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Jaw Jerk
The jaw jerk reflex, or masseter reflex, is a stretch reflex used to test the status of a patient's trigeminal nerve (cranial nerve V) and to help distinguish an upper cervical cord compression from lesions that are above the foramen magnum. The mandible—or lower jaw—is tapped at a downward angle just below the lips at the chin while the mouth is held slightly open. In response, the masseter muscles will jerk the mandible upwards. Normally this reflex is absent or very slight. However, in individuals with upper motor neuron lesions the jaw jerk reflex can be quite pronounced. The jaw jerk reflex can be classified as a dynamic stretch reflex. As with most other reflexes, the response to the stimulus is monosynaptic, with sensory neurons of the trigeminal mesencephalic nucleus sending axons to the trigeminal motor nucleus, which in turn innervates the masseter. This reflex is used to judge the integrity of the upper motor neurons projecting to the trigeminal motor nucleus. Both ...
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Trigeminal Nerve
In neuroanatomy, the trigeminal nerve (literal translation, lit. ''triplet'' nerve), also known as the fifth cranial nerve, cranial nerve V, or simply CN V, is a cranial nerve responsible for Sense, sensation in the face and motor functions such as biting and chewing; it is the most complex of the cranial nerves. Its name (''trigeminal'', ) derives from each of the two nerves (one on each side of the pons) having three major branches: the ophthalmic nerve (V), the maxillary nerve (V), and the mandibular nerve (V). The ophthalmic and maxillary nerves are purely sensory, whereas the mandibular nerve supplies motor as well as sensory (or "cutaneous") functions. Adding to the complexity of this nerve is that Autonomic nervous system, autonomic nerve fibers as well as special sensory fibers (taste) are contained within it. The motor division of the trigeminal nerve derives from the Basal plate (neural tube), basal plate of the embryonic pons, and the sensory division originates in ...
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Neurological Examination
A neurological examination is the assessment of sensory neuron and motor responses, especially reflexes, to determine whether the nervous system is impaired. This typically includes a physical examination and a review of the patient's medical history, but not deeper investigation such as neuroimaging. It can be used both as a screening tool and as an investigative tool, the former of which when examining the patient when there is no expected neurological deficit and the latter of which when examining a patient where you do expect to find abnormalities. If a problem is found either in an investigative or screening process, then further tests can be carried out to focus on a particular aspect of the nervous system (such as lumbar punctures and blood tests). In general, a neurological examination is focused on finding out whether there are lesions in the central and peripheral nervous systems or there is another diffuse process that is troubling the patient. Once the patient has be ...
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Amyotrophic Lateral Sclerosis
Amyotrophic lateral sclerosis (ALS), also known as motor neuron disease (MND) or—in the United States—Lou Gehrig's disease (LGD), is a rare, Terminal illness, terminal neurodegenerative disease, neurodegenerative disorder that results in the progressive loss of both upper and lower motor neurons that normally control Skeletal muscle, voluntary muscle contraction. ALS is the most common form of the motor neuron diseases. ALS often presents in its early stages with gradual muscle Spasticity, stiffness, Fasciculation, twitches, Muscle weakness, weakness, and Muscle atrophy, wasting. Motor neuron loss typically continues until the abilities to eat, speak, move, and, lastly, breathe are all lost. While only 15% of people with ALS also fully develop frontotemporal dementia, an estimated 50% face at least some minor difficulties with cognitive disorder, thinking and behavior. Depending on which of the aforementioned symptoms develops first, ALS is classified as ''limb-onset'' (b ...
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Multiple Sclerosis
Multiple sclerosis (MS) is an autoimmune disease resulting in damage to myelinthe insulating covers of nerve cellsin the brain and spinal cord. As a demyelinating disease, MS disrupts the nervous system's ability to Action potential, transmit signals, resulting in a range of signs and symptoms, including physical, cognitive disability, mental, and sometimes psychiatric problems. Symptoms include double vision, vision loss, eye pain, muscle weakness, and loss of Sensation (psychology), sensation or coordination. MS takes several forms, with new symptoms either occurring in isolated attacks (relapsing forms) or building up over time (progressive forms). In relapsing forms of MS, symptoms may disappear completely between attacks, although some permanent neurological problems often remain, especially as the disease advances. In progressive forms of MS, bodily function slowly deteriorates once symptoms manifest and will steadily worsen if left untreated. While its cause is unclear, ...
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Spondylosis
Spondylosis is the degeneration of the vertebral column from any cause. In the more narrow sense, it refers to spinal osteoarthritis, the age-related degeneration of the spinal column, which is the most common cause of spondylosis. The degenerative process in osteoarthritis chiefly affects the vertebral bodies, the neural foramina and the facet joints (facet syndrome). If severe, it may cause pressure on the spinal cord or nerve roots with subsequent sensory or motor disturbances, such as pain, paresthesia Paresthesia is a sensation of the skin that may feel like numbness (''hypoesthesia''), tingling, pricking, chilling, or burning. It can be temporary or Chronic condition, chronic and has many possible underlying causes. Paresthesia is usually p ..., imbalance, and muscle weakness in the limbs. When the space between two adjacent vertebrae narrows, compression of a nerve root emerging from the spinal cord may result in radiculopathy. Radiculopathy is characteri ...
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Age And Ageing
''Age and Ageing'' is a bimonthly peer-reviewed medical journal covering all aspects of geriatric medicine and gerontology. It was established in 1972 and is published by Oxford University Press. It is the official journal of the British Geriatrics Society and the editor-in-chief is Roy Soiza (University of Aberdeen). Abstracting and indexing The journal is abstracted and indexed in CINAHL, EMBASE, Science Citation Index, Scopus, and MEDLINE/PubMed. According to the ''Journal Citation Reports'', the journal has a 2020 impact factor The impact factor (IF) or journal impact factor (JIF) of an academic journal is a type of journal ranking. Journals with higher impact factor values are considered more prestigious or important within their field. The Impact Factor of a journa ... of 10.668. Editors-in-chief The following persons have been editor-in-chief of the journal: * A. N. Exton-Smith and H. M. Hodkinson (1972–1985) * H. M. Hodkinson (1986–1987) * J. Grimley Evans (1 ...
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Cremasteric Reflex
The cremasteric reflex is a superficial (i.e., close to the skin's surface) reflex observed in human males. This reflex is elicited by lightly stroking or poking the superior and medial (inner) part of the thigh—regardless of the direction of stroke. The normal response is an immediate contraction of the cremaster muscle that pulls up the testicle ipsilaterally (on the same side of the body). The reflex utilizes sensory and motor fibers from two different nerves. When the inner thigh is stroked, sensory fibers of the ilioinguinal nerve are stimulated. These activate the axon, motor fibers of the genital branch of the genitofemoral nerve which causes the cremaster muscle to contract and elevate the testis. Clinical conditions In some males this reflex may be exaggerated which can occasionally lead to a misdiagnosis of cryptorchidism. The cremasteric reflex may be absent with testicular torsion, upper and lower motor neuron disorders, as well as a spine injury of L1-L2. It can ...
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Tendon Reflex
A tendon or sinew is a tough band of dense fibrous connective tissue that connects muscle to bone. It sends the mechanical forces of muscle contraction to the skeletal system, while withstanding tension. Tendons, like ligaments, are made of collagen. The difference is that ligaments connect bone to bone, while tendons connect muscle to bone. There are about 4,000 tendons in the adult human body. Structure A tendon is made of dense regular connective tissue, whose main cellular components are special fibroblasts called tendon cells (tenocytes). Tendon cells synthesize the tendon's extracellular matrix, which abounds with densely-packed collagen fibers. The collagen fibers run parallel to each other and are grouped into fascicles. Each fascicle is bound by an endotendineum, which is a delicate loose connective tissue containing thin collagen fibrils and elastic fibers. A set of fascicles is bound by an epitenon, which is a sheath of dense irregular connective tissu ...
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Temporal Muscle
In anatomy, the temporalis muscle, also known as the temporal muscle, is one of the muscles of mastication (chewing). It is a broad, fan-shaped convergent muscle on each side of the head that fills the temporal fossa, superior to the zygomatic arch so it covers much of the temporal bone.Illustrated Anatomy of the Head and Neck, Fehrenbach and Herring, Elsevier, 2012, page 98 ''Temporal'' refers to the head's temples. Structure In humans, the temporalis muscle arises from the temporal fossa and the deep part of temporal fascia. This is a very broad area of attachment. It passes medial to the zygomatic arch. It forms a tendon which inserts onto the coronoid process of the mandible, with its insertion extending into the retromolar fossa posterior to the most distal mandibular molar.Human Anatomy, Jacobs, Elsevier, 2008, page 194 In other mammals, the muscle usually spans the dorsal part of the skull all the way up to the medial line. There, it may be attached to a sagittal ...
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Electromyography
Electromyography (EMG) is a technique for evaluating and recording the electrical activity produced by skeletal muscles. EMG is performed using an instrument called an electromyograph to produce a record called an electromyogram. An electromyograph detects the electric potential generated by muscle cells when these cells are electrically or neurologically activated. The signals can be analyzed to detect abnormalities, activation level, or recruitment order, or to analyze the biomechanics of human or animal movement. Needle EMG is an electrodiagnostic medicine technique commonly used by neurologists. Surface EMG is a non-medical procedure used to assess muscle activation by several professionals, including physiotherapists, kinesiologists and biomedical engineers. In computer science, EMG is also used as middleware in gesture recognition towards allowing the input of physical action to a computer as a form of human-computer interaction. Clinical uses EMG testing has a varie ...
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Masseter
In anatomy, the masseter is one of the muscles of mastication. Found only in mammals, it is particularly powerful in herbivores to facilitate chewing of plant matter. The most obvious muscle of mastication is the masseter muscle, since it is the most superficial and one of the strongest. Structure The masseter is a thick, somewhat quadrilateral muscle, consisting of three heads, superficial, deep and coronoid. The fibers of superficial and deep heads are continuous at their insertion. Superficial head The superficial head, the larger, arises by a thick, tendinous aponeurosis from the zygomatic process of the maxilla, the temporal process of the zygomatic bone and from the anterior two-thirds of the inferior border of the zygomatic arch. Its fibers pass inferior and posterior, to be inserted into the angle of the mandible and inferior half of the lateral surface of the ramus of the mandible. Deep head The deep head is much smaller, and more muscular in texture. It arises from th ...
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Cranial Nerves
Cranial nerves are the nerves that emerge directly from the brain (including the brainstem), of which there are conventionally considered twelve pairs. Cranial nerves relay information between the brain and parts of the body, primarily to and from regions of the head and neck, including the special senses of Visual perception, vision, taste, Olfaction, smell, and hearing. The cranial nerves emerge from the central nervous system above the level of the Atlas (anatomy), first vertebra of the vertebral column. Each cranial nerve is paired and is present on both sides. There are conventionally twelve pairs of cranial nerves, which are described with Roman numerals I–XII. Some considered there to be thirteen pairs of cranial nerves, including the non-paired cranial nerve zero. The numbering of the cranial nerves is based on the order in which they emerge from the brain and brainstem, from front to back. The terminal nerves (0), olfactory nerves (I) and optic nerves (II) emerge f ...
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