Anatomy of the Peripheral Neuromuscular System The essential features of the peripheral neuromuscular system are motor nerves, sensory nerves, autonomic nerves, the neuromuscular junction (NMJ), and muscle fibers. Motor neurons originate in the spinal cord and brainstem and innervate skeletal…
Spinal Cord Organization The spinal cord serves as a conduit for information relayed between the brainstem and peripheral nervous system. In addition to this purely conductive function, there is substantial neural processing at segmental levels of the spinal cord. This…
Brainstem Brainstem anatomy includes associated connections with the cerebellum, spinal cord, and hemispheres. In addition, cranial nerve anatomy and function are integral to brainstem anatomy. Clinical diagnosis of brainstem dysfunction requires an understanding of motor and sensory pathways through the…
Basal Ganglia The basal ganglia are composed of the following deep nuclei, which have complex interrelationships: ■ Globus pallidus ■ Putamen ■ Caudate nucleus ■ Subthalamic nucleus ■ Claustrum ■ Substantia nigra The neostriatum consists of the putamen and caudate…
Introduction The cerebral hemispheres contain the very essence of our being. They allow us to speak, form complex thought, interact with the world, have interpersonal relationships, understand humor, and more. They accomplish this through complex organization and specificity. A theme…
Neuroanatomy is an enormous field, with textbooks devoted solely to the subject. In this book, we presume the reader has a foundation in basic neuroanatomy and neurophysiology. Here we will take the clinical approach to neuroanatomy. We will organize by…
Purpose The principal reason for documenting the history and examination findings is communication, whether with other providers, with patients, or with themselves when they see the patient again in a future encounter. These different communications used to have different content—a…
Synthesis of assessment and plan includes methods to determine the information we want to convey as well as the method for presenting the information. We will consider these separately. Development of the Assessment and Plan Assessment is formulated by considering…
Many specialists, including neurologists, are first trained in general medicine. As such, they interpret their findings in the context of the entire body. For this reason, they must remain facile in performance and interpretation of the general medical examination. However,…
Mental Status Mental status examination consists of evaluating level of consciousness, cognitive function, and language. The neurologist obtains a great deal of information regarding mental status as they take a history. Questions may be answered clearly or not, the historical…