Bài giảng Vỏ não

Nội dung text: Bài giảng Vỏ não

1. VỎ NÃO
2. Các tế bào vỏ não
3. BÓ THÁP - Bắt nguồn từ tế bào tháp ở lớp III. + Tháp chéo (90%). + Tháp thẳng (10%)
4. BÓ GỐI - Bắt nguồn từ tế bào tháp ở lớp III. Tận cùng sợi trục tiếp xúc với nhân các dây thần kinh sọ não. Chi phối vận động các cơ vùng đầu mặt cổ
5. SỢI TIỀN VẬN ĐỘNG • Bắt nguồn từ các tế bào tháp ở lớp V. Tận cùng sợi trục chi phối các nhân vận động ngoại tháp. Kìm chế bớt hoạt động tự Lớp V phát của các nhân vận động dưới vỏ
6. ĐỊNH KHU VẬN ĐỘNG
7. ĐỊNH KHU VẬN ĐỘNG
8. ĐỊNH KHU VỎ NÃO
9. ĐIỆN NÃO (Electroencephalography)
10. CÁC ĐẠO TRÌNH MẮC NỐI TIẾP Chuyển đạo: 2 - 4 4 - 6 6 – 8 8 – 10 12- 14 14 - 16
11. CÁC ĐẠO TRÌNH MẮC SONG SONG Chuyển đạo: 1 3 5 7 9 11 13 15
12. PHÂN LOẠI SÓNG ĐIỆN NÃO - Sóng nhanh: tần số 7 chu kỳ/giây. + 7 – 12 chu kỳ/giây. +  > 12 chu kỳ/giây. - Sóng chậm: tần số < 7 chu kỳ/giây. +  3 – 7 chu kỳ/giây. +  < 3 chu kỳ/giây.
13. ĐIỆN NÃO BÌNH THƯỜNG BIÊN SOẠN: TS. ĐÀO MAI LUYẾN
14. Media file 1: A 10-second segment showing a well-formed and well-regulated alpha rhythm at 9 Hz. Note that it is very regular, rhythmic, waxing and waning, and posterior dominant. The contrast between the first and second halves of the page illustrates the reactivity of a normal alpha rhythm, with attenuation upon eye opening.
15. Media file 3: This is an example of an alpha rhythm with a wider distribution than is typical. If frequency and reactivity are normal, this is another variation of normal. A similar EEG pattern can be seen in patients in a coma (ie, alpha coma), but in these situations it is usually unreactive
16. Media file 4: This is an example of "slow alpha variant." The patient's alpha rhythm at 12 Hz is seen in the second half of the sample. The first half shows a subharmonic at half that frequency, and this is the "slow alpha variant
17. Media file 5: A sample of awake EEG showing the normal or usual amount of beta activity. As shown here, beta activity is often easier to identify during relaxed wakefulness or early drowsiness.
18. Media file 6: Mu rhythm over the left (greater than right) central region. To be absolutely certain that this is a mu rhythm, reactivity should be tested. However, morphology (not absolutely typical but fairly so), frequency, and distribution strongly suggest that this is a mu rhythm
19. Media file 7: An example of a typical normal alpha rhythm, showing clear attenuation upon eye opening (second half of page)
20. Media file 8: This is the normal amount of beta activity, frontally predominant, with waxing and waning amplitude.
21. Media file 9: Alpha rhythm with somewhat "spiky" or sharply contoured morphology. When fragmented (eg, in drowsiness), this can be misinterpreted as sharp waves.
22. ĐIỆN NÃO TRONG GIẤC NGỦ
23. A. Electroencephalography (EEG)
24. Media file 1: The earliest indication of transition from wakefulness to stage I sleep (drowsiness) is shown here and usually consists of a combination of (1) drop out of alpha activity and (2) slow rolling eye movements.
25. Media file 2: Slow rolling (lateral) eye movements during stage I sleep. Like faster lateral eye movements, slow ones are best seen at the F7 and F8 electrodes, with the corneal positivity indicating the side of gaze.
26. B. Sleep stage I EEG sample.
27. Media file 3: On this transverse montage, typical vertex sharp transients are seen. In contrast to K complexes, these are narrow (brief) and more focal, with a maximum negativity at the mid line (Cz and to a lesser degree Fz). These are seen in sleep stages I and II.
28. Media file 4: Vertex waves are focal sharp transients typically best seen on transverse montages (through the midline) and would be missed on this longitudinal bipolar montage if it did not include midline channels (Fz-Cz-Pz). Vertex waves are seen in sleep stages I and II.
29. C. Sleep stage II EEG sample.
30. Media file 6: This shows a K complex, typically a high-amplitude long-duration biphasic waveform with overriding spindle. This is a transverse montage, which shows the typical maximum (manifested by a "phase reversal") at the midline.
31. Media file 5: Positive occipital sharp transients of sleep (POSTS) are seen in both occipital regions, with their typical characteristics contained in their name. They also have morphology classically described as "reverse check mark" and often occur in consecutive runs of several seconds, as shown here.
32. Media file 10: A mixture of spindles (ie, bicentral short-lived rhythmic 14 Hz bursts) and positive occipital sharp transients of sleep (POSTS) can be seen. POSTS occur in stage I, but the presence of spindles is "diagnostic" of stage II.
33. D. Sleep stage III EEG sample.
34. Media file 7: Typical sleep spindles with short-lived waxing and waning 15-Hz activity maximum in the frontocentral regions. Note the associated slow (theta) activity that also characterizes stage II sleep.
35. Media file 8: Vertex sharp transients. This transverse montage illustrates the maximum negativity (manifested by a negative phase reversal) at the midline. The location is similar to that of K complexes, but these are shorter (narrower) and more localized.
36. Media file 11: A mixture of positive occipital sharp transients of sleep (POSTS) and spindles (fronto-central short- lived rhythmic 14-Hz bursts) can be seen.
37. E.Sleep stage IV EEG sample.
38. Media file 13: Slow wave sleep with predominantly delta activity
39. Media file 12: Slow wave sleep with predominantly delta activity, especially in the first half.
40. P. Rapid eye movement sleep EEG sample.
41. Media file 16: In addition to rapid eye movements, this rapid eye movement sleep record is characterized by brief fragments of alpha rhythm (first half) and central saw tooth waves (second half).
42. Media file 17: This is a good example of saw tooth waves seen in rapid eye movement sleep and their "notched" morphology.
43. Media file 15: Typical saccadic eye movements of rapid eye movement sleep are shown, with lateral rectus "spikes" seen just preceding the lateral abducting eye movements.
44. Media file 14: Rapid eye movement sleep with rapid (saccadic) eye movements. While muscle "atonia" cannot be proven without a dedicated electromyogram (EMG) channel, certainly EMG artifact is absent with a "quiet" recording. Also, no alpha rhythm is present that would suggest wakefulness.
45. Media file 18: This is a good example of saw tooth waves seen in rapid eye movement sleep and their "notched" morphology, best seen here in the Cz-Pz (last) channel.
46. Media file 9: K complex, with its typical characteristics: high-amplitude, widespread, broad, diphasic slow transient with overriding spindle. On the longitudinal montage (left), the K complex appears to be generalized. However, the transverse montage clearly shows that the maximum (phase reversal) is at the midline (Fz and Cz).
47. Media file 19: This illustrates the typical appearance of saw tooth waves on a polysomnogram (PSG) display, equivalent to 1 cm/s.
48. EEG bệnh lý