nerve examination leprosy

8/12/2019 Nerve Examination Leprosy

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Nerves Examination

Department Dermato-venereology

FK-UNSRI/RS dr. Moh Hoesin

Palembang

2008


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Which nerves should you examine?

N. Auricularis magnus

N. Ulnaris

N. Medianus

N. Radialis

N. Peroneus communis

N. Tibialis posterior

N. Trigeminus

N.. Fasialis


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Is the nerve tender?

While you feel each nerve,

look at the patients face to see if you are causing him pain

Remember that when you press very hard even a normal nerve

will be painful


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Is the nerve thickened?

While you feel each nerve,

look at the patients face to see if you are causing him pain

Remember that when you press very hard even a normal nerve

will be painful


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N. Auricularis magnus

Great auricular nerve is first visualized by

turning the head to one side

The nerve stretches across the

sternomastoid muscle

Once visualized the patiet is asked to turn

the head against the resistance os

examiners hand hed on the chin, the

nerves is palpated


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N. Auricularis Magnus Examination


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N. Ulnaris

Ulnar nerve lies above the olecranon

posse

Feel the right ulnar nerve with left hand

ang left nerve wth right hand


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N. Ulnaris Examination


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N. Radialis

Radial nerve is palpated in the radial

groove


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N. Radialis Examination


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N. Radialis


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N. Medialis

The median nerve is palpated by flexing

the elbow and the palpating deeply

between he flexor tendon, at the wrist


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N. Medialis


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N. Peroneous communis

Common peroneal nerve is felt at the neck

of fibula on both sides.

The patient is asked to sit on the chair

relaxed while palpation

It is felt two centimeters below the head of

fibula


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N.Peroneous Communis Examination


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N. Tibialis Posterior

Posterior tibial nerve is felt posterior and

inferior to the medial malleolus


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N. Tibialis Posterior


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Lagophthalmos

Facial nervebranch to the eyelids

Ask the patients to close his eyes ang keep them lightly

close as if sleeping

Lagophthalmos means paralysis of the eyelids so that they do not close completely

examination


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Lagophthalmos

The patient is trying to close his eyes

Measure the gap between the eyelids. Here it is about 2 mm


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Testing for anaesthesia

There are two reasons for testing for

anasthesia

To help with diagnosis and classification

To decide whether there is a risk of future

problems such as ulcers and other

damage


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Testing to help with diagnosis and classification

Where to testSkin lesions

- hands, feet, legs

What to use Thin points of cotton wool


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Testing to decide risk of future damage

Where to test- Palms and soles of feet

- Cornea

What to use The points of pencil, piece of grass,

a nylon monofilament (10 g)


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nerve examination leprosy

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