brainstemThere are 6 functional planes from top to bottom, and 10 brain stem reflexes (BSR) can be selected to determine the function of various planes of the brain stem, so as to understand the disease development trend and determineprognosis。
brainstemnormalNeuroreflexAnd the presence or absence of pathological nerve reflexCerebral nerveThe degree of functional damage or inhibition, and then the patient's conditionprognosisIt is of great significance to make corresponding judgments, and it is also an important basis for judging the level of coma (cortex, diencephalon, midbrain, pons, and medulla) and brain death.Understanding and mastering the relevant brainstem nerve reflex will help clinicians better grasp the patient's condition in medical practice, so as to better grasp clinical medicine.
ciliary Spinal reflex(CSR): Pain irritationclavicleUpper zone causes ipsilateralpupilexpand.Meaning: The disappearance of this reflex indicates that the damage extends to the diencephalic plane
Frontal oculomotor reflex (FOMR): during the examination, the patient's outer skin of the eyebrow tip is pulled outward and upward with the finger and fixed, and then the finger is gently buckled with a pinch hammer, causing the ipsilateral oculomotor muscle to contract and close the eyes.Meaning: This reflection disappears asDiencephalon-midbrainThe plane is involved.
Vertical vestibular reflex (VOVR): when the patient bends or raises his head, his eyes and head move up and down in the opposite directionVertical movement。Meaning: This reflex disappears as the diencephalon midbrain plane is involved.
pupilReflection to light(PLR): Light stimulation causes the pupil to shrink.Meaning: The disappearance of this reflex is the manifestation of damage extending to the midbrain plane.
CornealReflex (CR): touch the cornea with cotton to cause eye closure.Meaning: This reflection disappearsPonsThe plane is damaged.
Masticatory muscle reflex (MR): It causes contraction of the masticatory muscle by striking the chin.Meaning: Absence of reflex is the involvement of pons plane.
Horizontal vestibular ocular reflex (HOVR): When the head moves left and right, the binoculars move horizontally in the opposite direction.Meaning: The disappearance of this reflex indicates the involvement of the lower pontine plane.
Palm chin reflex (VMR): light strokePalmThenarThe genius muscle of the same side contracted in the area of.Meaning: The appearance of this reflex indicates the cortex-SubcorticalThe plane is involved.
The first 8 arePhysiological reflex, onBrain stem injuryCan disappear in turn.The last two arePathological reflex, when damage is involvedbrainstemWill appear.According to the examination results, the dysfunction plane is divided from top to bottom: cortex subcortical plane, diencephalon plane, diencephalon midbrain plane, midbrain plane,PonsPlane, medullary plane.
Clinical significance
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The appearance of pathological metacarpchin reflex shows that the cortex -SubcorticalRegional involvement;The disappearance of the ciliary spinal reflex and the metacarpophalangeal reflex indicates the expansion of the damageDiencephalonPlane;foreheadOrbicularis oculi muscleReflection, verticalityVestibular reflexDisappearance and corneaMandibular reflexAppears as diencephalon -midbrainCharacteristics of plane involvement;pupilReflection to lightThe disappearance and the presence of corneal mandibular reflex indicate that the damage extends to the midbrain;Corneal reflexThe disappearance of masticatory reflex and corneal reflex showed that the superior pontine plane was involved;The disappearance of horizontal vestibular reflex indicates the involvement of the inferior pontine plane;Oculocardiac reflexDisappearing, dilated pupilsApneaIt shows damage of medulla oblongata,brain death。
