Q41. spinothalamic tract와 관련된 감각 양상은?

Q42. dorsal column-medial lemniscus와 관련된 감각양상은?

Q43. discriminative touch란?

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Sensory Modality Ascending tracts

Q44. corticobulbar tract에서 bulb의 의미는?

Q45. corticospinal tract를 pyramidal tract라고 하는 이유는?

Q46. fractionated movement의 예는?

Q47. extrapyramidal

pathway에 관여하는 신경핵은?

Descending tracts

Connections of Basal ganglia

Q48. 소뇌의 손상으로 같은쪽 사지의 운동 장애가 나타나는

기전을 Fig. 1.31로 설명하시오.

Process of Clinical Diagnosis

Symptom Sign Syndrome Disorder Disease

Neuromuscular axis (system)

Aetiology of neurological disease

The disorders of the neuromuscular system are of four major types In relation to causation or aetiology. Four major cause of disease there are appropriate types of investigation, leading to specific forms of treatment. The four causes are ranked in order of clinical priority so that conditions that are common, potentially life-threating and reversible with prompt treatment are either established or excluded first.

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Extrinsic disorders

Decompressive neurosurgery

Systemic disorders

Vascular disorders

Q50. 유전변성 (heredo-degeneration)의 분류와 그

차이점은?

System degeneration

Degenerative disorders

Q51. 병의 경과(rate of evolution of the disorder)에

따른 원인을 설명하시오.

Q52. 신경해부학과 임상 징후의 연관성을 이해하기 위해 알아야

할 3가지 요소는?

Q53. 신경계 증상의 원인이 외인성 혹은 내인성 인지를 구별해야 하는

이유는?

P. 045

In order to understand fully the relationship between neuroanatomy and clinical signs, it is necessary to know the routes of the major sensory and motor pathways, the significance of lesions of the ‘lower motor neurone’ and ‘upper motor neurone’ and the general functions of the cerebellum, basal ganglia and cerebral cortex. The neuroanatomical information contained in this chapter represents the minimal and essential knowledge required before the clinical approach to the neurological patient. Without this knowledge, it is impossible to interpret the significance of the signs elicited on examination of the nervous system as described in the standard texts on ‘clinical methods’. The continual practice of the examination of the nervous system through experience, and the development of clinical acumen, permit the highly accurate localisation of lesions within the central and peripheral nervous systems.

Q54. 말초의 감각이 척수까지 도달하는 경로는?

Q55. 척수에서 감각신경로의 퍼짐 (divergence)으로 척수 혹은 아래쪽

뇌줄기 손상으로 해리감각장애 (dissociated sensory loss)가 나타나는

이유를 설명하시오.

Q56. 8째 목분절의 반쪽이 절단된 경우 나타나는 증상(Brown-Sequard

syndrome)을 설명하시오.

Upper motor neuron

Lower motor neuron

Q57. lower motor neuron 손상에 의한 증상의 병태생리를 설명하시오.

Upper motor neuron

Lower motor neuron

Q58. 경직(spasticity)의 특징 3가지?

Q59. 항중력근(antigravity mm.)은?

Q60. pyramidal weakness에서 나타나는 비정상적 자세(abnormal

position)은?

Q61. Babinski sign의 적정자극 (adequate stimulus)은?

Q63. 소뇌 손상 이외의 조화운동불능 (incoordination)의 원인은?

Q64. 소뇌 손상에 의한 ataxia와 감각성실조 (sensory ataxia)를

구별하는 방법은?

It is sometimes mistakenly thought that incoordination of the limbs is synonymous with a disorder of the cerebellum. This is not the case, whereas it is true that lesions of the cerebellum do lead to incoordination. A patient with a short leg and an arthritic hip joint, for example, will have an incoordinate gait. Moreover, weakness of the limbs due to disease of the central or peripheral nervous system will cause incoordination. Damage to the peripheral sensory nerves or to the dorsal columns of the spinal cord deprives the brain of proprioceptive information from the limbs, thus causing lack of coordination of the arms and an ataxic gait. This is known as ‘ sensory ataxia ’. When patients with sensory ataxia close their eyes, they readily lose their balance and this is known as Romberg's sign . This does not happen with lesions of the cerebellar pathways.

lack of order

Q66. 경축(rigidity)과 경직(spasticity)을 비교하시오.

Neuropsycholoical functions in the cerebral hemisphere

실행증

인식불능증

공간지남력장애

실어증

실독증

실서증 계산불능증 기억상실

Q67. 도관 (catheter)을 internal carotid a.까지 도달하는 경로를

설명하시오.