CNⅠ:OlfactoryNerve(嗅神经)Foster-Kennedysyndrome:Frontallobetumorscauseopticatrophyonthesideofthetumor,papilledema&smellontheoppositeside.见于额叶底部肿瘤,表现为病变侧因肿瘤压迫而视神经萎缩,病变对侧因高颅压而视乳头水肿和嗅觉减退OpticNerve(视神经)ClinicalCorrelation视力障碍&视野缺损•Opticnerve-Ipsilateralvisualloss(同侧全盲)•Opticchiasm-Bitemporalhemianopsia(双颞侧偏盲)•Optictract-Contralateralincongruoushomonymoushemianopsia(对侧视野同向偏盲)•Opticradiations-Quadranticfielddefect(象限盲)1.视辐射全损坏:对侧视野同向偏盲2.视辐射下部损害(颞叶):对侧视野同向上象限盲3.视辐射上部损害(顶叶):对侧视野同向下象限盲•Occiptallobe-corticalblindness/Contralateralcongruoushomonymoushemianopia•对侧视野同向偏盲,对光反射存在&macularsparing黄斑回避OculomotorNerve/III(动眼神经)外侧核:上睑提肌&上直肌(上&内)/下直肌(下&内)/内直肌(内)/下斜肌(上&外)正中核:内直肌(辐辏运动)E-W核:瞳孔括约肌&睫状肌(缩瞳&调节反射)Completedamagesymptoms:1.上睑下垂Ptosis2.外下斜视/分离性斜视Divergentstrabismus3.瞳孔散大Dilatedpupil4.调节反射&对光反射消失Lossoflightandaccommodationreflex5.复视DiplopiaTrochlearNerve/IV(滑车神经)上斜肌:下&外Abducensparalysis/VI(外展神经)外直肌:外Internuclearophthalmoplegia核间性麻痹/mediallongitudinalfasciculussyndrome内侧纵束综合征ReflectsdisconnectionoftheoculomotornucleusfromthecontralaterallateralgazecentreWhenattemptingtolookthecontralateralside,Ipsilateraleyefailstoadduct,contralateraleyeabductwithnystagmus,convengencereflexisnormal.脑桥侧视中枢&动眼神经核之间内侧纵束上行纤维病变患侧眼不能内收,对侧眼球外展伴有眼震,辐辏反射正常2.后核间性眼肌麻痹脑桥侧视中枢&外展神经核之间内侧纵束下行纤维病变患侧眼不能外展,对侧眼球内收正常(伴有眼震?),辐辏反射正常3.一个半综合征oneandahalfsyndrome一侧脑桥侧视中枢&对侧交叉来的内侧纵束同时受累患侧眼球不能内收&外展,对侧眼球不能内收,外展时伴有眼震Uppernuclearophthalmoplegia核上性麻痹1.侧向凝视麻痹1)皮质侧视中枢(额中回后部)受损,双眼向病灶侧共同偏视Lobegazecentreinjure,failtoattemptingtolookthecontralateralside.2)皮质下侧视中枢(脑桥)受损,双眼向病灶对侧共同偏视2.垂直凝视麻痹皮质下垂直同向运动中枢(上丘-上半司向上运动,下半司向下运动)受损,双眼垂直运动障碍;核上性麻痹共同特点:NoDiplopia无复视twoeyesinvolved双眼同时受累;reflexmovementexist麻痹性眼肌的反射性运动仍保存(不能随意向一侧运动,但声响可产生转向该侧的反射活动)Horner’ssyndromeThedescendingsympathetictract由颈上交感神经径路损害所致Lesionsresultinipsilateral病变同侧:1.miosis/Smallpupil瞳孔缩小2.mildptosis眼睑下垂3.hemi-anhidrosis/lossofsweatinginlesionside损面无汗4.apparentenophthalmos眼球内陷TrigeminalNerve三叉神经周围分布VS中枢分布Peripheral:眼支ophthalmicnerve&上颌支maxillarynerve&下颌支mandibularnerve,破坏性症状表现为分布区域痛觉、温觉、触觉均减弱或消失,角膜反射减弱或消失,咀嚼肌瘫痪Central:三叉神经脊束核(痛温觉),病变后表现为同侧面部呈剥洋葱样分离性感觉障碍,痛温觉缺失而触觉存在(部分三叉神经脊束核),咀嚼肌无力、萎缩、张口时下颌偏斜(三叉神经运动核)facialnerve面神经双侧皮质脑干束调控:上部面肌-额肌&皱眉肌&眼轮匝肌对侧皮质脑干束调控:下部面肌-颧肌&颊肌&口轮匝肌&颈阔肌VestibulocochlearNerve前庭蜗神经/位听神经GlossopharyngealNerve&VagusNerve舌咽神经&迷走神经二者有:共同的神经核(疑核&孤束核)、共同的走行、共同的分布Bulbarpalsy真性球麻痹PseudobulbarPalsy假性球麻痹ImpairmentofnucleiorcranialnervesofIX&X&XII,bilateralorunilateraljawjerkabsence下颌反射消...