Cranial nerves, I - olfactory nerve and disorders

Olfactory nerves that subserve the sense of smell have their source cells in the mucous membrane of the top and back part of the nasal cavity. Bipolar sensory cells, the distal portions of which consists in ciliates processes are of penetrating the mucous membrane in the upper part of the nasal cavity. The core processes of these nerves, approximately twenty each side, passing through ethmoid cells, which form the brush as olfactory glomeruli terminals dendrites cribiform plate. Axons mitral cells enter the olfactory Groove frontal bones to the brain. Subsequently, the olfactory tract divided into olfactory medial and lateral grooves. The medial straie becomes the opposite of the previous commisure. Lateral stretch fibers emerge from distribution to previous perforated substance and end up in the complex prepiriform and medial and cortical nuclei of the amygdaloid area. The latter represents the main olfactory cortex.

Testing: before assessing olfactory sensations, one must determine that the nasal passages are not blocked. Local allergic rhinitis, the plyps and sinusitis that undermine smell injuries must be excluded. The test substance should be non-irritating and volatile. Fresh ground coffee, asafoetida, eucalyptus oul power oil or lemon are some of the common test substances used. Substances such as chloroform that can stimulate the gustative final-organos or peripheral nerves trigeminal neuralgia in nasal instead of stimulating olfactory nerves, mucosal endings must be avoided. Each ditch should be evaluated separately with another grave be masked.The patient must be ordered to inhaled and identify the substance of ensayo.La odor perception is more important than the identification.

Smell disorders

1 Quantitative: Loss (anosmia) reduction (hyposmia) or greater acuity (which).

2 Qualitative: Distortion of smell (dysosmia or parosmia)

3 Delusions and hallucinations of smell.

Anosmia occurs only if the disease is bilateral.La head injuries, olfactory groove meningiomas and aneurysms of previous previous or brain communicates artery are some of the causes of the unilateral anosmia.Hyperosmia tends to be a feature of neurotic patients.Dysosmia or parosmia can occur with local abnormalities in the nose.Olfactory hallucinations and delusions usually suggest psychiatric disorders.However, it can be associated with uncinadas where olfactory experience is brief and accompanied by an alteration of consciousness and other phenomena epileptic seizures.

The olfactory nerve is one of the twelve cranial nerves in the human body and is very important if your function and disorders are known.

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Nutritional disorders of the nervous system

The central and peripheral nervous system may suffer deprivation of various nutrients. Pyridoxine (vitamin B6), thiamine (vitamin B1), cyanocobalamin (vitamin B12), Nicotinic Acid (vitamin B3), Pantothenic acid deficiencies are important among them.

Nutritional polyneuropathy: this may be the shortcomings of thiamine pyridoxine, cyanocobalamin, niacin, Pantothenic acid, alone or in combination.

Thiamin deficiency: this leads to neurological, cardiac or mal-efectos, is known as dry beriberi. Although originally described among people who subsist on rice polished as the main energy intake, the present beriberi is seen more among alcoholics. Neurologic injury takes the form of polyneuropathy symmetrical sensorimotor, characterized clinically by tingling, numbness and distal parts of the extremities.Motor phenomena are lower motor neuron bilateral lesions characterized by loss of two times ankle, gout and the fall of the wrist. There are deep, giving rise to the sensitivity of the calf hyperaesthesia. Some cases can develop Wernicke's encephalopathy.

Vitamin B12 deficiency resulting neuropathy can coexist with myelopathy in many cases.Neuropathy can be provable in 50-60% of subjects suffering from pellagra and subclinical deficiency of vitamin B6 deficiency niacina.La form produces polyneuropathy.More floridly is considered as a complication of isonicotinic acid (INH) hydrazide therapy.6 Mg of vitamin B6 administration prevents the development of this type of neuropathy.

Burning feet syndrome (also known as a condition in which the subject experience burning pain in the feet, especially Gopalan serious during the night, in order to interrupt the dream. examination may reveal cyanosis, excessive sweating, pallor, capillary dilation on both third pies.Una areas of these patients may show the sensibilidad.Mas loss often have may be presente.Muchos patients respond dramatically to injections of Pantothenic acid, suggesting that this vitamin deficiency can play an important role in the pathogenesis of the syndrome.)

Glossopharyngeal nerve and vagus nerve (9th and 10th cranial nerve) and its disorders

Since these two cranial nerves intimately connected described here together. Glossopharyngeal nerve has a sensory component and speedboat. Motor fibres originate the nucleus ambiguus, located on the side of the spinal cord. Along with the vagus, and accessory nerves, leave the skull of the hole jugular. Muscle stylopharyngeus whose function is to provide the elevate the pharynx. Autonomic efferent fibers of the glossopharyngeal nerve arise from the inferior salivatory nucleus. Preganglionic fibers become otic ganglion of less superficial petrosal nerve. and postganglionic fibres pass through the auriculotemporal nerve fifth branch to reach the Parotid gland. The nuclei of the glossopharyngeal nerve sensory fibres are located in petrous found in petrous below of the hole bone jugular ganglion and also the upper ganglion, which is small. Exteroceptive fibres supplied faucial tonsils, the rear wall of the pharynx, part of the soft palate and sensations of taste of the rear third of the language.

The vague: this is the longest among all the cranial nerves. Motor fibres originate the ambiguous nucleu and supply of all the muscles in the throat, the soft palate and larynx, with the exception of tensor veli palati and stylopharyngeus. Parasympathetic fibers emerge from the dorsal efferent kernel and left cord as preganglionic fibers part craniosacral autonomous nervous system. These fibres end nodes close to the viscera supplying post-ganglionic fibers. Is parasympatahetic function. Therefore, vagal stimulation produces bronchial constriction, bradycardia, secretion of the gastric and pancreatic juice and greater peristalsis.Sensory part of the vague has their nuclei in the jugular in ganglion and ganglion vague nodoso.El sensations from the subsequent appearance of the external auditory meatus and adjacent pinna and the sensation of pain from the duramater lining the posterior cranial fossa.

Testing: It's better to test features of nerve IX and x together as they are affected usually together. Consult for symptoms such as dysphagia, dysarthria, nasal regurgitation of fluids and hoarseness of voice. Part of engine is tested by examining the uvula when the patient is made to open the mouth.The uvula is usually unilateral vague media.Paralisis online, palatal arc is flattened and dropped from ipsilaterally. The phonation the uvula is diverted to the normal side.

Gag reflex or pharyngeal reflex occurs through the application of a stimulus, such as a bucket of cotton to the wall of pharynx psoterior or squeezes region or language.If the mirror is present, there will be accompanied by retraction of the tongue pharyngeal muscles contraction and elevation.This reflex afferent arc is favoured by the glossopharyngeal, while the efferent is through the vago.Este reflection is lost in both nerve injury 9 or 10.Comprobar General sensation on the posterior wall of pharynx, soft palate, tonsils faucial and taste on the third back of the tongue. These are problems in glossopharyngeal paralysis.

Disorders of nerve functions of the ninth and tenth

Isolated from any nerve involvement is rare and usually involved together, often the nerves of the 11th and 12th centuries also may be affected. The glossopharyngeal neuralgia resembles the trigeminal neuralgia, but is much less common. It is presented as a paroxysmal pain originating from the throat of tonsillar fossa.It may be associated with bradycardia and in such cases is called neuralgia vegoglossopharyngeal.Una trial of phenytoin or carbamazepine is effective for pain relief.Brain stem as a disease of motor neuron, vascular lesions as lateral Medullary infarction or bulbar poliomyelitis injuries can affect these together resulting in bulbar paralysis nerves.Basal meningitis and posterior Fossa tumors can involve these nerves outside the brain stem.Complete bilateral paralysis of vague is incompatible with life.Especially on the left recurrent laryngeal nerve, participation occurs in thoracic injury and this produces only hoarseness of voice without dysphagia.

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Nutritional disorders of the nervous system and its manifestations

Some food nutrient deficiency can cause disorders of the body systems. The type system is no exception and disorders such as myelopathy, encephalopathy, visual disorders, malnutrition and slow development of the brain are all nutritional disorders of the nervous system.

Myelopathy

Demyelination can occur in lateral and subsequent columns of the spinal cord as a result of the deficiency of vitamin B12. Although it is mostly seen as a complication of pernicious anemia, can develop in resulting from causes of vitamin B12 deficiency.Myelopathy manifests as subacute combined degeneration, i.e. dysfunction pyramidal extensions and the subsequent columns.The other parts of the nervous system affected include peripheral nerves and optic nerves. the Neurologic injury and Hematological abnormalities (macrocytic anemia) coexist in many cases, but in some, neurologic injury may precede the anemia.Tratamiento with vitamin B12 always corrects anaemia, but if the condition is advanced neuropathy is irreversible.

Encephalopathy

Thiamin deficiency causes the classic example of nutritional encephalopathy, Wernicke's encephalopathy.The pathological changes include demyelination and Petechial haemorrhages in and around mammilary bodies and the third ventricle and aqueduct.Wernicke's encephalopathy can manifest modified palsies consciousness, ataxia, nystagmus and ocular.Una acute encephalopathy may develop in alcoholics and undernourished people who receive large doses of carbohydrates (especially glucose parenteral therapy) without concurrent tiamina.La management response to the parenteral administration of thiamine 100 mg is dramatic in such cases. Encephalopathy is a feature of Pellagra (niacin deficiency). East manifest as dementia, limbs, spasticity ataxia extrapyramindal riots.

Visual disturbances

Nutritional amblyopia can develop multiple nutrients including vitamin B12 deficiency. This value defines in insidiously with or vision, photophobia and discomfort of retrobulbar on how to move the eyes. Reduced visual acuity.Develop central or parenteral scotomas but peripheral vision fields can remain intact.Stracham syndrome is a combination of visual disturbances, ataxia, deafness and Mucocutaneous lesions.

Malnutrition and brain development

The human brain shows jets development between 15 to 20 weeks of gestation and growth continues for about two years after birth.The most important events are the proliferation of neurons and glial cells tracts myelination.Severe malnutrition (protein and energy) that occur during fetal life and in the early parts of children can leave behind the damage that not correctable by therapy posterior.Esta condition is quite common in desarrollo.A countries regret that the problem of child malnutrition is closely linked with the socio-economic and geographic factors is maximum public health importance to ensure adequate nutrition during pregnancy and lactation.

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