神経の復習。
弓状束の障害。
顔面神経麻痺の原因検索はどこまでするのか。ACEとか測定しますかね。
・The patient is recovering from a stroke and has normal fluency and comprehension (correctly follows oral commands).
脳梗塞後の構音障害のケース。3つのうちのどれか。
This results from a lesion in the arcuate fasciculus, the white-matter tract that connects the Broca area (which lies in the frontal cortex) and the Wernicke area (found in the temporoparietal cortex) in the dominant (usually left) cerebral hemisphere.
繰り返せないのは弓状束の障害！
ウェルニッケの障害はすらすらしゃべるけど、意味をなさない言葉を発する。
言葉を発せない。
いずれにしても左の脳梗塞。病歴的には右上下肢麻痺はありがち。
The patient is exhibiting symptoms of facial nerve palsy, a lesion of cranial nerve VII that affects the muscles of facial expression.
Patients with sarcoidosis, tumors, diabetes, AIDS, and Lyme disease are at increased risk for facial nerve palsy, although half of the cases are idiopathic (Bell palsy). Important signs of Bell palsy are the sudden onset of ipsilateral ptosis and facial droop. Patients may also experience decreased lacrimation and hyperacusis on the affected side and loss of taste sensation to the anterior tongue.
Corticosteroids and antivirals are used to improve facial nerve function and mitigate neuronal damage.
顔面神経麻痺で表情筋の障害。流涙、味覚も障害。
大半は特発性。
サルコイドーシス、腫瘍、糖尿病、AIDS、ライム病はリスク。
→顔面神経麻痺の時の検索。
治療はステロイド。
The facial nerve (CN VII) is derived from the second branchial (pharyngeal) arch.
顔面神経は第2咽頭弓。
The first branchial arch gives rise to the muscles of mastication, the mylohyoid, the anterior belly of the digastric muscle, the tensor veli palatini, and the tensor tympani. These muscles are innervated by the mandibular branch of CN V.
第1咽頭弓は三叉神経。
咀嚼筋、顎舌骨、顎二腹筋前方、口蓋帆張筋、鼓膜張筋→顔の下の前の方の筋！
・The third branchial pouch第3咽頭窩 gives rise to the inferior parathyroid glands and the thymus. Abnormalities in the pharyngeal pouches are seen in DiGeorge syndrome.
第3咽頭窩は下の副甲状腺と胸腺。
異常があるとディジョージ症候群。
・The fourth branchial pouch第4咽頭窩は上の副甲状腺。
異常があるとDiGeorge syndrome.
・The thyroglossal duct甲状舌管は甲状腺憩室と舌をつなぐ。
第2咽頭弓から発生。成人では盲孔になる。
