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Jaw Jerk
The jaw jerk reflex or the masseter reflex is a stretch reflex used to test the status of a patient's trigeminal nerve ( cranial nerve V) and to help distinguish an upper cervical cord compression from lesions that are above the foramen magnum. The mandible—or lower jaw—is tapped at a downward angle just below the lips at the chin while the mouth is held slightly open. In response, the masseter muscles will jerk the mandible upwards. Normally this reflex is absent or very slight. However, in individuals with upper motor neuron lesions the jaw jerk reflex can be quite pronounced. The jaw jerk reflex can be classified as a dynamic stretch reflex. As with most other reflexes, the response to the stimulus is monosynaptic, with sensory neurons of the trigeminal mesencephalic nucleus sending axons to the trigeminal motor nucleus, which in turn innervates the masseter. This reflex is used to judge the integrity of the upper motor neurons projecting to the trigeminal motor nucleus. ...
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Trigeminal Nerve
In neuroanatomy, the trigeminal nerve ( lit. ''triplet'' nerve), also known as the fifth cranial nerve, cranial nerve V, or simply CN V, is a cranial nerve responsible for sensation in the face and motor functions such as biting and chewing; it is the most complex of the cranial nerves. Its name ("trigeminal", ) derives from each of the two nerves (one on each side of the pons) having three major branches: the ophthalmic nerve (V), the maxillary nerve (V), and the mandibular nerve (V). The ophthalmic and maxillary nerves are purely sensory, whereas the mandibular nerve supplies motor as well as sensory (or "cutaneous") functions. Adding to the complexity of this nerve is that autonomic nerve fibers as well as special sensory fibers (taste) are contained within it. The motor division of the trigeminal nerve derives from the basal plate of the embryonic pons, and the sensory division originates in the cranial neural crest. Sensory information from the face and body is proc ...
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Neurological Examination
A neurological examination is the assessment of sensory neuron and motor responses, especially reflexes, to determine whether the nervous system is impaired. This typically includes a physical examination and a review of the patient's medical history, but not deeper investigation such as neuroimaging. It can be used both as a screening tool and as an investigative tool, the former of which when examining the patient when there is no expected neurological deficit and the latter of which when examining a patient where you do expect to find abnormalities. If a problem is found either in an investigative or screening process, then further tests can be carried out to focus on a particular aspect of the nervous system (such as lumbar punctures and blood tests). In general, a neurological examination is focused on finding out whether there are lesions in the central and peripheral nervous systems or there is another diffuse process that is troubling the patient. Once the patient has been ...
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Age And Ageing
''Age and Ageing'' is a bimonthly peer-reviewed medical journal covering all aspects of geriatric medicine and gerontology. It was established in 1972 and is published by Oxford University Press. It is the official journal of the British Geriatrics Society and the editor-in-chief is Rowan Harwood (University of Nottingham). Abstracting and indexing The journal is abstracted and indexed in CINAHL, EMBASE, Science Citation Index, Scopus, and MEDLINE/PubMed. According to the ''Journal Citation Reports'', the journal has a 2020 impact factor The impact factor (IF) or journal impact factor (JIF) of an academic journal is a scientometric index calculated by Clarivate that reflects the yearly mean number of citations of articles published in the last two years in a given journal, as ... of 10.668. Editors-in-chief The following persons have been editor-in-chief of the journal: * A. N. Exton-Smith and H. M. Hodkinson (1972–1985) * H. M. Hodkinson (1986–1987) * J. Grimley ...
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Cremasteric Reflex
The cremasteric reflex is a superficial (i.e., close to the skin's surface) reflex observed in human males. This reflex is elicited by lightly stroking or poking the superior and medial (inner) part of the thigh—regardless of the direction of stroke. The normal response is an immediate contraction of the cremaster muscle that pulls up the testis ipsilaterally (on the same side of the body). The reflex utilizes sensory and motor fibers from two different nerves. When the inner thigh is stroked, sensory fibers of the ilioinguinal nerve are stimulated. These activate the motor fibers of the genital branch of the genitofemoral nerve which causes the cremaster muscle to contract and elevate the testis. Clinical conditions In boys, this reflex may be exaggerated which can occasionally lead to a misdiagnosis of cryptorchidism. The cremasteric reflex may be absent with testicular torsion, upper and lower motor neuron disorders, as well as a spine injury of L1-L2. It can also occur if ...
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Tendon Reflex
Tendon reflex (or T-reflex) may refer to: *The stretch reflex or muscle stretch reflex (MSR), when the stretch is created by a blow upon a muscle tendon. This is the commonly used definition of the term. Albeit a misnomer, in this sense a common example is the standard patellar reflex or knee-jerk response. Stretch reflex tests are used to determine the integrity of the spinal cord and peripheral nervous system, and they can be used to determine the presence of a neuromuscular disease. ::Note that the term "deep tendon reflex", if it refers to the muscle stretch reflex, is a misnomer. "Tendons have little to do with the response, other than being responsible for mechanically transmitting the sudden stretch from the reflex hammer to the muscle spindle. In addition, some muscles with stretch reflexes have no tendons (e.g., "jaw jerk" of the masseter muscle)". *The Golgi tendon reflex, which is a reflex to extensive tension on a tendon; it functions to protect musculoskeletal integ ...
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Temporal Muscle
In anatomy, the temporalis muscle, also known as the temporal muscle, is one of the muscles of mastication (chewing). It is a broad, fan-shaped convergent muscle on each side of the head that fills the temporal fossa, superior to the zygomatic arch so it covers much of the temporal bone.Illustrated Anatomy of the Head and Neck, Fehrenbach and Herring, Elsevier, 2012, page 98''Temporal'' refers to the head's temples. Structure In humans, the temporalis muscle arises from the temporal fossa and the deep part of temporal fascia. This is a very broad area of attachment. It passes medial to the zygomatic arch. It forms a tendon which inserts onto the coronoid process of the mandible, with its insertion extending into the retromolar fossa posterior to the most distal mandibular molar.Human Anatomy, Jacobs, Elsevier, 2008, page 194 In other mammals, the muscle usually spans the dorsal part of the skull all the way up to the medial line. There, it may be attached to a sagittal crest, a ...
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Electromyography
Electromyography (EMG) is a technique for evaluating and recording the electrical activity produced by skeletal muscles. EMG is performed using an instrument called an electromyograph to produce a record called an electromyogram. An electromyograph detects the electric potential generated by muscle cells when these cells are electrically or neurologically activated. The signals can be analyzed to detect abnormalities, activation level, or recruitment order, or to analyze the biomechanics of human or animal movement. Needle EMG is an electrodiagnostic medicine technique commonly used by neurologists. Surface EMG is a non-medical procedure used to assess muscle activation by several professionals, including physiotherapists, kinesiologists and biomedical engineers. In Computer Science, EMG is also used as middleware in gesture recognition towards allowing the input of physical action to a computer as a form of human-computer interaction. Clinical uses EMG testing has a variety of ...
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Amyotrophic Lateral Sclerosis
Amyotrophic lateral sclerosis (ALS), also known as motor neuron disease (MND) or Lou Gehrig's disease, is a neurodegenerative disease that results in the progressive loss of motor neurons that control voluntary muscles. ALS is the most common type of motor neuron diseases. Early symptoms of ALS include stiff muscles, muscle twitches, and gradual increasing weakness and muscle wasting. ''Limb-onset ALS'' begins with weakness in the arms or legs, while ''bulbar-onset ALS'' begins with difficulty speaking or swallowing. Half of the people with ALS develop at least mild difficulties with thinking and behavior, and about 15% develop frontotemporal dementia. Most people experience pain. The affected muscles are responsible for chewing food, speaking, and walking. Motor neuron loss continues until the ability to eat, speak, move, and finally the ability to breathe is lost. ALS eventually causes paralysis and early death, usually from respiratory failure. Most cases of ALS (a ...
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Multiple Sclerosis
Multiple (cerebral) sclerosis (MS), also known as encephalomyelitis disseminata or disseminated sclerosis, is the most common demyelinating disease, in which the insulating covers of nerve cells in the brain and spinal cord are damaged. This damage disrupts the ability of parts of the nervous system to transmit signals, resulting in a range of signs and symptoms, including physical, mental, and sometimes psychiatric problems. Specific symptoms can include double vision, blindness in one eye, muscle weakness, and trouble with sensation or coordination. MS takes several forms, with new symptoms either occurring in isolated attacks (relapsing forms) or building up over time (progressive forms). In the relapsing forms of MS, between attacks, symptoms may disappear completely, although some permanent neurological problems often remain, especially as the disease advances. While the cause is unclear, the underlying mechanism is thought to be either destruction by the immune system ...
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Spondylosis
Spondylosis is the degeneration of the vertebral column from any cause. In the more narrow sense it refers to spinal osteoarthritis, the age-related wear and tear of the spinal column, which is the most common cause of spondylosis. The degenerative process in osteoarthritis chiefly affects the vertebral bodies, the neural foramina and the facet joints (facet syndrome). If severe, it may cause pressure on the spinal cord or nerve roots with subsequent sensory or motor disturbances, such as pain, paresthesia, imbalance, and muscle weakness in the limbs. When the space between two adjacent vertebrae narrows, compression of a nerve root emerging from the spinal cord may result in radiculopathy (sensory and motor disturbances, such as severe pain in the neck, shoulder, arm, back, or leg, accompanied by muscle weakness). Less commonly, direct pressure on the spinal cord (typically in the cervical spine) may result in myelopathy, characterized by global weakness, gait dysfunction, l ...
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Masseter
In human anatomy, the masseter is one of the muscles of mastication. Found only in mammals, it is particularly powerful in herbivores to facilitate chewing of plant matter. The most obvious muscle of mastication is the masseter muscle, since it is the most superficial and one of the strongest. Structure The masseter is a thick, somewhat quadrilateral muscle, consisting of three heads, superficial, deep and coronoid. The fibers of superficial and deep heads are continuous at their insertion. Superficial head The superficial head, the larger, arises by a thick, tendinous aponeurosis from the temporal process of the zygomatic bone, and from the anterior two-thirds of the inferior border of the zygomatic arch. Its fibers pass inferior and posterior, to be inserted into the angle of the mandible and inferior half of the lateral surface of the ramus of the mandible. Deep head The deep head is much smaller, and more muscular in texture. It arises from the posterior third of the lower ...
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Cranial Nerves
Cranial nerves are the nerves that emerge directly from the brain (including the brainstem), of which there are conventionally considered twelve pairs. Cranial nerves relay information between the brain and parts of the body, primarily to and from regions of the head and neck, including the special senses of vision, taste, smell, and hearing. The cranial nerves emerge from the central nervous system above the level of the first vertebra of the vertebral column. Each cranial nerve is paired and is present on both sides. There are conventionally twelve pairs of cranial nerves, which are described with Roman numerals I–XII. Some considered there to be thirteen pairs of cranial nerves, including cranial nerve zero. The numbering of the cranial nerves is based on the order in which they emerge from the brain and brainstem, from front to back. The terminal nerves (0), olfactory nerves (I) and optic nerves (II) emerge from the cerebrum, and the remaining ten pairs arise from the ...
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