PENGANTAR NEUROLOGI

Dr FUAD HANIF SpS M.KES

SMF NEUROLOGI RSUD
BANJAR
 BATASAN

NEUROLOGI ADALAH ILMU YANG

MEMPELAJARI TENTANG
PERSARAFAN, BAIK
YANGFISIOLOGIS MAUPUN
PATOLOGIS.
SKEMA PEMERIKSAAN
PENYAKIT SARAF
1. SKEMA
ANAMNESA PEMERIKSAAN PEMERIKSAAN
FISIK PENUNJANG

GEJALA DIAGNOSA KLINIS

TUMPANG DIAGNOSA LOKALISASI
TINDIH DIAGNOSA ETIOLOGI

DIAGNOSA BANDING
CARA PEMERIKSAAN

SSP (SUSUNAN SARAF PUSAT)

TERLETAK DIDALAM TULANG SEHINGGA
TIDAK DAPAT DI INSPEKSI, PALPASI, DAN
AUKULTASI SECARA LANGSUNG,
MELAINKAN DENGAN PEMERIKSAAN
KHUSUS (TEKNIK STIMULUS RESPONS)
URUTAN PEMERIKSAAN

1. ANAMNESA
ALLO-ANAMNESA
HETERO-ANAMNESA

2. PEMERIKSAAN FISIK
STATUS PRAESENSI : vital sign
STATUS INTERNA
ETIOLOGY IN NEUROLOGIC DISORDERS :

TRAUMA : HEAD / SPINE TRAUMA

VASCULAR : STROKE
INFECTION : ENCEPHALITIS, MENINGITIS
TUMOUR
DEGENRATIVE PROCESS : PARKINSON,
DEMENTIA
IDIOPATHIC : EPILEPSY
 STATUS NEUROLOGI
RANGSANG MENINGEAL
SARAF OTAK
PEMERIKSAAN MOTORIK
PEMERIKSAAN SENSORIK
PEMERIKSAAN REFLEKS
PEMERIKSAAN KOORDINASI
PEMERIKSAAN FUNGSI LUHUR
ANAMNESA
1. KELUHAN UTAMA
2. RIWAYAT PENYAKIT SEKARANG
3. RIWAYAT PENYAKIT DAHULU
PEMERIKSAAN FISIK
1. KESADARAN
2. TEKANAN DARAH
3. NADI
4. RESPIRASI
5. TEMPERATUR
PEMERIKSAAN NEUROLOGIS
1. DIPERIKSA RANGSANGAN MENINGEAL
PEMERIKSAAN MELIPUTI :
TANDA KAKU KUDUK
TANDA KERNIG
TANDA LASEQUE
TANDA BRUDZINSKI
2. PEMERIKSAAN SARAF OTAK
SARAF YANG DIPERIKSA
NERVUS I (OLFAKTORIUS)
NERVUS II (OPTIKUS)
NERVUS III, IV, VI
NERVUS V (TRIGEMINUS)
NERVUS VII (FASIALIS)
NERVUS VIII (VESTIBULOCOCHLEARIS)
NERVUS IX (GLOSSOFARINGEUS)
NERVUS X (VAGUS)
NERVUS XI (ASESORIUS)
NERVUS XII (HIPOGLOSUS)
Cranial
Nerves
Nuclei of
Cranial
Nerves
Motoric
Cranial
Nerves
Nuclei
Sensoric
Cranial
Nerves
Nuclei
 CN V (TRIGEMINAL)
SENSATION OF FACE, OPEN/CLOSE JAW,
MASTICATION, CORNEAL REFLEX)
CN VII (FACIAL)
FACIAL MOVEMENT AND
EXPRESSION,
TASTE OF ANTERIOR
TWO THIRD OF
TONGUE,
BLINKING REFLEX
Central 7th palsy Peripheral 7th palsy
CN VIII (VESTIBULO-COCHLEAR)
BALANCING
SENSE OF HEARING
CN IX (GLOSSOPHARYNGEAL) AND CN X
(VAGUS)

ELEVATION OF PALATE/UVULA, GAG REFLEX

CN XI (SPINAL
ACCESSORY)
HEAD MOVEMENT,
SHOULDER
SHRUG/ELEVATION

CN XII TONGUE
MOVEMENT
MOTOR SYSTEM

MUSCLE BULK
MUSCLE TONUS
MUSCLE POWER/STRENGTH
FASCICULATION
SENSORY SYSTEM

SUPERFICIAL SENSORY MODALITIES : PAIN

PERCEPTION, TEMPERATURE DISCRIMINATION, LIGHT
TOUCH

DEEP SENSORY MODALITIES : VIBRATION SENSE,

POSITION SENSE

CORTICAL FUNCTION : TWO-POINT DISCRIMINATION

(EXTINCTION), STEREOGNOSIS
REFLEXES

PHYSIOLOGIC REFLEX [MUSCLE STRETCH (DEEP)

REFLEX] : BICEPS, TRICEPS, BRACHIORADIAL, KNEE
JERK (KPR), ANKLE JERK (APR)

SUPERFICIAL REFLEX : ABDOMINAL SKIN REFLEX,

CRESMATERIC, ANAL, BULBOCAVERNOUS

PATOLOGIC REFLEX : BABINSKI, CHADDOCK,

HOFFMANN TROMMER, REGRESSION
SUBSPECIALTIES IN NEUROLOGY

NEUROPEDIATRIC OR
DEVELOPMENTAL NEUROLOGY
NEURO-RADIOLOGY
NEURO-PHYSIOLOGY
NEURO-PSYCHOLOGY
NEURO-ANATOMY
NEURO-REHABILITATION
CEREBRO-VASCULAR DISEASE (CVD)
CNS INFECTION
EPILEPSY
PERIPHERAL NERVE
NEURO-OPHTHALMOLOGY
SIGN AND SYMPTOMS IN
NEUROLOGICAL
DISEASES
Due to location
Cerebral
Hemisphere Cerebellum
Brain section
Central Nerves System
Cervical
Medulla Thoracal
spinalis
Lumbosacral

Nucleus

Peripheral nerves system Ganglion

Nerve root
SYMPTOMS & SIGNS
Cardinal symptoms

General cerebral disorders

High intracranial pressure

Consciousness Intoxication

Metabolic disorders

Focal cerebral disorders

Disturbances of ARAS /
brain stem
 Causes of decreased LOC

Intra-cranial Extra-cranial

Diffuse Focal Hepar

Meningitis, Stroke, Renal

Encephalitis Tumour, Lungs
Abscess
Diabetes
Intoxication

Lumbal
CT-Scan
puncture

Laboratory
Cardinal symptoms

Meningeal irritation : - Infection

- Haemorrhage

- Radix irritation
 Cerebral : hemiparese, hemiplegy
- Vascular
- Infection
Motor dysfunction : - central - SOL
- Degenerative process

Medullar : segmental paralytic

- Upper motor / central

Hypertonic / spastic

Hyperreflexia

Pathological reflex
 Cranial nerve

- Perifer

Segmental : - Myotomal
- Radiculopathy
- Neuropathy
- Lower motor :

Hypotonic / flacid

Hypo / areflexia
Sensoric dysfunction :
Exteroceptive
Pain
Temperature
Touch
Proprioceptive
Vibration
Deep pain
Position
Cerebral
Cortical
Thalamic
Medullar
Radicular
Organic
Autonomic :

Symphatic Regulation of blood pressure,

respiration, micturation, bowel
Parasymphatic habit, sweating
Equilibrium :

Central :

Cerebellum

Posterior medulla spinalis

Peripheral :

Vestibular
Higher Cortical Dysfunction :
Cognitive dysfunction
Neurobehaviour
Memory
Immediate
Recent
Long term memory
Language
Verbal
Non verbal
Dyslexia
Dysgraphia
Orientation
Time
Place
Person
 Praxis

Calculation

Insight

Executive function

Visuospatial

Emotion
Higher Cortical Dysfunction :

Degenerative Dementia

Vascular Stroke

SOL Intracranial tumor

Neurotransmitter Psychiatric disorder

Symptoms :

Memory problem

Executive dysfunction

Language dysfunction, aphasia

Disorientation

Disinhibition

Behaviour disturbances

Dispraxia