Urgent neurological syndromes. Movie 2. (1990)

Documentary №51822, 2 parts, duration: 0:19:57
Production: Centrnauchfilm (CNF)
Director:Otto M.
Screenwriters:Karneev K.,Otto M.
Camera operators:Fedorovich K.

Annotation:

Educational film for students medvuzov. Considers meningeal syndrome and radicular syndromes.

Reel №1

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Pedestrians are in a hurry on the streets of the city.

Parking of cars on the streets of Moscow.

An ambulance is in a hurry on call.

The neuropathologist of the ambulance A.M. Sidorov interviews the patient to whom they arrived on call.

The patient complains of a severe headache.

The patient is in the cocked trigger position, the pose is caused by reflex tonic muscle contraction, mainly associated with overexpression of the posterior roots of the spinal cord.

If a patient has photophobia, a manifestation of general hyperesthesia, against the background of headache, then it is of great importance to identify reactive adjunctivated pain symptoms, one of which is the zygomatic symptom of Bekhterev.

Meningeal syndrome includes musculotonic syndromes, rigidity of the muscles of the occiput.

With passive bending of the head, reflex bending of the legs occurs simultaneously.

At the same time reflex opening of the mouth.

Of practical importance is the identification of increased tone in the legs, the so-called Kernig symptom, and the lower Brudzinsky symptom.

All these symptoms may not be pronounced in a single patient, the causes of meningeal syndrome at the prehospital stage remain unknown and therefore therapy cannot be differentiated.

Meningeal syndrome includes a number of acute neurological diseases that are life-threatening to the patient and, first of all, cerebral hemorrhage and meningitis.

The patient is transported lying down.

The complexity of determining the shell syndrome does not necessarily require the presence of the entire group of meningeal signs.

It is not always the case that the patient is in the cocked position.

Psychomotor agitation, local or general epileptic seizures are often observed.

With the patient's first complaints of pain in the head and neck, the so-called partial meningeal syndrome can be detected.

Muscle rigidity or a zygomatic symptom of Bekhterev, or soreness of movement of the eyeballs.

The most constant is Kernig's symptom.

Often meningeal syndrome develops only 10-12 hours after the onset of the disease, and this is also the difficulty of determining the shell syndrome.

Detection of meningeal syndrome in children.

Examination by a doctor of an infant.

Meningeal syndrome can be detected by an ambulance doctor.

To determine the causes of the syndrome, the patient should have a lumbar puncture.

Previously, the nature of the process can be determined by the color of the liquor.

Samples of liquor.

Meningitis can be secondary, for example, with otitis media.

hospitalization should be in the specialized department.

The doctor in the ambulance tells in what pathological processes the radicular syndrome develops.

A cartoon explaining the types of root syndrome.

The patient explains to the doctor his painful sensations.

Express somatic examination.

With cervical-level radiolucopathy, the four lower cervical roots are almost selectively affected, of which the defeat of the roots of C6 and C7 is significantly predominant.

The sensitivity test indicates a lesion of the C6 root.

The doctor found out the hyposthesia zone.

Emergency therapy begins with the use of analgesics and vitamins of group B.

Additional survey of the patient.

In some cases, cervical radicular syndrome, as a result of damage to the vertebral arteries, may be joined by symptoms of insufficiency of the vertebral-basilar system.

In this case, hospitalization is indicated.

Key words

Meningeal syndrome.
Neurological diseases.
Cervical radicular syndrome.

Reel №2

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A cartoon explaining the symptoms of thoracic radicular syndrome.

The doctor listens to the patient's explanations recorded on a tape recorder.

The ambulance doctor comments on these explanations and tells about recommendations for further treatment.

The patient takes medicine.

A nitroglycerin tablet does not relieve pain, an electrocardiogram (ECG) is done.

ECG does not show acute cardiac pathology.

The patient is examined by a neuropathologist V.A. Radchenko.

The doctor presses on the paravertebral points in the thoracic spine.

According to the innervation zones of the affected roots, hyper or hyposthesia zones are revealed in the form of transverse bands, which indicates the loss of the root function.

The doctor explains the diagnosis to the patient.

Thoracic radicular syndrome can be a manifestation of not only osteochondrosis, but also a tumor disease of the spinal cord and roots, purulent inflammation of the epidural tissue, tuberculous spondylitis, and even a primary or secondary tumor of the spine.

The radiologist examines the X-rays.

In this particular case, signs of osteochondrosis of the thoracic spine are clearly expressed.

Interview of patients in the neurological department.

A cartoon showing the consequences of a lumbar spine injury.

Neuropathologist V.A. Radchenko examines the patient.

The diagnostic value in lumbosacral radiculitis is the straightening of lumbar lordosis, soreness during palpation of the spinous processes of the spine at the level of the affected disc is a fairly frequent sign of a herniated intervertebral disc.

Almost always with radicular syndrome, reflex tension of the long muscles of the back is visible.

Soreness is revealed by palpation of paravertebral points.

Reflex scoliosis is more often in the direction of the affected root.

Flexion and extension of the trunk is significantly limited.

The picture shows osteophytes, a decrease in the height of the disc, scoleosis, which corresponds to the clinical picture of the disease.

The doctor continues the examination, checks the symptoms of tension.

These symptoms are characteristic of lesions of the lumbosacral spine.

Another patient with a lesion of the upper lumbar roots is characterized by positive symptoms of Wasserman and Matskevich.

With chronic root syndrome, vegetative-atrophic disorders are often detected.

It is necessary to examine the motor sphere, paresis of the foot is revealed.

To exclude the myelitic process with a root component, it is advisable to make sure that there is no pathological symptom of Babinsky.

A decrease in the knee reflex is characteristic when the process is localized in the upper lumbar region.

A decrease or absence of the achilles reflex on the side of the pain syndrome is a symptom of prolapse and indicates a lesion of the root.

A change in sensitivity on the posterior-outer surface of the thigh and lower leg is also a symptom of prolapse and indicates a root lesion of L5 and S1.

The doctor announces the diagnosis.

Conducting a tomographic examination.

According to the results of the study, the patient has a chance to do without surgery.

The doctor conducts a course of manual therapy.

Key words

Thoracic radicular syndrome.
Osteochondrosis.
Sciatica.

Personnel:

Radchenko V.A., vrach-nevropatolog.

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