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Snout Reflex
The Snout reflex (also orbicularis oris reflex) or a "Pout" is a pouting or pursing of the lips that is elicited by light tapping of the closed lips near the midline. The contraction of the muscles causes the mouth to resemble a snout. This reflex is tested in a neurological exam and if present, is a sign of brain damage or dysfunction. Along with the "suck", palmomental reflexes and other reflexes, snout is considered a frontal release sign. These reflexes are normally inhibited by frontal lobe activity in the brain, but can be "released" from inhibition if the frontal lobes are damaged. They are normally present in infancy, however, and until about one year of age, leading to the hypothesis that they are primitive or archaic reflexes. Frontal release signs are seen in disorders that affect the frontal lobes, such as dementias, metabolic encephalopathies, closed head injuries, and hydrocephalus. All of these disorders produce diffuse cerebral damage, usually involving many areas ...
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Snout
A snout is the protruding portion of an animal's face, consisting of its nose, mouth, and jaw. In many animals, the structure is called a muzzle, rostrum, or proboscis. The wet furless surface around the nostrils of the nose of many mammals is called the rhinarium (colloquially this is the "cold wet snout" of some mammals). The rhinarium is often associated with a stronger sense of olfaction. Variation Snouts are found on many mammals in a variety of shapes. Some animals, including ursines and great cats, have box-like snouts, while others, like shrews, have pointed snouts. Pig snouts are flat and cylindrical. Primates Strepsirrhine primates have muzzles, as do baboons. Great apes have reduced muzzles, with the exception being human beings, whose face does not have protruding jaws nor a snout but merely a human nose. Dogs The muzzle begins at the stop, just below the eyes, and includes the dog's nose and mouth. In the domestic dog, most of the upper muzzle contains organs for ...
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Reflex
In biology, a reflex, or reflex action, is an involuntary, unplanned sequence or action and nearly instantaneous response to a stimulus. Reflexes are found with varying levels of complexity in organisms with a nervous system. A reflex occurs via neural pathways in the nervous system called reflex arcs. A stimulus initiates a neural signal, which is carried to a synapse. The signal is then transferred across the synapse to a motor neuron which evokes a target response. These neural signals do not always travel to the brain, so many reflexes are an automatic response to a stimulus that does not receive or need conscious thought. Many reflexes are fine-tuned to increase organism survival and self-defense. This is observed in reflexes such as the startle reflex, which provides an automatic response to an unexpected stimuli, and the feline righting reflex, which reorients a cat's body when falling to ensure safe landing. The simplest type of reflex, a short-latency reflex, has a s ...
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Neurological Exam
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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Brain Damage
Neurotrauma, brain damage or brain injury (BI) is the destruction or degeneration of brain cells. Brain injuries occur due to a wide range of internal and external factors. In general, brain damage refers to significant, undiscriminating trauma-induced damage. A common category with the greatest number of injuries is traumatic brain injury (TBI) following physical trauma or head injury from an outside source, and the term acquired brain injury (ABI) is used in appropriate circles to differentiate brain injuries occurring after birth from injury, from a genetic disorder (GBI), or from a congenital disorder (CBI). Primary and secondary brain injuries identify the processes involved, while focal and diffuse brain injury describe the severity and localization. Recent research has demonstrated that neuroplasticity, which allows the brain to reorganize itself by forming new neural connections throughout life, provides for rearrangement of its workings. This allows the brain to ...
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Palmomental Reflex
The palmomental reflex (PMR) or Marinesco-Radovici Sign or Kinn reflex or Marinesco Reflex is a primitive reflex consisting of a twitch of the chin muscle elicited by stroking a specific part of the palm. It is present in infancy and disappears as the brain matures during childhood but may reappear due to processes that disrupt the normal cortical inhibitory pathways. Therefore, it is an example of a frontal release sign. Eliciting and observing response The thenar eminence is stroked briskly with a thin stick, from proximal (edge of wrist) to distal (base of thumb) using moderate pressure. A positive response is considered if there is a single visible twitch of the ipsilateral mentalis muscle (chin muscle on the same side as the hand tested). Clinical relevance Gheorghe Marinescu and Anghel Radovici in their seminal 1920 paper hypothesized that both the afferent (receptive) and efferent (motor) arms of the reflex are on the same side (ipsilateral) to the hand stimulated; this hy ...
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Frontal Release Sign
Frontal release signs are primitive reflexes traditionally held to be a sign of disorders that affect the frontal lobes. The appearance of such signs reflects the area of brain dysfunction rather than a specific disorder which may be diffuse, such as a dementia, or localised, such as a tumor. One reflex thought to have good localizing value is the palmar grasp reflex which usually signifies damage to the frontal lobe of the opposite side. The glabellar reflex or "glabellar tap" is present in individuals with extrapyramidal disorders such as Parkinson's disease. These reflexes are believed to be "hard-wired" before birth, and are therefore able to be elicited in the newborn. As the brain matures, certain areas (usually within the frontal lobes) exert an inhibitory effect, thus causing the reflex to disappear. When disease processes disrupt these inhibitory pathways, the reflex is "released" from inhibition and can be elicited once again, hence the term "frontal release sign". Some ...
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Frontal Lobe
The frontal lobe is the largest of the four major lobes of the brain in mammals, and is located at the front of each cerebral hemisphere (in front of the parietal lobe and the temporal lobe). It is parted from the parietal lobe by a groove between tissues called the central sulcus and from the temporal lobe by a deeper groove called the lateral sulcus (Sylvian fissure). The most anterior rounded part of the frontal lobe (though not well-defined) is known as the frontal pole, one of the three poles of the cerebrum. The frontal lobe is covered by the frontal cortex. The frontal cortex includes the premotor cortex, and the primary motor cortex – parts of the motor cortex. The front part of the frontal cortex is covered by the prefrontal cortex. There are four principal gyri in the frontal lobe. The precentral gyrus is directly anterior to the central sulcus, running parallel to it and contains the primary motor cortex, which controls voluntary movements of specific body parts ...
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Dementia
Dementia is a disorder which manifests as a set of related symptoms, which usually surfaces when the brain is damaged by injury or disease. The symptoms involve progressive impairments in memory, thinking, and behavior, which negatively affects a person's ability to function and carry out everyday activities. Aside from memory impairment and a disruption in thought patterns, the most common symptoms include emotional problems, difficulties with language, and decreased motivation. The symptoms may be described as occurring in a continuum over several stages. Consciousness is not affected. Dementia ultimately has a significant effect on the individual, caregivers, and on social relationships in general. A diagnosis of dementia requires the observation of a change from a person's usual mental functioning, and a greater cognitive decline than what is caused by normal aging. Several diseases and injuries to the brain, such as a stroke, can give rise to dementia. However, th ...
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Encephalopathy
Encephalopathy (; from grc, ἐνκέφαλος "brain" + πάθος "suffering") means any disorder or disease of the brain, especially chronic degenerative conditions. In modern usage, encephalopathy does not refer to a single disease, but rather to a syndrome of overall brain dysfunction; this syndrome has many possible organic and inorganic causes. Signs and symptoms The hallmark of encephalopathy is an altered mental state or delirium. Characteristic of the altered mental state is impairment of the cognition, attention, orientation, sleep–wake cycle and consciousness. An altered state of consciousness may range from failure of selective attention to drowsiness. Hypervigilance may be present; with or without: cognitive deficits, headache, epileptic seizures, myoclonus (involuntary twitching of a muscle or group of muscles) or asterixis ("flapping tremor" of the hand when wrist is extended). Depending on the type and severity of encephalopathy, common neurological sym ...
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Closed Head Injury
Closed-head injury is a type of traumatic brain injury in which the skull and dura mater remain intact. Closed-head injuries are the leading cause of death in children under 4 years old and the most common cause of physical disability and cognitive impairment in young people. Overall, closed-head injuries and other forms of mild traumatic brain injury account for about 75% of the estimated 1.7 million brain injuries that occur annually in the United States. Brain injuries such as closed-head injuries may result in lifelong physical, cognitive, or psychological impairment and, thus, are of utmost concern with regards to public health. Symptoms If symptoms of a head injury are seen after an accident, medical care is necessary to diagnose and treat the injury. Without medical attention, injuries can progress and cause further brain damage, disability, or death. Common symptoms Because the brain swelling that produces these symptoms is often a slow process, these symptoms may not surfac ...
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Hydrocephalus
Hydrocephalus is a condition in which an accumulation of cerebrospinal fluid (CSF) occurs within the brain. This typically causes increased intracranial pressure, pressure inside the skull. Older people may have headaches, double vision, poor balance, urinary incontinence, personality changes, or mental impairment. In babies, it may be seen as a rapid increase in head size. Other symptoms may include vomiting, sleepiness, seizures, and Parinaud's syndrome, downward pointing of the eyes. Hydrocephalus can occur due to birth defects or be acquired later in life. Associated birth defects include neural tube defects and those that result in aqueductal stenosis. Other causes include meningitis, brain tumors, traumatic brain injury, intraventricular hemorrhage, and subarachnoid hemorrhage. The four types of hydrocephalus are communicating, noncommunicating, ''ex vacuo'', and normal pressure hydrocephalus, normal pressure. Diagnosis is typically made by physical examination and medic ...
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Pyramidal System
The pyramidal tracts include both the corticobulbar tract and the corticospinal tract. These are aggregations of efferent nerve fibers from the upper motor neurons that travel from the cerebral cortex and terminate either in the brainstem (''corticobulbar'') or spinal cord (''corticospinal'') and are involved in the control of motor functions of the body. The corticobulbar tract conducts impulses from the brain to the cranial nerves. These nerves control the muscles of the face and neck and are involved in facial expression, mastication, swallowing, and other motor functions. The corticospinal tract conducts impulses from the brain to the spinal cord. It is made up of a lateral and anterior tract. The corticospinal tract is involved in voluntary movement. The majority of fibres of the corticospinal tract cross over in the medulla oblongata, resulting in muscles being controlled by the opposite side of the brain. The corticospinal tract contains the axons of the pyramidal cell ...
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