{"id":61,"date":"2017-02-24T12:57:02","date_gmt":"2017-02-24T12:57:02","guid":{"rendered":"http:\/\/neurous.dk\/?page_id=61"},"modified":"2018-07-02T13:24:52","modified_gmt":"2018-07-02T13:24:52","slug":"vii-n-facialis","status":"publish","type":"page","link":"https:\/\/neurous.dk\/?page_id=61","title":{"rendered":"VII. N. FACIALIS"},"content":{"rendered":"<p>Den prim\u00e6re funktion er ansigtets mimiske muskulatur. Den \u00f8vre del af kernen innerverer pandens muskulatur og er dobbelt kortikalt innerveret (modtager 1. neuron fra begge hemisf\u00e6rer), mens den nedre del af kernen innerverer den nedre del af ansigtet og kun modtager krydsede fibre fra modsige hemisf\u00e6re. Nerven innerverer m. stapedius i indre \u00f8re (stapediusrefleks). Udover motorisk funktion har nerven parasympatisk innervation til t\u00e5rekirtel og spytkirtler (gl. submandibularis og sublingualis), smag p\u00e5 forreste 2\/3 af tungen.<\/p>\n<p><strong>Unders\u00f8gelse<\/strong><br \/>\nM. orbicularis oculi vurderes ved at bede patienten knibe \u00f8jnene maksimalt sammen og s\u00e5 fors\u00f8ge at \u00e5bne dem mod modstand. Det kan man normalt ikke, heller ikke hos en \u00e6ldre kooperende patient.<\/p>\n<p>M.orbicularis oris unders\u00f8ges ved at bede patienten vise t\u00e6nder og ved at vurdere kraften i de oppustede kinder og kraften ved maksimalt sammenknipning af l\u00e6berne.<\/p>\n<p><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/249798304?app_id=122963\" width=\"1440\" height=\"810\" frameborder=\"0\" title=\"Unders&oslash;gelse af den motoriske funktion af n. facialis\" webkitallowfullscreen mozallowfullscreen allowfullscreen><\/iframe><\/p>\n<p>&nbsp;<\/p>\n<span class=\"collapseomatic \" id=\"id6a780f3fa80e5\"  tabindex=\"0\" title=\"<strong>Central eller perifer parese<\/strong>\"    ><strong>Central eller perifer parese<\/strong><\/span><div id=\"target-id6a780f3fa80e5\" class=\"collapseomatic_content \">\n<\/span>Ved 1. neurons l\u00e6sion ses s\u00e5ledes kun affektion af kontralaterale nedre del af ansigtet (central facialisparese), mens affektion af selve nerven medf\u00f8rer lammelse af hele ansigtet ipsilateralt.<\/p>\n<p>Ved perifer affektion ses nedsat kraft i m. orbicularis oculi og ved betydelig parese manglende \u00f8jenlukning med opaddrejning af \u00f8jet (Bells f\u00e6nomen). Desuden kan ses lammelse af stapediusrefleksen medf\u00f8rende hyperacusis.<\/p>\n<p>Udover den motoriske funktion innerverer facialis parasympatisk gl. lacrimalis og glandula parotis.<\/p>\n<p>Ved perifer facialisparese b\u00f8r abducensfunktionen testes mhp l\u00e6sion i pons, da kernerne for disse 2 nerver ligger meget t\u00e6t p\u00e5 hinanden. . Man b\u00f8r sp\u00f8rge til udsl\u00e6t og fl\u00e5tbid (neuroborreliose) ligesom tumor i parotis b\u00f8r unders\u00f8ges.<\/p>\n<p>Ved bilateral perifer facialisparese b\u00f8r Miller-Fishers variant af Guillain Barr\u00e9, sarkoidose, borrelia, myasthenia gravis, facioscapulohumeral muskeldystrofi, ALS, HIV, syfilis og lignende overvejes, se [Campbell 2013].<\/div>\n<p>&nbsp;<br \/>\n<span class=\"collapseomatic \" id=\"id6a780f3fa8101\"  tabindex=\"0\" title=\"<strong>Referencer<\/strong>\"    ><strong>Referencer<\/strong><\/span><div id=\"target-id6a780f3fa8101\" class=\"collapseomatic_content \">\n<strong>Campbell WW. <\/strong><em>DeJong\u2019s The neurologic Examination. <\/em>Seventh Edition. Wolters Kluwer; Lippincott, Williams and Wilkins, Philadelphia 2013:1-818.<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Den prim\u00e6re funktion er ansigtets mimiske muskulatur. Den \u00f8vre del af kernen innerverer pandens muskulatur og er dobbelt kortikalt innerveret (modtager 1. neuron fra begge hemisf\u00e6rer), mens den nedre del af kernen innerverer den nedre del af ansigtet og kun modtager krydsede fibre fra modsige hemisf\u00e6re. Nerven innerverer m. stapedius i indre \u00f8re (stapediusrefleks). UdoverContinue reading &rarr;<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-61","page","type-page","status-publish","hentry","no-thumb"],"_links":{"self":[{"href":"https:\/\/neurous.dk\/index.php?rest_route=\/wp\/v2\/pages\/61","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/neurous.dk\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/neurous.dk\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/neurous.dk\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/neurous.dk\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=61"}],"version-history":[{"count":7,"href":"https:\/\/neurous.dk\/index.php?rest_route=\/wp\/v2\/pages\/61\/revisions"}],"predecessor-version":[{"id":912,"href":"https:\/\/neurous.dk\/index.php?rest_route=\/wp\/v2\/pages\/61\/revisions\/912"}],"wp:attachment":[{"href":"https:\/\/neurous.dk\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=61"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}