Neuroanatomy
Dr Raymond Chang
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Pupil Examination
Subtitles in English for this video can be displayed by clicking on (first button on the bottom right hand corner of the video). The size of the pupillary aperture at any point in time is dependent on a balance between sympathetic tone, parasympathetic tone, the light reflex and the near reflex. The light reflex is an…
Examining the Cranial Nerves
Subtitles in English for this video can be displayed by clicking on (first button on the bottom right hand corner of the video). General Inspection During the general inspection of the cranial nerves, we should look for whether the patient has any ptosis, abnormal eye movements and facial asymmetry. We should also inspect for whether there are any neuro-cutaneous features (for example in patients…
Intention Tremor
Intention tremor can be elicited by the finger-nose test. In normal patients, the movements between the physician’s finger and patient’s nose should be smooth, but adjustment is allowed according to the patient’s upper limb power. This man has intention tremor and impaired finger-nose test on the right side, whilst the left side is normal. Discussion on intention…
Upper Limbs
Subtitles in English for this video can be displayed by clicking on (first button on the bottom right hand corner of the video). Inspection of the Upper Limbs After adequate exposure, one should then lay the patient’s arms out comfortably. The examiner should stand at the end of the bed / facing the patient if the patient is…
Heel-shin Test
In this video, the patient exhibits a positive heel-shin test on the right side. Compared to the left (normal) side, the right lower limb is seen to be rather clumsy. The heel-shin test is a test to screen for ipsilateral cerebellar function. Once again, clear instructions are required for this test, and you could see…
Osmotic Demyelination Syndrome
This is a set of cranial MRIs from a patient with osmotic demyelination syndrome, formerly called central pontine myelinolysis. Osmotic demyelination syndrome occurs when wide fluxes in serum sodium levels are induced by too rapid correction of hyponatremia. Oligodendrocytes, which forms the myelin sheaths, are particularly vulnerable to osmotic changes. If the osmotic stress is…