Materials for auditory self-work. List of study practical tasks necessary to perform at the practical class.



List of study practical tasks necessary to perform at the practical class.

Materials and methods: neurologic hammer, needle, cotton-wool, weight set, subject (big) glass, Weber’s compasses.

Investigation object: human being.

 

Task 1. To investigate hands and face skin pain sensitivity

There may be painful sensation in face and head region at oral cavity organs diseases. For example, at the diseases of teeth of superior jaw sensation locus is localized for incisival teeth in a region of plica fronto-nasal (it’s maximal in superciliary arc at 1,5 cm from its middle); for canine teeth (fang) and premolars – in naso-labial region of corresponding side; at injury of the 1st and 2nd molars – in cheek region; the 2nd and 3rd molars – mandibular region. At pathology of teeth of mandibular: for teeth incisivi, canine teeth and 1st premolar - chin region; for the 2nd molar – in sublingual region maximal downwards and backwards from the mandibular angle or at region of acoustic external meatus; at the diseases of the 3rd molar maximal pain is localized in front of muscle sternocleidomastoid.

One can irritate the skin of face or hand by neadle. The irritation mustn’t be too strong or frequent. One should first determine whether the investigated person differentiates prick or touching. For this aim it’s necessary in turn but without regular order to touch to skin with blunt and acute subject. While this procedure the investigated person is proposed to find out the character of influencing (blunt or acute one). The injections must be short-termed, they mustn’t cause acute pain. For clerifying of the boundaries of changed sensitivity the investigation must be performed out off healthy locus and on the contrary.

 

Task 2. Temperature sensitivity investigation on hand

For stimuli you must use 2 test tubes (with hot – of 40-50°C and cold 25°C or lower water). One should determine first whether the investigated person differentiates warm from cold (healthy people feel the temperature difference in 2°C). Then you must compare the temperature stimuli perception intensivity on different skin locuses of hands, face and to determine the boundaries of increased or lost temperature sensitivity.

Task 3. Muscular-articular sensitivity investigation

At muscular-articular sensitivity investigation one should check up the sense of passive movements, localization sense, skin kynaesthesia, pressure and weight sense. The investigator asks the investigated person close his eyes, the first one moves the fingers of investigated person. The last (investigated person) must find out the localization of extremity. The investigated person must reproduce the localization of other extremity with his closed eyes. If he doesn’t differentiate light movements their altitude must be increased. The investigator muct touch to the investigated person’s very easy without extra (spare) influencing onto the skin receptors.

Skin kynaesthesia must be checked up by shift of plica, the investigated person must determine the direction of shift.

Task 4. Pressure and weight sense investigation (Weber-Fechner’s law)

The investigated person is sitting with closed eyes and puts his hand on the table. The investigator puts subject glass to the ends of investigated person’s straighten fingers. The investigator puts the weight of certain mass onto the glass and the pressure sense is estimated. Then while slow increasing the weight mass the investigated person is asked when he will feel the addition in weight. The experiment must be performed several times while checking up the sensation threshold at different loading (10, 20, 50, 100 and 200 g) and the constant quantity must be estimated (K= addition size /origin weight mass).

In conclusion it’s necessary to compare constants received in 5 experiments. Under norma the investigated person must tell about difference in 10% of weight mass.

Task 5. Complicated sensitivity types investigation.

Stereognostic sense - is the ability to recognize by palpation familiar subject with closed eyes (coin, key, pin, neadle etc). Healthy person usually solves this task easy and successfully, he characterizes subject’s features (dense, soft) correctly.

 Discriminative sense – separate sensation of 2 irritations putted on the skin simultaneously. It is investigated with Weber’s compasses. Compasses legs are making together up to double touchings will be percepted like one. Norma: 1,0-1,5 cm between legs should be percepted like 2 separate points.

 Irritation location sensation – the investigated person must answer where the irritation is made by the investigator.

Skin plica kynaesthesia-see task number 3.

5. Literature recommended:

1. Lecture course.

2. Mistchenko V.P., Tkachenko E.V. Methodical instructions for dental students (short lecture course).-Poltava, 2005.-P. 26-29.

3. Mistchenko V.P., Tkachenko E.V. Methodical instructions for medical students (short lecture course).-Poltava, 2005.-P. 26-29.

4. Mistchenko V.P., Tkachenko E.V.  Methodical instructions on Normal Physiology on practical classes for dental and medical students.-Poltava, 2005.-P.40-46.

5. Ganong W.F. Review of Medical Physiology.-21st ed.-2003.-Section II.

6. Kapit W., Macey R.I., Meisami E. The Physiology Colouring Book: Harpers Collins Publishers, 1987.-P. 86.

7. Guyton – Ganong – Chatterjee. Concise Physiology /Ed. By Dr Raja Shahzad Gull: M.B.B.S., F.C.P.S., King Edward Medical College.-Lahore, 1998 (1st Edition).-P.264-268.

8. Guyton A.C. Textbook of Medical Physiology.-NY, 1992.-P. 580-605.

 6. Materials for self- control:

A. Control questions:

1. Total representations about pain: types, mechanisms, noceoreceptors, noceoceptive sensitivity spinal and stem conductive ways.

2. Modern data about noceoceptive system. Analgesia.

3. Temperature receptors structure.

4. Spinal and stem temperature sensitivity conductive ways.

5. Proprioceptive sensitivity ways.

6. Spinal and stem deep sensitivity conductory ways.

 

LESSON 13
Posterior brain physiology. Posterior brain role investigation in motor and sensor functions regulation

 

The topic studied actuality.

Dentist should remember that oral cavity different functions (afferent, secretory, motor, adsorbtive) disorders can be determined by local factors, peripheral nerves diseases as well as central cerebral structures injures. Medulla oblongata and pons cerebri belong to such central structures. They contain nuclei of such nerves which provide oral cavity organs and face functioning. Trigeminal, facial, glosso-pharyngeal, hypoglossal cranial nerves belong to them.

Dentists can get in touch with patients with oral cavity afferent function disorders when different sensitivity types (tactile, temperature and gustatory) are disturbed. Masticatory and mimic musculature activity became changed due to oral cavity motor function disorder. Also one can meet secretory dysfunction. It is expressed in salivary glands activity changing. Patient complaints on general sensitivity loosing, sharpening, reducing or injure (anesthesia, hyperesthesia, hypoesthesia, dysesthesia), speech and mastication injury, hypo- or hypersalivation.

Normal functioning of this brain part is vital because even the least injury of this area as a rule leads to grave vital activity disorders (respiration, heart and vessels, digestion activity disturbances).

 

2. Study aims:

To know: posterior brain reflectory activity; posterior brain morphological-functional peculiarities; reticular formation ascendant and descendant influence mechanism; cranial-cerebral nerves role; medulla oblongata centers.

To be able to: investigate cranial-cerebral nerves function and posture static reflexes.

 


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