臨床執(zhí)業(yè)醫(yī)師考試大綱復(fù)習(xí)神經(jīng)病學(xué)名師輔導(dǎo)講義

1、臨床執(zhí)業(yè)醫(yī)師考試大綱復(fù)習(xí)神經(jīng)病學(xué)名師輔導(dǎo)講義第十五篇 神經(jīng)病學(xué)第1章 神經(jīng)病學(xué)概論考綱要求腦神經(jīng)：第、對腦神經(jīng)的解剖生理和臨床表現(xiàn)。運(yùn)動(dòng)系統(tǒng)：上運(yùn)動(dòng)神經(jīng)元癱瘓解剖生理、臨床表現(xiàn)、定位診斷，下運(yùn)動(dòng)神經(jīng)元癱瘓解剖生理、臨床表現(xiàn)、定位診斷，椎體外系損害的臨床表現(xiàn)，小腦損害的臨床表現(xiàn)。感覺系統(tǒng)：淺感覺解剖生理、臨床表現(xiàn)、定位診斷，深感覺解剖生理、臨床表現(xiàn)、定位診斷。復(fù)習(xí)要點(diǎn) 一、腦神經(jīng)記憶：十二對腦神經(jīng)的記憶：一嗅二視三動(dòng)眼，四滑五叉六外展，七面八聽九舌咽，十迷一副舌下全。（嗅神經(jīng)）、（視神經(jīng)）、（動(dòng)眼神經(jīng)）、（滑車神經(jīng)）、（三叉神經(jīng)）、（外展神經(jīng)）；（面神經(jīng)）、（位聽神經(jīng)）、（舌咽神經(jīng)）、（迷走神經(jīng)

2、）、（副神經(jīng)）、（舌下神經(jīng)）。 1視神經(jīng)（）（1）解剖結(jié)構(gòu) 視覺感受器為視錐細(xì)胞和視桿細(xì)胞。視神經(jīng)起源于視網(wǎng)膜的神經(jīng)節(jié)細(xì)胞，經(jīng)視神經(jīng)孔進(jìn)入顱中窩，在蝶鞍上方形成視交叉。來自視網(wǎng)膜鼻側(cè)一半的纖維交叉到對側(cè)，而來自視網(wǎng)膜顳側(cè)一半的纖維不交叉，繼續(xù)在同側(cè)走行。不交叉的纖維與來自對側(cè)視網(wǎng)膜的交叉纖維合成視束，到達(dá)外側(cè)膝狀體。在外側(cè)膝狀體更換神經(jīng)元后，再發(fā)出纖維，經(jīng)內(nèi)囊后肢后部形成視輻射，而終止于枕葉視皮質(zhì)，即紋狀區(qū)。在光反射徑路中，光反射纖維不經(jīng)外側(cè)膝狀體，而是在外側(cè)膝狀體前方離開視束，經(jīng)上丘臂進(jìn)入中腦上丘和頂蓋前區(qū)，與兩側(cè)動(dòng)眼神經(jīng)副核聯(lián)系，司瞳孔對光反射。參閱6版神經(jīng)病學(xué)p33圖2-24。（2）生理

3、功能 視神經(jīng)為特殊的軀體感覺神經(jīng)，主要傳導(dǎo)視覺沖動(dòng)。（3）臨床表現(xiàn) 視神經(jīng)受損所產(chǎn)生的視力障礙和視野缺損范圍，具有很重要的定位診斷價(jià)值?！纠?】 2004a偏盲型視野缺損最常見于a糖尿病性視神經(jīng)乳頭水腫 bgraves病浸潤性突眼.c嗜鉻細(xì)胞瘤陣發(fā)髙血壓眼底出血 d垂體腺瘤鞍上發(fā)展 e希恩（sheehan）綜合征垂體梗塞 2動(dòng)眼神經(jīng)（）和展神經(jīng)（） 動(dòng)眼神經(jīng)、滑車神經(jīng)和展神經(jīng)共同支配眼外肌，管理眼球運(yùn)動(dòng)，合稱眼球運(yùn)動(dòng)神經(jīng)，其中動(dòng)眼神經(jīng)還支配瞳孔括約肌和睫狀肌。3三叉神經(jīng)（） 三叉神經(jīng)為混合性神經(jīng)，含有軀體感覺和特殊內(nèi)臟運(yùn)動(dòng)兩種神經(jīng)纖維。感覺神經(jīng)司面部、口腔及頭頂部的感覺，運(yùn)動(dòng)神經(jīng)支配咀嚼肌的運(yùn)

4、動(dòng)。29c91afe4ced1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91afedd1b6c87d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af95ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9d1b6c8795ad9c91afe4ced1b6c8795a1afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ce

5、d1b6c8795ad29c91afc91fe4ced1d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6cd1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af8795ad9c91fe4ced1d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c87d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af5d1b6c8

6、795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91afad9c91fe4ced1b6c8795ad29c91afb6c8795ad29c91afb6c8795ad29c91afd1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c879

7、5ad29c91affe4ced1b6c8795ad29c91afc8795ad9c91fe4ced1b6c8795ad29c91afd1b6c8795ad9c91afed1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8d1b6c8795ad9c91afe4ced1d91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91afc91fe4ced1d1b6c871afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91afc91fe4ced1d1b6c879

8、5ad9c91afe4ced1b6c8795ad91afe4ced1b6cd1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af8795ad9c91fe4ced1d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c87d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af5d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1

9、b6c8795ad9c91fe4ced1b6c8795ad29c91afad9c91fe4ced1b6c8795ad29c91afb6c8795ad29c91afb6c8795ad29c91afd1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8791afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91afc91fe4ced1d1b6c8795ad9c91afe4ced1b6c8795ad91afe

10、4ced1b6cd1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af8795ad9c91fe4ced1d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c87d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af5d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad

11、29c91afad9c91fe4ced1b6c8795ad29c91afb6c8795ad29c91afb6c8795ad29c91afd1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91affe4ced1b6c8795ad29c91afc8795ad9c91fe4ced1b6c8795ad29c91

12、afd1b6c8795ad9c91afed1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8d1b6c8795ad9c91afe4ced15ad9c91d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91affe4ced1b6c8795ad29c91afc8795ad9c91fe4ced1b6c8795ad29c91afd1b6c8795ad9c91afed1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8d1b6c

13、8795ad9c91afe4ced195ad9c91afe4ced1b6c8795ad91afe4ced1b6cd1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af8795ad9c91fe4ced1d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c87d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af5d1b6c8795ad9c91afe4ced1

14、b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91afad9c91fe4ced1b6c8795ad29c91afb6c8795ad29c91afb6c8795ad29c91afd1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91affe4ced1

15、b6c8795ad29c91afc8795ad9c91fe4ced1b6c8795ad29c91afd1b6c8795ad9c91afed1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af795ad9c91fe4ced1b6c8795add1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af29c91

16、af4ced1b6c8795ad1b6c8795ad9c91afe4ced1b6c8795ad91afd1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91afd1b6c8795ad29c91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91afd91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c9d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af1afd1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91afd1bd1b6c8795ad9c9