Term
| What are the advantages of the neurologic exam? |
|
Definition
-helps determine if neuro dz even exists
-defines abnormal clinical signs
-localization of syndrome
-asses severity of dysfunction
-arrive at a tentative diagnosis
-may provide a prognosis |
|
|
Term
| What equipment do you need for a neuro exam? |
|
Definition
-reflex hammer
-penlight
-neddle, hemostat
-squeaky toys |
|
|
Term
| Once the neuro exam is finished, attempt to have one location explain all f the neurologic deficits. If this can't be done, then what? |
|
Definition
| -diffuse or multifocal nervous system disease exists |
|
|
Term
| What do you evaluate ina neuro exam? |
|
Definition
-mentation
-gait/posture
-postural test rxns
-cranial nerve exam
-myotatic reflexes |
|
|
Term
| What are the 5 levels of conciousness in ascending order? |
|
Definition
| -normal => obtunded (depressed) => hysteria => stupor => comatose |
|
|
Term
| what is the difference between a stuporous patient and a comatose patient? |
|
Definition
-stupor: can be aroused with noxious stimulus
-comatose: cannot be aroused by noxious stimulus |
|
|
Term
| As a general rule, what part(s) of the nervous system is/are responsible for metation changes? If there are alternating levels of consiousness, what does it suggest? |
|
Definition
-cerebral and/or brainstem
-metabolic dz |
|
|
Term
| What are the common mentation changes that occur due to a frontal lobe lesion? |
|
Definition
| -head pressing, demented, loss of learned behavior, pace compulsively, get lost in forners, doesn't recognize owner |
|
|
Term
| What are the common mentation changes that occur due to temporal lobe lesions? |
|
Definition
|
|
Term
| What are the common mentation changes that occur due to temporal lobe lesions? |
|
Definition
| -sleepy, stupor, or comatose |
|
|
Term
| What does a head tilt suggest? |
|
Definition
| -unilateral vestibular lesion |
|
|
Term
| What does head bobbing/ head tremor suggest? |
|
Definition
|
|
Term
| What does truncal curvature suggest? |
|
Definition
| -vestibular dz on the side of the lesion |
|
|
Term
| How do you assess gait and locomotion? |
|
Definition
-allow animal to move about freely, preferably unleashed on a non-slippery surface
-walk and run animal if deficits are subtle
-turn animal in circles |
|
|
Term
| In quadrupeds, gait is initiated in what part of the brain? |
|
Definition
|
|
Term
| What does the cerebellum do? |
|
Definition
|
|
Term
| What does the vestibular system do? |
|
Definition
| -maintains body posture and balance |
|
|
Term
| What does the spinal cord do? |
|
Definition
| -acts as a conduit for the brainstem, cerebellum, and vestibular system |
|
|
Term
| True or False: Cerebral cortex and diencephalon lesions often cause a gait abnormality. |
|
Definition
| -FALSE, lesions from caudal midbrain down (midbrain, medulla, spinal cord, PNS) cause gait abnormalities; also cause ipsilateral paresis |
|
|
Term
| The anatomic landmark for focal lesions that produce ipsilateral hemiparesis with gait abnormalities is in the _______. |
|
Definition
|
|
Term
Describe the gait abnormalities regarding the following locations:
a) cerebral diencephalon
b) mid-brain, pons, medulla
c) cerebellum
d) spinal cord
e) PNS |
|
Definition
a) no weakness, no gait abnormalities
b) ipsilateral weakness
c) no weakness, dysmetrias
d) ipsilateral, teta, paraparesis
e) monoparesis |
|
|
Term
|
Definition
|
|
Term
|
Definition
| -no voluntary movement, paralysis |
|
|
Term
| Definition: monoparesis/plegia |
|
Definition
| -weakness/paralysis in a single limb |
|
|
Term
| Definition: Hemiparesis plegia |
|
Definition
| -weakness/paralysis involving the throacic and pelvic limb of same side |
|
|
Term
| Definition: Paraparesis/ plegia |
|
Definition
| -weakness/paralysis in the pelvic limbs |
|
|
Term
| Defintion: Tetraparessi/plegia |
|
Definition
| -weakness/paralysis in all 4 limbs |
|
|
Term
|
Definition
| -a form of dysmetria where the animal overshoots with muscle movements |
|
|
Term
| Do frontal lobe lesions cause wide or narrow circles? What about vestibular lesions? |
|
Definition
|
|
Term
| Does the animal circle toward or away from the lesion? |
|
Definition
|
|
Term
|
Definition
| -inability to regulate the range, rate, and force of movement |
|
|
Term
| What are the dysetric signs of cerebellar involvement? |
|
Definition
| -hypermetira, truncal ataxia, head tremors, intention tremors |
|
|
Term
|
Definition
| -defined by degrees of difficulty supporting weight and the gait varies from slightly shortened to complete inability to support weight |
|
|
Term
|
Definition
| -delay in the protractionphase or swing pahse of the gait |
|
|
Term
| What is in the ventral horn? |
|
Definition
|
|
Term
| What are the postural tests? Which are most repeatable? |
|
Definition
-lateral hopping
-dorsal knuckling
-placing
-hemiwalking
-wheelbarrowing
-backwards stepping
-Most repeatable: knuckling and hopping |
|
|
Term
| What are the uses of postural tests? |
|
Definition
-detect subtle neuro deficits in patients htat have minimal abnormalities in gait
-assess for asymmetry
-localistion of lesion to cerebrum or diencephalon when the gait is normal
-in and by themselves they are not localizing |
|
|
Term
| What must be intact for animal to perform postural tests? |
|
Definition
| -everything from tip of toes to cerebral cortex: peripheral n + spinal cord + brainstem + midbrain + diencephalon/thalamus + cerebral cortex |
|
|
Term
| All sensory info crosses sides at the ______. |
|
Definition
|
|
Term
| What are the components of a reflex arc? |
|
Definition
| -sensory organ + dorsal root/ganglion + dorsal horn + ventral horn/root + peripheral nerve + muscle/myoneural junction |
|
|
Term
| What are the parts of the LMN unit? |
|
Definition
| -ventral horn + ventral root + peripheral nerve + NMJ/muscle |
|
|
Term
| True or False: A reflex will not occur if the spinal cord is broken. |
|
Definition
| -FALSE, will still occur as long as the reflex arc is intact |
|
|
Term
| What spinal cord segments control the biceps reflex? |
|
Definition
|
|
Term
| What spinal cord segments control the triceps reflex? |
|
Definition
|
|
Term
| The TL withdrawal reclex utilizes what nn? |
|
Definition
| -axillary, musculocutaneous, median, ulnar in C5-T1 |
|
|
Term
| What cord segments are for patellar reflex? |
|
Definition
|
|
Term
| What cord segments are for PL withdrawal reflex (sciatic n)? |
|
Definition
|
|
Term
| What cord segments are fore anal reflex? |
|
Definition
|
|
Term
| Where do the UMN cell bodies originate? |
|
Definition
| -cerebral cortex, brainstem |
|
|
Term
| What are the functions of the UMN system? |
|
Definition
-keep tone in extensor mm
-keep posture correct
-initiate voluntary motor movement
-have inhibitory influence on LMN |
|
|
Term
| Where is the origin of the LMN cell bodies? |
|
Definition
| -nuclei of CN's and ventral horns of sppinal cord |
|
|
Term
| What are the functions of the LMN system |
|
Definition
-carry out function of cranial nerves
-carry out function for a specific msucle/reflex |
|
|
Term
| What are the clinical signs for LMN damage? |
|
Definition
-LMN damaged in brainstem, ventral horn, or peripheral n
-hyporeflexia/areflexia + hypotonia + severe and rapid muscle atrophy + paresis to paralysis |
|
|
Term
| What are the clinical signs for UMN damage? |
|
Definition
| -hyperreflexia + excessive tone (spascticity) + slow and gradual muscle atrophy + paresis to paralysis |
|
|
Term
| What lives in L5-S3 (lumbosacral) cord segments? What are the signs of a lesion here? |
|
Definition
-LMNS for rear limbs, tail, anus, and bladder
-poor patella/gastroc/withdrawal/anal reflexes (LMN signs to PL) |
|
|
Term
| What is located in T3-L4 (thoracolumbar) cord segments? What are the signs of a lesion here? |
|
Definition
-UMN coming from brain
-hyperreflexia and spasticity |
|
|
Term
| What lives in C6-T2 (cervicothoracic) cord segments? What are the signs of a lesion here? |
|
Definition
-LMNs to fron limbs and UMN for PL
-LMN to TL (paresis etc) and UMN to rear (hyperreflexia/spasticity) |
|
|
Term
| What is located in C1-C5 (cervical) cord segments? What are the signs of a lesion here? |
|
Definition
-UMNs for TL and PL
-UMN signs (hyperreflexia/ spasticity) for PL and TL |
|
|
Term
| What lives in brainstem? What are the signs of a lesion here? |
|
Definition
-cranial nerve nuclei and UMN
-LMN to cranial nn and UMN to TL and PL |
|
|
Term
| What needs to be intact for UMN signs to be manifested upon neuro exam when an UMN lesion is present? |
|
Definition
| -LMN unit; without it, there could be no reflexes to show hyperreflexia |
|
|
Term
| If a patient had both a LMN and UMN lesion to rear limbs, which signs would you see? |
|
Definition
|
|
Term
| When the spinal cord is injured, there is a consistent progression to the functional loss of neural activity. Outline this progression from least to most injury. |
|
Definition
| Mild ataxia/proprioception loss => mild motor weakness => nonambulatory paresis => paraplegia => loss of deep pain perception |
|
|
Term
| True or False: Voluntary motor is always lost after deep pein in the case of spinal cord injury. |
|
Definition
| -FALSE, voluntary motor is always lost first |
|
|
Term
| Do we have good or poor prognosis with lost of deep pain? |
|
Definition
|
|
Term
| How do we assess deep pain perception? |
|
Definition
-toe pinch with hemostats
-check for a sensory band
-hemostat clamped on anus
-diminished panniculus reflex
-look for response |
|
|
Term
| A positive withdrawal reflex (does/does not) equal pain perception. |
|
Definition
|
|
Term
| What is a sensory band? How do we evaluate it? |
|
Definition
-when you can draw a ring around the anima's trunk where caudal to the ring the animal is anesthetic and cranial to it the animal has goodd pain perception
-walk up the body on the dorsal and ventral surfaces with hemostats to assess it |
|
|
Term
| Which cranial nn innervate the extraocular muscles? |
|
Definition
|
|
Term
| What is CNII? What does it do? |
|
Definition
-Optic nerve
-afferent for vision, PLRs, menace rescponse |
|
|
Term
What percentage of retinal fibers cross at the optic chiasm in the following species:
a) cat
b) dog
c) horse |
|
Definition
|
|
Term
| What is CN III? What does it do? How do we test it? |
|
Definition
-Oculomotor n
-constricts to pupil and motor to extraocular mm
-test PLRs direct ro indirect |
|
|
Term
| What CN innervates the lateral rectus? If broken, what signs will you see? |
|
Definition
-CN 6
-you will see medial strabismus if an issue |
|
|
Term
| What CN innervates the dorsal oblique? If broken, what signs will you see? |
|
Definition
-CN4
-dorsomeial strabismus |
|
|
Term
| What is CNV? What does it do? If broken, what are the signs? |
|
Definition
-Trigeminal n
-sensory to face/gums/cornea/nose & motor to mm of mastication
-see lack of reflexesw, dropped lower jaw, muscle atrophy |
|
|
Term
| What is CN VII? What does it do? How do you test it? |
|
Definition
-facial n
-motor to mm of facial expression & taste to anterior 2/3 of tongue
-test with menace and palpebral |
|
|
Term
| What is CNVIII? What does it do? If broken, what do you see? |
|
Definition
-Vestibular
-hearing and balance
-circling, head tilt, ataxia, etc |
|
|
Term
| What are the two divisions of vestibular function? |
|
Definition
| -central vestibular (brainstem) and peripheral vestibular (inner ear) |
|
|
Term
| What are tonic eye movements? How are they clinically relevant? |
|
Definition
-the initial slow deviation of the eye in the opposite direction as the movement of the ehad
-used to asses vestibular function |
|
|
Term
| What are some clinical signs of vestibular dysfunction? |
|
Definition
| -lack of tonic eye movements, head tilt, circling, falling to one side, truncalcurvature, tolling, nystagmus |
|
|
Term
| What four ways do we classify nystagmus? |
|
Definition
-direction
-spontaneous or induced
-horizontal, rotary, or vertical
-is the type changing? |
|
|
Term
|
Definition
| -static change of position of the globe within the eye |
|
|
Term
|
Definition
| -dynamic change in position of the globe |
|
|
Term
| Compare and contrast Centraland Peripheral Vestibular dysfunction. |
|
Definition
-Central: all types of nystagmus seen, can be changing, no weakness, postural tests are normal
-Peripheral: horz or rotary nystagmus, spontaneous, not changing, may see wekness, poor postural test rxns |
|
|
Term
|
Definition
-CN II = diencephalon/thalamus
-CNIII = mid-brain
-CN V-XII = medulla |
|
|
Term
| What is the vertebral location of sacrococcygeal syndrome? |
|
Definition
|
|
Term
| What nn are involved in sacrococcygeal syndrome? Clinical signs? |
|
Definition
-sacral and coccygeal
-LMN to tail, bladder, anus |
|
|
Term
| What are the clinical signs of cerebellar syndrome? |
|
Definition
| -no weakness, intention tremors, hyypermetria, truncal ataxia, generalized ataxia, central vestibular signs |
|
|
Term
| What motor deficits and mentation changes are associated with mid-brain syndrome? |
|
Definition
-Motor deficits: UMN paresis/plegia to the front and rear with poor PLRs/mydriasis, anisocoria worse in light
-Mentation changes: lethargy, stupor, coma |
|
|
Term
| What are the clinical signs of diencephalon syndrome. |
|
Definition
| -minimal weakness, contralateral deficits in lieu of normal gait, blindness with or without PLR deficits, mentation changes |
|
|
Term
| What are the clinical signs associated with cerebral syndrome? |
|
Definition
| -minimal wekness, contralateral postural deficits with normal gait, mentation changes (seizures, pacing, loss of training) blindness wiht normal PLRs |
|
|
Term
| What are the clinical signs of polyneuropathy syndryome? |
|
Definition
-generalized weakness of all four limbs
-diminished to absent tendon reflexes
-rapid muscle atrophy
-hypotonia |
|
|
Term
| What are the clinical signs of Polynyopathy syndrome? |
|
Definition
-generalized weakness of all four limbs
-good tendon reflexes
-stiff stilted gait
-muscle pain
-excercise intolerance |
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