BING'S LOCAL DIAGNOSIS IN NEUROLOGICAL DISEASESPDF电子书下载

CHAPTER 1 TRACTS，CELL GROUPS AND BLOOD SUPPLY OF THE SPINAL CORD 17

Introduction 17

Tracts of the Spinal Cord 17

Descending Exogenous Tracts 18

Tracts Descending from the Cerebral Cortex 18

Tracts Descending from Subcortical Structures 19

Ascending Exogenous Tracts 21

Short Posterior Root Fibers and Ascending Pathways 21

Intermediate Posterior Root Fibers and Ascending Pathways 23

Long Posterior Root Fibers and Ascending Pathways 24

Intersegmental，or Association，Tracts 25

Anterior Root Fibers 26

Topography of the Long Spinal Tracts 26

Nerve Cell Groups of the Spinal Cord 27

Blood Supply of the Spinal Cord 29

Arterial Supply 29

Venous Return from the Spinal Cord 31

CHAPTER 2 SPINAL CORD FUNCTIONS 32

Sensory Function of the Spinal Cord 32

Superficial，or Exteroceptive，Sensibility 32

Deep，or Proprioceptive，Sensibility 32

Combined Sensibility 33

Impulses from the Periphery Which Do Not Enter Consciousness 33

Summary of the Spinal Pathways Conveying Afferent Impulses 34

Somatic Motor Function of the Spinal Cord 35

Voluntary Movement 35

Tonus and Reflexes 36

Trophic Function of the Spinal Cord 37

Visceral Motor Functions of the Spinal Cord 38

Vasomotor Function 38

Sudomotor Function 42

Pilomotor Function 43

CHAPTER 3 THE LOCALIZATION OF SPINAL LESIONS IN THE TRANSVERSE PLANE 44

The Localization of Lesions Causing Disturbances of Motility 44

The Characteristics of Motor Disturbances Due to Pyramidal Lesions 44

The Characteristics of Paralysis Due to Anterior Horn Lesions 48

The Manifestations of Lesions Involving Both the Pyramidal Tract and the Anterior Horn 50

The Localization of Disturbances of Sensibility 51

Localizing Significance of Combined Motor and Sensory Disturbances 56

Lesions Involving Both the Posterior and the Lateral Columns 56

Transverse Lesions of the Spinal Cord 57

Distinctions Between Partial and Total Transection of the Spinal Cord 61

Unilateral Lesions of the Spinal Cord 62

Differential Diagnosis Between Extramedullay(Intradural)and Intramedullary Spinal Tumors 66

CHAPTER 4 ANATOMICAL AND FUNCTIONAL ASPECTS OF SPINAL SEGMENTS 69

CHAPTER 5 SEGMENTAL LOCALIZATION OF SPINAL LESIONS 73

The Localization of Motor Changes of Spinal Origin 73

The Localization of Sensory Changes of Spinal Origin 88

The Localization of Reflex Changes of Spinal Origin 93

The Alignment of Spinal Cord Segments and Vertebral Spinous Processes 95

CHAPTER 6 LOCALIZATION OF LESIONS OF THE CERVICAL AND UPPERMOST THORACIC SEGMENTS 98

Compression of the Spinal Cord in the Region of the Foramen Magnum 98

Cervical Disk Herniation 99

Horner＇s Syndrome 99

Respiratory Disturbances 103

Pulse Disturbances 103

Vasomotor and Sudomotor Disturbances 103

Behavior of Reflexes 104

CHAPTER 7 THE LOCALIZATION OF LESIONS OF LOWER SEGMENTS OF THE SPINAL CORD 105

Innervation and Function of the Urinary Bladder 105

Disturbances of Bladder Function 106

Innervation and Function of the Sigmoid and Rectum 108

Disturbances of Rectal Function 108

Innervation and Function of the Male Genital Organs 108

Disturbances of Sexual Function 109

Other Clinical Features of Conus Medullaris Lesions 110

CHAPTER 8 X-RAY LOCALIZATION OF SPINAL TUMORS＆by Bernard S．Epstein，M．D 113

CHAPTER 9 THE STRUCTURE OF THE BRAIN STEM 118

Section Through the Lower Medulla Oblongata at the Level of the Pyramidal Decussation 118

Section Through the Medulla Oblongata at the Level of the Sensory Decussation 125

Section Through the Medulla Oblongata at the Level of the Lower Third of the IVth Ventricle 126

Section Through the Medulla Oblongata at the Level of the IXth Nerve 128

Section Through the Pons at the Level of the VIth and VIIth Nuclei 129

Section Through the Pons at the Level of the Vth Nerve 130

Section Through the Upper Part of the Pons at the Level of the Decussation of the IVth Nerve 131

Section of the Midbrain at the Level of the Inferior Colliculus 132

Section Through the Midbrain at a Lower Level of the Superior Colliculus 135

Section Through an Upper Level of the Midbrain 135

CHAPTER 10 GENERAL RULES FOR THE LOCALIZATION OF LESIONS IN THE BRAIN STEM 136

General Features of the Brain Stem 136

Principles of Localization of Brain Stem Lesions 141

CHAPTER 11 THE LOCALIZATION OF LESIONS INVOLVING CRANIAL NERVES Ⅸ THROUGH Ⅻ 157

Manifestations of Functional Loss 157

The Hypoglossal Nerve 157

The Spinal Accessory Nerve 157

The Vagus Nerve 161

The Glossopharyngeal Nerve 162

Irritative Phenomena 165

Differentiation of Supranuclear，Nuclear，and Infra-nuclear Lesions 166

Disturbances Due to Unilateral Supranuclear Lesions 166

Disturbances Due to Bilateral Supranuclear Lesions：Supranuclear Bulbar Palsy 168

Paralysis of Nuclear Origin 170

Paralysis of Infranuclear Origin 170

CHAPTER 12 THE LOCALIZATION OF LESIONS INVOLVING THE FACIAL NERVE 173

Anatomy and Functions 173

Clinical Features of Nuclear and Infranuclear Lesions 175

Supranuclear Innervation of Facial Movements 181

Clinical Manifestations of Interruption of Supranuclear Facial Fibers 182

CHAPTER 13 THE LOCALIZATION OF LESIONS INVOLVING THE ACOUSTIC NERVE 183

The Vestibular Nerve 183

Anatomy and Functions 183

Tonic Neck and Labyrinthine Reflexes 186

Ocular Nystagmus 188

Vertigo 191

The Cochlear Nerve 193

Anatomy and Functions 193

Clinical Features of Cochlear Nerve Disorders 195

CHAPTER 14 LOCALIZATION OF LESIONS INVOLVING THE TRIGEMINAL NERVE 200

Anatomy 200

Symptoms and Signs of Interruption of Trigeminal Nerve 203

Symptoms of Irritation of the Trigeminal Nerve 205

Symptoms and Signs of Lesions of Root Ganglion and Divisions 205

Disorders of Autonomic Components of the Trigeminal Nerve 207

Localization of Lesions of the Nucleus of the Spinal Tract of the Trigeminal Nerve 208

Manifestations of Supra-nuclear Lesions 209

CHAPTER 15 LOCALIZATION OF LESIONS INVOLVING THE EXTRAOCULAR NERVES 210

Anatomy 210

Functions of the Extraocular Muscles 213

Infranuclear Palsies 214

Clinical Features 214

Causes and Manifestations of Infranuclear Palsy 216

Nuclear Palsies 219

Conjugate Ocular Deviation 220

Supranuclear Palsies 222

CHAPTER 16 DISORDERS OF CEREBELLAR ORIGIN 225

Anatomical and Functional Considerations 225

General Orientation 225

Afferent Pathways 226

Efferent Pathways 229

Clinical Features of Cerebellar Lesions 231

Cerebellar Ataxia 231

Cerebellar Hypotonia 234

Disorders Observed in Association With Ataxia and Hypotonia 235

The Importance of Ataxia as a Sign of Cerebellar Disturbance 236

Ocular Nystagmus 238

Involvement of Extra-Cerebellar Structures in the Presence of Cerebellar Lesions 238

Cerebellar Disturbances Induced by Supratentorial Tumors 240

CHAPTER 17 THE ARTERIAL SUPPLY OF THE BRAIN STEM AND CEREBELLUM AND SYNDROMES OF ARTERIAL OCCLUSION 241

The Vertebral Arteries and Their Branches 241

The Paramedian Bulbar Syndromes 241

The Lateral Bulbar Syndrome 243

Syndromes of Occlusion of Branches of the Vertebral Artery 244

Syndrome of Total Occlusion of Vertebral Artery 244

The Basilar Artery and Its Branches 245

The Anterior Inferior Cerebellar Artery 245

The Internal Auditory Artery 247

The Pontile Arteries and the Syndromes of Their Occlusion 247

The Superior Cerebellar Artery 250

Midbrain Branches of the Posterior Cerebral，Basilar and Anterior Choroidal Arteries 251

CHAPTER 18 THE CEREBRAL CORTEX AND ITS MOTOR PATHWAYS 254

General Organization and Functions 254

Functional Subdivisions of the Cortex 258

Corticofugal and Corticopetal Pathways 262

Corticofugal Fiber Systems 262

Corticopetal Fiber System 263

Components of the Corona Radiata and Internal Capsule 263

Craniocerebral Topography 265

CHAPTER 19 THE LOCALIZATION OP MOTOR AND SENSORY DISTURBANCES OF CEREBRAL ORIGIN 266

Disturbances of Motility and Sensibility of Cortical Origin 266

Motor Deficit Due to Corticosubcortical Lesions 266

Sensory Deficit Due to Cortical Lesions 269

Manifestations of Excitation of the Motor Cortex 273

Sensory Irritative Phenomena 276

Disturbances of Motility and Sensibility of Subcortical Origin 277

Manifestations of Lesions of the Centrum Semiovale 277

Manifestations of Lesions of the Internal Capsule 277

Characteristics of Acute Internal Capsular Lesions 278

Characteristics of Chronic Internal Capsular Lesions 278

Atypical Forms of Cerebral Hemiplegia 282

Clinical Features of Temporal Lobe Lesions 283

Hearing 283

Smell 283

Taste 284

Other Sensory，and Motor Disturbances 284

Disturbances in Behavior and the Occurrence of Seizures 284

Effects of Brain Shifts in the Presence of Intracranial Masses 286

Medial Shift of a Hemisphere 287

Downward Shift of the Brain 287

CHAPTER 20 THE LOCALIZATION OF FRONTAL LOBE DISORDERS 289

Frontal Release and Allied Phenomena 289

＇Frontal Ataxia，＇ 293

Mental Disturbanes 294

CHAPTER 21 THE LOCALIZATION OF DISTURBANCES OF VISION AND PUPILLARY REFLEXES 295

Anatomical Considerations 295

The Localization of Lesions Interrupting the Optic Pathways 299

Lesions Involving the Optic Nerve 299

Lesions Involving the Optic Chiasm 299

Lesions Involving the Optic Tract 302

Lesions Involving the Visual Radiation 304

Lesions Involving the Visual Cortex 306

Positive and Negative Scotomas in Lesions of the Visual Pathway 308

Opticokinetic Nystagmus 309

Visual Agnosia and Alexia 309

Metamorphopias 311

Visual Inattention，or Extinction 312

Localizing Value of Papilledema 312

Localizing Value of Optic Atrophy 315

CHAPTER 22 THE LOCALIZATION OF ANARTHRIA，APHASIA AND APRAXIA 317

Anarthria and Aphasia 317

Apraxia 321

CHAPTER 23 THE LOCALIZATION OF EXTRAPYRAMIDAL MOTOR DISORDERS 324

Anatomical and Functional Background 324

Afferent Systems 324

Efferent Systems 326

Localization of Extrapyramidal Disorders 328

Clinical Syndromes 330

Disorders Characterized by Rigidity，with or without Static Tremor 330

Variable Rigidity，Usually with Action Tremor 335

Variable Rigidity with Alternating Swings of Posture，Either Athetoid or Choreo-athetoid 336

Continuous Involuntary Movements with or without Rigidity 340

CHAPTER 24 THE LOCALIZATION OF LESIONS OF THE THALAMUS 342

Anatomical and Functional Considerations＆by Paul I．Yakovlev，M．D 342

The Subdivisions of the Pallium 342

Thalamic Nuclei 344

Clinical Considerations 352

General Disturbances 352

The Thalamic Syndrome 353

CHAPTER 25 THE CLINICAL FEATURES OP LESIONS OF THE HYPOTHALAMUS，PITUITARY GLAND AND UPPER MIDBRAIN 355

Hypothalamic Disorders 355

Hypopituitary States 364

Acromegaly 364

Chromophobe Adenoma of the Pituitary and Craniopharyngioma 366

CHAPTER 26 ARTERIES OF THE CEREBRUM AND SYNDROMES OF THEIR OCCLUSION 370

The Circle of Willis 370

The Internal Carotid Artery 371

Anatomy 371

Syndromes of Occlusion 371

The Posterior Communicating Artery 373

The Anterior Choroidal Artery 373

Anatomy 373

Syndromes of Occlusion 375

The Anterior Cerebral Artery 375

Anatomy 375

Syndromes of Occlusion 380

The Middle Cerebral Artery 380

Anatomy 380

Syndromes of Occlusion 382

The Posterior Cerebral Artery 382

Anatomy 382

Syndromes of Occlusion 385

CHAPTER 27 LOCALIZATION OF ANEURYSMS OF CEREBRAL ARTERIES 387

Manifestations of Rupture of an Aneurysm 387

Cerebrospinal Fluid 388

Manifestations of Aneurysm Prior to Hemorrhage 389

CHAPTER 28 INTRACRANIAL TUMORS：LOCATION，TYPE，CEREBROSPINAL FLUID 394

Location and Clinical Peculiarities of Various Intracranial Tumors 394

Meningiomas 394

Cerebral Angioma 397

Pinealoma 397

Gliomas of the Cerebrum and Brain Stem 398

Cerebellar Tumors 402

Cerebrospinal Fluid in Intracranial Tumors 404

CHAPTER 29 X-RAY LOCALIZATION OF INTRACRANIAL LESIONS，ESPECIALLY TUMORS＆by Bernard S．Epstein，M．D 405

Changes in Plain Films 405

Pneumoencephalography 411

Cerebral Angiography 416

CHAPTER 30 THE USE OF ELECTROENCEPHALOGRAPHY IN NEUROLOGICAL DIAGNOSIS＆by Richard G．Berry，M．D 419