Blueprints Neurology by Frank W. Drislane MD, Dr. Juan Acosta, Louis Caplan MD, Dr.

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By Frank W. Drislane MD, Dr. Juan Acosta, Louis Caplan MD, Dr. Bernard Chang MD MMSc, Andrew Tarulli

Blueprints Neurology presents scholars with a whole evaluation of the most important issues and concepts—perfect for clerkship rotations and the USMLE. This variation has been thoroughly updated—including new diagnostic and remedy details throughout—while keeping its succinct, equipped, and concise variety. a hundred board-format questions and solutions with whole right and fallacious solution motives seem on the finish of the book.

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Failing that, noxious stimuli such as nailbed pressure or a pinch on a flexor surface can be applied TABLE 3-1 Brainstem Reflexes Reflex Cranial Nerves Involved How to Test Pupillary II (afferent); III (efferent) Shine light in each pupil and observe for direct (same side) and consensual (contralateral side) constriction Oculocephalic (doll’s eyes) VIII (afferent); III, IV, VI (efferent) Forcibly turn head horizontally and vertically and observe for conjugate eye movement in opposite direction (contraindicated if cervical spine injury has not been ruled out) Caloric testing (if necessary)* Same Inject 50 mL ice water into each ear and observe for conjugate eye deviation toward the ear injected Corneal V1 (afferent); VII (efferent) Touch lateral cornea with cotton tip and observe for direct and consensual blink Gag IX (afferent); X/XI (efferent) Stimulate posterior pharynx with cotton tip and observe for gag *Caloric testing should be performed if turning the head is contraindicated or does not result in eye movement.

The nerve is stimulated in at least two locations (distal and proximal), and the distance between the two sites of stimulation is measured carefully. The distal latency, compound muscle action potential (CMAP), and conduction velocity are recorded. The CMAP is a recording of the contraction of the underlying muscle. The distal latency is the time interval between stimulation over the distal portion of the nerve and the initiation of the CMAP. Conduction velocity is calculated by measuring the difference in latency to CMAP initiation between proximal and distal sites of stimulation.

Qxd 10/4/08 3:17 PM Page 29 Chapter 4 Blueprints Neurology Chapter 4 / NeuroOphthalmology Chapter NeuroOphthalmology An understanding of visual impairment, pupillary disturbances, and oculomotor control is essential in the diagnosis of neurologic disorders. Maximal interpretation of our environment is accomplished through the integration of visual, somatosensory, motor, and auditory information. A systematic approach to evaluating patients with “visual” problems includes the analysis of: vision, eye movements, and integration of visual information.

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