, sutton reap lus, nude suse, cerebel Un inp cul verotal ata amie, ce rope 9 pure do Ingeura ve feces scandete ale sisemelo staal = cofbels spre ae foal rope gala ote suplnetara, de ‘do vor lunge la sslom concep gi le allo satcme ‘Seecondente ee Funcfilesubsisterullexrepiramidat inierea miseSlor voluntae si montorsaren progress mia, transfer 1 modicrealnformatior dea necurtex a le ‘oor (ra lesa otresyplmorar ae prmsora). + Grecia automata” fomemerreanerucurior pen Injres, cong inwtarea) ac motor iste ‘oor Null caus! eae foc da ign ati motos+ modules atv imbice 31 cognitive exin impkares ‘tena pron oat (13. UCL. BAZALISAU CORPUS STRIATUM Corp sat esto cal mai mare component a gangs zal, cut prtund in etorle coer, find ical in We corporate rile! eaudat, putamen 1 plobus pataus, ‘oceu! caudal otto separat heamplet de puaman pen apes ‘eioma gi feeneaza’mprund neostatl El cone. un Fauctansmtatorinblor aiddgama-nio-bate (GABA) sal ect scecaina (ch), pega coe ae mal gleeee 9 ai eucrenemfton: arkoinn, sola P.neuropepl ¥ ‘Globus palicue formcs polecetit, ied siuat ral te putamen separ! do lp tama defo mielnzate puns {nina edule extrnt. © lama srs amina_ moduler Intern) Hiatt ire par atorala say ecema 0 pxte medal Shu ble Globus paldue ete avesal Je nuMeroase To imeunasia, cooa co Wt confraaepectcracerte. Teron de ‘la lena eo rf lapse lsu als imrouns ag fr par era 2 pmo rg sg Sedat Sonic ppsioon a gcraeusinoe ste "utenti Se ct ura cone ae i casua exten Se opener pda Ge ‘csi onan ee ae Sv Wo OR ‘Cone near ips Eton pan cro del bl pr he! nc, oma obese Eas seomponen sauna me ‘ingens ne cd, ene omporan. Nn ‘suntan ea eet ane ere a ‘ob ec ce ater eu etary me Eon re 11.4 SUBSTANTIA GRA, Substarjanoogr esto un nucle akegi stat n padi orb, care, ae! afin unchdserbea aco oto input Ge vedere funcjonal da stor xrapramdal, dion coneiinsor 31 fei sl. Ae cous porn detneta ah pune veuare a ‘eurovancitrir ula sa cones par aticults (eta. {oloesle GABA ca neurearsratr ssa grote Ta rvl ‘alsul it ruses vol eran, verter ocomedl Fuca la vehi coretral pee mga de et sah Inlarmedl GABA’ 3 swstafel P) 1 pars compacta (oral ~ fGctoys dopemina- OA ga poet pa neoabtal) Pars Sompacia ‘ne wn pigment nag *neuromelanina, Pars rateula cone $1 canst mare do onan gama deosboslza (GAD), nacre pau stare GABA W., MUCLEUL SUBTALANG (LUYS) Necll suttalamic lu Liye este stucira stata venta io talamus char acl de capeul iter ce peneste eps Jeo ‘Sorex are log birerfale ov GP (gous pas) ech ‘a als vasclare e la acos rel sure uate de apa mga Fetus de. rare smploare dap hema 1.2. EXAMINAREA MOTILITATI VOLUNTARE otitatea copings ottaton misciror exseuste de un ‘xganis, peta foos fat mad cornea Pent apeceea moti so ovamnescs: migarile active, fora ‘Seamentars gs ncn probele de pares,2.1, WSCARILE ACTIVE Peru exemnares migeaior acto | so dau paceniu rte comerai pe eae scott va eveou, n topul even (recs do\ mite, Paden vebus. safe cone Somer eso pet xno rt rie si tunchit unind pacar f meecie mies i ost ate $ret #8 rom cote posse afc esos, e-reurdoak, care po ipa efscunes mgt. vere eco, ps (aout een concldet oe, are, itl algo. 12.4, MEMBRUL SUPERIOR tell min vem post 9 de a ofec 5 ar do 14, fexa dagetelor: agi pacer #8 nels urn, miggare oxen 68 fexord peta $1 prefund a Eopstor fem ers neice median ulnar (rv Un mopeaed Sf etugonintinsecl i mii. cu except ole dol ‘bre bel opozantuts pose, sur ductor a posal ari Row pobenh care sur inet de nevl median) 3a 122, extenia dogetalor: se thoazd_ mira pacers sug ol deposi n oensi, migareexocla ‘e'etansorl copter, pn eral nterosos cosa ram dn ada, ee caeapunda ca rade C7, C8 2 abductia degotelor eee rut pace st rps cope tear eet onl cena ca Inert de dcria C8 Tera ulnar 5. oposta police pin intemal moschi Seat oon nat 46 sis 8 GF, 8, Fre‘bane punta sunt poste utoaro gc ‘oa purus ou mugs more palmat foie ground al degenor “pate radla pn ragoenie C7-7t {rere median) wimg flexor refund al dept = potee als, pn radsee C771 (calcu) 2 extansia puma eu mug extensor conn st dogattor, ung evens a patos, cut exiorsor 8 plea xonsir yrpn'h indent extensor pops dogeuh mi ph ‘Gibco C68 fer radial 1 mugen hing abdvte a pllals, Irate radia C27 (net aa). = execu ou mucha fsa eapan cuba erate rasaeile CT {Ti foar cuit extra radia a mand pn exansorul oda 3 eet aan CO-C(ne ra). pucae o oc decea poder ete migcre combina 2 «anv arufatel cot sept abn flexi anfebrajll: rug pedir 56 ioe anita, cu mina in supnade, mieaoa eta execs cu suo ‘ujchlorbcope bah brat afr pin rm rar {C56 (nora muscuocuten), &mugchull coraccorail pn ‘cred resco C8-C7 (nv musculoeutan) 9 amg Leg guar resend erat" ron 6 (rr rtebrajlu: agin pact fact rigoaea do edensio a ersbrajul, care oe eeu Cu sion Iuptiorbepe gl ancone, eral de asicinta C8, CY. C8 rer radiapons leone cy hc or on fens C41 (oored madi) A, suplnain so secuenah cu jlo mschaar lung supiator (ratios neva de racacale CCECT (nev ‘ad eos bran IOS din Examinim ponsa medicals, lestind fea segment se poe gi dott mie aia S sboucje 0 ler iors, izes (imal 15 grade) © ace We eens pont cd err s8 nian panda 60 de grade » sch ide fo est rvel pl 6D oe Grade i In weune a TTexamines gos do abduct adsc » deat, ttoo. sensor ‘mig conte Teenie epuse. oo rive antabrauld oe examines ff eweneia antebraji coir cent =ox de Nee 3 8 ener cesta neces spunea la caso miei pan 8 oven Fora o fesle dorsal a pisonill se testeash ngind pasion 3 exocut fos maxim, cota risten examin Iigearea de 3 Wege de abe porn sus, sre gam Fora de fone plantar se exsinases ngind pasion 38 pac migra de ingen os ab: eo la iw Esto uta oxominarea fl de Nose ontario a hac cere pose nia tn daghosiesea unl vaste: raelna LS Ss ‘reroll Gas anipra Peni dorsal a halon (fetres sav duce is mscsinoa foctirs seotel gen, caf exotic Fora Fora de foxe sl exonsie a genunchiht se examinaaza ‘uaa radacina St face lenin plantas ahalucll(aeciorea rgd paca et guoute mga cia fxisan puso, de Sioa Geeta ots sel su ingots aaa a. tra eva ann Serb, onde fern de fot ne ot cou amr,Tosiarea tore! de atducje gi adduct so clotvoazd xn stare recet arnabr f fja een so lon. 8 ‘ramble are co Zo xscutemigeares cerca membrane de pe pan pat, onraute vecsone cobra fli eeba3 con 1123. PROBELE DE PAREZA ‘Pentru mambrle superoare: Este rugatpacerti 58 tra Balle nse fo fol cate secure: in med roel membla supetoata amin In acess pate facta Ose8 un rile are tncnia de 228 Sepa nn apeoem pte oxi pt ena Ge [robe pala. Proba pasta ma sees seed rim poco #8 {nd bajo rinse In poate da supa, fora esa find ma Imoe. gmoney del do forsee tence a ob 2 poste {Se roma, c= apo = rads. rons eon stor pat dec Iolo de tp cea, mombrl cu doc reser avend tran de a tut 'in pane de prone Ete 9 probe ula pent renee {ul dtl eal de tl mira sua in career a cd 8 ‘otecuta cares de pons y a ‘Mamba cu tsk alt va cea mal fepede pe pt pt+ asilescu: pet in decubt dorsal este rug sd exec mal Thule net de fxn exon, simon cu elo oud bre trae ip un Goo cr cine oe ard pa. Nem + Bars pace n deca vera sto ugt 56 mentin membrle Poot fetta de veal gerunchi wih obtuz,membu Farszl Vo clon mot rapade pe lal pt 8 ocuto lt Eros robin rile yc spot wna ete Sul pact In carl nu paint necooperont, sac sau in ela do coms, u vom poo apreciamicarie solve 3 fa serena, St vom pace coptia staal Gobet mots eecuar pb de Jerelttn nacwee doite’exomnaor = anbel merbre supercar sou Inforoar s ésarea ler s8 cada smutan pe pan atl mombrlpaaszt va singe mal repedo plot pal 1 Ce 1.3, EXAMINAREA MOTILITATH REFLEXE Motuates tater rereaita un respune motor la un ser deca realzst pon lemoaal itor nenos, ATU rofex ups fecplond cae pimesie sul cdl afore, cent (nner factor care va rela micaoaca sf! esl 1. REFLEXELE OSTEO TENDINOASE. Refloxeie osteotendincase (ROT) feyeaiia un tp do rigours intacu,cae resins an stnroa un receptor ey Seer unc for auremuseusr, cae prio angi shapes cn mul antror maduar‘stmusaca' un new metor'@. Stem 9 foriracie muscuar, Focare flex So ines Inve care ne ft oo tn deterures ocak ane ieun ROT to ind ‘oor cena car e modeas nents. Examinara lr to face shor uti decane eloxe esta oblate comoaare or ting eae) In od nema la 0 perule a unui tondon se obtine o srgurs onrxi,aealmenstats Se poole anc fel uate. saben SeSetaete Penta examinarea ROT pacirtl vobio 68 fo cét mai rola, poze comoat sl simatic ponrue pulea aoreca rer aainete de manbe, Deck pace esto fla. ‘Scweire ait selxim, exammandut tn inp co 9 punem dverss fneba eau i rugim 38 evacuta cree mica cl eoopl do 3 Inauce 0 aia demmara (rarave do Geartware). Deonhoarea se oe ruginé pacer a8 srig’ Sh, 28 tpemse8. sou, pei tvaminaesrfixeor dea meme ifriare, #820 spuce dah 8 Yod nse fos (area Jas), 28 mpegs cuClocan de retee bu sa 8 cada Ker, cvomigcare ale Pe uy gi se uae ui pe bra. Paint exe Se ra. ey ral leat So cite rama, relat $a . Pate Webbed gi mn doch ‘ tar ait pacer a Sncube wonton pSsicnle CBT, Se pets mci de roa 8 tnibr ae cue 2 ce ec rermedore ince soma sin fobion (cnte L344. nel tama) so perth {endorlcodcepsula femurs mea ub hla opt lateral "umitndese micas. de etende a camber conti Yel arpa pl (poe au in dost das nd exon pesos up brat sb gun paenlrcando goes fe “+ achilan (ciclo $182. nono til porcute ‘erdondul‘adhlan seterad fa paras © load Pent oct deca corel, se mentine meer Intern So poste do senna gi olla eera 20 ‘osoacd Ena amnston ls el pats mend S'is 90%, penru e everja Sexa scone In marl Bereta tndonu. Dacd pagent posto faba ‘SSurma I vom rga 2 se apex In erunch pe maranes pati cy pale In sors semen 930 marae Clonusul este expresin unui eSspuneexagert (patloge) Scandi gvalacet mays supusnindot, ind adosea aso {ROT poteunates eau conoid la pera tendon =o ‘jn mat mite spins na dosr 9 egurd migre cum So Inegéseaca’ med nema) Clorusl_ a eps a. pasoanale ‘inital doar n azul aor crea leu de NMC. Exit Sot ‘pur a conus 4) plantar: examination fecesca wr momo efor prt inrodcaro uni mn sus genni plone mins face doritsa reset picorua go monje: n mod ronal se protuce nc un fel de migeare. Pala itp nem in onaune Sao Ae dons ts vor Tagan cea2 rtuln: pacer se af In deci coral cu membre ovate ine: se acfonoass bru de tus re puna’ ‘sue tendon vecapel in mod nal nu Se pre es ‘nace. neazdeleaun de NMC apr catarltimce sl sokle, enclu ‘ra ame ROT pain ma ut tui “) nperrtectviste sau refs polchinetcs, clonade, wna Ini lconea de nouton mar Coal uss aootee ‘eu a caves obo moateares (susie h sue tno 28 Ge contol super af acesora dev i) Geode ae ‘ave eat det operon goons snk 2) suena ROT, crete ded iene al ele ‘crwad zion newer ak peer eterna he pee 9 poinaopsto peed, sou ‘ae malar in cadulunoratecun genetics ohiromal nae ‘sho punta + sblten eens tomate” Eells oat sige © len rar eau aloaroa Seen biatralt ros achilles: cl al eevert so ‘note neural pater, dar ponte dvs vel ere ‘Stora de racine St sau mal ooo ery ail bate, 3) diminuores ROT. sugeroaza newopalla perfec, bok seule sau sion carbon ROT pot diminuste sau absonte in stale iat ale unor luni severe de neuron motor can, n aes de go spina 4 sons reflexogena Inti 39 costs eajneren ROT #2 pera ls dstan do lec! rarmal gs eo supa rl on mos onmal we soca cu iperetatn, 3 inversacea reflex esto 0 comsinsie ino absenje Tos ett (lecune do NMP ssqmsctars) fo nd atege 38 peri un nie ma os Gesina do AAIG) cu etnies a [hi eniagorit: Exemp ROT bio at absent. da soe in ps cpl oe lose da ren roe parr itm voto ost tm £3) #0 soe een Sheed ase abe 6) eter pers s rer ese crtlonea 5 sunt mata ecsrtt ated ROT ron Se act aan pork ce soft te nue se por co Benders deo poe baa al vnc err fd So Petit sin cul 1139. REFLEXELE CUTANATE. Sunt efexe oe apa n mod flog ca rspuns a excaren ‘wgyront El sin refer planoptoe find conole de NM. S"Refioxee cutanate abdominals: so" cop pr sularea {ogumentilpercteks sodornal Gu son urd obec asc terre" tte, delerminanduse epee nel conc sean ser, ber cole tea el 7 2 oct oahdonbieua fo ci oral T90) 3. intron ar! cv ead nahin (es nce aa 3) ‘osenla or pe poole supe © feline do neuron nate conta. dar Webue 68 fam cont de posbilisten spacial lo endl ne-neuege: abet, itrvenflchrucle absomn, ‘Sen mulipi, vrei sits abomen destin, muscle haseofleu cutanat plantar (4-82: sche pn ncora marge Sere 2 plana cu un stor! bont (aes) nepre cba be Images rae, pind is baza eget, Ta mod kegs 2 te exis hurr dogeao eu aca opus mic pss 2 St Is care nv tmnt proces de minizare 9a care ee Date one extersa Pas xa cle gepeto rod fata, {etext eremastorian (L1-L2): 56 obine ang ou une nt 4 ss nos, fogumorilrogur superiors a cosa Apare "mod logic ocontacle @ magia remaster, ce detain area hare 0 testeuul Reon cepare in cea euro promo, In paclni cu © pisos locals (neal ‘cael Spi cia) sau a vist {eflrulBulb-cavernos (S384) 0 one contac mage bo caveros, eave se snle pin palores penis fapoia ‘cull np co est pt land ne poet index {eflowul oso (15 29 bn contac rage ele pin velar tegument eel n ane veal cy un sober 1+ Retox anal (S3-88): sobre conta since sal exam pin ences tguranitor pera. 134, REFLEXE PaToLoGice ‘Sunt refine primitive care nu se obi i nul sas, lowe in ean apa enor lun veuroge, dar ere sunt rezone n prime an de va nod tion: Ffemnul Babinski: exammim veel cura planar gach Poconul face xtnsa alco oe caste Sega po cre grt oobi cone Batok, ce somites ces oo ‘+ Semul Oppenteim: so cotoard po fala enteroard a bi rerctand o comprose cu ptcaa 9 indxu, lar apaia tna Frauen are Senos sonniease cay sori Bante ‘+ Somat Shitfor: oe cupste ron Acie gs pots cope {rtoa hlueald nazi ecu da NMC: ‘+ Somnul Gordon: compress musculus gamtiore poste rie exten hake, cu aay sere,Semnut Rossolino: x8 cbine pin pecutiacu ait ciocandt Ge rans ta baza degtlo pe faa pears, feed aus 6 lene de AMC se rode ena eae cre it ha ~ ‘7a fel mater at enor nro meer conv la ment 1rd rere palona, mane tamu Babs cae fro‘ a dcper oe -Sonne sos vas Sempal Hotimann: examintend joe mina pact care ‘sble 38 relat, cu coals mind apes fangs dsl de 3 degli 2 sau 90 Meteazaputomc ftriac pen pecare So rahi, aceon snows detnd Nea 9 saute folca dente sfonde NMC poste Cnetert cca ‘mull Saint ta mina. femnul Marinescu-Radovicl (flext!_paime-mentonir) ‘lara amnerel tone cu aparal unset bon Soin 9 iecare @ mertouh co acoeay pane, Rel ape ed ‘par cle IC in roame pesudotulbor arse Poa a inde norma, allo vrs care au tus focrane Aestroedorors contra Somnul Trocmner: oxamiatonl apuct ine poles 91 indo folarga proxmala » degotuul mjocu al pacer, custard Inara aces cl dogo! milous do la Soins mana vege falar dai cageuts milo a rvel palmar se pote obra Sega spt ea sen Hoan, neal wor ene ‘alr pramide Reflesul de apucare forfat(grseping|: aingeoa sou porcua Dalnal pacentula dearmina fois fof dopeiscr ncaa Drinerenoblectis (mana examiner feepecty cu fot a osbilates de 8 destoce dogetle fa pac cu Iain Wena Sintra) Reflex de sugere:porciiabuzelor pacer produce, in med Fotcloge, pacar eu leu size Fonoserporlo, mig ce un Retin poate dacngat lca auton unl sblsseanque acal ve burs pacer sun gu cd poste #3 spre 9 Frelepare acne. Posta Winton caz de deren po las waumatos, anoxioe sau degree. Refine juguior a buzolor (Toulouse): se porcut yor buza ‘Supaiar sau spall hive nas tua soprears In eal oer ‘Geum coscopantine (rape! In snsomel peoudeulba eau (Eeunt sipransogare" bistro) pare "0. gras oi,Zerit, 9s pote bizeor, pan concerns {eft glabele: se ports usar tunes packer ne 'prncene coca ‘ce In mod ternal detain clove mig de ‘ibe, ce sunt euchmale, char daca pare se fod ‘elope, poset prea persitentesoesor gc 40 opr Stim persia tml, Przersoast eer ie cae ‘ronor anv Sonex tl sca aca prt {eter do pl eae fr lestne medars): apa la excl ‘oleptie culanats a mambra ener h cone. cera oe ‘ne ret ical pe gab, gabe ps eoaped 3 Sopa baz Nola suotor a car ex eon rotorale de macratan ‘oer repress ives anor aes mule. Refit patoice su serieaie dor Spd vicea de 2 3 tema prociel do misineae fan a occas 1B se pati mmo fog -TONUSUL MUSCULAR Musodstums so oa pemanent int-o sare do canracfe unt rt pin iormedl rea mate dependant de ‘ul motor prt, at su enrol neurons meter con a Seti’ al Macy ‘azl a stoma esto Teed Dil ese fool h mod nomal ge ore fteucepins Cae etl coteonal ee staan se ‘ui do trander Aenea fb cantabsanseace, pale ‘ear vente pe clea retaleopnela pons vesibubspinas BIE. Acoso aur inert de un ate fs rltsnaple care ‘ara corel use baa tcl orca 141. XAMINAREA TONUSULUL MUSCULAR. Ponty examines torus mutculrtobe 88. algun ed paciet sit eanat, vom oxcuta mica Des la atta ra, uae arto, uit exstena unl reer upoore nomi Suma ei osc resurar nnmg. te pode mina acon fs execu ei mig de pronati i supe ‘re ttveoz® antaraul 9 se executa migcal de flee 9) ural su sola in aricalaia purr 50 execute 9\evtoniaatabape bat (Sivek mambreornferoae 4 ruleszl gerunct tro pare Ih aa, cu pact In owt oveal pert a examina esa no gust fe agenzh 0 mind sub gerurc ss fe ald Gene, umarna eta po 6 feo fea exer foo ena seria bal perl el lanlsett: Tra acostrmanevte pte nn al nt is + Normotone =o joa rentn a micrie eects fla artes pe ba. purl (enna n prelinaren ‘rotate ean els ae aS pu de Be lla icarea tcl de cre ‘enunchlr els linge foa a micas de Nel pe raped + Hiptonie = sedges rextenfs rormate a. mice Folrotea aria, is exe acess” menfneroa fedolr pe plant goth le ores "buses 3 (nunchor alle sing fesa la tana gare pe ‘aapse. © hpslonie marea sete denuml aceite Feotnia pute ‘inh ick de neuron cer freien, amp, go 1+ Hlbertonia = cepoes tonusiuimcuar poate de dou 5. spa (ipstenis de te pin): pradomina pe 2 ta mombrole. supeiowe. $1 pe extonsor Ta membre oars mami spar ends Go 2 inn fe a trata ipsam tector mal mae. migra, le a cedeest tn med bree te ste trusea a gorurchlor, cletele se lies cu Ugur de ps paul uncotSind fore ded Bene gumbo po ccc, Stata apare in eee nauron mor cnt 2 rigidtate (ipetonle de tp extrapcamia) sto ‘1m ropatat pe exon extensors inconsar 9 cedeaze {Gao coo se ederacs mal ales inves ‘ul eee, il opie lemedara glimpse gest [okie extol, peas 0 migareeocadat Se pate ete mul ful Nes ‘spare slocarea mises pasne Husa ‘ula ind Bokaval ete rgat st moblzeza mera noo S ‘SH pate. Rigiist earn rola se tialese Ih ‘arse extapramiae bala Parison Un at tp de cep a Yondeull muscular, cond fala, poste conserats raise Go. decatare au bre C8 vor deta examen pacer comatas. 2, TONUSUL MUSCULARDE POSTURA fo torus nacear menfecharumor posit, Post f tect n ants paldogh sper eventos ever Mesa Sr Po rafexele de postrt = oar n mjc Gop oprea net sige pave de exe, pn reves a pei a segment ‘eave ‘Se oxamineaz8 pin oie poiv 9 hala sau pil care mod somal n onetime eva posh iis Persons ose primate da examina pin migcaren pia este palo re wiarum i pacer sda tarapramssis sou cu ool 2, Reflerole postural (de adapta posturlé) = ape a ‘mosifearn de psi, Sr aerreseciacare mune area ‘orto nor grupe mtessare pert a peanterarosarea Seexammneaca pin Troclonarea paconu af! opie otastacd ste spate, ‘ind, in mod normal pin rotees insu garter anor acon pasvosca pozia, Dac ese wn pace cu hipton, ru Se produce seoaisradrsare i acesta se, oploazd ipo! (So ‘ene sarnatorl este tine sta in spall pacer), ‘pares poll geri, stuaa near med normal clei sa denn de al Yacfonso rospe sural co eye fomuaue la pele cu mipxon nu mal ape ast ere oat tap india eons solu43. TONUSUL DE ACTIUNE ps incon mie vale, pn regres sl sie gnge resco. asd adres postr naar a migetea ‘tote Se cramineacs ino abe mses 5.coNcLuzit te gupe muscu 2 “hiprtonle dep spastic (spatickate) 5 TRGT wt polinada, teat net Sa cae refexogens 4 -prozonartloxeorpatoloice 5 Sbotiosretloselorcotanateabdominae sn spars trv or prin ipsa de [ROT aoe sau dimindate Inter factat 4 cabeontaraferelr patoogic rf mareate in trtora mugehiorafeetat Ii uma examin ovis vo putea conhziora decd un Sort ete ot da lent NIC RP rs a a ra {en unde save mut repstn sau une ered 43, ORENTAREA M FATA UNUL PAGINT CU DEFIOTE oat Deft mtr eft en poset va as cae pr iia scat, modeliaias deste 9 eve, Tn erie Ido peccope: secu le Reuonutl meter canal st nr, Tenens neroriesa saa Stor miscues Yo po ootiet| Oe eae Ke ee | é (CRE) eeeIV. MISCARI INVOLUNTARE Sunt mice spr a aves o comand cara care pot feaelte pr vais nd conedna une asus pisogce Hot rive ae str ce ecorsonenza mobi I ape se ‘Tetley, In tng sau fara miei, n rau su ‘cate, se ol Tregste ra ute tpt de mgcan imolrae {WU evicenores Tor neo tte suse 20 examina [en este do mute or nacasr at pune ef execus sunt Gr sau maneve port evidonerea mgasr olrtare! 8 ‘oascd, 2 nea So nt Bae ee al 4 ed "Solo var nents ‘Cont an mig inlurtare arimice, nergul eaordnat, eu sb. doors fa, tera (ma sles dt, goraraisia, Migr ahve aesantucacs |Fenohie sau slate de concer @ sapar np soma Is ‘alse seodacl ou Mpotose gc exe penddare, Lesunia 82 si rosin Tams, tu rou, ce * Hemalisml Esto 0 mijare nvluniar owe arp, unc. olen, cx ‘eeaaed un mombtu sau un Pemicop, t= afeceaza mal les clare rocnals loo raped unc! strep ma mul on. ‘ne sean ruul stl ala Lys ote mai me ‘toc eg vasouara Esteo migcao invlulad tens, cu ampiteine mit autos, srucass, reroguaa, co spare mal sie i momele (ceo j impeds mornerea ural posh sutteanoror Te cou Esto consort ce ind canccc uri sarees ‘eovate i acvintea apoio anton. Posto feta un ‘uremia un henicarp sau poste ft generalns ge nage ‘cela eco ca 9) eoeea. Poste coousia C0 coe, hd (score soe, * Distonia Reprezhia menotea timp indelungat a une atu sau a | post ead 91 neffogn. Pate fates Ta un gu “ar (rea Ie un mombr (rampa seon Ira ‘ore launch (Store aca, seu poate generale. Lecunla 50 gases tt In situ exrepramial ar contac apa 9 pe rmusclturaoporca gp cea angen + Tremont ‘ste osc ml mut sau ma pula ics une porn T'deosebagie in me esenl do. Upurie do migean ‘verse fesese pana scum Esto 'Sngutl care pose pare gi mod Fetoge "remona fiiologerprezhtsacontuaren tremor subi normal {eta postea Agar ia ahs sandig. in ean de oboseas, ices ce oxtana (cafe, aloo), ore puterrice. ‘romora patologi posta h couzal'd leur vari, ca umare tronord were pa hepa cre orulmusy 9 rem, a Ronen ce 48 oxtsenre la ever la Merb Supercar gmap I cele foot, fans bute sau nbs {sproape roca peal sapans i cepare mpl som Le Aobutl stechuns dpa tinal migede votre sau iu ‘arcu tmp poste pris gin aoste stl se acantiaza To ‘moje. ess, La mentee speroare capil un sspet ‘arti ind Inti plana fexin-stenia dpe a ‘Suca pole pena susina mars agpocl de nunca ani’). Chase. acon ip de remorse indegte In sndroanae ‘tapromiae inspec In Boa Pastis, “rumen carbo: n Yor Fao seh we ces ire restau ago dapare eps stp orbles au no coneanicr “ae rugind palo s8 exer orbelaul, Evcenprea ul‘Be ace, com arf rtm cas, ger ec ‘rem coebace ttemertt postural spree memo su la wren stu no une oat pare in opaue 9s aoontaazd in tush tinge co necect oprcaia sport Poste spar In secu irene pred) risxal (i), rreperes eport de Sollnpasen loot orporul ese famla) este de eaura necnoscit, ou ‘oni do 8 ssocand, cv debt la vari tensa fete "rll meme acleg fri Eae postural 9 raver Inve 'MLI-NU se modi sarwien In exec unl mpc vltar, ‘nindise oe ample, cy vires, Series cut doer ren, pot ca pe misura toca imp 8 perasle sores smn saris eet ga ‘sunt mig bite, sate, fice sau amie, ale une 2 mc cro ln Samer ce ro fe octane lun singr mage 0 parte Und Tuga au ut me de fr), mutforde sau generat, i nce Se cao 5 "ea deteminal (lrme parscuare de eplepsi onesie, ‘cat ta cegenoratv,enctlopat ostncien Moline ‘Sunt contac cantrue le unt magehi sau orp muscle, treroié constonia, da ehee! aval fei care cesoune wnat ‘crcl sponta. le’ neronior motor porn (eu Poel 150 scandal, oop gs termed re pat ‘toa ase eupranilese pn vere fac cum ar 8 sro map eure ‘sun mies evolu, sorotpe, alloc, cre its te mgcth brute UnoorpotFeantt vous pty Sart >; dar ca mere existe cv asocerea une anata aes Se These mat tecven! To eu fle gla, UU dat pol finde ofes pane capa ‘baile ‘Sunt contac spetane ale une thre muscure, care nu loseaz sogmortul repo, ied oy abe ‘sun wig stot la unul mem parazal ri intro an cal snd, n mod our. + Fascicuatile ‘sunt mia fw ale ure uit) meter, viable sub pee, Incand lez de neuron motor peters. Dach sn moloneren ttepare ca urmares une seen (elero Iarala amotctes, rote Stinald mascuare progresiva, ele depersene de en min ipa dere est pei acu np: Rent ore Sut expats eo Un neuen vos cae erate proungi ce da rastore lage maton ‘aunts motos rein dmerelun, cova co mpune © cotare ‘elumubi perkaronula, peru a face fala mataboke st ane ‘Seaans nowt stuf. Pertariona devine eel ines momar cafe spotan Ih mad spores, scans deuce ins Vee 1S suprtja mugs, dar fark adsl o igeae le pose uml de foscoual. Dees nual seurior dei eae Yo) mt mar, sau dtugerea 22 produce in-un ean de tp fost cu oes proces da recap 8 volt musclre mal poste eves oe opera stots muaculr cae eae inverspoporionall cu Feast. NB. okt neuonior mojo este complex: rtrvnn_motiatea Yokintrt engi mctatn roflend q@ outer ard Feslarea onusulu muscleV. EXAMINAREA MERSULUI Mereul este 9 aefune coardents 2 neceat neparse jer motor cs cle sel Wesul poate & sngura adieare 1's sod cu re in ve, dor Opler cartier oscar do mers pot 8A. simetice sau Bl asmtries + casa modifier simetiee, se ome cover medicare: ast mie: "Timers parkinsonian = tcl antec, fra srl bree, uneor cu uti de dear. Balan bier {orf acnst, ure absent doer utr, I fazloprocooa de 1a Panioon. Oats cauza a acet ip d mars oconstiue rela ngs cu medeanente dn guparourseptcae map. 2, mers peoudobulbar (marche a petits pas) = cu ‘nuchal opt gc tan neo pasta Asoe nara crerae tien, bioorae, sa mal ales In ‘et pacer x lesen ‘mere norma 2. mers bara ga i micare ampli 2 membre Inferiore = atanto sonora (In ead hourarion de sonsbiaie profudd ln ceuropal pao, lc’ le crceanek ostrare# mma arin teeta bterala obo parietal). Pale oye Aseordonatneregua cu mica trot ale brea infra, ind ‘mero atonal und wes fc psu face ade 0 Ingcare pro ampla a por are et eat x goal pe -2, nacoordonat, nevegulat = taxi cersbeloast, tendinga do "deviore spre. paras afectata (in bot strosctlnre, sclrezd mull intone oot sau ule Steamer) Paps neegun, meres, cba Targa de eae eva trl sa rope a ona lio inal, a sderezel mae, compresior medias, lsare ‘a ina tte oblast cu. dictate, ont spas, an fa" gonunchil sau gdu” Pap sunt agus Sor Gruen kr pose ra decd pacientes 2 so “abe lez mo mace inrepot de migese genunchlor ‘> impieica do var picts, care pu poog erecta Tele sis Papi sunt equa, cl in ane al ul Sopettr 91 ‘ora retd piso Se ining ln pase cups Gonos te ppl extem (peroneal cern). rele LS, lezun Ile une, pars mayer ea au pero nap mica best 2 lena nde proxi, ring a pacers ropa sou cu deplectiuvare de gol Grovinen compu asts tater de pe un pc pe al 2 aprane: pacer parc a uit foot pal, are {pe lo. inaedo tea coral deectuoar, ce apere Iho Mtrovscloe cu bsolare fonts sau heoefala noted, Pace payeqio cd ala, ‘ioe, cy" pay mic, Igut, neon na rougogte e8 svorseze. dat Gu ail al 2Saro, cn dpiaares se ameboreszt nat. Parl ae sompora 2ere a it 8 rear ‘finer tm, ebrs, rope core ‘menu ganar neraracteretc une pelo al evden rst peer etn sma pu psoas daa se “ enstnta rot= 2 moses esosse = mare apt dee patlogle etopedich nate, teen a vel ody, nog de meme) te, vom pe cont ' aed eee 2. deictmcae= mrs cost = hemipart,cfcee mete Cereal, sderexs mula Sau a8 paloioge ce sfecioaza newt Iotor geval Beceil nfoce fsa memoria ifr In real Slee genunehidul sou lanatdetortaspastcl 9, perdu 2 Bip aco © mica de Somice, moran parmanert xe Frambrane, sathgina pemanont coll cu vat pon 4 df unital pene fsa dered = pons = mere stopat unlatral este supimentare v7 raga pint 8 meer one reap. mal pe vl (npoatl caal deft moter a nvlt ‘estocnomonier sa parla de ror pores),maul peeled erp in cat det fois oss ‘lod su 8 pro ener, VI. EXAMINAREA SENSIBILITATI VIA. NOTIUNI DE ANATOMIE Crgnele reopen sonal (aaa petri) calog nonrah n mecu ekem 91 tem, cor sat tanonise feted conor Sri een iirmosore 1 ral 8 Froproceptori sunt organle sents mioaroctineioe (Grourde) pres 9 coho, soe gteoe mn mune rteuo ‘Fron Su sama moet >a mans, ce ogee incon pe 2 meg ermine seronse ier, co £6 o8ese in fn aaa feuds vase, organe nee, cu fein teaitares Es areca gee erase ee ae se mony co ea cen = eee pep Se aT a ea areas conan mene spina. La nivel maculae jing hn mianao postage, ure nraport op de sonsbtate cues a 0 ‘ect ater Tirta care adue normale extorceptie (armic, ‘lureroace tactile protopatics fs sinapsa cu cal ‘Sale perfor com posster (al dotea oun a i) Atont scesor hoon! Veeco {reruogendu ae in comieue st aninnoaes mma! {9 aung In cordon! trl pus, unde formeazd un ecu candor num Waetlapinodalmie = spinotectal Fereie actus spinotume $n. fecal seabalmsdiva impound cy fers [trl troverseacl bubul, unten paduncl cereal 9 se foprese in llamas, unde se pasegla col de-! ellos eure fi, cu cae fc eal Poko eco (Gen neron ale vel sal cortal, In bul parca cade ae ald homunculus sea (ae 3.1 2 + rte care ranspatsnormailo proprioceptie slo Sensis tata epletie patane codons Posteroera tara srapea tin acoso conoane ued ive bub, sub Yom a dou wach ‘Scerdontoy dune acta spine-bulbare, nad ul Gall (grec shu Burdech (cures), In bub ron a a, send lle otal bobo (lamsel med), ce gingers, undo a {eloa nowon al ct, a carte se prseteaz ot [ob pao nora posta ‘uburaria do sonstiltate pot avea dente grade, de joa Hpoestase (ecSdoea percept) pnd ta sneston (ipso ‘Saude pert, pein ena p38 sansbitta, Ma ra se Ininopte sonst de iperestei (paroape accent). De mute of tibure de sersbiai nu sur Iso do maniestie cic, secestina examinee foarte rqurossa. Ext 6 tur de seribaite ce se enamineaza In mod bint 4) vbrtorie Aimioartrokineved 5) tacts 9 dareoaes Series ‘Viz. EXAMINAREA SENSIBILITATIL xamnara sonsbitay poste ")Yecul in cade ish serering, frt st et ‘pamnest sulin 2) pura de snplomeialogla panna 3} impued de somnelo nowcloice events le rata ‘canine porn a onion lnraminare sansbla neces concontare eooporre sn ‘oe pacntal bund snjelogee a corona 6 ceier, = i amin repeats pent o acute mal mare e morse Ste ile pacer ri 0 co 3 sa i Fam dues pocontifles co Iso core 9 dct éspunere i (roa lite 8 sonst pot sublective (ascrce de pace sb Se tomo fr topert de oreo =a) oblectve (owcefate de Sinctr pon mice specie), Bele subctve de eansitste pot descr de pacent sub Paattu, ecu neptune, cu topograbe vreb Th mde cous ion Exameatond Te grpeaci in ganorl si Tesereacbibr seni goals eve foc a orc el wena ind ocean ier raport Go leatzres isi" Elomnoroa va f cordata i ou ananneza, care ne pool {tan cases singtonetoea 2, eam PERCY Examinare sensibltsttsupertclae (ctl, dueroase_ rica) neces renmum da ten, Nu" Yom puloa examina (ie pacond pum speci goser verse anestoce uperic ‘pga revaget memtrlr aun simul aoctapt, seu pin apart aqme ale cep ts un tpn vat cl © ora spot, nugand pact s2 ne. spund_ decd ‘espa percept ene ace! tu valaza de 80 zd la fa, Tree ab inowoim a8 toprowcom sural co “+ Ponta aansibtatea termicd se vor atnge succesiy ‘eet sana ae corp cu deus pret, una cx ap (alt const cu aparece, sau cuun erent spec, in mato dst, car 8 temperstin dete. Se poate {ola 9 copocoul pera tea dacs pacientes ‘eos ls aingeeaacesisa do mani sau pio rans do tenors, ptr eat Inaat ao reso 28 at Srenaren ons Go hi ach opal + Ponta eonsbitsteadreroasa_ so foseste un ac pois sufiert de ascuft pena fea 0 sorzale Sloreas, dar are rt info pe poco, ud dass orotate menine acaosl In foato pune exainate, ‘robue sb ne suadum s8 recicer sma de. aoaoay Iiunatste ce focare la Se leaps iil parca ‘inuowa ape conprosup lets \Vi2.2.EXANINAREA SENSISILITATH PROFUNDE Eraminarea sensi _profunde (vttore gi rlcarroknetes) recess claboraea pacer fr se exch ceria co uaa sa facom i lor se feces exsire, s* Pannsensbitatea mioorvekinetica pace va ss cu ox toot, gt eramanatl B va mobson, dogs, Pncinic Fug doar uma flan, (prt a 9 area Forma de fale tour de receplom gva_ruga pecans dagetnle (doo pre palma su inne), ura ES"b presi a ost mormat deste. mesalatea de ‘taminse.SeIneope cu mean ample pol se reoucefoes 9h pon tea prose Setanomned scan ned 9 nr er europe ealbrat ou bral stardarazats- 128 H2) Soaps pe iete provmranie cscaso 31 20 Crmaceste prcapa wbvatice Pent a obine o vbr Uineans Jo 126 He uta necaea ea arextzoeco de ‘opal super al depot 6 te ie ingurbol ‘vel verneor de pe fla psteoard a sumer poco! webu ci mest opleat perpen pe foci do massa presiine cansan, Panel [3 sto cuca in pone tessa, oc thigh ‘tanta eran se aps lapazonul pe sem, cavicu (roms (eon mrt slectto), porta cs pacers (aye coe de vor reba tia, lies scale se ‘face in merantln care pace ne infrmeszd cdr In cife worl, pin tie. vlon ct bie To Tec colar pone virtuale dopo sala dapazon Se oamineasa nivel acer ieflanpane Incele, Casta tial Se theo dl le compart "ange cu dear ‘Tuburrie oe sensiltte po oor Ie iin ls pecion! taza fh rape oetamrea leno lil canal (2 orox pind ts sve mada vor deta uur de setliate {ee i un em in gine sau chi fun hernia) 990 treca se va wimins compara parea siinga cu pares deep prt eienta aernfle de percep. {il modu se gon mt alto pur ce tuba fancied tp de lesin de trl fet afer perf se ot ri ecu dos a nivel unt dametom cau tr war prere Treble eta clr iin Ine Serva radia gcoa neilSee ol VL3. INERVATIA NEVRITICA A La membros supeiare: ‘unt 4 par parr care inerveazd mombeu super dn puna dove at seat care pol alec, empnind median, “a eb 6 ‘stibts terior copendante de fecare ce aces nen, pant! do vedere seta sunt elena m magi. Exarinares Trane doiennaros une! evertuse tabu de sense [Ac termes sau dures erty examiars une event tubure do sensbale {etal medina sau cubfaluiut se oramipeazs. senaatea ‘Sericls a vel nla, ds (tins flange), tte marines ine imessan) extoma (cui) 9 ast 5 Persy examen sensi dleminse de nor rail, vom cla eventualele mss de percep a hive ibacheesSensblatee datos ned anlar eta exit a vel fel itao rl superarV4. INERVATIA RADICULARA (DERMATOAME) Exorinarce senabitai se ip_radcur ui extenees wre tro toe, Scena" aren ate Soca ashoar pin_ onc cael. (cronies slngob, Scalar. Exasnaren so eesusesé at pe fly nanos & nia pe als Polenta oe examinear pring dn rene cereals ino, rmonbyolsupeiare ied patlonals In spate, Se va exams Sauber tipo: drape prove ne tai wind Stee Serepere nenctenie: rd demalomer est sub mandibulé este C2, wind {63.4 pan la vo umd un (5, oar pca coh aj anterotatrala a antbrule alm CTs aps cea “peels anteromesal antebreubl, unde se af C8, 3h Sorat unde seas 1 ‘Trnchil 9 xamingazs ait pe la anaricor, 8p o20 postaronrh. dacs apare 0 uburate de serail, fn dela ni Fri messan (e roper ube tn dtemnorea nivelul une overt tore pan ave colanal vertebrae Ca punts Ula marlon an 1475, (chord costal anal tls nial at 2 ‘br rr nape ca emetom cxtiratlsupertr scoops Soa rch ol conan L293, pM el ‘dtc Le even oa intend Gamblin Ise ‘rol bi, Sent pe fifa teas gamba Plone Ta vealed Sar veapectnd Sept mi. Pov posterioard a piciorutul se afta dermatomu $4, la rivehul {ume pra pe tas posurosaterl acne Seto mek compen gl gemba p fe poses nr ‘Sach 83:90 fest ig econ concnres stale parang ase ne sm)| ‘VIS. SINDROAME MEDULARE, ‘5.1, NOTIUNLDE ANATOMIE + Maguva spina este localzat in canal vertebral, alu en caprpunotee wortebroor (7 canter § Sele da oraron magnum, dela taza rani, pe veld verstetor Li-L2, do unde eentnul Cy conu eon, Est Impl tn 31 de sogmente madulare: 8 ceria, 12 ‘oral, Slombar,S sare eacegan + Este cones cu nor spinal. pen termed core se {ce treme comencior superowre Get Cee ape Devers pmvee sie Iv do meningete spinal, seul, de enero spre exterior, on 3 fl: para, sano ormat Ine duramater spit gi periostl versal a spi epidural. care cent leet cork lx, gas Peed Yenos veretral tem’ Batson, acess Win’ whe “are vencose 9 realioaz’ gate Ite susie rato cone (care cleeac’ singe in tela vencasa cerebral) vensle dn evista, ‘bdomnall g pena, rprezentnd practic 0 alo cree Iigare si dserinar'a colar cancers, infec, Solace la cele,+ Goutal oa sacl dural care sine pans a rive $2. VL: EXAMINAREA CLINICA © esis neal dete atta funeor meta foxes secive sub vol or Gata lets lta eos prin examina: T Moora car este nell spr unde 26 chine spurs i (radacmisrerfr spina embo-socap) CGR ‘+ Maauva spina corre substan ba ang tn car sa (2a vac descandgni.geacendene prince, oo oe {renemtere impulse otioses del else ponfti 9 + Subst abs exe mpi in cordoane: posterior (rte Get i Burdecs) Fatert arcurlespinaaimie lateral, eplnocersbelo, rama) 9 nterior (fect epntalanic ater. ‘+ Substana enusie ete Imps cose osteior (neon serena oe prmese impusr_pin ‘Batonla petaome ste nor pal Tatra (onal toe) CLE "se af neuron roganglona ssterali ner vegeta spa) Sntrfor (Roun! maa lear mx ema Th ichle Smtr le noon spinal) ‘Zona ntemedars (non do esos pnt integrase inal eerssgmariar 9 nc ada), ‘152, NOTUN DE FZIOLOGIE + Roto: area nivel unde ms oom activin ers {Senta cee eo els super une avo snabttoa Tetines macula afs anv sa deasupra zon ~ supeoare unde sabes inaginea neon moa, fee” Sonne ‘Vis4, CONSIDERATHCLICE + Seciunes medulad total: 7" Datet moter nal sub iol ein: parapegle (pan Tene torocalo) sau tetraplegie (pent Teco cereal). ~ boi ‘onlul volun al connate ¥ Abolea tuturor tpurlor de. sonsbiiate sb ‘vis Png In hua 0 ein de vgs aun poss Rec ‘camer radar corspande ‘verwbrl Tespecive, apo cosa ‘etal ar ur im da oglre al apt docs moive pérand un ‘cal ole dou, all inet no rasew médva Se end ‘ll vetbrelor 23 Creisea uoroaré@ eolcanel venbraledetrmind maven clad ale nesta adut madras taming ive trl LL Ia sie vorselor C2 1a T10, la rum spoil vertebrae se ada 2 pet @ afta egmonl ‘edu cvepureatoe ~ a nivel vorbelr T1-712 eorespun a segment mesior mbar “in pl verbs se a8 segmental meduar tome+ ‘Sindromut de hemisotune malaréBrown-Sequara: °P psa = Sik moro Drs nr pape gm anon aad en ¥ Contoltera:- scare sana tmaigesice Sib iva local (pm afesares, wee ‘pollanic aera ¥ Serta tacos mu ste sft catorta ‘ae se pare o band de Tipo su anestoae cu Sprepune inaratr in dermatosis {spon domaton, a rv tex Dy} + Sindromul substan! eenug <" Abolea sensibltaltermo-lgeniee, cy carscor ‘spend cupocvarea sonsbily ttle vara poprocapive In gece forte: soci ingame. Dafit motor artless tote muscular In ‘ein aca pin plea ele Sa ‘omulartray, cl spasteltte su nel zk + Sindromul de cordoaneposteioare: 7 Avolvs sensi propriocoptive sinful ‘orator cu apa sea 9 serra Rear Rot exageate ral de eens pation ‘Anastasia tarmonaeztd sb % fetogtatea sensbitat proprioceptive g vibrato + Sindromut de sclarozi medulara combinaté (condor porteigae ttre): iNectaren eordoanelor pastercare cu opa Uburaror “do seraisite "reptocapira Wirstone ou stxe sen Romberg poze.‘Aectaen condoanolrltraa ob roan act Paid 9 spain dechuts mator, spot ‘xageries ROT pezena fencer ptsogie + Sindromut de om medutar: ~ mis co ape yey ta conse {ie apa a coca preston OURS Tulburan snetiene prec incontinent iad arc ¥,lnpoan aos * Absenfarefiexsior anal bulbocavero= + Siaromul de coada oats ~ Der radicular In ecto nvr besser (oll pinch g's werk ware) Tulburai de sensiitate cu ipo sa hipresteie cllapocteasimetrcd ng, Defic motor "st arefene ostectondinoast ‘crespunzta rive leh V6. SINDROMUL TALAMIC ( DEJERINE-ROUSSY) Jat exo sje obi prty ete cia sensi tetra al tole rut prt batt Sosa ‘erat, ca we! len ars vo Pe a brs * ‘respects, conrolitrl lint, sfectaros senstlt asoca® eho Ieromens: : Barer tales eta) extrem olen, paroxsie $i gat WABI, dectangatd ma Sos de small termi (ap ree seu ea daternira flees oso eee 4 Homianopsie homonima _aterala prin afectare: ‘ganalonullgentutat letra Femistaco gi sindrom cereelos Migedn corecaatonice #1 aspoctul caractoristic dt 7. ements tlamie (in leita tatamice ister NB. Singromultalamio. se saocass. in" mod. tecvent ct hhomiparesd "contelaterala, pin sufelna "cops item: {formatne anatomied aint In nda vocnaaté cu aarsoey VL7. SINDROMUL CORTICAL PARIETAL ‘Senebitates contend Iniograrea sonsblt so face a nol eotca in abu prota. Prosegs ne ez In act rvldeteminé para no ‘See cblecive cwacersie ave i fcaearea aco, Eramnarea bisa sential corel presi + Colaba a pacer, aeoarec se secuaara x oc inci repuara Wexpioai la pace ala, cu uburan rnezc, cog ‘a do comperament, cu desoronan tempor pall ls prop ereoand sua acy Mtr al star co congo, ‘Se oxmneses umiloaree seme. ‘+ Diseriminarea tact conta In apreierea cst la can fun porcoput separa do ral ac lo, splot smutar ‘cu compesul Weber, icepdnd-se cu puncte mal copstate ‘nchednd epaaul pina end epee ecalarea Set ‘multor Detana mend cae sunt gercopi separate ‘Similac cra lunch de 2008, ind aopenden uml de recep acl existe mm noe > 29 nme pupa degeeio dea mans > .emmpaliopumantd de pe dau gelled a ink > onmpecosd mainsSe flososie mal ales stab detain dnamicd a evlut torte a serait Titania tel srt act este porcoput Batra (atingem asentt fill pe ans, ofl po. call. ring 38 (Genenee memtral pe care tam sts), ar stn cing 1 ‘Sige simian po ambla meme nu va pereope dec ‘nei at alia pe mamta snes, at do pres opus ‘Smsord santos (dec anger mer 3 pares opus lesan i ost pore) ‘+ Slasoanozis’ regres capactateapaceniul de 8 Serene pn sul tac obec, round Weniaea or ‘pune! de vedere rel, arin suc mater S'stareegnszie’Imposbitesworfcat cect pin Patra, Se plasoneh un elect omar (eon, chew, ened) th aa past soot est Tat 3 ‘Gentes oc ici. > smoronnoseeresncaa fame 5 Ammtomes rsiroatea ral dn cv ur hese oncom, > [mii ial win shel om sail Ste pacoo ponte dumb ‘mod corect. _ + Demetri arashowstaxia ope caosttoa pace Sarre eee cue sur ste fe pole co ‘Sania (wee 38 am sai do ave ce st a cbmc nce persone enlableepuanarse arin en cpt Pass ret no we ft ctor Merle Cu ur otic bont se cevenoaza Soa sou e Mark pe mina paces, acest ins i nod noma cables cu oe nia + Tepogmass rarer eapacajea de local wn si tc alot de examinee Mopaanogia enpesilaia local tirade + some ona croseo peer 91 PRlematonnozie’ mpostltaica recunoaset! Ui ‘Reno oa chara ut og hei. > Mu igestenge" pact sre senzafa 8, sro ‘amt us fr putea rocunoagto Ge ep 8 este ‘ora de propel segment core NB. No tei tat tat acct examine 58 fae paints ‘ind conch Exinae doping de sensiblisia tact marron wot penit caro nu vom putea objine ioral Gaspre eens ‘Sone real vel lal maja acetr tour de sensi,VI EXAMINAREA CEREBELULUI VILA. NOTIUNI DE ANATOMIE ‘Corbi ar rd de moda forerise snztve perry 8 tsa rel atta etl tral hat ‘reba nScopu cordonry mages precize mare Coebei fejond srecie a ttne. mig pocum 91 Baan rele ~ ‘toch mele soos anogons {Tecul spocsebeloe cota conine infsmali prontocetve 3 Dota tb pn penal eee er np orbs vera enero, in pune do vedera functional se ding We ro ceorebold cu gg egies si rou be af ‘eons mes aricerelul (lobul locculo-nodur etait ula oe conor cu ser ve (dl ts acta rogl eo + Palnocetebeil lobul anterior, wvula, amg areveulus, declve) ate conenunt ch Eacbel gon madwa sping gin SProcaobaoese, vara rol 10 posi ‘mune. + Novcerebelul (obul posterior) are cone {Si eartrals avd ln cordonares mie Ccoondnare rere combinaroa wor ac sunt neces prouetsmigeeor fie 9 de mare Scrat {Mbtenres,ecosor obec exo necesard itgrrea, ‘inate cu cole mata, fapl care 30 eolzoaz 1 ¢ carr natnor mos, Tesi do coownare Webue ielocomméet, porary opine snferma_ ernst. Ande robubacd ‘ste somnu cril al lezlulercareboti 9 88 ‘Mantes prin mize Ipato co coodorae, care mu se Soreazh telus motor’ ubsraior ce senate micorolinetcs ei nes uma. sou oer ie rate, De sree iintosneurdbglor ru tstazh certo deca pt ce a [Sine one sopmertarg, tomas moscuar gi sansbiiates Paconlih Pderes seis miesckaracs post die is fesa recon flne sera), ge aoaea so va examine sesbiales ‘rotunda inten coos \VII2. EXAMINAREA FUNCTILOR CEREBELULU! In toate tile alactunte se ve compare aries stant a coc paras creapt Setectear pobitates ented posit ortostatie cu ar rin de susie. med normal pacontl tebe sé! mer ‘ity tn aceaelpraiefr late. Exefa une lei a wee atlorebeuld va face lnponbissccasa robs, pacentt Tet! bare ona Ge susioae gc mole supose In otugle vied ost! n lola doce, cl tena de 9 spr ae ie cect dn pe fui cn poate duce iar Inposbatates SRodtatsrail asi lini grave, pect ru poste eB Stern ert aot mid i porsoane, avid teria Soctdore spe sae Frere, car poste 1 nasi, reget, cu ba tage de austere cu de om beat (are oboe), eager saa ‘eubslost Pal sunt trepul, resin, dezrsona, Sufela ‘Srebcas se pool evident at ine rgd pace 8 se ioe Pree Sc asinda ae scunbe ure deca de mrs, sous Eo'Sprewsct bees, sual care vem pusa eel lzhni 3. membre supariore + testa ndie-na, near rugim pacer 38 uc, dee ‘Soong po trans, wipers os execu In trol tera fark cut ou prize far ez. Daca ‘hina esun n alecaz® coownarea, paces nu ve ice Alopt doe! pe rtd nal va Sepsis ou va Seige. cbscind propss. (lametre, bios ol Riper), Tota aceashprcbl se poate evden un amor co accertueses To aprosiora do i, de ope 9 esta a aceon, sunt tremor inortiona Ny est eigen a proba oa afcta ct oo cil dacs ¢ Si dos sora prota Ta moe real mica famae eld Soci oc ncig Se rept cae: ‘ramble man, + proba marinatslor ete rat pacer x8 execute mig Fie Se prone 9) susan care In mod moral ou ‘Shetice, 0 sulted corebalosss va dotemins leioaes eucampineraa mien go parte bot (Gisdadocokineale, eiadocokine) ‘+ Py sa mal paleexseuta su acini palm pe poruneh 9 ae erin truse, deoindve nace! ‘lpm na, bmp 20 10 secunde+ semnul Riddoch: pecan 8 cy Peso nts, lar mn ‘oda o2 postonoaca tn Nperronape, ofan afar ‘aos examiner exerts o peau axupra cor Jo bral eat eel, mam! aoc va ve fe cons, va fads © fila esto rgat 8 Gil un eas! pe geunehi cobalt pcor, tm ‘peso peatil (probe ealegerunch)). La part’ sande Imigare ete for gu fr ela Tn cazul wor len pace ‘opageste anu mu ago ta prousd, pete aves ila acest rv tremor ianjonal Penta cbinares ne! format mal press pecan post rips 84 eabaare ou un cdl pe creasia i ‘au pier, 8 ma repoe crc, coed oevetvals dest ‘ela oct nals a migeset. + Gu accel semicae vo poste facus proba moral: ce petit st exaaie morgen mn ambels sour, ntind Pareraba aernts ve sxacus esor dus membre 5. ranch! + paint ete rats rico din deci does fr abo Eats. Io mod noi, pacetlfaeazl cu cline la atid 950, ieh fire af ao. dezocilbrezs, Lean ‘rebel tv face idle eScle dep paral paul ‘Se decncibyee cu tencnia doa e8e no pa. tua, un det mtr tat pox tain ovat mal ie Ne oe te psaaeaposia, mand oleung oebost Ste ncabins wc acn spend CA Ave oti merges patil. tle wes erbele ea, rare deo gana se eresc Use Ps cr ce cs on aon mol, rarest 0a wget Dae oc oes 0 isso ctealesh, manu aL et Eats rr ve rover a sei robs pee See aa) pce wr f sxe to cre ay esiom serena, cae eves co a Be ears ve need gs vo asad fc alo seine rote. tee Sowar-olmes: so cee pace of fcd a Sar a akc tri mgcare la cre amino = ani op ce caer fod una Aah err aim creplasn va rand a tr 68 eee ae cel cn acre cto, 0 fo ‘ctl do cen toa retee a ee (Crane find poral peel pase) nd naa, dal cy eplcare pa spats pent mere cat do (Govlte te ior bezel a susie, pact raoale Genuncni, pater cu afecare catelast nu face aost ‘Stn ons rc 98 cada dc mu eee pone (osinerge ‘erebeloasa = proba Anton: Babine {6 vorbis: poate scandet, extn, rovoguats eo nena, pin secon arg epee 9 9 mse co 7. seis s0 modi, Io. seneul apariii uni ‘macrografi, oi fre ma neegusis. Putom igo pacer 58 ‘Sheesh paraiso nie ropere pe care Ile am nl puter Sanstata ck parent! ru poste pune kana mee, dapignd recent Nel ncercare doa doce o parle cu o ssl dat nu va reupinacoeag!caua, par intrsctndo, ._ VIl3. SINDROMUL CEREBELOS: 4) Hipotonie muscular 2) Reflex ecto-tandlnoase pendulare 5} Onostapunea poss dor ev basa lag de sustners, 8) Doscompuneres micro, secadare or (at nerie) 5) Netogmus 4 Tara deserts (mar, naregulat) 119) Talbrat de vor explosive: seandst)Vill, NERVII CRANIENI Nee rain cnt re elo! sav pt ap ‘er sonar pen anh specs. Ong Ten ena 1 Scag pe Goo pore) ee te enc crea uns ‘totter cre. patae sub coret Co ‘ra pin ae cbc |. NERVUL OLFACTIV (PERECHEA A) 14. NOTIUNLOE ANATOME ‘Anteater octet att din epi oct, cle do samaas'n oma ke cc facto (uie + Calle oat (neuron st eprezeiato de-caule Senzovala bipolar, cores a vc mucoose feare ‘in coiiia namie. Denastla acastr eauons pron ‘hamasenab caro sunt sop) dmc scare repre prose chomerecepai aac + Noni cesar neuro slesseee ner oft cae bio ‘Srna chu @ emo roaeaarsinapse lial ‘ulbull ote (cae efit deasupra lel error) cu encrle cellar rial, cafe ropes col do-a coisa neuron 3 ca oliacive. Lagitura snap Irie era eur ‘pore exile til se faco pn tamed unl dense Sora ese frmgazs glomoril oat + ton cldsor mal oeaaa wactul fact, cares an farful ols gee termine vel igen fact unde Ferner a0 sv, fom dou fcc, til oftactive Interns gl_medial, care dolifcazs sabcanja pera ‘ron eats sauna nv ail oacv,wenume: 2" si pra roprezniats ae uncu (pres mosale 1 rucoula amigdorn) #2. pai anecoar & ‘Grsuns hpocample oa eatrna) letund ala a intermedi, cae so off dossupra tig ‘Stacy, gore ee un rol esamnieaty om ‘a secondara an oginea septal = supa: Imedale aot ror, crea opt cu ttoma Tire, find impteatl_ tn decangarea roachor ‘emotional rode de percapla mies \ViL1.2, NOTIUNLDE ZIOLOGIE Cecha are popfeatea de 2 prezenta 0 mare acomodar, antec porn ea seneai lactv £8 fe poop al al np, (eo recast sores pet Tarn muccase naale so af aeapon tigen odor in are otalmicd a pov gerne, care sunt ‘Sho de substan tnt, cur e¥ amonacu, sod acatioce, aor per, care, de aones rw tru Uae nts ccd © ‘Su ol"1. AAMINAREA CLICK A SMATULULOLFAGTY Nena ofaciv mu ropa un ayy cae st ne. adios mall deca de imprint In mod teen Be ic pore sine se ses o uber odorant nes ‘Se examineaza. pa ind care nate ecuionineo po sloa) pact fad ou cc Ine, flosna te suoatane Ge 4 sipun, cafa, mort aleoe, tira, tn, lee vie ‘Sel eve roast rade Ini pea + So.umarosecspoctataa bona de a perce detele roves (ogtttes rerio 8 co) $182 le ana (tna corneal ge) (14 GONSIDERATH GLINICE + © acd entvopostrerd_ de. cranks (in cat uu ‘raumatim crane-corera) para sear sop, posta ‘i deterring Gsbupeoa far otacive cae Wavecenrs lana cibetoora, conduc. ia sparta nose! (ines ‘oats. Aces leaun pot pamite scugeren LOR an ‘jaf siortnadian in" cava, raza (oroge), Sfonandone spre dogrotie de tracks dela erorma, estzand © eae so comniare Ine medal ‘toner gi cavtica crsisns care poate consion lt Drude apontior foc a arate + Tumare (mening sau plosma) sau abcess do lob froma, recum 9! meningoamele deze ve foe Srforoar. pot lamina Ia deat 0. sche a lack (hipesmie) ce cica nia etre, prin corpresia rect pa oct babu oat + Lvl ait eel ail tacivo ornare dn fot temporal doomind apa alulnailroactive(rzle Linens) de cla mal mute oto arse Nop + Elath so eeddoe flog a poreopel faci oda eu ‘nantes in vata, sa lemparar. Th cazl unor het ‘ial do ca rspratn euperiare VIlI2, NERVUL OPTIC (PERECHEA A I-A) xaminares noraiul ope poate oprezente hela unr ‘dagroston neurloice, 9. Ge eeaba ose de 0 inpartn|s cals pn examen nelope ‘ula. NoTIUN DE ANATOMIE Nerv op indesinate exch 0 fncfe strana. Retna repr grate pales peers a analatordl vz fd ects (iy 10 ern. Cael otocepoare sit opecents de celle 1 conu gi cu hastonape 9s afin seal 2, profng, l rete, Srdnd al dee wenfora infra veualsporopula sub oma ‘ono de arin. mpulsu occ: (Cts cs conur unt spree pena vedora dura petra acta eancaniate le vel free contalo (aca prozante in rime mai mic dest cole cu ostonage (aroma 7 mire). ‘Coule cu bastonage srt specie pen ydorea rectum inca por os, rezone n eumar mal a (@poxmatv 130 de miane) imple! nenos ete ranans mal dapane cello bipolar, "pocarea rotnol conduce 1a eparla nul defect ‘monocular de cmp veut. Lexie centrale tp Ii apoporea decal opi deeming © sfocare mal (gave dott n cz lecor peter, m> Aedes nerws-opiecoduea a aaa cata Imoneciare cop parle tls SM ea Soon >"Lecanie bo rv madon sl chissmel (cum ar 1 in fetclogia Mootza, eteming sec fro haeae fre se euegas®. ia sees vel, Cl” pat femianopsii temporal. a > Deck este scat para lead a chissmol (6 ‘exer inn avr do alr caro, ria ‘Seda, va fezuta un aoe Go inp Yaval le rv Pig erie» orl, batt co maopae o@ pis + Lerius posterior e chasms optics: "Ufslunie eactwlor opice determina spar hemianopsie Homenime ater sng sau dente (fone do sSrpal tempera sets, ell ftortor find ato ‘deowreceosines se aang ‘enofori goiter inde se Hnchideacst ‘eter cravaa sis gy gy > Aleciarea raafior opice candice tot i apse ‘tang sou cope cat), or eau (langle de clmpul tamper {fears uperore sou neroare, cond a apse ‘racranopallor,lfotoae sau supetcare In acest ca, Fri este past, ledunea fin postror de gangiond (once rl m> Leciunie stat ae tom alpine conduc |e sparia une! nemianopsshomonimo contort, rations wow aztec Pr pee Foren viru eate seca > Lea stra le cartons cpl primar (aa 17) ‘etemina aria eel eoeticaa cs pantares RM, > ‘etre alr do aso 8 9119 conduc a epee gnoctior vale 1a, NERV CRANIEN I (QCULOMOTOR COMUN), ROHLEAR), VI ( ABDUCENS). * ‘al attiates gobior coda (GO) aes er inleré sunt examinat Impreund, ernst an Ohne Pee soo 2 Seam ie Dope Mie GO pot pte nt: + ig voluntare sacadate slo GO: mgt {pice we GO dea un pnt Se ati st (Gola un cbiee alu console db bul ‘ont, + Migs de umd: mig loni_porirs fares um obec mises, contol Oe Il eco. + ie ele vestibulo-oculare: mic alo (60 de ‘componsare_s_igerior eapubh foi mengnses fe unl oie, cote ‘so nce corel! vostula, 1+ Convergena: mist co asigur fares uni ‘bint oo ae apyope e och, conte de In runeh rousure dob otal oc dn cabal ruc vecibusn ‘st inept, stl rel cl col glob coda = Imobtzbaca Ingrown, coups. Stile importante sunt canta priv aerate sin punta 9 faeseulllongtainal medal (FLW) re unten ' 1V'eo parle n mezecefal cu nue Vi ‘nial puntMirae er 113.4. NERVUL OCULOMOTOR COMUN (PERECHEA A I-A) 1133.4. NOT DE aNATOMIE Nuclul motor sl_cclometeruts conan so aft oesaat 0 sencefal rte colcllor evacigemen! topo, sproape de lemedand, enter de pod corte ‘estrul cent reclou ext de tm mul utc “lateral ( undo, npr postr spe arteror loses 'e pany mugs ception, ble Ieror 9h éropt Irn Co ea pe) edit care inereszh cpt spi contlaora) + Cnial (care dsaraste Flea! pees! siperoae tee. “onl care plese do i acest compen motor megane re tognaradmazencefahaas st emarg. a. nel fous ‘erpednculate, ances dr maznostl pute yal mle se ald i acetal Enlorpaasrngatcn vente dn sudeu Ednge-Wesipal 9 akatuese nal ceumotet ‘mun, a rece pear carahra pocteors i ceebeloed ‘sipotoar le spol un taact ane, PrereacS dia mater ina sinus cavernos, cos Mngt portal lara soot SJurgand fa veut aur ebiate supercars, de unde pabunae ‘tb Le sonst nivel se die in da smart ver sup mshi rp! ferrell ett). "Nucl! vgcoral al nerwis et leit ncleul Esing Westphal car ote ocatt fot a nivel mezencet Sorat Se ucou! motor. Axon (re proanglnae) paresovo acest ruceu ‘ner arr, air de ele motor (exterior acetra), pre {Geo cand miloc, sus cavernos Wi faura etter supercars ‘de pavurg tn of aces axon vor foe snap i ganglion cil Be pene fore poxganglonae cae alalose nari la ‘eur Gh numar de 6-10) cara Iereacl’ mupehiol constrtor Pupler g! mayehi ilar, are elomink msn pups TomLeiune lr nknsencaza ne pera compat de ‘ar onuometer coma deem patie hasan La deteminarea dimenslast pul rtnvine 9 simpaic, ‘8 coboard din Npolalamus panto tunctad cab, spor rae 33rd pn intel cont cllospina (COTLE, eae eure oi rSdSina TY alunge la ganghnul Serves nese, ‘ke saps apo fomneaca un pox parcartdan ahseee cay ‘orn cu fara cai! Bool pin nar ay hing! afnge "Op utr pp3.3.2, NOTIUNI DE FIOLOGIE Nor oedometr con nares umd museca ~ Sept cne ndasce GO. ee ~ ‘rept infor eae coboer GO (inround cu met Ste spre nat So nara ep sper oe ier cre ric GO ~ ‘ito plosape supercars 13.13. CONSIDERATH CLIVCE sane iat ger Cloner oma Geoina td ~ "Plat palpebral: paces post canensao paza ‘neil pn enact mae fea pes ‘es epneaans ~ Srabiem ivergert st epatfa plop, care se ‘nfo our ee cin pe Gove eoberit abu, Sr seal moqchior Shi supatr pte Metacafe tore peasinstn) oto poi: 7 Vasc: aves desir coral potest ‘au coreaed sprouse toc no infarct mezenetale, cu open snort com ‘ber (bras cere i de toa lal sectom promis! contrast) se Boouht dak (erat Gro iar Wome ara ora para we arora Soci. i ein 1 ne mening nda rca cov Se eaten re ciaom® pune #0 empoah, Se uns megane as “Hari ‘teTob temporal: detest do unos, steece,Younatune (perl sae Se cv spare ete lca platy dats fect face ‘eootte carga atin exon reeish ¥, eau rvt sinus eavencewonbotobia) ¥ Mononeurpatia sibets, esac der a ectares'tlr ‘matt wtense, cu pasblce bo Inga ole vegetave (etapa aac). VIlL3.2. NERVUL TROHLEAR (PERECHEA A 1V-A) ‘3.21. NOTIUNLDE ANATOME Nucl! motor ete ocala n tegmental mezenefall, i caller evarigamerh nee, Th aoperea nal medane efi de apeducl cereal, ‘oni prdsane tut l lau un act polio, ow ‘weruciyesi nial villa acuisr supa ener” Gk Imecencal pe prea. postaioet a. soesia. Osiris sat Incrodr, ecare mug ble supericr va ners de ner natn “Taint umat este do-a kngil pounce orb re srtilecuabral postr corebloes supaora prt ca ‘era Perforeazs apo ramtar gran sinusulcaveros, pe (Serie lar al acer, pnd four oar cupario, do unde Saint, 'Se vido api fn Wel eau mal mute rest care nerves rmugenial be superior ‘v3.22. NOTIUNLDE FZIOLOGIE Esto cel mal mic nev earlan, avid rum 2400 axon, camparay eu ner op ere re 1000000 a0 Ex.S ne conan comet de pe pan posteriara archi core ate sng ne ania caress erucigeazs carpet ‘ow cal mai ing wae invari (75 em). ‘i323, CONSIDERATILGLINICE Peralta nes woelesr defend afectarea ugh ic supeor, lon trmare'GO va ft devat exten, doer se ‘Scaler pare diplopia, care este maxim le pra fr Jos (cod ur sou (aboard set). Poni a compensa dptopn, pacar are tandinfs doa ples cap do paren epusd, panty a Yl se nor GO nea,ron aes ls siz cu cal deit exam pin para bleu Spero Paraze ener trotear det -nclnaeacapui spe singe ooo posite Bol intamston ¥ Compre etsoinale de anewiome do. acters ‘aebral postoard sou crebeloas suproad ¥ Lacuna nivel sinuaulcavernos Lacuna rive sur bare superioar, VIll3.3, NERVUL ABDUCENS (PERECHEA A Vi-A) ‘v3.3.1, MOTIUNLDE ANATOME Nucleut motor ecto lectzat in topmentil pont, In ‘sproperea ine medio, chr ane de verdes ‘ori nero fal frmeazd 9 bul nl nce motor ‘abducens toma cal oc u ‘soni cafe placa Gn rude! abducens mer ante 91 ‘erage pe fa antral la ancjunes at Traoctl novul merge antrr si lara! In epaful ‘ubarenoian afte! poserame, pero turratr aes 2 sero Uter conn Ie dura 9 sinc temporal pen 2ina in sinus caverns, unde ein fal Kral de ates oes "Rem mediterranea Neral iota pan taure rier Sipeoad in onbité 5 nereazS mugchil opt extern ‘iia.a2, NONUMLDE FIOLOGIE Muga rept exon dos un eel sctoneazs inpreun cu mei dots ceo a pon ena mics ‘aut le GO in ple oor ‘Vii39.3, CONSIDERATH CLINICE Lesunea noni aiducns determin din punct de vader Cini umdtcrae some! ~, Strablum convergent al GO de pate atocass Diplopie'n pvr atl de prea sci*ologl post poster eroa ‘lula rarer pone slater! Bastar poste ‘tering Unie pootn mada spaha ur ‘hiram ator (ile Guler prez Ista 62 ety abcns, prec lcs porter sera 9 ‘Sarom pasa contrat, ~ Lectin i vet vertcllul 4 turorcerbeoase interned ering: dtr ato do since {emporas poste alec niece de roche Fracture tcl ceaiu Fpertensiane iniracranian, dun la ive sinesuut caverns, cum ar ‘ombopebi lest asst is, WS.4, EXAMINAREA CLNICA A OCULOMOTRICTTATH A. Examenul mosliatt gebior cela cupid exeminrea smatand ponte perochi MN Vi Se. chucrs, Wil dock ‘apie sut sence say daca ext poss petal, dard secs ‘hl cular sunt pases, sau et Un stoim rettcus6 tal es verge sou eorngor), tos pl Su ope tern, pasion este rugat a ate mig active ctte velar) ala bier ct n tats dec escndt "presse in sus, Infos a Sapa la etnge Se etocueaet ‘aniares migaike enna ale gobo oot ug polenta ‘uméresscl un cbc! (a exempl on crton pe xe high aie cele pau rec Iara dap, Ing esr, supe $1 ‘tor mola sue. oe Vor cosa etn un sss ga itror excuse 0 into anumia arecfe. De scerenas, pacers no v2 carunca ai una plop, ra arumta ect B. Exam eosoranea, Yellen ftomoter, rfl de convergent cal de acomodare Pent examines convergent se spropio un obit de la istana ‘do 60" comotl cave Mosul pacer, pan 1a 8-10 ‘hrm cea ind pomanon boc Bsvt oman pate pata ala een ‘hat nel Poco Deco ata aha ‘aa © rmsd dita run pure fg a, ap ‘ae sn mpm ooanmonpra res as aoe ea ' gmigedndse n sensors mobiza capa, D. Test scope: uae tabi ote fs sents prin exaninea oe ere porienula =i prncnecl ch oe ila ape abr om oe om ‘te precora srtioml este itis Ge outer ial Gear ‘lcd elo Ser orev noma ns ci Feat cst coi: oct dept owls ‘eat net ate Ings oats rv cass voc og ‘Pogo tea Sl ocul ing Yor frome carte ard un bet (amanare apna) fa ENA Paco {ecco rca extort url parca a Gopancos costae recla de scne @ muscu poraleat ele. Sout rag to lara una de Cone, inginoa lls ted ove extrour ara ‘area in sen oracle ua tage se ere ‘nim examine metsehalaciare vo Gta, doc ete 4, pzefe itagmusunt dont oa 0 igre vlna s eae AS on sens de ra 48 rated), Sona ens (oni esl eign Voniooas a ‘Monell esti sotat arco ap lie) ete cos ‘teadues dbl ocr In posts noma nd ea ce Stoning Sul nisapmusuldecsree este oceatd l gar ‘Vill NERVUL TRIGEMEN (PERECHEA A V.A) ‘V4.1. NOTIUNL DE ANATOMIE re ram oft, max manors ste un nen’ mig, In tcipal senaly, care segurk sine fe do are $0 eonponeats motare ce nerveazl ‘uscdtura mastetor ‘Nenu enorpe de pe fala medioitora 8 pun, cl © ‘kin geratv mare ura motor mal MS ‘Ganglion cent (uigaminal rau sariuna) se af Ip pangul ott erarene loc, ces rarfiesndirae cole el amt Samed (1), maxes (V2) andousrs (V3), care ene ain ‘Sank in ae eter supeoars, otra flu respec gra ‘ral, Ramara omic gi unear com madaré roc pn emus {ivenos, lsu de nent srlonston, Insets doa pls cia ‘anand’ Ramure ote ar sos comun curl manu. Ls ‘Spr daca conansfecare ram sa snd ira mabtudne So Nucl! motor sau masteatot est loetzt foil pu ‘Nuceul senza gpm est cel mal mae dit to rice rior canes fs Thine pe tool kngeres, vunchi ‘retral pang lela maven! dole segment caval. oe brass mezencetsc, poring ruse Faculul spins, Nucieul Inevancefalc canine profoneuroi sensi cr andr cae fnorg sur do conponeets moore rari). clog itornal [omoeptne Ge ls magi masteaton. Aron se poectez a rivet ‘count motor geen aclguréndae i scost fel con tafe al maseafel. Este sng eae cae protoneuond sen se ‘ts lo vl Yunchuls cerebral Nuclut porin ess aul on ‘eutoneuron sess implat hr siares sonal tele fl Noctou! tractus spinal est eprezerin de 0 eloara do colo care Trorge de nivel pul pon, ude spe madua, In speci ‘so Fnpicall tn petcapfa sensi temo‘Aon doutoneurenor se proctesc’ a rv fomafurs tulle, niceut masicatr per refed mostena) @ ncoeoal "riya actl ventral tigeminotalamie (merit $a nucle lame ental posterior convoaieral pats mca hte here ‘emul patra. Newer! wr! in tars se petocnss fy sme inferoaa a grat postcentralipsiaterl 142, CoNsiDERATH cUNICe + Flacurle masintul facial sou do te civ cranial pot Dacd i purer po pecion 8 aca cave pas pe lc, Tarte # Inept oxi inci vo ance ln nou 6 ‘vee soosla spre para lzad cu ofa Pum > Rare nistagmusul orzorl sau ozo saan tiedad ca vercal cate ese mares eneromds ‘esl cai, Secusa rapid pe care o cbservim ‘ol este de parts opuse lexi ‘+ Ga uae, reine cd sindronul vesibular pole este un sino amon, decarecs toate rebel fectuatea pact Su pete do pares lest, do eur drat gone {or zie, splamar, ra in). Unoon apare gl sleare ‘rporena cure, oy rezetaipeasz + Din atalniepose voir oso rtamso’ i vasulare of nivel wee Ines, sau fom teroae. oh Ugh pontocreble, cum a neuthoma ge sous. 22; SINDROMUL VESTIBULAR CENTRAL + Aare cm uma lector de anv wunehil cerebral (aed ere) aa + De unc db vote cic pass resnic un vot ou ‘racer gemarant mai sous sa ners fot de cet dn ‘Sforem year peer ec mal pu eva oot ‘na are rere vote aap + Roar ate somne neuroloice cae stents ofecaea afr ‘tain nonosse oon sa) rent Soren say egokrie + Gin pec do vedere aioe, vom const ‘F"Proreja ringtone, dar ol vocal feo glogremeni > (RforesproearRember, «bajo, su 2 nicafel are 0. devia nesitomatzl, i Eoncrsari ine sensi dove sos ecu. + Ca unnae,rejnem ef sncroms vostoulr onal ote Store isrmonc, coo dural mal lng det cal arlre, seu 0 vote. mal grave, evand In vedo toi pe care acunde «Bint stoops ponibtesmitn:gaidogle vascular de wold tas carebar arse sau" hamorea Stingobuta sa unos neapeencinetoese. ‘VLG, ECAMINAREA CLINICA ‘ATontim scltatoa auava po rnd, la facare uae, pin trcorsa gett eeep ee gird pan ne spurd (oct ude 9 docs sunel este ean no 81. Probe Wober: Pio danazol fat In-ubeata ee php vet, sar id pert ned roma oa nabs ncaa wl surat 7 tansmiste: virjiose sud mal bine do patea Scinava daowoce nual ntfort cu agometee 32 leabeeae recieve aie ft ear Se perepte:voraie se aud mel bine de paren ‘SSndioes fst Weber naga. & > . Prob Rinne: La indi rar, conducaes aan @ ureter exo al mare doe soa oeoasl Piru! depaconl af [iva se aoaza po mastoda png cand pact me spune cama ‘mal aude, moment eare dapazonul este pasa In aja rec do scoot pat, cam + cm tn sn find auzt Tn med noma ‘nck prosmate 20:0 de scunds ms goa), In coz uel st 7 tranamisie:dapazonul esto auzt 0 peroadé mal SAEs et ee cnet oun {ej toc, conduceren oss © suns ind mal mar ded sea send (Rinea napa). Se peeepie: up ao aude sunt sural in mad ‘ua? rane pouty radia, ait consacerea sean, Eiplene cesses ind edie yyy 1. Obsorvim prezejanistagmusul In moment in eae fexaningm meso tanga ale glbler ocular. Acasa poste f ‘rzonal vere ozo geal 1 Ceca proba Romberg: pacar sy para, cu raj pe nos or, psarle tle url de cl rere oc Jn'mod noma fu a produce ict 0 dovisie a coum eazu ‘stone uni sian vestbuar de tp pene se ve rodice, To ‘fehofe onl, © deve do paren ects focal, pace ‘hzindo cade acon pat.F. Proba_braelorntinge: pune pact 33 sce mero auperoar Info cr occ vm ostia & dae 4 aces de paroa vosiaukil alecat hy carl unl seen ‘ostulr dtp perfor, VIIL7. NERVUL GLOSOFARINGIAN (PERECHEA A 1X-A) VIL74,NOTUNI De ANATOMIE Nee Kemeny de nivel burke ob bak edna eben ai, tocs pe fa gua (uno ca has eon pa) se di crane tv gu gsr undo eae Sele ssp 9 lr cre cone cas care adacd plate dora vicars case de ud and raden £8 ramon ferngne a el pel cra ang eal ‘A. Components moter: inpdsle de a NMC dn aia reponse zoe corks gurg pn asia cactuba ‘io NM nara cn pron superotrd «nucle ambigu Ba Atl MP cn bl omoass ced IK cre eno de a ‘vil bulb su oma a 3 rac Trl oral Ilr n fone ranians posters peo Sanu poy gee ‘ilar ster de neu vag 9 Sossee, De a ees tl Sol ‘olor mera spe muchiu stiarnglan pe care Minerveaza scot. Std odo aris angen timp dole ia verb B. Congonenta vgelatva motors. ei proganglona: paresmpai! sea oosaa i mleut salvator inferior dn bull find sub Influera ipotlamvsuil 2 ester fact. Axon peso neon se ata cola component lo neni emer Din gars jugar. Nervul impanie pouch ela nv ganglonas ero aur a vols caval pres une formese4 np ao. oreaed mucoasa eam, canal aust cele Tattler, lr fre motor formenzé nervulpetos inferior car ‘Sunge 28 feck siaped In ganglonl tie, Je unde peacd fn Pesrgony pte enon panda ae, . Componaa vegetativssanzoriasy chemoreceptor i bubul esioiean menitorzeaes nv exparuns ‘dn creda Sangin, lr baroreceptor do ‘arusul creidan monroe, ‘vel tnsuri arte, Impure sung pen ner earotn! Sargon! ifr, sar dol soni meg pn tract ola opr Tucleut ‘solar, do unde 0 resizer conexun ‘Cu substan, Fateulataascendents 9 hipotlamue, pens deange fap teow perry cord feeveniel care, 2 fecvena rapa ‘tonsil ae. Iultrio gustave in memes posterioers tbl (acn {aman sunt tanern do neuron de ganglion! glosoarngat inferior, a cor exon era pn gua ugar ang tn bub, ur sscasioneazd pin wactl sottar pana la nice! solar. Ge ne ‘ont ghg. In nucle venta! posterior tall isi ontolatrall do undo impulstle sunt crue ms parte nat ‘tava cn wemoa itrord a gras poston ©. Conponeva sonal: sesibiaiaa temolgeaict « ‘sqm waco aces ‘upefer ster! posetewo a tims ese waned pet ‘ont unor neuro! caro ao. sia ganglonl glorafangln ‘uperior 1 Inferior. impulse pr dtore meng ws acts ‘eigominal In paten caida 9 nuclelu trigeminal ue So oh ‘urn secinda a cior axe eruigaazs nia moana son ‘ewon tera én muctel ventral postecor al tlemusul car protcoast in givaulpestcantal ver. cons ccuice ‘+ Datta proper demand X 91 Xl lsunta ioe oe ‘esfarngon sul extem de a,+ Mevaga lwo eta erzeit. se saat ssne dure porosied S616 lesents Is nivel Ghd 8 acre sre pata anterior ree seh anda ‘acute cusroas pot f dodangalo ce dogo seo Vik ExaMNAREA cuiNic& [A Eramingm fneta motor: th ees oes de dee serelr ‘espediafxingea (Gerote posta) care tn cat {ei lezun do new Ik ecle Yactonat de pares rtioaes data conzacht mucus slfamngian ios (earn cetinel thi Vora) Exernaren acest port pereches aa ct penta 8 iran, acogh ree fend Impl nitea ‘ahi plate ging al mal tecvert seca ‘npreun. Vea examen new og 2, Exam funeflasenat prin tstven senabiitcp in ‘men postroara ‘al ola smd peretela posto ‘singel 'Exaringm functa sensorial pin letarea gus In toimee stro alibi (ar po le rl i amare baz im). 1. Examine Tune salvae pin precren saga aici le ‘vel dot a Stan st Wold el des dea pero ‘Retr. "Ermira tunel eine: ~ Reflex faringian: so excita poole poste: at farngo fegunea”trsise 3) bien Imo Gotominngt-se caneacs msc fngeh 3 fee ib ro Se ana de ae har Refit slousule) cartgln: pin comprinarea ‘Sus caren sta a ie eal ica carte comune e pode in ad ormat Srdoarde, ripstensune arterials» vosodetao Dorr tar sins nea do iporeceabiate sin vu \is.1. NOTIN DE ANATOMIE, Nenu vag emerge dea sive! tubulin nucleul ambigut) lose dn can pon gra ugusra nce ca af ct dol ‘Sanglton! Eorzoral,euperorGugul) inferior (odor), a vei (tub nevul veg so ae re vonauguara ira area carob Siena, soboar spre baza gat, wade a valde dere panty ‘nge despa, porru a ahnge la plexurle cardiac, pulmonar 4 ‘sotagian. Dale pou esefegan, av rater nen gas ssn ‘Stop ere inervear&oranel abdominal panda sare sla "A. Comporaia motor: xan neurone: meted dn clout ambigwu ioe dn ulb pe le rive g6ur! jue. sng pn Intros 9 tl va a musculatura constleteare a fringe § Inmusculatrs sinsee a lrngell femur fringe Waversezs gonglon never, voce Ine artrle carota ems @ ers frmesse Plowul feringon care asin nwo huscustu fangols pall maa, oF excep mugen tenga feral nora) muges two ‘tl pst inervet do eompononta eter a ner NERVUL VAG (PERECHEA A X-A) + Nowullaringeu suparior merge 6o la gangion iro, Pir deta Go ramura frngina, 26 Side bout Fame neral leringian ite i xterm, Acosta in rs Ineneszs mugen coneneor Pienr gi -ciotoian # ‘anita lx fanglan 9 nor care super. “7 Newallangeu recurent re valecs forte In sings (merge poster po sub acul rie gt atnge. fe ‘modasinul super) 91 raapa (ge pe sub area ‘uncavi) skngand In sal de aes sol. 9 Inorossa mecuaten mene lool cu excep moychuly eesti. B, Conponena vogelatvi moto: neuron prasirpat ‘sunt loath nucleul metoe dorsal vogulul (an _pange ‘erro patstigoal vagal) 9! sunt sub Infra Impulsrior an‘it8.2, CoNSIDERATHCUNICE * 0 lexune unser its ny veg dloming vagus! (pin tectaros misculstu irisecl rings lcs ogulo pera Tondo (phn imgdabiiatsy Na ples mos at sectar rugeilvatr peat fers acs © repkabe 9 eu plsbare rte de tse Leelee ‘ea pe ns Su vor prune in wanes linge ees ‘ow paral. La examipre vor anata ed Va ple eat fob Se pacion alc lar ln ete davis de prs ‘pus ca mare 3 seu mugs hort conta, * Lezlunea blatral do nan vag detain Ieren deel chil n roe tr ca lringle ea cn, spria ose 8 Stora abserja reflex ce tue, Va ea eur ‘seep est mob ata eSnd pace ete stat foun tele + In paraale istorsle de nerv vag spare econ funcie egeatie cu crize ce ‘atc, bromnopege ft past Ise, + 0 eriune » nervuulttingeu recurent dtemind para az vale galelersie cu spare rigugll. hose st oa Inirpls In cus tenor: chic levels atu (endererecomie.carotidand eau Wodocomio) te Lumar suru anism ert care afetaza lage! eee sting. sau" pin metasiaze le rive ganghonier Nasty + Hipracivitates vagal dotomin hipersecroje gases care eteming “eral pases. Paci cl icse. patie pesistont sau ecurenis pot Fay cu vagstomle ccc (pr segenarea nora grt rept su stan ‘+ Stmularea ram aurculre in canal suc exam posto See a mow choavene ie a‘unr as ‘Se anat ccas eon woe rem X12, SISTEMUL NERVOS PARASIMPATIC oS SION ev parasite (SNP) repent ca doa ous corpanents a stm ros vegeta, curl eres funaitratoneme (eget) n cond Bae. Newent sttomult newos porssmgaie ‘rnc corarat ea pate vel mévesserst a ‘Nero pr euron! postangtorar,eecsle parsempaton “ind thsi beatae doc cate span ‘Sol nervos persimgate foee—19_c8 mediator scaticotina, printed dous ip ge reeepat odie muscarinic 5 nicotine. Acemcatna eto rapid metaolzadin blemedul caloeterazs, efeil parsimpaca fd ca urna Se ‘ra seus drab ded ela sinpace(asrenaine ¢ nradonana uk metatozte mn aprxeraty 60 de mnt), Fee pregagtonsre ‘Mereart satesind la rived gangionior, care sefoneseh pe ‘weapon neni postganglonar. Fite pesigongionae ereacs po! acaleolnd cae sma recep mosaic de In ahd nel ba Exit tip do recoptrt moscerin Mt sunt ocala} five sistema narvs: > We ut at a a a ead a ome tinea caciaes aint actunes sill emote Detemind bradicarai, reducares.forilor contac ale Iujeniuld card atl ezn do conducere a nodulal Stlovenvculr, Nu au sie seupn Yrlor canada fuji eariac vere > Mo sunt Ioctza a nivel muscular netede a vassor ‘Sengune svt plamnlr detrminind vesoconstchie Gi bronboconatictie. Se ma alt gla nvel tases ‘eta tubull digest. detomingnd crogteres moblRa Intestinal diatareastnctorelor.Racopor MS sara it {larivaul sor glade, tim ar coe salvare,caora este Searetin ecopir ict se a la nivel postgangloner alt in sistema ners parasimpate et 9 Incl spate, pocim In Imujei eda ycsulole maculosipasnalXIl. EXAMINAREA PACIENTULUICU TULBURARI SFINCTERIENE XXIL4. NOTIUNI DE ANATOMIE ‘Sucre necesar function normale a miu sunt AA Veale trnar,orgn carta eral pe sur foal {in fixe lungl de mojch ted numa detrusor." Acete fe "usulare sunt et! rant, net contrac ar deter vdcerea Volumold veces! Det exinderfyetor moscusre fo rel fee, conectadetwmoni ceteris § dost snc 'B.inorata parasimpatic8 a vezch unr, neti sper genie lemeriu! regi peal in funclonares Sostoregane * Pera vecict cont receptort sara des lung freer ‘muscdare, Aerenfee br ahnga nari pal a radii dorsal $184 ger termad fol Conul Suet Wezel ‘Sat arial eogmertaor S182 md {Est afref co lug taal centul pont via + De a con sacat veda, eferelale mag grin radicine anterioare 82:84 spre coads oo ea, Sungied pin gle ‘oer a era) pavc. Aceste fre, prepenglonare fae ‘Shans n sratont sn pes vessal suet npr veel, endo ematg tbe. postganglionare.Simisrea neck svi eromia conc paomics a datusruks . rv simpli veil soe road Se rie: + Oriines inva sinpsico se gezetn In neuron simp prevanglonat calzal In cosmele aterale Se méuelT12- + Axon proganglonar vec dn maui prin che antroare hy lanfl simpaic paravertebral, tr snapsd spol pt ‘neni spine! i ganglion simpatel ol blues ste, Soe ganglonul mezenter interior. ‘+ Dips snap, terate postganglonars foreacd_nerv presacral sus poe Rpogasti ag a voc), mal {asi bigonu vesiea + ‘Ale fe postargonare mary cs ner pave! ng la + Funclonaee sinpatcubi nu este inet pe dptin iat Stmusroa newer smpass sr webu at ne actvttos baresnpatia 58 ine. conracba vezeh Dag! nd este Germanrata cine inpleares"empatcl in tancloraon ‘eel, aceda eto sigur mplet io esos soni abot '. Mugeni sr al perinelul, nus sfinctral exer a wale, cag masculatura poral! abdominal, oor 10 Ireertant arene. Funcionarea aces esta ragais fh tmator Motonewoni care Inarveszs. musculsturs abdominal. sunt plas n cose arteoar de aval Sg 82, + fie cma ot cn ri tt code 5 pon gaura each cea mal aropat gl ormoazs ner Ppusendal seco mina aleauese ner pains cae Sing sfineteral exten 1 perneu ‘+ Alorenele somatowenstive Ta inti, pis gh uri Sora sjng tren! pees nor recta nein. ner Sora pont Fone poster ale seprerisor ‘Strate 8283, in conul moduler Control supraspinal ee esenal pat o icine oma i ‘Un cone important oe ats fermatunes reticle pot flint impuiun faiitatore porns michone. + Un oft cen so gdsega™ In. reglunea preoptics a Imezencefaull, simulans mofunea 3 ssigurtnd sdepeea buat ope. + Roprezonrea cortcls vere 9 ft nll paracontr Invosndsaa margat mos emserolorstmre sas a cotemiiand conracha ved. Un al cary coral din ‘rus fort ibe gues vos, + Foro descondenta de la cen corto tue prin econ ‘rarer colospnal i retclespna,n prea anterolateral mauveXiL2. NOTIUNIDE FIZIOLOGIE In focare of se scuraieszA In vere cca $0 ml do tn tena geen cee td ual cd 9 amen cat 40 il de singapore senza da ves pln. Micha ‘al dacangat mal la 4-800 ml do ena infeea mchur so foce bin contractia museulaurt abdominal 2 daegmatl, coe co fetid crogtres presi irasbdomiale, Acs fat cave le Iniensitcarea teatsuor dela oeepor fn pee vez pan leer nor pv ceil spal vel! dit con eminal in “agmarios soorie S284. Simian, inpuleut acerdorto colts ‘su centr dn formationes reticulata porns. = unde Pleocs stmul fctiaiot spre contul savat spr! Deca mu exalt Input hibton de le vo scoala cre 30 benece Procesl, $2 va neice micunea. Smutan eu scares cota ‘ele parasinpate, at stra octet, etc ior te a ‘own maton cin torentslesacate S182 gf de acd la mah ino” Acsasio de In ralaxarta finer extern 5 antacia muyehilr perineal cs portelal abdonsal ‘tice sutrina co apare po ae be eo St ma ce a Darturorea tent proce XIL3. CONSIDERATICLINICE ‘A. Lesion nl lft uo toni, ticle a preclne nora emia emis odes ‘contro cofey sre cna in mperise, cd vere exe oar pax up Impestitaen ges ibe volun micfunea rt ineadecvate; ie «firs sa una. Nol Tonusl anal ote normal Be Vries newogend_ orn Tanners ior spine ean seqmanl sacl apna eck domes sees ‘ruil, ata, tumor lee pa). + veil apt ace orssaren un ape sb 250 + nposttates contol volun li su oad mehr + Sedgenamipn ane ou: perce a + feces absent 1 thet ponte manta Gen fromane vegetative de Sorte. Genes enous Ceseres speci ‘lia ase onal do riche ingens su de vazeh Fasano eee NB, Tonueul anal ote normal pare onda In contpae; ost spare anion “EVoned automat (Senenats, pn las le ui excl scl sou oa clo sro era Ge eg ese en saoet veal (eu co cal date saat we Nei fiech, destin, 5 plsuaen percep! mpl vex + neontnena pe prea pl, Stampa patra coin do eae + clu wna important cus rd neo) wet eral. oj sacar csr Ineontnens pen oeal on hal es, ase ImotosXill, PACIENTUL CU TULBURARIALE ‘STARII DE CONSTIENTA. Pacer cu tub al stil de cangtons nw Ilene cameo nu pots parca act exarnae, coe ce Geter ¢ ‘Sana ‘lea de cea poco et” congtent.Examona pedentl corates tobue 38 ne sie n'a enc verti fecun ale SNC ovens oe mel orien tun) Seopa iu newooge le un pala! conato et de a dteine dard ua exo rush ce lesan stvcurae cereal, Je © ‘Storie meaboies, ea de ambela ‘ous eemant in cranes newclogch ro pot ont sees ' aimtia constant Ince ganaa sega qi oes reaps Dorr espana ebrote 2, feflene anormale ce pot ica tunes une arama are ona cereal Stare mental ste ovals pn obseraresréepunsior pion str via aut a dcop Gree) Siem roelt sctvclor ascondont meine. stared de consent normal Porurbsea sev seeshl stom deerind ‘Storr st de ‘eva fnaman se poate ie 1: Eneflopade cura: uburarea functonaitii crbrale ce stctac tot roar, inci sera acthaor ascent ecu Tense sau asada cu ‘oromene de orion le alr . 9. Uedurineertoiae: cole ce produc suernis rect ‘rons eae XII, EXAMINAREA PACIENTULUI CU TULBURARI ALE STAR DE CONSTIENTA Exarinaespacienul incl weve $8 umarosec 1) apreceres tr do conor 8 mod repeat, mind Ile parame care germ campararaa an pace de [aun moment la aft sau compe ne. examenel ‘loctata da exanitael er. 2) Dierenren vei os conform clases do ma Inert sniment. “amon lt ocr Pet ares he ib cong cooler core up. coma) pol sta Una ‘obtener ewan, oo mses et et hse al ie norris wi ‘losses acta pee Mousctrie nla de congars Ssoaiaedadecee cy sonra specin, in noceans 9 manean Fomarens sos anghtres ror Sater ih Sc lag de apres do aneen lag oma Seae=GC8) ete 0 sas iol, raps ug ott fo repeat prt! spreseraa nivel sa co creo ce lal epic wor motor dose cht te oa GLASGOW COMA SCALE: DESCHIDEREA OcHILOR PUNCTAL Flenle snormals(gldtate prin decorteas). Extecie anormal gies prin dacerebrte).. bon. 24 se Go cn oa nn ee alate rate dni Cmca ne Siar Fo a= Intimp: Ce ziasa? Ce dts eta? Ca uns, antic arsine resto? mn spar noo fs seas? Ice spa? Ino eng? sutra propre persoane: Ce teas hr fae, cope? ‘Yom nota repurcate cle mel bun -ortat “eon, foosind propor scutes hgh ute readecvate inte hintaigoie buona tre rps NB. Tretuie 38 exchudom o eventual serena sou rcepth Caren poate de dae false cu pee nse scone ‘Se, eprecics ca fina in com, pace exe cumeazd ‘marinum 8 punete (ou doscde cei ms execu cemoncin, ma ‘votesa) ta ‘aeste examiner. Pasion cy scond eS au" ‘ota rideala gun foc rescue a recta Sone vegeta ‘Examinare paclentll cub aes do content pean mie: pecs palo - Zac Nemigca au presi mic? Dac mca sunt rezone rica egal ele pou membie? + fulsome et mie anormal? Posbis 1) membre supercars "ih fave fa nek ttror tela ale iferoar Ta exon tre trator = postu 3 docotcare 2] meri peau exe oval coh n Pronai> lela acl! pur cal nero in etl Ivtltaror aster = porturs de decersbrore 3) overs capuul pare cu hia rerérut ‘super 5roaba enone trior~hemipaees 4) seus spa, do ato socnde la veld rmembreor = miecton. ©. Capul git < Se examine’ capu peru evdentes un everiua «Se perc ceri fnd poss existenja anor extents tn cazdefracur <'Se xamineaz’ urecle asd pent evdenorea ‘ngeiior sau e eared etalon ; Seema evra retewo doom NB. Nu vom recuge la sesle shamans ch elo evident "ounatan canon pana fu aie xcs on pos mats ace ‘cufacta, care rece abllae-madats . Ploapete: aati ni sponta plogpele? + Iso comand parent sf sect mich do chon {desericre le ploospar +, Sotectazd rect ta dure: peset nie oc? {Exist ipa at looapolo? Smeres sau semeticn? 1 Ess pass palpebrai? 1 ist asimotre fans? , Aculites views: pu so poata examin Ie pocents Ua A Fah ee sina Cine pone ‘prea in prezenfa tau absora ‘ole do. srat (cle) i Saris bused a und obec (mira exansatont rela ies siatwnn ne A. Sadi il + rcv» encfaopati metas mires ji Tenia tareants Eee oh fegle)- mraz (pups poste mn ero! comun pose anos)= ex posi au? ncaa nel poz ncaa: li ocd, ‘Sovasa 9 fle orzo 9 ff de voila, so wugorescs ‘echne do tune ‘aninares moUlat ocuare poate evaluat pin incurs noe ‘ged ale abl oauar pi rarmocil no rox Resa! echlr do papugd sau foal ocucetae se obi pn ‘igerea capa pace Ne vom rcurge a scene fst dock dp ce fost exsucd © Iron cone {Gind reel ese prezet, ot paca rd fal In tmp co ‘io pen ae gcd. Aste, migcrea cap! rel Paden ‘Sate part eveusesmigeeiar cor Serres capt ep crema fae pose cl, care pot vee umioares niger 1) abi och se mie sore stings 2 an oct pve naire 5}am sigur oc oe mig, cll ramane ‘Se ott caput do pata tng pol sre sate pe Putem main uroarle stat "Ochi se mie ge parton opusd crecjol do migca a capi, Ca cum & i Inanie = neal, Pasir vigh ue ‘su oor de papa, acest find ba. “ra mges io pa, darn owt = para pr ‘conkgts = eae deur corer 3 Eo Ita suf unl lb ool paraise de pare boone “Eso tas migcarea ghoul ocular, cu excep abi ‘ar pup ce mad = paral do nor ocdomotr com, “5 Gleb our Sut gf exoaLa ric © migcae lesue tera de uch oot ‘Dees un poet comstos nu are rex ochre panies ‘nseamnd cf @ zune tabu i afoctze areal rex alee [abn nen westbulrgproprocetn caval ferea = ner ii, sr mugen nade). Ma par, close conoteash lerijele"cu stereo In punto sub poole erp letra abeena rela pec orate Raton come pose fin apreciorea ses ar vigemen Reena eaeentue i) pss sar pecan cu capt gone a 30 de grade fl orzo Seated 5010 fo Ge pd oc ir rothn, Apa ee ses lot ‘hupa carat semicrclr ca cng capa pacientes suck {ae prea pus ctr. De aonea ct aserl Vor Pr Se wechea ejecta. Acoust deaf pert pan un ns det, ‘cause 0 manevea de evdonfore a manus extoooure Posen comalo ear ar pos sues nz sl mtv spl, acd rel ocovestover ost absor. col ma pebabt st eine 8 pu su bulb malaria al are, 1, Vi"scat. Vill Spo docscbre do refs osdecaae rata ruovesibuar ests rere in pacon vig La palent let Fett ecvvostouar nu numel ok me devia gobi cul, dr Produce 9 nalapmis In drole Ivers recht ject. Components fet ete nareef roc ja, ce rep nso ver I Nerul facia pote 6 examina rn aprecea sett gimasolor abn as nocoopt, pn exaroarea unr prestn aris onporomsndouare 4. Nes glosoferingan 9 vag sunt evslua prin xarinaea ‘ston’ vebpalin farhgn cgi Saas ce soca dows poze real de fevaca ls smut nocicep, apicab In cee zoe ‘pull cogs Cane ase erocron prot come, de spaslale, ovea co detomind © Bros la manele do mobisare Pas = eaten ri tmbindae # mice Seu timtsen Pea. se poate rece la eroacre mombry #9 noteza vagerea mantra respect, sau so ‘Sringe a pore emelona pacar! we areca peu 1M Roflexee osteo tendinoese gl patclogice- ex cap XIlL2, CAUZE COMUNE PENTRU STAREA DE CONA ‘A Procete tue sau mutiocale 2 hiperaicomio > Ripon % flttorta de amind_(enetalepaio Wamele) sults hepatica trate onal rapa onsdrentsm + medicaments tonzodazepin, arbuce, epace, tales ¥ alee Intocyose’encetate ree simplex sau a vi) ‘ascot: eneflopate hperenaa 2, cureacie meningeal “Vastlre hemoraglasuberanoiland “eoese: mening bectanen sau ral 8. Lerlun upratetoile Themed exreauate ‘sobre intraerebale 2 echo tumor © prima 1 eunare eaeaze) sess ©. Leriun subtentrae “nemoragh © Sontine 2 acho de tanh creat 5 tumor ereolonce 4 atowse cobalt XIIL3, HIPERTENSIUNEA INTRAGRANIANA Fenomenul de angsare sau homie cobras consté t Sema rao pechon cae se rock ath & jen acu caro 0 perjune a erelonas ota oat a ea Dron soap rai, ie arama Sond (regres result Serena SkingRaroen ml apo doe staat cae ext up ‘Angarea posto avea fe a etl uneusu paca bul tempor ivl frou ve spars faa postcard co sxc Sorel oa ind cnr re on et XL. ANGAJAREAUNCALA (MPOCAMPICA) (formstine uterl exaz8 lob topo untral rit ‘eotoron,compringnd pereshea «a Ge ne enon psa pal et fra, siptows catered tue ‘real, Su cher tx Wun Oat acest proses Spore eles lence, ceca co determin sczleraet [oceel de copes a preauntnrocenone. Senne cies proce. miriazaIpallterais gi sare do lezune fil spalrina (rue cima prs a tin er crates sunt super inevel > homipleal psistras > plot piped ors spa > respiratie Cheyne- Stokes lla perechi 2. rvProgreso ete de cle pi 7113.2, ANGAJAREA CENTRALA © uno duprteiola foxoarh dence (alamus 5 stucule legate de acai, tuto ne tcl cea superior fnisfsrele cerebro) pi tontum. Acaats dune la © comers, Ini pe zona suparoar evn ter popu bull Sore dice procoe: Tesplai noregolte puplersctve mitico Eresteee onsale mambrelor omnul Babinski tates Sinevolite > roeprafi Chayne- Stokes > ‘igiate prin dacertcare:epontn sau In stu nciep pare 0 coy torus muscusr oo addueba bree, ‘ts aniebra mnor¢ecnat membroe esos > midis ti Posture de: decerebrare: ssontan sau ls srl nacicap Spare © cresare a tonusuty musi ou sddurha bel, Sonat gt prensa aniobrajor” ql exten membraor we is rooia oso de oi tert Ingorra, patel eu postrs de docorcare au un prognestc ma ‘bun decency posure decoretare vs XIV. SINTEZA EXAMINARII NEUROLOGICE > Elacares cores a anaes, cu puncares_eamenisor fee dn eeu! bol ne ornteacdnieun em Bae lo ldonencaresentanilunce the naurigon focal 2% “rd iba fate * ‘ular mess i cogntve > xaminareanauaiogi espe "7" Oocensrea uno st parlor, soins dt rigedevolntar pecum sia aro muscu + Examiner merous (ach ole pat sau dich a) ‘el conrenca a8 ridt pecen notte + Erecuorea proto! Rona. > xarinarea nee crnen “Neri fac Nev ope: AV, CV gun de oct i Nand salometo gest coniate ale GO, pee REM doc conseneal 7 Nora tigen serabata fe compenenia moto (rome eng et corean Newall tata fo Y Neral acusico-vestoulr acuta audi, probele Nan glocoaringan 9 vag: degiia pent soide = The, ata, rofocos vlopalin fingan. le Nerul accesar mgr efecuate de SoM Wopee % Nerul hipeglor otites mb, exten aeor 1 {eaceustor ingiae > xamenal maa eta rivll membre supeose: mig active Segmontare, fof muscu sogmentid, probe de fated, ors mca (a hiyetl member infrioa: mig axe egmertar, fora, muscular segment, probe de prez tous miu. 4 ROT qlrefonl patloice Examen coos > examen sential PTootron sara tatiana g tmo-alpzicn pe sopnente{Ts wil otc vio esse soba seice ioe ric & ona > Seaman finer rte > Examiars bap > Exonrares ner cole speroa (i * Scere ara: in ‘nals oxen serio, abule st fm caps 38 seein nr a ete fy ra Sagres mare carats, iid xin Sago ‘ge pet pcan cata ul bacon ts ‘Soin pracinn secs n hoje da pats Spas BIBLIOGRAFIE 4. ADAMS, RAYMOND, VICTOR, MAURICE - Pines of Neucey, En, Mere Now Yo 2001 IAINOT, J.-¥, NARARAS, A~ Los paralysis ples boc 2 Saon Pass 198 F GONSTANTINOVIC! ALEXANDRU, ADAM DANIL - Examinaes ours, Bucuest 197. TPFULLER Gu MANFORD M. — Neurogy, Church Livingstone — ooo. FSkaY HENRY. Anatomy f te Haman Body, Twenysih ection, 6 HacKINNON, PAMELA C.., MORRIS, JOHN F,- Oso Textbook (i Funeona aatony 1654, SI MOHR Ps GAUTIER, C Guide to Cia! Neurology 1996. 1, MOORE, KEITH L. = CinicalyOronted Ansty = 198, 8: MUMENTHALER, MARK ~ Nevtlogcal Dieretl Dagnosts 2 Eaton 192 S0/PATTEN, JOHN —NeucogjalDiferetal Diana, 2 Eton — J CETROVANU ION, DAN STEFAN ANTOHE, HORATIU VARLAM ‘evrenatonte cri ig 1968. "72 WLR. WD, RG GROSSMAN Medal Neucilgy, Newoonalicl Ghanouepnaldogel Prcles Baits Cia Newoscance, Esin Hedy. 8, {A WMLEON-PAWELS, LNDA, STEWART, PATRICIA A, AKESSON, EtzaBert J Cranal renosiAratey and Cinical Coneren-1668 yume, Pa yo RAUCH ese in any, ‘ethon 1657,