{"id":7172,"date":"2021-07-01T09:00:01","date_gmt":"2021-07-01T00:00:01","guid":{"rendered":"https:\/\/wp.meccari.jp\/?p=7172"},"modified":"2023-12-25T12:12:23","modified_gmt":"2023-12-25T03:12:23","slug":"menu_28","status":"publish","type":"post","link":"https:\/\/wp.meccari.jp\/eigocafe\/menu_28\/","title":{"rendered":"Menu 28\u3000 \u8133\u795e\u7d4c\u306b\u95a2\u3059\u308b\u82f1\u8a9e\u8868\u73fe"},"content":{"rendered":"\"\"\r\n\r\n

\u3053\u3093\u306b\u3061\u306f\u3002\u300c\u533b\u5b66\u82f1\u8a9e\u30ab\u30d5\u30a7<\/strong><\/span>\u300d\u306b\u3088\u3046\u3053\u305d\uff01<\/span><\/p>\r\n\r\n

\u3053\u3053\u306f\u300c\u30b3\u30fc\u30d2\u30fc1\u676f\u5206\u300d\u306e\u6642\u9593\u3067\u3001\u533b\u5b66\u82f1\u8a9e\u306b\u307e\u3064\u308f\u308b\u8a71\u3092\u6c17\u8efd\u306b\u697d\u3057\u3093\u3067\u3044\u305f\u3060\u304f\u30b3\u30fc\u30ca\u30fc\u3067\u3059\u3002<\/span><\/p>\r\n\r\n

\u672c\u65e5\u306e\u30c6\u30fc\u30de\u306f\u300c<\/span>\u8133\u795e\u7d4c\u306b\u95a2\u3059\u308b\u82f1\u8a9e\u8868\u73fe<\/strong><\/span>\u300d\u3002<\/span><\/p>\r\n\r\n

\u533b\u5b66\u751f\u306b\u3068\u3063\u3066\u300c\u8133\u795e\u7d4c<\/strong>\u300d\u306f\u89e3\u5256\u5b66\u3084\u8133\u795e\u7d4c\u5185\u79d1\u3060\u3051\u3067\u306a\u304f\u3001OSCE\u3067\u3082\u975e\u5e38\u306b\u91cd\u8981\u306a\u9805\u76ee\u3067\u3059\u3002\u305d\u306e\u540d\u79f0\u3092\u82f1\u8a9e\u3067\u3082\u5b66\u3093\u3067\u3044\u308b\u65b9\u306f\u591a\u3044\u3068\u601d\u3044\u307e\u3059\u304c\u3001\u305d\u306e\u6a5f\u80fd\u3092\u8abf\u3079\u308b\u305f\u3081\u306e\u8eab\u4f53\u8a3a\u5bdf\u3084\u6240\u898b\u306b\u95a2\u3059\u308b\u82f1\u8a9e\u8868\u73fe\u3068\u306a\u308b\u3068\u610f\u5916\u3068\u77e5\u3089\u306a\u3044\u3068\u3044\u3046\u65b9\u3082\u591a\u3044\u3068\u601d\u3044\u307e\u3059\u3002<\/span><\/p>\r\n\r\n

\u305d\u3053\u3067\u4eca\u6708\u306f\u8133\u795e\u7d4c\u306b\u95a2\u3059\u308b\u69d8\u3005\u306a\u82f1\u8a9e\u8868\u73fe<\/strong>\u3092\u3054\u7d39\u4ecb\u3057\u307e\u3059\u3002<\/span><\/p>\r\n\r\n

\u305d\u3082\u305d\u3082\u8133\u795e\u7d4c\u3063\u3066\u4f55\u3067\u305d\u3093\u306a\u306b\u91cd\u8981\u306a\u306e\uff1f<\/strong><\/span>
\r\n\u7686\u3055\u3093\u3054\u5b58\u77e5\u306e\u901a\u308a\u3001\u300c\u4e2d\u67a2\u795e\u7d4c\u7cfb<\/strong>\u300d central nervous system<\/strong> (CNS<\/strong>) \u306f\u300c\u8133<\/strong>\u300d brain<\/strong> \u3068\u300c\u810a\u9ac4<\/strong>\u300dspinal cord<\/strong> \u304b\u3089\u6210\u308a\u7acb\u3061\u3001\u305d\u308c\u4ee5\u5916\u306e\u795e\u7d4c\u306f\u300c\u672b\u68a2\u795e\u7d4c\u7cfb<\/strong>\u300dperipheral nervous system<\/strong> (PNS<\/strong>) \u3068\u306a\u308a\u307e\u3059\u3002\u3053\u306e PNS \u306f\u901a\u5e38 spinal cord \u304b\u3089\u51fa\u3066\u3044\u307e\u3059\u304c\u3001\u300c\u8133\u795e\u7d4c<\/strong>\u300dcranial nerves<\/strong> (CN<\/strong>)<\/span> \u306f\u300c\u8133<\/strong>\u300d\u3068\u300c\u8133\u5e79<\/strong>\u300d\u304b\u3089\u51fa\u3066\u3044\u307e\u3059\u3002<\/span><\/p>\r\n\r\n

\u795e\u7d4c\u7cfb\u306e\u75c7\u72b6\u304c\u3042\u308b\u5834\u5408\u3001\u969c\u5bb3\u90e8\u4f4d\u3092\u7279\u5b9a\u3059\u308b\u305f\u3081\u306b\u69d8\u3005\u306a\u300c\u795e\u7d4c\u5b66\u7684\u8a3a\u5bdf<\/strong>\u300d neurological examination<\/strong> \u3092\u3057\u307e\u3059\u3002<\/span><\/p>\r\n\r\n

\u300c\u8133<\/strong>\u300dbrain<\/strong> \u306b\u969c\u5bb3\u304c\u3042\u308b\u3068\u8003\u3048\u308b\u306a\u3089\u3070 mini-mental state examination<\/strong> (MMSE<\/strong>) \u3092\u884c\u3063\u3066\u8a8d\u77e5\u6a5f\u80fd\u3084\u8a18\u61b6\u306e\u7570\u5e38\u3092\u63a2\u308a\u307e\u3059\u3057\u3001\u300c\u5927\u8133\u57fa\u5e95\u6838<\/strong>\u300d basal ganglia<\/strong> \u3084\u300c\u5c0f\u8133<\/strong>\u300dcerebellum<\/strong> \u306b\u969c\u5bb3\u304c\u3042\u308b\u3068\u8003\u3048\u308b\u306a\u3089\u3070 coordination<\/strong> \u306e\u7570\u5e38\u3092\u63a2\u308a\u307e\u3059\u3002\u540c\u3058\u3088\u3046\u306b spinal cord<\/strong> \u306b\u969c\u5bb3\u304c\u3042\u308b\u3068\u8003\u3048\u308b\u306a\u3089\u3070 deep tendon reflexes<\/strong> (DTR<\/strong>) \u3092\u78ba\u8a8d\u3057\u307e\u3059\u3002\u305d\u3057\u3066 peripheral nerves<\/strong> \u306b\u969c\u5bb3\u304c\u3042\u308b\u3068\u8003\u3048\u308b\u306a\u3089\u3070 sensation<\/strong> \u3092\u78ba\u8a8d\u3057\u3001neuromuscular junction<\/strong> (NMJ<\/strong>) \u3084 muscles<\/strong> \u306b\u969c\u5bb3\u304c\u3042\u308b\u3068\u8003\u3048\u308b\u306a\u3089\u3070 motor function<\/strong> \u3092\u78ba\u8a8d\u3057\u307e\u3059\u3002<\/span><\/p>\r\n\r\n

\u300c\u8133\u795e\u7d4c<\/strong>\u300dcranial nerves<\/strong> (CN<\/strong>) \u306e\u3046\u3061\u3001CN I<\/strong> \u306f brain<\/strong> \u304b\u3089\u3001CN II<\/strong> \u306f\u300c\u9593\u8133<\/strong>\u300ddiencephalon<\/strong> \u304b\u3089\u51fa\u3066\u3044\u307e\u3059\u304c\u3001CN III<\/strong> \u304b\u3089CN VI<\/strong> \u306e4\u3064\u306f\u300c\u4e2d\u8133<\/strong>\u300dmidbrain<\/strong>\u3001\u305d\u3057\u3066\u305d\u308c\u4ee5\u5916\u306e4\u3064\u306f\u300c\u5ef6\u9ac4<\/strong>\u300dmedulla oblongata<\/strong> \u304b\u3089\u3068\u3001\u5168\u3066<\/strong>\u300c\u8133\u5e79<\/strong>\u300d\u304b\u3089\u51fa\u3066\u3044\u307e\u3059<\/strong>\u3002\u3064\u307e\u308a\u300c\u8133\u5e79<\/strong>\u300dbrainstem<\/strong> \u306b\u969c\u5bb3\u304c\u3042\u308b\u3068\u8003\u3048\u308b\u306a\u3089\u3070\u3001cranial nerves<\/strong> \u306e\u8eab\u4f53\u8a3a\u5bdf\u3092\u3059\u308c\u3070\u826f\u3044\u306e\u3067\u3059\u3002\u305d\u306e\u610f\u5473\u3067\u3082 cranial nerves \u306e\u8eab\u4f53\u8a3a\u5bdf\u306f neurological examination \u306b\u304a\u3044\u3066\u91cd\u8981\u306a\u3082\u306e\u3068\u306a\u308b\u306e\u3067\u3059\u3002<\/span><\/p>\r\n\r\n

Anosmia \u3063\u3066\u4f55\uff1f<\/strong><\/span>
\r\n\u3067\u306f\u3053\u306e12\u5bfe\u306e\u8133\u795e\u7d4c\u306b\u95a2\u3059\u308b\u82f1\u8a9e\u8868\u73fe\u3092\u5177\u4f53\u7684\u306b\u307f\u3066\u3044\u304d\u307e\u3057\u3087\u3046\u3002<\/span><\/p>\r\n\r\n

CN I: Olfactory Nerve <\/strong>
\r\n Sensory: Smell<\/strong><\/span><\/span><\/p>\r\n\r\n

\u6700\u521d\u306e\u8133\u795e\u7d4c\u306f\u300c\u55c5\u795e\u7d4c<\/strong>\u300dolfactory nerve<\/span><\/strong> \u3067\u3059\u3002\u8eab\u4f53\u8a3a\u5bdf\u3067\u306f\u7701\u7565\u3055\u308c\u308b\u3053\u3068\u304c\u591a\u304f\u3001\u53e3\u982d\u3067 \u201cHave you noticed any changes in your taste or smell at all?<\/strong>\u201d \u306e\u3088\u3046\u306b\u8cea\u554f\u3060\u3051\u3067\u6e08\u307e\u305b\u308b\u3053\u3068\u304c\u4e00\u822c\u7684\u3067\u3059\u3002<\/span><\/p>\r\n\r\n

COVID-19 \u306e\u75c7\u72b6\u3068\u3057\u3066\u3082\u91cd\u8981\u306a\u300c\u55c5\u899a\u7570\u5e38<\/strong>\u300ddysosmia<\/strong><\/span> \u3067\u3059\u304c\u3001\u3053\u308c\u306b\u306f\u4e0b\u8a18\u306e\u3088\u3046\u306a\u7d30\u304b\u3044\u8868\u73fe\u3082\u3042\u308a\u307e\u3059\u306e\u3067\u3001\u3053\u308c\u3092\u6a5f\u4f1a\u306b\u899a\u3048\u3066\u304a\u304d\u307e\u3057\u3087\u3046\u3002<\/span>
\r\nAnosmia<\/strong><\/span>: \u55c5\u899a\u6d88\u5931<\/strong><\/span>
\r\nHyposmia<\/strong><\/span>: \u55c5\u899a\u920d\u9ebb<\/strong><\/span>
\r\nParosmia<\/strong><\/span>: \u55c5\u899a\u932f\u8aa4<\/strong><\/span><\/p>\r\n\r\n

CN II: Optic Nerve<\/span><\/strong><\/span>
\r\n Sensory: Vision<\/span><\/strong><\/span><\/p>\r\n\r\n

2\u756a\u76ee\u306e\u8133\u795e\u7d4c\u304c\u300c\u8996\u795e\u7d4c<\/strong>\u300doptic nerve<\/strong><\/span> \u3067\u3059\u3002\u540d\u79f0\u3068\u3057\u3066\u300c\u4e09\u53c9\u795e\u7d4c\u300dtrigeminal nerve \u306e1\u756a\u76ee\u306e\u679d\u306b\u5f53\u305f\u308b\u300c\u773c\u795e\u7d4c\u300dophthalmic nerve \u3068\u6df7\u5408\u3055\u308c\u308b\u65b9\u304c\u3044\u308b\u306e\u3067\u6c17\u3092\u3064\u3051\u307e\u3057\u3087\u3046\u3002<\/span><\/p>\r\n\r\n

\u3053\u306e optic nerve \u306e\u8a3a\u5bdf\u3067\u306f\u300c\u8996\u529b\u691c\u67fb<\/strong>\u300dvisual acuity test<\/strong><\/span> \u304c\u91cd\u8981\u3068\u306a\u308a\u307e\u3059\u3002\u3053\u306e visual acuity test \u306b\u95a2\u3059\u308b\u82f1\u8a9e\u8868\u73fe\u306b\u95a2\u3057\u3066\u306f\u3053\u3061\u3089<\/span><\/a><\/span>\u306e\u300c\u6c17\u3092\u3064\u3051\u305f\u3044\u8996\u529b\u691c\u67fb\u3067\u306e\u82f1\u8a9e\u8868\u73fe<\/strong>\u300d\u306b\u307e\u3068\u3081\u3066\u304a\u304d\u307e\u3057\u305f\u306e\u3067\u662f\u975e\u3054\u78ba\u8a8d\u304f\u3060\u3055\u3044\u3002<\/span><\/p>\r\n\r\n

\u300c\u8272\u899a<\/strong>\u300dcolor vision<\/strong> \u3092\u691c\u67fb\u3059\u308b\u969b\u306b\u306f\u300c\u77f3\u539f\u5f0f\u8272\u899a\u691c\u67fb\u8868<\/strong>\u300d\u3092\u4f7f\u3044\u307e\u3059\u304c\u3001\u3053\u308c\u306f\u82f1\u8a9e\u3067\u306f\u5358\u7d14\u306b Ishihara chart<\/strong><\/span> \u3084 Ishihara plates<\/strong><\/span> \u3068\u547c\u3070\u308c\u3066\u3044\u307e\u3059\u3002<\/span><\/p>\r\n\r\n

Accommodation \u3068 Convergence \u3063\u3066\u4f55\uff1f<\/strong><\/span>
\r\n\u6b21\u306b\u300c\u773c\u7403\u904b\u52d5<\/strong>\u300d\u306b\u95a2\u3059\u308b3\u3064\u306e\u8133\u795e\u7d4c\u3092\u307f\u3066\u3044\u304d\u307e\u3057\u3087\u3046\u3002<\/span><\/p>\r\n\r\n

CN III: Oculomotor Nerve<\/span><\/strong><\/span>
\r\n Motor: Eyeball\/Pupil\/Eyelid Movements<\/span><\/strong><\/span>

\r\n\r\nCN IV: Trochlear Nerve<\/span><\/strong><\/span>
\r\n Motor: Eyeball (Downward and Outward) Movements<\/span><\/strong><\/span>

\r\n\r\nCN VI: Abducens Nerve<\/span><\/strong><\/span>
\r\n Motor: Eyeball (Outward) Movements<\/span><\/strong><\/span><\/p>\r\n\r\n

3\u756a\u76ee\u306e\u8133\u795e\u7d4c\u304c\u300c\u52d5\u773c\u795e\u7d4c<\/strong>\u300doculomotor nerve<\/strong><\/span> \u3067\u3059\u3002\u3053\u308c\u306f\u773c\u7403\u3092\u69d8\u3005\u306a\u65b9\u5411\u306b\u52d5\u304b\u3059\u3060\u3051\u3067\u306a\u304f\u3001optic nerve<\/strong> \u3068\u5354\u8abf\u3057\u3066\u300c\u77b3\u5b54\u53cd\u5c04<\/strong>\u300dpupillary reflex<\/strong><\/span> \u306b\u3082\u95a2\u4e0e\u3057\u3066\u3044\u307e\u3059\u3002<\/span><\/p>\r\n\r\n

\u3053\u306e pupillary reflex \u306f\u300c\u30da\u30f3\u30e9\u30a4\u30c8<\/strong>\u300dpen light<\/strong>\uff08\u82f1\u56fd\u3067\u306f pen torch<\/strong> \u3068\u547c\u3073\u307e\u3059\uff09\u3092\u4f7f\u3063\u3066\u300c\u7e2e\u77b3<\/strong>\u300dmiosis<\/strong><\/span> \u3092\u751f\u3058\u3055\u305b\u308b\u305f\u3081\u3001\u300c\u5bfe\u5149\u53cd\u5c04<\/strong>\u300dlight reflex<\/strong><\/span> \u3068\u3082\u547c\u3070\u308c\u307e\u3059\u3002\u3053\u3053\u3067\u306f\u540c\u3058\u773c\u306b2\u56de\u305a\u3064\u5149\u3092\u5f53\u3066\u3001\u540c\u3058\u773c\u306e\u300c\u76f4\u63a5\u5bfe\u5149\u53cd\u5c04\u300d<\/span>direct light reflex<\/strong><\/span> \u3068\u53cd\u5bfe\u5074\u306e\u773c\u306e\u300c\u5171\u611f\u6027\u5bfe\u5149\u53cd\u5c04<\/strong>\u300dconsensual light reflex<\/strong><\/span> \u3092\u78ba\u8a8d\u3057\u307e\u3059\u3002<\/span><\/p>\r\n\r\n

\u3053\u3046\u3044\u3063\u305flight reflex \u306e\u82f1\u8a9e\u8868\u73fe\u306f\u660e\u5feb\u306a\u306e\u3067\u3059\u304c\u3001\u308f\u304b\u308a\u306b\u304f\u3044\u306e\u304c\u300c\u8abf\u6574\u53cd\u5c04<\/strong>\u300daccommodation reflex<\/strong><\/span> \u3067\u306e\u8868\u73fe\u3067\u3059\u3002\u3053\u308c\u306f\u60a3\u8005\u3055\u3093\u306b\u300c\u5bc4\u308a\u76ee\u300d\u3092\u3057\u3066\u3082\u3089\u3046\u691c\u67fb\u3067\u3001\u4e21\u76ee\u304c\u4e2d\u592e\u306b\u5bc4\u308b\u300c\u8f3b\u8f33<\/strong>\uff08\u3075\u304f\u305d\u3046<\/strong>\uff09\u300dconvergence<\/strong><\/span> \u3068\u3001\u77b3\u5b54\u306e\u300c\u53ce\u7e2e<\/strong>\u300dconstriction<\/strong><\/span> \u3068\u3044\u30462\u3064\u306e\u53cd\u5fdc\u3092\u898b\u308b\u691c\u67fb\u3067\u3059\u3002<\/span><\/p>\r\n\r\n

\u305d\u3057\u3066\u77b3\u5b54\u306e\u8996\u8a3a\u3068\u3053\u306e light reflex<\/strong> \u304a\u3088\u3073 accommodation reflex<\/strong> \u306e\u6b63\u5e38\u6240\u898b\u3092\u8868\u3059\u8868\u73fe\u304c\u3001 \u201cThe p<\/strong><\/span>upils are e<\/strong><\/span>qual and r<\/strong><\/span>ound, r<\/strong><\/span>eact to l<\/strong><\/span>ight and a<\/strong><\/span>ccommodation.\u201d \u3067\u3001\u3053\u306e\u7565\u8a9e\u3067\u3042\u308b PERRLA<\/strong>\uff08\u300c\u30d1\u30fc<\/strong>\u30e9\u300d\u306e\u3088\u3046\u306b\u767a\u97f3\uff09 \u306f\u82f1\u8a9e\u570f\u306e Patient Notes\u300c\u30ab\u30eb\u30c6\u300d\u3067\u3082\u3088\u304f\u4f7f\u308f\u308c\u307e\u3059\u3002<\/span><\/p>\r\n\r\n

\u3061\u306a\u307f\u306b\u300c\u7e2e\u77b3<\/strong>\u300d\u306f\u533b\u5b66\u82f1\u8a9e\u3067 miosis<\/strong><\/span>\uff08\u300c\u30de\u30a3\u30aa\u30a5<\/strong>\u30b7\u30a3\u30b9\u300d\u306e\u3088\u3046\u306b\u767a\u97f3\uff09\u3068\u306a\u308a\u3001\u300c\u6563\u77b3<\/strong>\u300d\u306f mydriasis<\/strong><\/span>\uff08\u300c\u30df\u30a3\u30c9\u30e9\u30a3<\/strong>\u30a2\u30b7\u30a3\u30b9\u300d\u306e\u3088\u3046\u306b\u767a\u97f3\uff09\u3068\u306a\u308a\u307e\u3059\u3002\u300c\u30db\u30eb\u30cd\u30eb\u75c7\u5019\u7fa4<\/strong>\u300dHorner syndrome<\/strong> \u3067\u306f\u300c\u7e2e\u77b3\u300d\u306e\u4ed6\u306b\u300c\u773c\u77bc\u4e0b\u5782<\/strong>\u300dptosis<\/strong><\/span>\uff08\u300c\u30c8\u30a9<\/strong>\u30b7\u30a3\u30b9\u300d\u306e\u3088\u3046\u306b\u767a\u97f3\uff09\u3068\u300c\u7121\u6c57\u75c7<\/strong>\u300danhidrosis<\/strong><\/span>\uff08\u300c\u30a2\u30f3\u30d2\u30c9\u30ed\u30a9<\/strong>\u30b7\u30a3\u30b9\u300d\u306e\u3088\u3046\u306b\u767a\u97f3\uff09\u3068\u3044\u3046\u75c7\u72b6\u304c\u73fe\u308c\u308b\u306e\u3067\u3059\u304c\u3001\u82f1\u8a9e\u3067\u306f\u3053\u308c\u3089\u306f ptosis<\/strong>, miosis<\/strong>, and anhidrosis<\/strong> \u306e\u3088\u3046\u306b\u300c\u97fb\u3092\u8e0f\u3080\u300drhyming \u3053\u3068\u3067\u3001\u65e5\u672c\u8a9e\u3088\u308a\u3082\u306f\u308b\u304b\u306b\u899a\u3048\u3084\u3059\u304f\u306a\u3063\u3066\u3044\u307e\u3059\u3002<\/span><\/p>\r\n\r\n

Oculomotor Nerve \u306b\u52a0\u3048\u30014\u756a\u76ee\u306e\u300c\u6ed1\u8eca\u795e\u7d4c<\/strong>\u300dtrochlear nerve<\/strong><\/span> \u30686\u756a\u76ee\u306e\u300c\u5916\u8ee2\u795e\u7d4c<\/strong>\u300dabducens nerve<\/strong><\/span> \u3092\u540c\u6642\u306b\u8abf\u3079\u308b\u300c\u773c\u7403\u904b\u52d5<\/strong>\u300d eye movements<\/strong><\/span> \u306e\u691c\u67fb\u3067\u306f\u3001\u300c\u9854\u3092\u52d5\u304b\u3055\u306a\u3044\u3067\u773c\u3060\u3051\u3067\u6307\u3092\u8ffd\u3063\u3066\u304f\u3060\u3055\u3044\u3002<\/strong>\u300d \u201cPlease follow my finger with your eyes without moving your head.<\/span><\/span><\/strong>\u201d<\/span> \u3068\u6307\u793a\u3057\u307e\u3059\u3002\u3053\u3053\u3067\u6ce8\u610f\u3057\u3066\u9802\u304d\u305f\u3044\u306e\u304c\u300c\u9854\u3092<\/strong>\u52d5\u304b\u3055\u306a\u3044\u3067\u300d\u306e\u8868\u73fe\u3067\u3059\u3002\u76f4\u8a33\u3059\u308b\u3068 without moving your face \u3068\u306a\u3063\u3066\u3057\u307e\u3044\u307e\u3059\u304c\u3001to move your face \u306f\u300c\u9854\u306e\u8868\u60c5\u7b4b\u3092\u52d5\u304b\u3059\u300d\u3068\u3044\u3046\u610f\u5473\u306b\u306a\u3063\u3066\u3057\u307e\u3044\u307e\u3059\u3002\u6307\u306e\u52d5\u304d\u306b\u5408\u308f\u305b\u3066\u300c\u9854\u3092\u52d5\u304b\u3059\u300d\u3068\u3044\u3046\u5834\u5408\u306e\u300c\u9854\u300d\u306e\u82f1\u8a9e\u306f face \u3067\u306f\u306a\u304f head<\/strong> \u306b\u306a\u308a\u307e\u3059\u3002\u307e\u305f\u691c\u67fb\u306e\u7d50\u679c\u300c\u5916\u773c\u7b4b\u306b\u7570\u5e38\u306a\u3057<\/strong>\u300d\u3068\u306a\u308c\u3070\u3001Patient Notes\u306b\u306f EOMI<\/strong><\/span>\uff08\u300c\u30a4\u30fc\u30aa\u30fc<\/strong>\u30df\u30fc\u300d\u306e\u3088\u3046\u306b\u767a\u97f3\uff09\u3068\u66f8\u304d\u307e\u3059\u3002\u3053\u308c\u306f \u201cE<\/strong><\/span>xtrao<\/strong><\/span>cular m<\/strong><\/span>uscles are i<\/strong><\/span>ntact.\u201d \u306e\u7565\u3067\u3001\u82f1\u8a9e\u570f\u306e Patient Notes\u3067\u3088\u304f\u4f7f\u308f\u308c\u308b\u8868\u73fe\u3067\u3059\u3002\u3000<\/span><\/p>\r\n\r\n

\u300c\u6b6f\u3092\u98df\u3044\u3057\u3070\u3063\u3066\u304f\u3060\u3055\u3044\u300d\u306f\u82f1\u8a9e\u3067\u4f55\u3068\u8a00\u3046\uff1f<\/strong><\/span>
\r\n\u6b21\u306b5\u756a\u76ee\u306e\u300c\u4e09\u53c9\u795e\u7d4c<\/strong>\u300dtrigeminal nerve<\/strong><\/span> \u306b\u95a2\u3059\u308b\u82f1\u8a9e\u8868\u73fe\u3092\u307f\u3066\u3044\u304d\u307e\u3057\u3087\u3046\u3002<\/span><\/p>\r\n\r\n

CN V: Trigeminal Nerve<\/span><\/strong><\/span>
\r\n Mixed: Facial Sensation & Chewing<\/span><\/strong><\/span><\/p>\r\n\r\n

\u3053\u306e Trigeminal Nerve \u306f\u300c\u773c\u795e\u7d4c<\/strong>\u300dophthalmic nerve<\/strong> (V1<\/strong>)<\/span> \u3001\u300c\u4e0a\u984e\u795e\u7d4c<\/strong>\u300dmaxillary nerve<\/strong> (V2<\/strong>)<\/span> \u3001\u305d\u3057\u3066\u300c\u4e0b\u984e\u795e\u7d4c<\/strong>\u300dmandibular nerve<\/strong> (V3<\/strong>)<\/span> \u306e3\u3064\u306e\u679d\u304b\u3089\u6210\u308a\u7acb\u3064\u306e\u3067\u3001\u5fc5\u7136\u7684\u306b\u4e00\u756a\u592a\u3044\u8133\u795e\u7d4c<\/strong>\u3068\u306a\u3063\u3066\u3044\u307e\u3059\u3002<\/span><\/p>\r\n\r\n

\u3053\u306e trigeminal nerve \u306esensation \u3092\u8abf\u3079\u308b\u969b\u306b\u306f cotton wool<\/strong> \u3092\u4f7f\u3046 fine<\/strong>\/soft-touch sensation<\/strong><\/span> \u3068\u3001neuro-tip<\/strong> \u3068\u547c\u3070\u308c\u308b\u91dd\u3092\u4f7f\u3046 pinprick sensation<\/strong><\/span> \u306e2\u7a2e\u985e\u306e\u611f\u899a\u3092\u78ba\u8a8d\u3057\u307e\u3059\u3002\u5177\u4f53\u7684\u306b\u306f ophthalmic<\/strong> nerve \u306e\u652f\u914d\u9818\u57df\u3067\u3042\u308b forehead<\/strong> \u3068\u3001maxillary<\/strong> nerve \u306e\u652f\u914d\u9818\u57df\u3067\u3042\u308b cheeks<\/strong>\u3001\u305d\u3057\u3066 mandibular<\/strong> nerve \u306e\u652f\u914d\u9818\u57df\u3067\u3042\u308b lower jaw<\/strong> \u306b\u5bfe\u3057\u3066 \u201cThis is what a cotton ball feels like. Can you feel that? Close your eyes. Let me know when you feel the cotton wool on your face. Did you feel the same on both sides of your face?\u201d \u3068\u6307\u793a\u3057\u306a\u304c\u3089 soft-touch sensation \u3068 pinprick sensation \u306e2\u7a2e\u985e\u306e\u611f\u899a\u3092\u78ba\u8a8d\u3057\u307e\u3059\u3002<\/span><\/p>\r\n\r\n

\u6b21\u306b trigeminal nerve \u306e motor \u3092\u8abf\u3079\u308b\u969b\u306b\u306f\u300c\u5480\u56bc\u7b4b<\/strong>\u300dmuscles of mastication<\/strong> \u3067\u3042\u308b\u300c\u54ac\u7b4b<\/strong>\u300dmasseter muscle<\/strong><\/span> \u306e\u53ce\u7e2e\u3092\u624b\u3067\u89e6\u308c\u3066\u78ba\u8a8d\u3057\u307e\u3059\u3002\u5177\u4f53\u7684\u306b\u306f\u300c\u6b6f\u3092\u98df\u3044\u3057\u3070\u3063\u3066\u304f\u3060\u3055\u3044<\/strong>\u300d\u3068\u6307\u793a\u3059\u308b\u306e\u3067\u3059\u304c\u3001\u82f1\u8a9e\u3067\u306f \u201cClench<\/strong><\/span> your teeth\/jaw for me.\u201d \u306e\u3088\u3046\u306b clench<\/strong> \u3068\u3044\u3046\u52d5\u8a5e\u3092\u4f7f\u3063\u3066\u8868\u73fe\u3057\u307e\u3059\u3002<\/span><\/p>\r\n\r\n

\u300c\u7709\u9593\u306b\u30b7\u30ef\u3092\u5bc4\u305b\u3066\u304f\u3060\u3055\u3044\u300d\u306b\u306f\u82f1\u8a9e\u3067\u4f55\u3068\u8a00\u3046\uff1f<\/strong><\/span>
\r\n\u6b21\u306f7\u756a\u76ee\u306e\u300c\u9854\u9762\u795e\u7d4c<\/strong>\u300dfacial nerve<\/strong><\/span> \u306b\u95a2\u3059\u308b\u82f1\u8a9e\u8868\u73fe\u3092\u78ba\u8a8d\u3057\u307e\u3057\u3087\u3046\u3002<\/span><\/p>\r\n\r\n

CN VII: Facial Nerve<\/span><\/strong>
\r\n Mixed: Taste from Anterior 2\/3 of Tongue & Facial Movements<\/span><\/strong><\/p>\r\n\r\n

\u3053\u306e facial nerve \u306b\u306f\u3053\u306e\u4ed6\u306b\u3082\u300c\u6d41\u6d99<\/b>\u300d lacrimation<\/b><\/span> \u3084\u300c\u553e\u6db2\u5206\u6ccc<\/b>\u300dsalivation<\/b><\/span> \u3068\u3044\u3063\u305f\u6a5f\u80fd\u306b\u52a0\u3048\u3001\u300c\u30a2\u30d6\u30df\u9aa8\u7b4b<\/b>\u300dstapedius muscle<\/b><\/span> \u306e\u8abf\u6574\u6a5f\u80fd\u3082\u5099\u308f\u3063\u3066\u3044\u307e\u3059\u3002\u5f93\u3063\u3066\u300c\u9854\u9762\u795e\u7d4c\u9ebb\u75fa<\/strong>\u300dfacial<\/strong> (nerve<\/strong>) paralysis<\/strong><\/span> \u306e\u969b\u306b\u306f\u3053\u308c\u3089\u306e\u6a5f\u80fd\u304c\u6d88\u5931\u3057\u305f\u75c7\u72b6\u304c\u73fe\u308c\u307e\u3059\u3002\u30a2\u30d6\u30df\u9aa8\u7b4b\u306e\u8abf\u6574\u304c\u4e0a\u624b\u304f\u3067\u304d\u306a\u3044\u3068\u97f3\u306b\u904e\u654f<\/strong>\u306b\u306a\u3063\u3066\u3057\u307e\u3046\u306e\u3067\u3001\u8a3a\u5bdf\u306e\u969b\u306b\u306f \u201cHave you noticed that you\u2019re hearing sounds louder than usual?<\/strong>\u201d \u306e\u3088\u3046\u306a\u8cea\u554f\u3082\u6709\u7528\u3067\u3059\u3002<\/span><\/p>\r\n\r\n

\u3053\u306e facial paralysis \u306e\u969b\u306b\u306f\u300c\u9f3b\u306e\u4e21\u8107\u304b\u3089\u5507\u306e\u4e21\u7aef\u306b\u4f38\u3073\u308b\u7dda\u300d\u3067\u3042\u308b\u300c\u9f3b\u5507\u6e9d<\/strong>\u300d\uff08\u3044\u308f\u3086\u308b\u300c\u307b\u3046\u308c\u3044\u7dda<\/strong>\u300d\uff09nasolabial fold<\/strong><\/span> \u304c\u6d88\u5931\u3057\u3066\u3001\u60a3\u5074\u5074\u306e\u300c\u9854\u304c\u4e0b\u304c\u308b<\/strong>\u300dfacial droop<\/strong><\/span> \u3068\u3044\u3046\u75c7\u72b6\u304c\u307f\u3089\u308c\u307e\u3059\u3002<\/span><\/p>\r\n\r\n

\u3053\u306e\u3088\u3046\u306a facial droop \u304c\u8a8d\u3081\u3089\u308c\u308b\u969b\u306e\u300c\u5371\u967a\u306a\u75be\u60a3<\/strong>\u300d<\/span> red flag<\/strong> \u3068\u3057\u3066\u306f\u300c\u8133\u5352\u4e2d<\/strong>\u300dstroke<\/strong> \u304c\u3042\u308a\u307e\u3059\u304c\u3001\u3053\u306e stroke \u306e\u3088\u3046\u306a\u300c\u4e2d\u67a2\u6027\u9854\u9762\u795e\u7d4c\u9ebb\u75fa<\/strong>\u300dcentral facial paralysis<\/strong> \u306f\u3001 Bell\u2019s palsy<\/span><\/strong> \u3084 Ramsay Hunt Syndrome<\/strong><\/span> \u306b\u4ee3\u8868\u3055\u308c\u308b\u300c\u672b\u68a2\u6027\u9854\u9762\u795e\u7d4c\u9ebb\u75fa<\/strong>\u300dperipheral facial paralysis<\/strong> \u3068\u533a\u5225\u3055\u308c\u308b\u5fc5\u8981\u304c\u3042\u308a\u307e\u3059\u3002<\/span><\/p>\r\n\r\n

\u300c\u9854\u306e\u8868\u60c5<\/strong>\u300dfacial expressions<\/strong> \u3092\u78ba\u8a8d\u3059\u308b\u305f\u3081\u306b\u306f \u201cPuff your cheeks for me.<\/strong>\u201d\/\u201cPurse your lips for me.<\/strong>\u201d\/\u201cShow me your teeth.\/Bare your teeth.<\/strong>\u201d \u306e\u3088\u3046\u306b\u982c\u3092\u52d5\u304b\u3057\u3066\u3082\u3089\u3046\u3060\u3051\u3067\u306a\u304f\u3001 \u201cPlease raise your eyebrows.<\/strong>\u201d \u3084 \u201cPlease close your eyes as tight as you can, and don\u2019t let me open them.<\/strong>\u201d \u3068\u6307\u793a\u3057\u3066\u7709\u5468\u8fba\u306e\u7b4b\u8089\u3092\u52d5\u304b\u3057\u3066\u3082\u3089\u3046\u5fc5\u8981\u304c\u3042\u308a\u307e\u3059\u3002\u3082\u3057\u7709\u306e\u52d5\u304d\u304c\u969c\u5bb3\u3055\u308c\u3066\u3044\u306a\u3051\u308c\u3070<\/span> central facial paralysis<\/strong> \u304c\u8003\u3048\u3089\u308c\u3001\u7709\u306e\u52d5\u304d\u3082\u969c\u5bb3\u3055\u308c\u3066\u3044\u308c\u3070<\/span> peripheral facial paralysis<\/strong> \u304c\u8003\u3048\u3089\u308c\u307e\u3059\u3002<\/span><\/p>\r\n\r\n

\u3061\u306a\u307f\u306b paralysis<\/strong><\/span> \u306f\u300c\u9ebb\u75fa<\/strong>\u300d\u3092\u8868\u3057\u3001palsy<\/span><\/strong> \u306f\u300c\u9ebb\u75fa\u3092\u5f15\u304d\u8d77\u3053\u3059\u75c5\u6c17<\/strong>\u300d\u3068\u3044\u3046\u610f\u5473\u306b\u306a\u308a\u307e\u3059\u306e\u3067\u3001\u533a\u5225\u3057\u3066\u4f7f\u3046\u3088\u3046\u306b\u3057\u3066\u304f\u3060\u3055\u3044\u306d\u3002<\/span><\/p>\r\n\r\n

\u201cPositive Rinne test\u201d \u306f\u3069\u3046\u89e3\u91c8\u3059\u308c\u3070\u3044\u3044\u306e\uff1f<\/strong><\/span>
\r\n\u3067\u306f\u6b21\u306b8\u756a\u76ee\u306e\u300c\u524d\u5ead\u8778\u725b\u795e\u7d4c\u30fb\u8074\u795e\u7d4c<\/strong>\u300dvestibulocochlear\/auditory nerve<\/strong><\/span> \u306b\u95a2\u3059\u308b\u82f1\u8a9e\u8868\u73fe\u3092\u307f\u3066\u3044\u304d\u307e\u3057\u3087\u3046\u3002<\/span><\/p>\r\n\r\n

CN VIII: Vestibulocochlear Nerve<\/span><\/strong><\/span>
\r\n Sensory: Balance & Hearing<\/span><\/strong><\/span><\/p>\r\n\r\n

\u300c\u524d\u5ead\u8778\u725b\u795e\u7d4c\u300dvestibulocochlear nerve\u306e\u8a3a\u5bdf\u3067\u306f\u300c\u97f3\u53c9<\/strong>\u300dtuning fork<\/strong><\/span> \u3092\u7528\u3044\u3066 Rinne test<\/strong> \u3068 Weber Test<\/strong> \u3092\u884c\u3044\u307e\u3059\u3002<\/span><\/p>\r\n\r\n

Rinne test<\/strong><\/span>\uff08\u82f1\u8a9e\u570f\u3067\u306f\u300c\u30ea\u30cd\u30fc<\/strong>\u300d\u306e\u3088\u3046\u306b\u767a\u97f3\uff09\u3067\u306f\u4e73\u69d8\u7a81\u8d77 mastoid process \u306b tuning fork \u3092\u3042\u3066\u3001\u805e\u3053\u3048\u306a\u304f\u306a\u3063\u3066\u304b\u3089\u8033\u306e\u5074\u306b\u8fd1\u3065\u3051\u307e\u3059\u3002
\r\n\u201cI will place the tuning fork on the bone behind your ear. Please let me know whether you can hear it and when you stop hearing it. Can you hear that? Let me know when it stops. Can you hear that?\u201d (Rinne Test<\/strong>)<\/span><\/p>\r\n\r\n

\u6b63\u5e38\u3067\u306f\u8033\u306e\u5074\u306b\u97f3\u53c9\u3092\u8fd1\u3065\u3051\u3066\u3082\u97f3\u304c\u805e\u3053\u3048\u307e\u3059\u3002\u3053\u308c\u306f\u691c\u67fb\u3057\u305f\u5074\u306e\u8033\u3067 air conduction<\/strong> > bone conduction<\/strong> \u3092\u610f\u5473\u3057\u3001\u3053\u308c\u304c Positive<\/span> Rinne test<\/strong> \u3068\u8868\u8a18\u3055\u308c\u307e\u3059\u3002Negative<\/span> Rinne test<\/strong> \u3068\u306a\u308b\u3068\u3001\u305d\u306e\u5074\u306e\u8033\u3067 air conduction <\/strong>< bone conduction<\/strong> \u3068\u306a\u308a\u3001\u305d\u306e\u8033\u306b\u300c\u4f1d\u97f3\u6027\u96e3\u8074<\/strong>\u300d conductive hearing loss<\/strong><\/span> \u304c\u3042\u308b\u3053\u3068\u304c\u793a\u5506\u3055\u308c\u307e\u3059\u3002\u300c\u691c\u67fb\u304c\u967d\u6027\u300d\u3068\u306a\u308b\u3068\u300c\u7570\u5e38\u304c\u3042\u308b\u300d\u3068\u30a4\u30e1\u30fc\u30b8\u3057\u304c\u3061\u3067\u3059\u304c\u3001\u6b63\u5e38\u3067\u3042\u3063\u3066\u3082 Positive Rinne test<\/strong> \u3068\u306a\u308b<\/strong>\u3068\u3044\u3046\u3053\u3068\u3092\u899a\u3048\u3066\u304a\u3044\u3066\u304f\u3060\u3055\u3044\u3002<\/span><\/p>\r\n\r\n

Weber test<\/strong><\/span> \u3067\u306f\u982d\u90e8\u306e\u4e2d\u5fc3\u7dda\u306b tuning fork \u3092\u7f6e\u3044\u3066\u3001\u805e\u3053\u3048\u65b9\u306e\u5de6\u53f3\u5dee\u3092\u78ba\u8a8d\u3057\u307e\u3059\u3002<\/span><\/p>\r\n\r\n

\u201cI will place the tuning fork in the middle of your forehead, and you will hear a noise, is it the loudest in one ear, or the other, or in the middle?\u201d (Weber Test<\/strong>)<\/span><\/p>\r\n\r\n

Weber test \u3067\u306f\u97f3\u304c\u5927\u304d\u304f\u805e\u3053\u3048\u305f\u5074\u306b\u300c\u4f1d\u97f3\u6027\u96e3\u8074\u300dconductive hearing loss \u304c\u3042\u308b\u304b\u3001\u3042\u308b\u3044\u306f\u305d\u306e\u53cd\u5bfe\u5074\u306e\u8033\u306b\u300c\u611f\u97f3\u6027\u96e3\u8074<\/strong>\u300d sensorineural hearing loss<\/strong><\/span> \u304c\u3042\u308b\u3053\u3068\u304c\u793a\u5506\u3055\u308c\u307e\u3059\u3002\u3082\u3057\u300cWeber test \u306e\u7d50\u679c\u3001\u53f3\u8033\u306e\u65b9\u304c\u5927\u304d\u304f\u805e\u3053\u3048\u305f<\/strong>\u300d\u3068\u306a\u3063\u305f\u5834\u5408\u306b\u306f \u201cWeber test lateralized<\/span> to the right ear<\/strong>\u201d \u306e\u3088\u3046\u306b lateralized<\/strong> \u3092\u7528\u3044\u3066\u8868\u8a18\u3057\u307e\u3059\u3002<\/span><\/p>\r\n\r\n

\u307e\u305f\u300c\u5e73\u8861\u611f\u899a<\/strong>\u300d balance<\/strong> \u3092\u8a55\u4fa1\u3057\u305f\u3044\u5834\u5408\u3001\u300c\u305d\u306e\u5834\u3067\u8db3\u8e0f\u307f\u3092\u3059\u308b<\/strong>\u300d\u3053\u3068\u3092\u3057\u3066\u3082\u3089\u3044\u307e\u3059\u304c\u3001\u305d\u306e\u5834\u5408\u306b\u306f \u201cClose your eyes and I\u2019d like you to march on the spot<\/strong><\/span> for me?\u201d \u306e\u3088\u3046\u306a\u8868\u73fe\u3092\u4f7f\u3044\u307e\u3057\u3087\u3046\u3002<\/span><\/p>\r\n\r\n

\u300c\u553e\u3092\u98f2\u3093\u3067\u304f\u3060\u3055\u3044\u300d\u306f\u82f1\u8a9e\u3067\u4f55\u3068\u8a00\u3046\uff1f<\/strong><\/span>
\r\n9\u756a\u76ee\u306e\u300c\u820c\u54bd\u795e\u7d4c<\/strong>\u300dglossopharyngeal nerve<\/strong><\/span> \u306810\u756a\u76ee\u306e\u300c\u8ff7\u8d70\u795e\u7d4c<\/strong>\u300d vagus nerve<\/strong><\/span> \u306f\u540c\u6642\u306b\u8a3a\u5bdf\u3059\u308b\u3053\u3068\u304c\u4e00\u822c\u7684\u3067\u3059\u3002<\/span><\/p>\r\n\r\n

CN IX: Glossopharyngeal Nerve<\/span><\/strong><\/span>
\r\n Mixed: Taste from Posterior 1\/3 of Tongue & Swallowing<\/span><\/strong><\/span><\/p>\r\n\r\n

CN X: Vagus Nerve<\/span><\/strong><\/span>
\r\n Mixed: Parasympathetic Nervous System<\/span><\/strong><\/span><\/p>\r\n\r\n

\u300c\u56a5\u4e0b<\/strong>\u300dswallowing<\/strong> \u3092\u8a55\u4fa1\u3059\u308b\u969b\u306b\u306f \u201cTake a sip of water and when you\u2019re ready, swallow.\u201d \u3068\u8868\u73fe\u3057\u307e\u3059\u3002\u300c\u553e\u3092\u98f2\u3093\u3067\u304f\u3060\u3055\u3044\u300d\u3068\u8a00\u3044\u305f\u3044\u5834\u5408\u306b\u3082\u5358\u7d14\u306b \u201cPlease swallow.\u201d \u3068\u8868\u73fe\u3057\u307e\u3059\u3002\u3082\u3057\u76f4\u8a33\u98a8\u306b \u201cPlease drink your saliva.\u201d \u3068\u8a00\u3063\u305f\u5834\u5408\u3001\u305d\u308c\u306f\u300c\u30b3\u30c3\u30d7\u306b\u6ce8\u304c\u308c\u305f\u553e\u6db2\u3092\u98f2\u3080\u300d\u3068\u3044\u3063\u305f\u6c17\u6301\u3061\u60aa\u3044\u8868\u73fe\u306b\u306a\u308b\u306e\u3067\u3054\u6ce8\u610f\u3092\u3002<\/span><\/p>\r\n\r\n

\u307e\u305f\u3053\u308c\u3089\u306f\u300c\u54bd\u982d\u53cd\u5c04<\/strong>\u300dgag reflex<\/strong> \u306b\u3082\u95a2\u4e0e\u3057\u3066\u3044\u308b\u306e\u3067\u3001\u300c\u54b3\u3092\u3057\u3066\u304f\u3060\u3055\u3044\u300d \u201cCould you just cough for me please?\u201d \u306e\u3088\u3046\u306a\u8868\u73fe\u3082\u3088\u304f\u4f7f\u308f\u308c\u307e\u3059\u3002<\/span><\/p>\r\n\r\n

\u307e\u305f\u53e3\u3092\u958b\u3051\u3066\u3082\u3089\u3044\u3001 \u201cSay \u2018ahh\u2019 for me.\u201d \u3068\u6307\u793a\u3057\u3066\u300c\u8edf\u53e3\u84cb<\/strong>\u300dsoft palate<\/strong><\/span> \u3068\u300c\u53e3\u84cb\u5782<\/strong>\u300duvula<\/strong><\/span> \u3082\u78ba\u8a8d\u3057\u307e\u3059\u3002\u3082\u3057\u3082 uvula \u304c\u3069\u3061\u3089\u304b\u306b\u504f\u3063\u305f deviated uvula<\/strong><\/span> \u3068\u306a\u3063\u3066\u3044\u308b\u5834\u5408\u306b\u306f\u3001\u305d\u306e\u53cd\u5bfe\u5074\u306e CN IX \u3068CN X \u304c\u969c\u5bb3\u3055\u308c\u3066\u3044\u308b\u3053\u3068\u304c\u8003\u3048\u3089\u308c\u307e\u3059\u3002<\/span><\/p>\r\n\r\n

\u3061\u306a\u307f\u306b\u65e5\u672c\u8a9e\u3067\u306f\u5473\u899a\u304c\u6d17\u7df4\u3055\u308c\u3066\u3044\u308b\u3053\u3068\u3092\u300c\u820c\u304c\u80a5\u3048\u3066\u3044\u308b<\/strong>\u300d\u3068\u8868\u73fe\u3057\u307e\u3059\u304c\u3001\u82f1\u8a9e\u3067\u306f \u201cShe has a refined palate<\/span><\/strong>.\u201d \u306e\u3088\u3046\u306b\u300c\u6d17\u7df4\u3055\u308c\u305f\u53e3\u84cb\u3092\u6301\u3063\u3066\u3044\u308b<\/strong>\u300d\u306e\u3088\u3046\u306b\u8868\u73fe\u3057\u307e\u3059\u3002<\/span><\/p>\r\n\r\n

(<\/span>Spinal<\/span><\/strong>)<\/span> Accessory nerve <\/span><\/strong>(<\/span>CN XI<\/span><\/strong>)<\/span>: \u526f\u795e\u7d4c<\/span><\/strong>
\r\n Motor: Head<\/span><\/strong>\/<\/span>Neck<\/span><\/strong>\/<\/span>Shoulder Movements<\/span><\/strong><\/p>\r\n\r\n

11\u756a\u76ee\u306e\u300c\u526f\u795e\u7d4c<\/strong>\u300d(spinal<\/strong>) accessory nerve<\/strong><\/span> \u306e\u8a3a\u5bdf\u3067\u306f\u300c\u80f8\u9396\u4e73\u7a81\u7b4b<\/strong>\u300dsternocleidomastoid\u00a0<\/strong>\u3068\u300c\u50e7\u5e3d\u7b4b<\/strong>\u300dtrapezius<\/strong> \u306e\u7b4b\u53ce\u7e2e\u3092\u78ba\u8a8d\u3059\u308b\u305f\u3081\u3001 \u201cTurn your head <\/strong>to the right\/left against my hand, and don\u2019t let me stop you.\u201d \u3084 \u201cShrug your shoulders<\/strong> for me, and don\u2019t let me push them down.\u201d \u3068\u3044\u3063\u305f\u6307\u793a\u304c\u5fc5\u8981\u306b\u306a\u308a\u307e\u3059\u3002<\/span><\/p>\r\n\r\n

Hypoglossal nerve <\/span><\/strong>(<\/span>CN XII<\/span><\/strong>)<\/span>: \u820c\u4e0b\u795e\u7d4c<\/span><\/strong><\/span>
\r\n Motor: Tongue Movements<\/span><\/strong><\/span><\/p>\r\n\r\n

\u6700\u5f8c12\u756a\u76ee\u306e\u300c\u820c\u4e0b\u795e\u7d4c<\/strong>\u300dhypoglossal nerve<\/span><\/strong> \u306e\u8a3a\u5bdf\u3067\u306f\u3001\u820c\u306e\u52d5\u304d\u3092\u78ba\u8a8d\u3057\u307e\u3057\u3087\u3046\u3002\u5177\u4f53\u7684\u306b\u306f \u201cOpen your mouth for me. Stick out your tongue for me.\u201d \u3068\u6307\u793a\u3057\u3066\u820c\u304c\u5de6\u53f3\u3069\u3061\u3089\u304b\u306b\u504f\u4f4d\u3057\u3066\u3044\u306a\u3044\u304b\u3092\u78ba\u8a8d\u3057\u305f\u5f8c\u3001\u982c\u306b\u624b\u3092\u5f53\u3066\u3066 \u201cPress your tongue into my fingers for me.\u201d \u3068\u8a00\u3063\u3066\u820c\u306e\u52d5\u304d\u3092\u78ba\u8a8d\u3057\u307e\u3059\u3002<\/span><\/p>\r\n\r\n

\u3053\u306e\u3088\u3046\u306b\u8a3a\u5bdf\u306e\u969b\u306b\u4f55\u304b\u6307\u793a\u3092\u3059\u308b\u969b\u306b\u306f \u201cPlease stick out your tongue for me<\/strong><\/span>.\u201d \u306e\u3088\u3046\u306b for me \u3092\u3064\u3051\u308b\u3068\u6975\u3081\u3066\u81ea\u7136\u306a\u8868\u73fe\u306b\u306a\u308a\u307e\u3059\u3002<\/span><\/p>\r\n\r\n

\u4ee5\u4e0a\u304c\u8133\u795e\u7d4c\u306b\u95a2\u3059\u308b\u82f1\u8a9e\u8868\u73fe\u306e\u307e\u3068\u3081\u3067\u3059\u3002<\/span><\/p>\r\n\r\n

\u8133\u795e\u7d4c\u306e\u8eab\u4f53\u8a3a\u5bdf\u306f\u56fd\u3084\u533b\u7642\u6a5f\u95a2\u306b\u3088\u3063\u3066\u3084\u308a\u65b9\u306f\u69d8\u3005\u3067\u3059\u306e\u3067\u3001\u8208\u5473\u3092\u6301\u3063\u305f\u65b9\u306f\u3053\u3061\u3089<\/span><\/a>\u3084\u3053\u3061\u3089<\/span><\/span><\/a>\u306e\u30ea\u30f3\u30af\u5148\u3067\u3001\u82f1\u8a9e\u570f\u3067\u306e\u8133\u795e\u7d4c\u306e\u8a3a\u5bdf\u3092\u64ec\u4f3c\u4f53\u9a13\u3057\u3066\u307f\u3066\u304f\u3060\u3055\u3044\u3002<\/span><\/p>\r\n\r\n

\u3055\u3066\u3001\u305d\u308d\u305d\u308d\u30ab\u30c3\u30d7\u306e\u30b3\u30fc\u30d2\u30fc\u3082\u6b8b\u308a\u308f\u305a\u304b\u3067\u3059\u3002\u6700\u5f8c\u306b\u4eca\u56de\u3054\u7d39\u4ecb\u3057\u305f\u82f1\u8a9e\u8868\u73fe\u3092\u307e\u3068\u3081\u3066\u304a\u304d\u307e\u3059\u3002<\/span><\/p>\r\n\r\n

Cranial nerves <\/span><\/strong>(<\/span>CN<\/span><\/strong>)<\/span>: \u8133\u795e\u7d4c<\/span><\/strong><\/p>\r\n\r\n

Olfactory nerve <\/span><\/strong>(<\/span>CN I<\/span><\/strong>)<\/span>: \u55c5\u795e\u7d4c<\/span><\/strong><\/span>
\r\n Sensory: Smell<\/span><\/strong><\/span>
\r\n\u3000\u30fb<\/strong>\u201cHave you noticed any changes in your taste or smell at all?\u201d<\/span>
\r\n\u3000\u30fb<\/strong> Dysosmia: \u55c5\u899a\u7570\u5e38<\/span>
\r\n\u3000\u30fb<\/strong> Anosmia: \u55c5\u899a\u6d88\u5931<\/span>
\r\n\u3000\u30fb<\/strong> Hyposmia: \u55c5\u899a\u920d\u9ebb<\/span>
\r\n\u3000\u30fb<\/strong> Parosmia: \u55c5\u899a\u932f\u8aa4<\/span><\/p>\r\n\r\n

Optic nerve <\/span><\/strong>(<\/span>CN II<\/span><\/strong>)<\/span>: \u8996\u795e\u7d4c<\/span><\/strong><\/span>
\r\n Sensory: Vision<\/span><\/strong><\/span>
\r\n\u3000\u30fb<\/strong> Visual acuity test: \u8996\u529b\u691c\u67fb\uff08\u8996\u529b\u691c\u67fb\u306e\u82f1\u8a9e\u8868\u73fe\u306f\u3053\u3061\u3089<\/span><\/a><\/span>\uff09<\/span>
\r\n\u3000\u30fb<\/strong> Ishihara chart\/plates: \u77f3\u539f\u5f0f\u8272\u899a\u691c\u67fb\u8868<\/span>
\r\n\u3000\u30fb<\/strong> Pen light\/pen torch: \u30da\u30f3\u30e9\u30a4\u30c8<\/span>
\r\n\u3000\u30fb<\/strong> Pupillary reflex: \u77b3\u5b54\u53cd\u5c04<\/span>
\r\n\u3000\u30fb<\/strong> Miosis: \u7e2e\u77b3<\/span>
\r\n\u3000\u30fb<\/strong> Mydriasis: \u6563\u77b3<\/span>
\r\n\u3000\u30fb<\/strong> Direct light reflex: \u76f4\u63a5\u5bfe\u5149\u53cd\u5c04<\/span>
\r\n\u3000\u30fb<\/strong> Consensual light reflex: \u5171\u611f\u6027\u5bfe\u5149\u53cd\u5c04<\/span>
\r\n\u3000\u30fb<\/strong> Accommodation reflex: \u8abf\u6574\u53cd\u5c04<\/span>
\r\n\u3000\u30fb<\/strong> Convergence: \u8f3b\u8f33<\/span>
\r\n\u3000\u30fb<\/strong> Constriction: \u53ce\u7e2e<\/span>
\r\n\u3000\u30fb<\/strong> PERRLA<\/strong>: \u201cThe p<\/strong>upils are e<\/strong>qual and r<\/strong>ound, r<\/strong>eact to l<\/strong>ight and a<\/strong>ccommodation\u201d \u306e\u7565\u8a9e<\/span><\/p>\r\n\r\n

Oculomotor nerve<\/span><\/strong> (<\/span>CN III<\/span><\/strong>)<\/span>: \u52d5\u773c\u795e\u7d4c<\/span><\/strong><\/span>
\r\n Motor: Eyeball\/Pupil\/Eyelid Movements<\/span><\/strong><\/span>

\r\n\r\nTrochlear nerve <\/span><\/strong>(<\/span>CN IV<\/span><\/strong>)<\/span>: \u6ed1\u8eca\u795e\u7d4c<\/span><\/strong><\/span>
\r\n Motor: Eyeball <\/span><\/strong>(<\/span>Downward and Outward<\/span><\/strong>)<\/span> Movements<\/span><\/strong><\/span>

\r\n\r\nAbducens nerve <\/span><\/strong>(<\/span>CN VI<\/span><\/strong>)<\/span>: \u5916\u8ee2\u795e\u7d4c<\/span><\/strong><\/span>
\r\n Motor: Eyeball <\/span><\/strong>(<\/span>Outward<\/span><\/strong>)<\/span> Movements<\/span><\/strong><\/span><\/p>\r\n\r\n

\u3000\u30fb<\/strong> \u201cPlease follow my finger with your eyes without moving your head<\/strong>.\u201d<\/span>
\r\n\u3000\u30fb<\/strong> EOMI<\/strong>: “Extraocular muscles are intact.\u201d \u306e\u7565\u8a9e<\/span><\/p>\r\n\r\n

Trigeminal nerve <\/span><\/strong>(<\/span>CN V<\/span><\/strong>)<\/span>: \u4e09\u53c9\u795e\u7d4c<\/span><\/strong><\/span>
\r\n Mixed: Facial Sensation & Chewing<\/span><\/strong><\/span>
\r\n\u3000\u30fb Ophthalmic<\/strong> nerve (V1): \u773c\u795e\u7d4c<\/span>
\r\n\u3000\u30fb Maxillary<\/strong> nerve (V2): \u4e0a\u984e\u795e\u7d4c<\/span>
\r\n\u3000\u30fb Mandibular<\/strong> nerve (V3): \u4e0b\u984e\u795e\u7d4c<\/span>
\r\n\u3000\u30fb<\/strong> Fine\/soft-touch sensation & Pinprick sensation: \u201cThis is what a cotton ball feels like. Can you feel that? Close your eyes. Let me know when you feel the cotton wool on your face. Did you feel the same on both sides of your face?\u201d<\/span>
\r\n\u3000\u30fb<\/strong> Motor: \u201cClench your teeth\/jaw for me.\u201d<\/span><\/p>\r\n\r\n

Facial nerve <\/span><\/strong>(<\/span>CN VII<\/span><\/strong>)<\/span>: \u9854\u9762\u795e\u7d4c<\/span><\/strong><\/span>
\r\n Mixed: Taste from Anterior 2\/3 of Tongue & Facial Movements<\/span><\/strong><\/span>
\r\n\u3000\u30fb<\/strong> \u201cHave you noticed that you\u2019re hearing sounds louder than usual?\u201d <\/span>
\r\n\u3000\u30fb<\/strong> \u201cPuff your cheeks for me.\u201d<\/span>
\r\n\u3000\u30fb<\/strong> \u201cPurse your lips for me.\u201d<\/span>
\r\n\u3000\u30fb<\/strong> \u201cShow me your teeth.\u201d<\/span>
\r\n\u3000\u30fb<\/strong> \u201cBare your teeth.\u201d<\/span>
\r\n\u3000\u30fb<\/strong> \u201cPlease raise your eyebrows.\u201d <\/span>
\r\n\u3000\u30fb<\/strong> \u201cPlease close your eyes as tight as you can, and don\u2019t let me open them.\u201d<\/span><\/p>\r\n\r\n

Vestibulocochlear<\/span><\/strong>\/<\/span>Auditory nerve<\/span><\/strong> (<\/span>CN VIII<\/span><\/strong>)<\/span>: \u524d\u5ead\u8778\u725b\u30fb\u8074\u795e\u7d4c<\/span><\/strong><\/span>
\r\n Sensory: Balance & Hearing<\/span><\/strong><\/span>
\r\n\u3000\u30fb<\/strong> Rinne test: \u201cI will place the tuning fork on the bone behind your ear. Please let me know whether you can hear it and when you stop hearing it. Can you hear that? Let me know when it stops. Can you hear that?\u201d<\/span>
\r\n\u3000\u30fb<\/strong> Weber test: \u201cI will place the tuning fork in the middle of your forehead, and you will hear a noise, is it the loudest in one ear, or the other, or in the middle?\u201d<\/span>
\r\n\u3000\u30fb<\/strong> Balance: \u201cClose your eyes and I\u2019d like you to march on the spot for me?\u201d<\/span><\/p>\r\n\r\n

Glossopharyngeal nerve <\/span><\/strong>(<\/span>CN IX<\/span><\/strong>)<\/span>: \u820c\u54bd\u795e\u7d4c<\/span><\/strong><\/span>
\r\n Mixed: Taste from Posterior 1\/3 of Tongue & Swallowing<\/span><\/strong><\/span><\/p>\r\n\r\n

Vagus nerve <\/span><\/strong>(<\/span>CN X<\/span><\/strong>)<\/span>: \u8ff7\u8d70\u795e\u7d4c<\/span><\/strong><\/span>
\r\n Mixed: Parasympathetic Nervous System<\/span><\/strong><\/span><\/p>\r\n\r\n

\u3000\u30fb<\/strong> \u201cCould you just cough for me please?\u201d <\/span>
\r\n\u3000\u30fb<\/strong> \u201cTake a sip of water and when you\u2019re ready, swallow.\u201d<\/span>
\r\n\u3000\u30fb<\/strong> \u201cOpen your mouth and say \u2018ahh\u2019 for me.\u201d<\/span><\/p>\r\n\r\n

(<\/span>Spinal<\/span><\/strong>)<\/span> Accessory nerve<\/span><\/strong> (<\/span>CN XI<\/span><\/strong>)<\/span>: \u526f\u795e\u7d4c<\/span><\/strong><\/span>
\r\n Motor: Head\/Neck\/Shoulder Movements<\/span><\/strong><\/span>
\r\n\u3000\u30fb<\/strong> \u201cTurn your head to the right\/left against my hand, and don\u2019t let me stop you.\u201d <\/span>
\r\n\u3000\u30fb<\/strong> \u201cShrug your shoulders for me, and don\u2019t let me push them down.\u201d<\/span><\/p>\r\n\r\n

Hypoglossal nerve <\/span><\/strong>(<\/span>CN XII<\/span><\/strong>)<\/span>: \u820c\u4e0b\u795e\u7d4c<\/span><\/strong><\/span>
\r\n Motor: Tongue Movements<\/span><\/strong><\/span>
\r\n\u3000\u30fb<\/strong> \u201cOpen your mouth for me. Stick out your tongue for me.\u201d<\/span>
\r\n\u3000\u30fb<\/strong> \u201cPress your tongue into my fingers for me.\u201d<\/span><\/p>\r\n\r\n

\u3067\u306f\u3001\u307e\u305f\u306e\u3054\u6765\u5e97\u3092\u304a\u5f85\u3061\u3057\u3066\u304a\u308a\u307e\u3059\u3002<\/span><\/p>\r\n\r\n

\u300cDr. \u62bc\u5473\u306e\u533b\u5b66\u82f1\u8a9e\u30ab\u30d5\u30a7\u300d\u3067\u306f\u7686\u3055\u3093\u304b\u3089\u6271\u3063\u3066\u6b32\u3057\u3044\u30c8\u30d4\u30c3\u30af\u3092\u52df\u96c6\u3044\u305f\u3057\u307e\u3059\u3002\u3053\u3061\u3089\u306e\u30ea\u30f3\u30af<\/strong><\/span><\/a>\u304b\u3089\u3053\u306e\u30ab\u30d5\u30a7\u3067\u6271\u3063\u3066\u6b32\u3057\u3044\u3068\u601d\u3046\u533b\u5b66\u82f1\u8a9e\u306e\u30c8\u30d4\u30c3\u30af\u3092\u3054\u81ea\u7531\u306b\u8a18\u8f09\u304f\u3060\u3055\u3044\u3002<\/span><\/p>\r\n

\u56fd\u969b\u533b\u7642\u798f\u7949\u5927\u5b66\u533b\u5b66\u90e8 \u533b\u5b66\u6559\u80b2\u7d71\u62ec\u30bb\u30f3\u30bf\u30fc \u6559\u6388\u3000\u62bc\u5473 \u8cb4\u4e4b<\/p>","protected":false},"excerpt":{"rendered":"\u3053\u3093\u306b\u3061\u306f\u3002\u300c\u533b\u5b66\u82f1\u8a9e\u30ab\u30d5\u30a7\u300d\u306b\u3088\u3046\u3053\u305d\uff01 \u3053\u3053\u306f\u300c\u30b3\u30fc\u30d2\u30fc1\u676f\u5206\u300d\u306e\u6642\u9593\u3067\u3001\u533b\u5b66\u82f1\u8a9e\u306b\u307e\u3064\u308f\u308b\u8a71\u3092\u6c17\u8efd\u306b\u697d\u3057\u3093\u3067\u3044\u305f\u3060\u304f\u30b3\u30fc\u30ca\u30fc\u3067\u3059\u3002 \u672c\u65e5\u306e\u30c6\u30fc\u30de\u306f\u300c\u8133\u795e\u7d4c\u306b\u95a2\u3059\u308b\u82f1\u8a9e\u8868\u73fe\u300d\u3002 \u533b\u5b66\u751f\u306b\u3068\u3063\u3066\u300c\u8133\u795e\u7d4c\u300d\u306f\u89e3\u5256\u5b66\u3084\u8133\u795e","protected":false},"author":15,"featured_media":6855,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"onecolumn-960.php","format":"standard","meta":{"_acf_changed":false,"_jin_ogp_image_url":"","_jin_last_featured_id":0,"footnotes":""},"categories":[63],"tags":[],"class_list":["post-7172","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-eigocafe"],"acf":[],"_links":{"self":[{"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/posts\/7172","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/users\/15"}],"replies":[{"embeddable":true,"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/comments?post=7172"}],"version-history":[{"count":1,"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/posts\/7172\/revisions"}],"predecessor-version":[{"id":7173,"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/posts\/7172\/revisions\/7173"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/media\/6855"}],"wp:attachment":[{"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/media?parent=7172"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/categories?post=7172"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/tags?post=7172"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}