Neuroanatomy
Dr Raymond Chang
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Sixth Nerve Palsy
In this patient, there is a mild esotropia on neutral gaze as the left eye is slightly deviated medially. There is impaired left eye abduction resulting in diplopia when the patient is instructed to look towards the left. Discussion of the sign Abduction of the eye is controlled by the lateral rectus muscle, which is…
Ocular Alignment and Extra-ocular Movement Examination
Subtitles in English for this video can be displayed by clicking on (first button on the bottom right hand corner of the video). Stereopsis (three dimensional vision) is important in our every day lives. This ability is dependent on aligning both foveae on the same object with slightly dissimilar perspectives to give a perception of depth….
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…
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…
Horizontal Nystagmus
In the first video, the patient has both horizontal nystagmus and vertical “down-beat” nystagmus. In the second video, the patient has a torsional nystagmus when looking to her right hand side. Discussion of the sign Nystagmus is defined as a rhythmic oscillation of the eyes. It usually consists of a slow drifting phase in one direction and a…
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…