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and smiles, for a slight weakness may be more evident in these circumstances than on movements to command The auditory meati and tympanic membranes should be inspected with an otoscope A 256 double-vibration tuning fork held next to the ear and on the mastoid discloses hearing loss and distinguishes middle-ear (conductive) from neural deafness Audiograms and other special tests of auditory and vestibular function are needed if there is any suspicion of disease of the eighth nerve or the cochlear and labyrinthine end organs (see Chap 15) The vocal cords must be inspected with special instruments in cases of suspected medullary or vagus nerve disease, especially when there is hoarseness Voluntary pharyngeal elevation and elicited re exes are meaningful if there is a difference on the two sides; bilateral absence of the gag re ex is seldom signi cant Inspection of the tongue, both protruded and at rest, is helpful; atrophy and fasciculations may be seen and weakness detected Slight deviation of the protruded tongue as a solitary nding can usually be disregarded The pronunciation of words should be noted The jaw jerk and the snout, buccal, and sucking re exes should be sought, particularly if there is a question of dysphagia, dysarthria, or dysphonia how to upload only pdf file in asp.net c# ASP . NET Document Viewer – Display PDF , Word, Excel & 50+ Other ...
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The ASP . NET MVC PDF Viewer control lets users load, view and print PDF files ... Open and display both normal PDF files and those protected with AES and ... plantar response poses special dif culty because several different re ex responses can be evoked by stimulating the sole of the foot along its outer border from heel to toes These are (1) the quick, high-level avoidance response; (2) the slower, spinal exor nocifensive (protective) re ex ( exion of knee and hip and dorsi exion of toes and foot, triple exion ) dorsi exion of the large toe as part of this re ex is the well-known Babinski sign (see Chap 3); (3) plantar grasp re ex; and (4) support reactions Avoidance and withdrawal responses interfere with the interpretation of the Babinski sign and can sometimes be overcome by utilizing the several alternative stimuli that are known to elicit the Babinski response (squeezing the calf or Achilles tendon, icking the fourth toe, downward scraping of the shin, lifting the straight leg, and others) An absence of the super cial cutaneous re exes of the abdominal, cremasteric, and other muscles are useful ancillary tests for detecting corticospinal lesions . mvc display pdf in view EVO PDF Viewer Control for ASP.NET
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