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Neuro Exam
VM 609 Midterm
69
Veterinary Medicine
Professional
09/17/2012

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Cards

Term
Parts of the Neuro Exam
Definition
mentation
posture and gait
cranial nerves
proprioception
muscle tone, size, spinal reflexes
pain
Term
Four levels of consciousness
Definition
alert
obtunded/dull
stupor
coma
Term
Alert
Definition
normal response to environmental stimuli
Term
Obunded/Dull
Definition
drowsiness and less responsive to external stimuli
Term
Stupor
Definition
state of unconsciousness and can only be aroused by painful stimulus
Term
Coma
Definition
state of unconsciousness and cannot be aroused by any stimulus including pain
Term
Level of Consciousness Control
Definition
primarily by ascending reticular activating system (ARAS)
rarely diffuse cerebral diseases
Term
Mentally Inappropriate/Dementia Lesion Location
Definition
lesion in cerebrum or thalamus
Term
Cerebrum/Thalamus Lesion Signs
Definition
abnormal cognition or loss of self awareness
wander aimlessly, headpress, other
often recognized by owner
Term
Head Tilt
Definition
rotation of the transverse plane of the head
Term
Head Tilt Lesion Location
Definition
Vestibular Lesion (peripheral or central)
Term
Vestibular Lesions
Definition
ipsilateral to lesion
head tilt
Term
Head Turn
Definition
rotation of the nose with the transverse plan of the head remaining perpendicular to the ground
Term
Head Turn Lesion
Definition
cerebral lesion
always ipsilateral to the lesion
may be associated with circling
Term
Pleurothotonus
Definition
head turn and body turn
always ipsilateral to the lesion
Term
Cerebral Lesion Signs
Definition
always ipsilateral to lesion
hemi-inattention/hemi-aversion
circling towards lesion
head turn and body turn
Term
Kyphosis
Definition
dorsal curvature of the spine
Term
Lordosis
Definition
ventral curvature of the spine
Term
Sciolosis
Definition
lateral curvature of the spine
Term
Torticollis
Definition
twisting of the neck
Term
Decerebrate rigidity
Definition
brainstem lesion
opistotonus with extensor rigidity of all limbs
Term
Decerebellate rigidity
Definition
acute cerebellar lesion normal mentation
opistotonus with flexion of the hips
Term
Shiff Sherrington posture
Definition
lesion of TL spine
have normal reflexes
inactivation of border cells
acute injury
Term
Paresis
Definition
weakness
Term
Types of Ataxia
Definition
vestibular
cerebellar
proprioceptive
Term
Vestibular Ataxia
Definition
leaning and falling to one side
rolling, listing, crab walking
may see head tilt and nystagmus
Term
Cerebellar Ataxia
Definition
inability to regulate the rate and range of movement
dymetria
impaired ability to control distance, power, speed
hypermetria-longer protraction phase of gait
hypometria-shorter protraction phase of gait
goose-stepping
accompanied by head tremors
Term
Proprioceptive Ataxia
Definition
clusmy and incoordinated
wide based stand and swinging gait
due to loss of sense of limb and body position
interruption of ascending proprioceptive pathway
Term
Diencephalon
Definition
CN 1 and 2
Term
Midbrain
Definition
CN 3 and 4
Term
Pons
Definition
CN 5
Term
Medulla
Definition
CN 6-12
Term
Menace Response
Definition
Afferent CN2
goes to contralateral cerebrum
comes into ipsilateral cerebellum to move head away
efferent CN 7 facial
Term
Fundic Examination
Definition
only way to visual nervous system
and vascular system
Term
Pupillary Light Reflex
Definition
affecter CN 2 to pretectal nucleus
efferent from Edinger Westphal nucleus to CN 3
Term
Anisocoria
Definition
unequal pupil size
Term
Sympathetic NS Tract to Eye
Definition
Hypothalamus to
thoracic sympathetic trunk
to cranial cervical ganglion
axons through middle ear cavity
to the pupillary dilator muscle and smooth muscle in orbit, eyelids
Term
Horner's Symptoms
Definition
ptosis
miosis
enophthalmaus
elevation of 3rd eyelid
may see congestion of bulbar conjunctiva in dogs
due to lack of vasoconstriction
Term
Cattle, Sheep, Goat Horners
Definition
ptosis
hyperthermia of ear
miosis
elevation of third eyelid
less sweating of nasal planum
excessive sweating in horses in denervated area
Term
Trantenstorial herniation
Definition
hernation through the tentorium membrane
increased pressure caused by mass lesion can cuase this
subsequent cerebellar tonsillar herniation
Term
Palpebral Reflex
Definition
afferent CN 5
lateral canthus maxillary branch
medial canthus olfactory branch
efferent CN 7
most reliable test for CN 7
Term
Corneal Reflex
Definition
afferent CN5 opthalmic branch
efferent CN 6 and CN 7
Term
Vestibular-Ocular Reflex
Definition
move head with something movement
efferent VN 8 (vestibular)
brainstem vestibular nuclear and cerebellum
afferent CN 3, 4, and 6
Term
Nystagmus
Definition
involuntary rythmic eye movement
fast away from the lesion
slow toward the lesion
Term
Jerk Nystagmus
Definition
slow phase in one direction with rapid recovery phase to return
resting
positional
Term
Pendular Nystagmus
Definition
small oscillations of the eyes with no slow of fast components
lesion in cereblleum or visual cortex
can be normal in some purebred cat breeds (Himalayan, Persian, Siemese)
Term
Strabismus
Definition
eye position
positional or resting
Term
Nasal Sensation Pathway
Definition
afferent CN 5 sensory maxillary and opthalmic
efferent CN 7
abnormal in one side but not the other can be a cerebral lesion
Term
Swallowing/Gag Reflex
Definition
afferent CN 9 and 10
efferent CN 9, 10, 11
palpate hyoid bone or stimulate pharynx with finger
Term
Tongue Movement and Tone
Definition
CN 12
may see unilateral atrophy of tongue
Term
Conscious Proprioception
Definition
happens at the level of the cerebrum
actually subconscious
Term
Placing Reponses
Definition
need to support weak patients but not too much
cats shouldn't let you put the paw on the table
dogs shouldn't stayed knuckled over
Term
Placing Deficit Lesion
Definition
contralateral cerebrum
ipsilateral brainstem
crosses at medulla
ipsilateral spinal cord segments
Term
Spinal Reflexes
Definition
test integrity of sensory and motor components of reflex arc
Term
Using Hammer
Definition
flat edge of hammer for tendon
tip of hammer for muscle belly
Term
Perineal Reflex
Definition
pudendal nerves S1,2,3
Term
Anal Reflex
Definition
pudendal and caudal rectal nerves
Term
Panniculus Reflex
Definition
tests lateral thoracic nerve and C8-T1 spinal cord segments
absent in 1-2 spaces caudal to lesion
can be normally absent in cats
Term
Detection of Nociception
Definition
test for deep pain sensation
looking for recognition of pain not the reflex
needs to reach cerebrum
flex the limb before eliciting painful stimulus
Term
Cerebrum Lesion Signs
Definition
mentation-behavior
head turn and circling
contralateral menace deficits
abnormal nasal sensation
proprioceptive contralateral deficits
normal spinal reflexes and tone
possible pain over calvarium
Term
Cerebellum Lesion Signs
Definition
normal mentation
cerebellar ataxia, hypermetria, dysmetria, intention tremors
ipisilateral menace deficits
normal proprioception
normal spinal reflexes and tone
pain possibly over calvarium
Term
Brainstem Lesion Signs
Definition
alterations in level of consciousness
head tilt ipsilateral
proprioceptive ataxia and/or vestibular ataxia
possible multiple cranial nerve deficits
ipsilateral proprioceptive deficits
normal or increased spinal reflexes/tone in all 4 limbs
possible pain over calvarium
Term
C1-C5 Spinal Cord Lesion Signs
Definition
normal mentation
paresis/plegia
long strided gait in all 4 limbs
proprioceptive ataxia
Horner's ipisilateral
thoracic and pelvic limb proprioceptive deficits
normal to increased thoracic limb reflexes
normal or increased pelvic limb reflexes
possible pain over spine
Term
C6-T2 Spinal Cord Lesion Signs
Definition
normal mentation
short strided in thoracic limbs and long strided in pevlic limbs
proprioceptive ataxia
Horner's ipisilateral
thoracic limb and pelvic limb proprioceptive deficits
normal to absent thoracic spinal reflexes
normal to increased pelvic limb reflexes
possible pain over spine
Term
T3-L3 Spinal Cord Lesion Signs
Definition
normal mentation
normal thoracic limb giat
paresis/plegia in pelvic limbs
normal cranial nerves
thoracic limb normal proprioception
pelvic limb proprioceptive deficits
thoracic limb normal spinal reflexes
normal to increased pevlic limb spinal reflexes
pain possible over spine
panniucl cuts off 1-2 segments caudal to lesion
increased tone to bladder
Term
L4-S3 Spinal Cord Lesion Signs
Definition
normal mentation
normal thoracic limb giat
paresis/plegia in pelvic limbs
normal cranial nerves
thoracic limb normal proprioception
pelvic limb proprioceptive deficits
thoracic limb normal spinal reflexes
normal to increased pevlic limb spinal reflexes
pain possible over spine
panniculus cuts off 1-2 segments caudal to lesion
decreased tone to bladder
decreased to absent anal tone
Term
Peripheral Nerve Lesion Signs
Definition
decreased hopping due to weakness
unable to swallow
sensory nerve deficit
muscle atrophy
normal to absent spinal reflexes
Term
Muscle Disease Signs
Definition
normal mentation
short strided gait
paresis/plegia
normal cranial enrves
normal placing but decreased hopping
muscle atrophy
Term
Junctionopathies Signs
Definition
normal mentation
exercise intolerance
may see one or mutliple nerves
normal placing but possible decreased hopping
normal or decreased to decrementing spinal reflexes
no pain
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