Fundamentals of Neurology by Marco Mumenthaler, Heinrich Mattle

By Marco Mumenthaler, Heinrich Mattle

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Any diminution of the normal cervical lordosis is best seen when the patient stands with shoulders and heels to the wall and bends the head as far back as possible. The back of the patient’s head normally touches the wall; if not, the distance from the occipital protuberance to the wall should be measured in centimeters. An abnormality of this type is found, e. , in ankylosing spondylitis. Reflexes. The abdominal skin reflexes are extrinsic muscle reflexes. They are tested by rapid stroking of the abdominal skin (e.

The corneal reflex is weak, because the efferent arm of the reflex arc is interrupted (rather than the afferent arm, as in trigeminal lesions). The clinical findings in facial nerve palsy, and the differentiation of peripheral and central facial weakness, are presented on p. 198 and in Figs. 18 on pp. 197 and 198. Fig. 9 Cover test. In concomitant, alternating, divergent strabismus, the covered eye (i. , the one that is not fixating) deviates outward. When the cover is rapidly switched to the other eye, the newly uncovered eye moves to the fixating position, while the covered other eye now deviates outward with a positioning saccade (→).

Some pathological reflexes are of the extrinsic type. 7. The most important normal intrinsic muscle reflexes Reflex Stimulus Response Muscle(s) Peripheral nerve Segment Masseter reflex tap on the chin or a tongue depressor laid on the lower teeth, with slightly opened mouth brief mouth closure movement masseter m. trigeminal n. V Trapezius reflex tap on the lateral attachment of the trapezius to the coracoid process shoulder elevation trapezius m. accessory n. XI C3−C4 Scapulohumeral reflex tap on the medial edge of the lower adduction and exhalf of the scapula ternal rotation of the dependent arm infraspinatus and teres minor mm.

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