Term
What reflex arc can we place the following symptoms:
Acute onset paraplegia;
No CP reflexes in R forelimb (limp);
Some Horner's signs (droopy R eye)
Hemiparesis on R side (front R limb is affected more than the R hindlimb) |
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Definition
C7-T2
Symptoms of FCE (Fibrocartilagenous Embolization) |
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Term
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Definition
Ventral spinal arteries are in greater number in cervical and lumbar areas;
Fibrocartilage found in the veins, access the artery by retrograde propultion;
Schmorl's nodules;
Fibrocartilage is a product of a hypertrophied endothelial cell; |
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Term
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Definition
Rule out other DDX!
Rads may look normal
Myelography (may show cord swelling in 41%) |
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Term
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Definition
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Term
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Definition
| Paresis affecting a single extremity or part of one. |
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Term
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Definition
| paralysis of one extremity, muscle, or muscle area |
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Term
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Definition
| an abnormally acute sense of pain, heat, cold, or touch; algesia. |
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Term
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Definition
| an abnormal sensation, as prickling, itching, etc. |
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Term
| LOCALISATION OF THE LESION IN THE PATIENT WITH MONOPARESIS |
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Definition
LOCALISATION OF THE LESION IN THE PATIENT WITH MONOPARESIS
The monoparesis in the front limbs is most commonly caused by the diseases of the peripheral nerve(s) or nerve roots. The diseases of endplates or muscles affecting just one limb are very rear. Diseases of the spinal cord in the cervical area usually cause hemiparesis or tetraparesis. Therefore, monoparesis in the front limb is usually caused by the lesion in nerves or nerve roots of the affected limb.
Monoparesis in the hind leg is also usually caused by nerve or nerve root lesion. It can be outside the spinal canal (peripheral nerve) or inside the canal (cauda equina). Additionally, also unilateral spinal cord lesions caudal to Th2 can cause monoparesis in the rear extremity. This is the exception from the general localization scheme. Vascular lesions are the most often causes of such unilateral spinal cord diseases (ex. fibrocartilaginous embolism). |
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Term
| DIFFERENTIAL DIAGNOSES OF THE MONOPARESIS |
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Definition
Vascular Fibrocartilaginous embolism, ischemic encephalopathy (D,C)
Inflammatory-infectious Plexus brachialis neuritis (D,C)
Traumatic Trauma (neuropraxia, axonotmesis, neuronotmesis) of plexus brachialis or isolated nerve(s) (D,C)
Anomalous -
Metbolic Hypothyroidism (D)
Idiopathic -
Neoplastic Primary: malignant nerve sheath tumor (D,C). Secondary: lymphoma, skeletal tumors (D,C)
Degenerative Lateralised disk herniation, degenerative foraminal stenosis causing nerve root compression (nerve root signature)
PS: D-dog, C-cat. |
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Term
| What segments of the spinal cord can be tested by the reflexes of the peripheral nerves? |
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Definition
Femoral n - L4-5-6
Sciatic n. - L4-S2
Peroneal n. - L6 -S2
Tibial n. - L6 - L2 |
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Term
| What are some symptoms of FCE? |
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Definition
- Loss of voluntary reflexes or extention of one or more joints;
- Loss of spinal reflexes of the limb;
- Loss of pain sensation; |
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Term
| What are the signs of "root signature?" |
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Definition
- Varying degree of LMN dysfunction in the legs (L4-S2);
- No CP reflexes'
- ? |
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Term
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Definition
-Reduced tail wag;
- No tone in the tail;
- Lameness or difficulty rising in the pelvic limbs;
- Dilated anus, absent anal reflex;
- Absent sensation in the perineal area;
- Lumbosacral pain; |
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Term
| Diagnosis of Cauda Equina? |
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Definition
Onset: acute or chronic
Is p painful or nonpainful
Bladder or bowel incontinance?
Trauma or animal bites
Young Manx or a Bulldog (deformed tail) |
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Term
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Definition
| an injury to a nerve that interrupts conduction causing temporary paralysis but not degeneration and that is followed by a complete and rapid recovery |
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Term
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Definition
| axonal nerve damage (as from compression or crushing) that does not completely sever the surrounding endoneurial sheath so that regeneration can take place |
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Term
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Definition
| The condition in which there is complete division of a nerve. |
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Term
Case:
9 year old, GSD, MN
Has been on Rymadil for 8 months;
PE:
Mentation normal;
NO CP deficits on L hindlimb, but the tail is flaccid!!!
Normal muscle reflexes
Where is the lesion?
What are DDX?
What is the diagnosis? |
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Definition
Lumbosacral regioun - L6 -S2
Differentials: Disc disease, tumor, discospondylitis, GME, Too chronic to be trauma, LS instubility.
Diagnosis: LS INstubility (lumbosacral instability, cauda equina, lumbosacral sclerosis) |
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Term
| What is a typical presentation of Lumbosacral Sclerosis? |
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Definition
Common in large dogs,
Initially painful
Progressive nerve root compression leads to incontinence; |
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Term
| Dogs with what skeletal defect can have an up to 8 times greater chance of developing Lumbosacral sclerosis? |
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Definition
| Transitional vertebrae at L7 |
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Term
| Are there any medical or surgical treatments for Lumbosacral degeneration? |
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Definition
Medical: NSAIDS, Tramadol, Acupuncture, Might use steroids?
Best treatment: surgery (Dorsal Laminectomy and LS) |
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Term
| Prognosis for animals with lumbosacral stenosis? |
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Definition
- if incontinence already exists- difficult to reverse, even after surgery;
- Long-term success ranges from 69-94%; |
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Term
| What disease has a signature "Marilyn Monroe" walk in hindlimbs? |
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Definition
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Term
| How can we differentiate hip dysplasia from lumbosacral stenosis? |
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Definition
| Dogs with hip dysplasia do not have CP deficits in the hindlimbs |
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Term
Case:
7 yo, GSD,
Low tail carriage, lumbosacral pain (acute);
Muscle reflexes are present
Did this dog have trauma? o confessed that dog came home howling.. from the road |
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Definition
| Lumbosacral and sacrocaudal fracture/luxation |
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Term
| What can happen to cats with fractured tail? |
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Definition
they may have a singling sensation that causes them to chew off their tail;
May have urinary incontinance;
Tail amputation may be necessary; |
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Term
| What should we do during a neurologic exam? |
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Definition
be very good at neuroanatomy
be able to conduct good p overview
perform a neuro exam
lesion localization |
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Term
| Where is the lesion if p is having seizures and has CP deficits in the R side of the body? |
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Definition
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Term
| A dachshund comes in with posterior limb paresis, what is the DAMNIT list? |
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Definition
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Term
| What nerve is tested when we pinch the lip with a hemostat? |
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Definition
| Maxillary branch of Trigeminal nerve |
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Term
| What nerves are resp. for palpebral reflexes? |
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Definition
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Term
| What can cause a middle age Labrador be unable to blink his eye? just one |
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Definition
If he had matching CBC and Chem signs (low T4, anemia, high Cholesterol), then it is Hypothyroidism Associated Facial Nerve Paralysis
Treat with Soloxone (they recover in 3 months) |
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Term
| How many % of p with acute otitis have OM? |
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Definition
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Term
| How many p with Chronic otitis have OM? |
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Definition
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Term
| Describe Hypothyroidism Associated Facial Nerve Paralysis |
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Definition
Supplement p with Soloxone
Gets better in 3 months
Two theories: one is that the more obese Hypothyroid p has more chance of compression of the nerves as they come out of the foramen; Another theory is Axonal flow.
DO NOT use Steroids!!! |
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Term
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Definition
Can be muscular or Metabolic reasons
Characteristic pelvic limb posture in a cat (stands on hocks)
Vascular: involves decreased vasodilatory molecues(prostacyclin, prostaglandin E1) and increased vasoconstrictive molecules (thromboxane A2, endothelin) in vascular endothelium;
Abnormal thickening of the perineurium;
Metabolic hypothesis: describes several cellular aberrations in diabetic p (polyol pathway, enzyme aldose reductase, accumulation of sorbitol;
Immune-Mediate Hypothesis: Myelin is attacked by the immune system |
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Term
| Diabetic Neuropathy clinical signs: |
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Definition
- can be sublclinical
- symmetric neurogenic m. atrophy (symmetric pelvic limb LMN paresis) with CP deficits, decreased reflexes, and muscle atrophy;
-may show Horners
-plantigrade posture in cats (hocks on the ground)
-decreased patellar reflexes |
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Term
| What is a test for Masticatory Myocytis? |
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Definition
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Term
| One of few cases when we can prescribe Steroids to neurologic p? |
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Definition
| Masticatory Myocytis to reduce inflammation |
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Term
| What is typical signalment of a dog with Masticatory Myocytis? |
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Definition
- Does not want you to touch the mouth
- Painful when we try to open the mouth
- May have concurrent polyarthritis |
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Term
| Describe a typical p with POLYMYOCYTIS? |
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Definition
GSD
has good CP
Exercise intolerance
Regurgitation
Looks like an immune mediated attack on muscle tissue of the patient, may go away by itself, may be triggered by stress, etc
-Treat it as an immune-mediated dz |
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Term
| What is the name for hypertonicity syndrome of Cavalier King Charles Terriers? |
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Definition
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Term
| List all verterbral segments: |
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Definition
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Term
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Definition
Cerebrum
Diencephalon
Midbrain
Cerebellum
Pons
Medulla oblongata |
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Term
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Definition
Frontal
Parietal
Occipital
Temporal |
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Term
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Definition
| Major pathway to and from the four lobes |
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Term
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Definition
Movement
Intellect
Behaviour
Consciousness |
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Term
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Definition
Sensation
CP
Touch
Pain
Temperature |
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Term
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Definition
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Term
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Definition
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Term
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Definition
| PUPILS, EXTRAOCULAR MUSCLES |
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Term
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Definition
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Term
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Definition
Consciousness
All motor and sensory tracts |
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Term
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Definition
Trigeminal
Chewing (know Trigeminal Neuritis) |
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Term
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Definition
Consciousness
Motor and sensory tracts |
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Term
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Definition
Facial n
defect causes loss of palpebral reflex |
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Term
| Why are sensory tracts more prone to damage? |
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Definition
Motor tract-covered by parenchyma, not as easy to damage;
Sensory tracts are on the periphery, contain fast fibers, so if pressure is applied on the cord, these suffer most. |
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Term
Case: GSD, 11 yo
hit by car 2 years ago
down on sound limb
hind limbs are limping, too
No CP deficits |
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Definition
Take rads: show degenerative changes in the hips;
DDX: HIP DYSPLASIA, ELBOW DYSPLASIA |
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Term
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Definition
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Term
| If p is BLIND and lost pupillary light reflexes, where is the lesion |
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Definition
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Term
| If p is BLIND but has normal pupillary response? |
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Definition
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Term
| Medial Strabismus (eyes meet at the nose) |
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Definition
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Term
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Definition
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Term
| What nerves are responsible for mvt and sensory innervation to the cheek, lip, palpebrae, ear? |
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
CN8
A head tilt usually indicates vestibular signs that may be a problem in the animal's middle or inner ear. |
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Term
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Definition
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Term
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Definition
CN9-10: Dysphagia, meagesophagus, laryngeal paralysis, paresis.
CN12 - Tongue paralysis |
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Term
| Knee jerk reflex (Patellar reflex) |
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Definition
| Femoral n., spinal segments L4-L6 |
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Term
| 2 main spinal reflexes of the thoracic limb |
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Definition
Musculocutaneous (Biceps m)
Radial (Triceps, caudal half) |
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Term
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Definition
Gastrocnemius m
Cranial tibial m |
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Term
| Toe pinch checks what nn? |
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Definition
| Flexor muscles and Sciatic nerve |
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Term
| What segment are Gastrocnemius, Cranial tibial n, and Sciatic nerve belong to? |
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Definition
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Term
| wHAT SPINAL SEGMENT IS CHECKED BYU ANAL TONE REFLEX? |
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Definition
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Term
| What does Babinski sign indicate? |
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Definition
Crossed extensor (UMN dz)
Muscle atrophy (disuse, neurogenic)
Urination (large, easily expressible bladder) |
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Term
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Definition
CP
Hopping, hemi, barrel walking
Placing toes back |
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Term
| How do we assess neck and back pain? |
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Definition
deep palpation
range of motion exam |
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Term
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Definition
Quadraparesis or quadriplegia
UMN signs to all legs
Neck pain |
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Term
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Definition
| Limb lameness due to neurologic disease, usually due to inflammation of the spinal cord or nerve root by compression with an intervertebral disc extrusion |
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Term
| If a patient showing depressed or missing reflex, put it in: |
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Definition
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Term
| If p can't walk (paresis paraplegia) what are ddx? |
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Definition
IV Disc disease;
Botulism
Tick paralysis
Coral snake envenomation
Metabolic(Hypoglycemia, liver dz, Diabetic neuropathy, Hyperkalemia, Uremic toxicity)
Idiopathic: Trigeminal neuritis
Toxic: Tetanus, plants, pesticides, heavy metals (lead) |
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Term
| When is CSF tap indicated? |
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Definition
Eisures,
Encephalopathy
Myelopathy
Prelude to myelography
Meningiopathies and Radiculopathy |
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Term
| What are some counterindications to CSF tap? |
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Definition
| increased ICP, Anesthetic risk patient |
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Term
| What was the old way of diagnosing Neoplasia via CSF? |
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Definition
Tupor gives increased ICP
No elevation in cell count of CSF
Elevation in protein (bc mass causes cellular destruction) |
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Term
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Definition
L4-L5 or Cicternal Magna: dogs
l5-l6: CATS |
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Term
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Definition
| THE OCCIPITAL PROTRUBERANCE, LATERAL TIPS OF THE WINGS OF ATLAS |
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Term
| Why woudl levels of IgG or IgM increase in CSF? |
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Definition
| Intrathecal immunoglobulin production or BBB breakdown |
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Term
| Diagnosis of Distemper and FIP with serum and CSF? |
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Definition
Do paired titers,
If levels of titer are higher in CSF, very suspicious of the disease |
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Term
| Name 3 reasons for protein elevation and normal cell count in the CSF? |
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Definition
Neoplasia
Disc dz
Neurodegenerative dz |
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Term
| What should be the predominant protein in CSF? |
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Definition
|
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Term
| What are major causes of bacterrial meningitis in cats and dogs? |
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Definition
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Term
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Definition
Most common (viral meningitis)
Dogs: RV, CDV, SRM, "Pug encephalitis"
Young cats: Feline polioencephalomyelitis
Lymphoma in any species |
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Term
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Definition
Dogs( GME, SRME, Other infectious agens)
Cats (FIP chronic) |
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Term
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Definition
Rare
Parasites
Eosinophilic meningitis (tx with steroids) |
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Term
| Other abnormalities that can be found in CSF? |
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Definition
| Hemorrhage, Infection (Crypto), Myelin fragments, Tumor cells, Cellular inclusions |
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Term
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Definition
Most common bone tumor
Usually above L2 |
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|
Term
| A mass that has uniformally distributed contrast on MRI is most likely? |
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Definition
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Term
8 yo Doberman,
CM,
ABNORMAL WALK, GAIT OF HIND LIMBS
CN are great! |
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Definition
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