Term
| Objectives of neurologic examination of large animals. |
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Definition
1. to establish that neurological disease actually exists
2. to determine if it is primary or secondary neurological disease
3. determine the anatomic location of the lesion in the nervous system
4. select appropriate diagnostic aids to determine definitive diagnosis
5. to establish a prognosis |
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Term
| Steps for making neurologic diagnois: |
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Definition
1. signalment
2. history
3. PE
4. neurological exam
5. diagnostics-rads, CSF collection |
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Term
| Perspective on neurological disease in ruminants |
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Definition
1. accurate diagnosis and management of CNS cases in cattle is difficult
2. obligation to make most accurate diagnosis possible
-zoonotic dz
-treatable dz
-nontreatable dz
-preventable dz
**Note: rabies should be on list for everything |
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Term
| Clinical signs of lesion in cerebral cortex. |
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Definition
1. mental status change
2. bizarre and inappropriate behavior
3. seizures |
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Term
| Clinical signs of lesion in basal ganglia. |
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Definition
| 1. Change in coordinated motor movement such as eating/drinking |
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Term
| Name all of the cranial nerves |
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Definition
I-Olfactory
II-Optic
III-Oculomotor
IV-Trochlear
V-Trigeminal
VI-Abducens
VII-Facial
VIII-Vestibulocochlear
IX-Glossopharyngeal
X-Vagus
XI-Accessory
XII-Hypoglossal |
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Term
| Rostral brainstem includes which cranial nerves and is responsible for what? |
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Definition
-CN: II, III, and IV
-reticular formation: consciousness
-visual pathways:
-menace response (test of vision)
-PLR
-Anisoscoria
-Horner's Syndrome |
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Term
| Name four hallmarks of Horner's Syndrome in horses: |
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Definition
1. mydriasis
2. enophthalmos
3. sweating
4. ptosis |
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Term
| Cranial nerves II, III, IV, and VI |
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Definition
1. Menace response (II)
2. position of the pupil (III, IV, VI)
3. ulceration of cornea (VII)
4. abnormal movement, nystagmus (VIII) |
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Term
| Rostral brain stem cranial nerves: |
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Definition
| -trochlear nerve (CN IV)-strabismus: static movement of pupil |
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Term
| Caudal brainstem cranial nerves: |
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Definition
1. trigeminal (V)-motor: inability to chew, dropped draw; sensory: sensation to the head
2. facial nerve (VII)-peripheral (lip/nose only); central (ear droop, corneal ulcers, muzzle pull)
3. vestibulocochlear nerve (VIII)-control balance, nystagmus, head tild, leaning to one side, deafness
4. glossopharyngeal n (IX) + vagus (X) + accessory n (XI)-paralysis of pharynx and larynx
5. Hypoglossal n (XII)-muscle of the tongue |
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Term
| If a lesions is on the right side of the face (right facial nerve) the muscle will be deviated to which side? |
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Definition
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Term
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Definition
-coordinates voluntary motor movement
-clinical signs of spasticity
-dysmetria
-intention tremors of the head
-loss of the menace response |
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Term
| Components of neurologic exam: |
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Definition
1. behavior, mentation
2. cranial nerve function
3. muscle mass/symmetry
4. cutaneous trunci reflex
5. (foals, calves, patellar reflex)
6. anal tone, tail tone, sensation of perineum
7. gait analysis
8. neck flexsion to right and left (should be able to reach nose to shoulder)
9. panniculus response-> sensory input from skin to spinal cord forward to T2 to motor nerve for cutaneous trunci
10. placement reactions (proprioception) |
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Term
| Components of neurologic exam (II): |
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Definition
11. walking in a straight line
12. walking with head elevated
13. walking up an incline (exaggerates upper motor neuron signs particularly of forelimbs; more hypermetria, ataxia)
14. walking up curbs (coordination, weakness, conscious proporioception)
15. backing (coordination)
16. circling (circumduction, interference, pivoting, knuckling, neck flexion)
17. tail pull |
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Term
| Localizing a lesion to spinal cord: assessment of gait and posture |
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Definition
1. motor cortex
2. brainstem
3. spinal cord
4. peripheral n
5. muscle function |
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Term
| Components of neruologic gait include: |
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Definition
1. paresis or weakness
2. proprioceptive deficit or ataxia
3. dysmetria (hypermetria, hypometria)=lack of coordinated movment
4. each limb must be evaluated
5. weakness
6. ataxia |
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Term
| Define hypometria and hypermetria |
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Definition
-hypometria=stiff movement, little flexion of the joints
-hypermetria=increased range of movment |
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Term
| List signs of weakness in the gait: |
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Definition
-dragging the limbs
-worn hooves
-low arc to the swing phase of the stride |
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Term
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Definition
-irregularly irregular
-poor coordination
-swaying from side to side
-weaving of the affected limbs
-abducted or adducted foot placement
-circumduction when turning |
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Term
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Definition
1 (subtle)
2 (mild)
3 (moderate)
4 (severe)
5 (recumbent) |
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Term
| Ataxia due to to compressive lesions: |
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Definition
-is usually bilaterally symmetrical
-but equine protozoal myeloencephalitis, WNV, and cauda equina neuritis may have assymetric limb involvement |
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Term
| Lower motor neuron signs related to neurologic gait analysis correspond to which type of reflexes and muscle response |
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Definition
-reflexes: hyporeflexia (areflexia)
-muscles: hypotonic, marked neurogenic atrophy, EMG abnormalities (after 5 days), WEAKNESS |
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Term
| Upper motor neuron signs related to neurologic gait analysis correspond to which type of reflexes and muscle responses |
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Definition
-reflexes: normal-hyperreflexia
-muscles: hypertonic, mild disuse atrophy, no EMG changes, ATAXIA |
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Term
| Spinal cord location of lesion corresponding to clinical signs |
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Definition
1. (C1-C6)=> ataxia, weakness, all four limbs, worse in rear; hyperreactive reflexes
2. (C6-T2): ataxia, weakness (forelimbs severely affected); depressed forelimb reflexes
3. (T2-L3)-normal forelimbs: ataxia and weakness in hindlimbs
4. (L4-S2)-normal forelimbs, ataxia, paresis near limbs
5. (S1-S3)-distended bladder, dilated anus, loss of tail tone |
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Term
| Lesions of peripheral nerves: |
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Definition
-usually unilateral loss of muscle tone cutaneous sensatio
-usually limited to one or two nerves (differentiate from musculoskeletal disease)
-diffuse PNS: occur with metabolic, toxic, and degenerative insults |
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Term
| Diseases of the peripheral nerves: suprascapular nerve |
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Definition
-innervates: suprapinatus and infraspinatus muscles
-result of damage: atrophy of the muslce
-clinically: abduction of limb during forward motion; little lameness observed
-Notes: spine of scapula, prominent shoulder joint, "sweeney" |
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Term
| Diseases of the peripheral nerves: |
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Definition
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Term
| Disease of the peripheral nerves: radial nerve |
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Definition
-innervation: extension of elbow, carpus, digits
-result of damage: extensor paralysis
-clinically: dropped elbow (loss of triceps function), flexion of limb usually carried due to lack of carpal extension |
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Term
| Disease of peripheral nerves: median/ulnar nerve |
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Definition
-innervates: flexors or carpi and digits
-result of damage: flexor paralysis
-clinically: lower limb in hyperextension walks as if hypermetric or stands with sawhorse stance |
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Term
| Diseases of peripheral nerves: obturator nerve |
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Definition
-innervation: adductor muscles of hindlimbs
-rest of damage: abduction of hind limb unilaterally or bilaterally
-clinically: historically, associated with calving paralysis of the sciatis, i.e. the peroneal nerve |
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Term
| Diseases of peripheral nerves: femoral nerve |
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Definition
-innervation: extensors of stifle
-result of damage: paralysis of quadriceps, muscles not weight bearing by stifle joint, limb flexed and toe dragged |
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Term
| Disease of peripheral nerves: sciatic nerve paralysis |
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Definition
| -leads to inability to place limb correctly or bear weight |
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Term
| Ancillary diagnostic tests: |
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Definition
-cerebrospinal fluid analysis: lumbosacral tap, performed best standing, parameters (cytology; ck, protein, glucose; viral titers (EEE, WEE, WNV, EHV); western blot for EPM)
-atlanto-occipital collection requires anesthetized patient
-plain radiographs (skull, cervical thoracic spinal cord)
-myelogram (compressive cervical spinal cord lesions)
-CT and MRI (skull)
-electromyography
-electroencephalography
-BAER=brainstem auditory evoked potential in a normal adult (Waves I, III, and V are labeled) |
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