1 Exam And Localization Flashcards
6 components of neurolocalization
Menation Gait/posture Cranial nerves Postural reactions Segmental reflexes Palpation and range of motion
Levels of mentation
Alert Obtunded Stuporous Comatose Ded
Obtunded
Decreased but not absent response to normal stimuli
Stuporouus
Non responsive to normal stimuli
Responsive to noxious stimuli
Comatose
Not responsive to noxious stimuli
Dead
“…look through their pockets for loose change”
Ataxia
Lack of coordination
Cerebellar ataxia
Wide based stance
Hypermetria
Truncate sway
Vestibular ataxia
Wide based stance
Leaning
Listing
Drunken sailor
Proprioceptive ataxia
Lack of coordination
Lack of awareness and paresis
Decerebrate posture
Comatose
Rigid extension in all limbs
Trying to die
De cerebellar posture
acute cerebellar lesions
Extended TL, flexed PLs
Schiff-Sherrington
Severe, acute T3-L3 lesions
Not prognostic
Testing menace
Afferent: CN 2
Efferent: CN 6
Testing PLR CN
Afferent: CN 2
Efferent: PS. CN2
Palpebral. Cranial nerves
Medial canthus: afferent. - 5 opth
Lateral canthus: afferent - 5max
Facial. Symmetry cranial nerve
CN. 7
Physiologic nystagmus. Cranial nerves
afferent.: CN 8
Efferent:: CN 3,4,6
Gag. Reflexs cranial nerves
Afferent:: CN 9,10
Efferent CN. 9
Tongue. Function. CN
CN 12
Cutaneous trunci nerves
C8-T1
Thoracic limb withdrawal nerve segments
Biceps. & usculocutaneous:: C6-C8
Triceps & radial: C8T2
Patellar reflexs Nerve segment
Femoral nerve
L4-L6
Withdrawal reflex nerve
sciatic
L6-S1
First neurolocalization segment (after brain)
C1-C5
Second neurolocalization segment
C6-T2
Third neurolocalization segment
T3-L3
Fourth neurolocalization segment
L4-S3
Segmental reflex deficits, brain or not brain
Not brain
CP deficits + ataxia + paresis, brain or not brain
Either
Behavior changes, CN deficits, seizures, brain or not brain
Brain
CN originating from the Forebrain
I + II
CN originating from the cerebellum
none
CN coming from the mid brain
III-IV
CN coming from the pons
V
CN coming form the medulla oblongata
VI-XII
How do forebrain deficits present
Seizures, circling, compulsive, behavior changes
Blindness, non-ocular (central blindness)
Postural reaction deficits
Normal gait
How do cerebellar deficits present
Head tilt, nystagmus, loss of menace,
Intention tremors, truncal sway, ataxia, hypermetria
What is not present with cerebellar deficit
Paresis, behavior changes, CP deficits
How do brain stem lesions present
Decreased mentation
CN deficits: III-XII
What gait will an animal have with brain stem deficiencies
Vestibular or proprioceptive ataxia
Central vestibular presentation
CP deficits Paresis ataxia Hypermetria Mentation \+/- other CN
Peripheral vestibular presentation
Head tilt
Nystagmus
Other CN deficits (VII)
Ataxia
What diarrheal medication may cause vestibular signs
Metronidazole
Extended, difficult to flex limb. Lesion location
Upper motor neuron
Flaccid, unable to support weight. Lesion location
Lower motor neuron
Neurolocalization: Animal with tetraparesis, ataxia, increased reflexes, +/- ambulation
C1-C5
Neurolocalization: tetraparesis, ataxia, Thoracic L: normal to decreased reflex, pelvic L: normal to increased reflexes, 2 engine gait
C6-T2
Neurolocalization: Paraparesis, increased PL tone, PL ataxia, normal to increased PL reflexes, normal TL reflexes.
T3-L3
Neurolocalization: PL ataxia, para-paresis, decreased PL muscle tone and reflexes, possible incontinence
L4-S3
Neurolocalization: general paresis, no ataxia, no pain, decreased reflexes
LMN
