REVISION PHYSIOLOGY y y 6 SPOTS 5 CNS, 1 Special sense (2marks each) EXPERIMENT ( LAB) 4: sensory, motor, cranial n, special sense

(5marks each, 3m based on checklist, 2m on Questions asked) SENSORY EXAMINATION SUPERFICIAL 1.Pain what tract? What type of pain? 2. temperature -what tract? -range of cold & hot temp 3.touch -crude touch (tract ? ) *Please dont drag the cotton along the hand , may form as itch n tickle -fine touch ( tactile localize, tactile discriminate, stereognosis) DEEP 1.examination of joint movement and position MOTOR SYSTEM EXAMINATION 1.muscle tone 2.muscle power (defect in cases of UMNL & LMNL) 3. examination of deep reflexs (tendon jerk) -ankle jerk (center S1,2) -knee jerk( center L3,4) -biceps jerk(center C5,6) -triceps jerk (C6,7) -brachioradialis reflex(center C6) *must know each center, response its elicit, whether its normal or not SUPERFICIAL REFLEX EXAMINATION -plantar reflex (center S1,2) *normal person, there is plantar flexion. *Abnormal if there is extension of big toe (+ve Babinski sign) * normal +ve Babinski sign during sleep, anesthesia, infant < 1year) . Pathological in UMNL. -abdominal reflex (center T7-10 for upper abdomen, T10-12 for lower) * normal response: contract of abdominal muscle, deviation of umbilicus towards COORDINATION AND GAIT 1. rapid alternating movement 2.finger to nose test & heel knee shin test (first do it with open eye, then repeat it with closed eye) 3.romberg s test 5thi.corneal reflex (by cotton), ii.facial sensation( check the upper n lower face) iii. motor (side to side jaw movement and clenching teeth) 7th CN i.corneal reflex ii.sensation (from ant 2/3 tongue) iii.motor( do some facial expression) CRANIAL N. EXAMINATION 1st- test for olfactory (check for anosmia) 3th,4th,6test for ocular movement , eye conjugation, pupillary light reflex, accomodation reflex. (check if there is ptosis)

2. vibration sense 3. pressure senses (must support the patient s hand) (all must be done in closed eye , do in same intensity, organized (do all left first, then right han, from distal to proximal ))

* check if there is spasticity, clonus, hypertonia or hypotonia (must be able to explain about UMNL &LMNL) *compare both side

the stimulus) Abnormal in UMNL & LMNL in affected region.

8,9th: 1.gag reflex 2.sensation ( post 1/3 of tongue) 3.motor: movement of palate for uvular displacememt 11th: Test for strength of trapezius and sternomastoid muscle 12th: test for tongue movement 7& 10-opposite to the site of deviation 5&12-same side with the site of deviation

Eye reflexes -light reflex (must know the reasons for indirect loght reflex) -corneal reflex (center at pretectal nucleus) -convergence reflex -Ishihara test -Landolts chart -Snellen s chart -confrontation test -computerized perimetry

Ear tests -Weber s test (if normal, person hear equally in both sides) -in conductive deafness, one hear better in diseased site. -in sensory deafness, one hear better in healthy side -Rinne s test (if +ve, person hear air conduction after bone conduction) -in conductive deafness, person cant hear air

conduction):Rinne ve -in sensory deafness, person hears both but in reduced way) :reduced +ve Rinne