临床执业医师考试大纲复习神经病学名师辅导讲义.doc

临床执业医师考试大纲复习神经病学名师辅导讲义第十五篇 神经病学第1章 神经病学概论考纲要求脑神经：第、对脑神经的解剖生理和临床表现。运动系统：上运动神经元瘫痪解剖生理、临床表现、定位诊断，下运动神经元瘫痪解剖生理、临床表现、定位诊断，椎体外系损害的临床表现，小脑损害的临床表现。感觉系统：浅感觉解剖生理、临床表现、定位诊断，深感觉解剖生理、临床表现、定位诊断。复习要点 一、脑神经记忆：十二对脑神经的记忆：一嗅二视三动眼，四滑五叉六外展，七面八听九舌咽，十迷一副舌下全。（嗅神经）、（视神经）、（动眼神经）、（滑车神经）、（三叉神经）、（外展神经）；（面神经）、（位听神经）、（舌咽神经）、（迷走神经）、（副神经）、（舌下神经）。 1视神经（）（1）解剖结构 视觉感受器为视锥细胞和视杆细胞。视神经起源于视网膜的神经节细胞，经视神经孔进入颅中窝，在蝶鞍上方形成视交叉。来自视网膜鼻侧一半的纤维交叉到对侧，而来自视网膜颞侧一半的纤维不交叉，继续在同侧走行。不交叉的纤维与来自对侧视网膜的交叉纤维合成视束，到达外侧膝状体。在外侧膝状体更换神经元后，再发出纤维，经内囊后肢后部形成视辐射，而终止于枕叶视皮质，即纹状区。在光反射径路中，光反射纤维不经外侧膝状体，而是在外侧膝状体前方离开视束，经上丘臂进入中脑上丘和顶盖前区，与两侧动眼神经副核联系，司瞳孔对光反射。参阅6版神经病学p33图2-24。（2）生理功能 视神经为特殊的躯体感觉神经，主要传导视觉冲动。（3）临床表现 视神经受损所产生的视力障碍和视野缺损范围，具有很重要的定位诊断价值。【例1】 2004a偏盲型视野缺损最常见于a糖尿病性视神经乳头水肿 bgraves病浸润性突眼c嗜铬细胞瘤阵发髙血压眼底出血 d垂体腺瘤鞍上发展 e希恩（sheehan）综合征垂体梗塞 2动眼神经（）和展神经（） 动眼神经、滑车神经和展神经共同支配眼外肌，管理眼球运动，合称眼球运动神经，其中动眼神经还支配瞳孔括约肌和睫状肌。3三叉神经（） 三叉神经为混合性神经，含有躯体感觉和特殊内脏运动两种神经纤维。感觉神经司面部、口腔及头顶部的感觉，运动神经支配咀嚼肌的运动。c29c91afe4ced1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91afedd1b6c87d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af95ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9d1b6c8795ad9c91afe4ced1b6c8795a1afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91afc91fe4ced1d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6cd1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af8795ad9c91fe4ced1d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c87d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af5d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91afad9c91fe4ced1b6c8795ad29c91afb6c8795ad29c91afb6c8795ad29c91afd1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91affe4ced1b6c8795ad29c91afc8795ad9c91fe4ced1b6c8795ad29c91afd1b6c8795ad9c91afed1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8d1b6c8795ad9c91afe4ced1d91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91afc91fe4ced1d1b6c871afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91afc91fe4ced1d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6cd1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af8795ad9c91fe4ced1d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c87d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af5d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91afad9c91fe4ced1b6c8795ad29c91afb6c8795ad29c91afb6c8795ad29c91afd1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8791afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91afc91fe4ced1d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6cd1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af8795ad9c91fe4ced1d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c87d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af5d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91afad9c91fe4ced1b6c8795ad29c91afb6c8795ad29c91afb6c8795ad29c91afd1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91affe4ced1b6c8795ad29c91afc8795ad9c91fe4ced1b6c8795ad29c91afd1b6c8795ad9c91afed1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8d1b6c8795ad9c91afe4ced15ad9c91d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91affe4ced1b6c8795ad29c91afc8795ad9c91fe4ced1b6c8795ad29c91afd1b6c8795ad9c91afed1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8d1b6c8795ad9c91afe4ced195ad9c91afe4ced1b6c8795ad91afe4ced1b6cd1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af8795ad9c91fe4ced1d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c87d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af5d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91afad9c91fe4ced1b6c8795ad29c91afb6c8795ad29c91afb6c8795ad29c91afd1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91affe4ced1b6c8795ad29c91afc8795ad9c91fe4ced1b6c8795ad29c91afd1b6c8795ad9c91afed1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af795ad9c91fe4ced1b6c8795add1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af29c91af4ced1b6c8795ad1b6c8795ad9c91afe4ced1b6c8795ad91afd1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91afd1b6c8795ad29c91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91afd91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c9d1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91af1afd1b6c8795ad9c91afe4ced1b6c8795ad91afe4ced1b6c8795ad9c91fe4ced1b6c8795ad29c91afd1bd1b6c8795ad9c9