tailieunhanh - Clinical signs and mechanisms: Part 2

(BQ) Continued part 1, part 2 of the document Clinical signs and mechanisms has contents: Neurological signs, gastroenterological signs, endocrinological signs, necrobiosis lipoidica diabeticorum, pyoderma gangrenosum, and other contenst. Invite you to refer. | CHAPTER 5 Neurological Signs Understanding the mechanisms and clinical significance of neurological signs poses several challenges that are unique to the neurological system the relevance of neuroanatomy and topographical anatomy patterns of multiple clinical signs examination methods with significant inter-examiner variabilities. Throughout the chapter we have tried to present neuroanatomical and pathophysiological concepts in a succinct and clinically relevant manner without forfeiting critical information. 265 266 Guide to the Relevant neuroanatomy and topographical anatomy boxes Guide to the Relevant neuroanatomy and topographical anatomy boxes The explanations of signs in this chapter include additional sections in boxes titled Relevant neuroanatomy and topographical anatomy . Understanding these two aspects of neural pathways is critical to understanding the mechanisms of neurological signs. For example the most common mechanism of bitemporal hemianopia is compression of the optic chiasm by an enlarging pituitary macroadenoma. The pituitary gland is located directly inferior to the optic chiasm . the relevant topographical anatomy . The nerve fibres of the optic chiasm supply each medial hemiretina and thus transmit visual information from each temporal visual hemifield . the relevant neuroanatomy . Dysfunction of these nerve fibres results in bitemporal hemianopia. Symbols have been used to signify important components of the relevant anatomical pathways. KEY TO THE SYMBOLS USED IN THE RELEVANT NEUROANATOMY AND TOPOGRAPHICAL ANATOMY BOXES Relevant primary neuroanatomical structures in the pathway s Significant topographical anatomical structure s Associated neuroanatomical pathway s 0 Decussation . where the structure crosses the midline X An effector . muscle A sensory receptor Structure receives bilateral innervation Abducens nerve CNVI palsy 267 Abducens nerve CNVI palsy DESCRIPTION There is impaired abduction and mild esotropia . medial .