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Diseases and Diagnosis > Block 2 #3 > Flashcards

Block 2 #3 Flashcards

1
Q

What is the primary goal of a neurological exam?

A

Localize problem

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2
Q

What are the 6 steps to a neurological exam?

A

Mental status
Gait and posture
Postural reactions
Cranial nerve exam
Spinal reflexes
Pain and sensation

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3
Q

What goes into the mental status exam?

A

Level of conciousness (brainstem)
Behavior (forebrain)

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4
Q

What is kyphosis?

A

Back bending up

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5
Q

What is lordosis?

A

Back bending down

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6
Q

What does the gait exam take into consideration?

A

Literally everything

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7
Q

What are the 3 key questions to gait exams?

A

Is the gait normal/abnormal
If abnormal, where is it abnormal
What is the problem

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8
Q

What is paresis of 4 limbs?

A

tetra

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9
Q

What is paresis of just pelvic?

A

Para

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10
Q

What is paresis of one side?

A

Hemi

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11
Q

What is paresis of a single limb?

A

Mono

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12
Q

What is vestibular ataxia?

A

Head tilt

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13
Q

What is cerebellar ataxia?

A

Dysmetria (hypermetria), tremors

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14
Q

What does hypermetria mean?

A

High stepping

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15
Q

What does ataxia mean?

A

Incoordination

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16
Q

What are the 3 types of ataxia?

A

Vestibular
Cerebellar
Proprioceptive

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17
Q

What is something you need to do during the menace response?

A

Cover the opposite eye

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18
Q

What cranial nerve does the menace response test?

A

II - optic

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19
Q

What cranial nerve does the pupillary response test?

A

III - oculomotor

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20
Q

What cranial nerve does the palpebral test?

A

V - Trigeminal

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21
Q

What branches of the trigeminal does the palpebral test?

A

Ophthalmic (most rostral)
Maxillary
Mandibulary (most caudal)

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22
Q

What is the nasal sensation test for?

A

Sensory for trigeminal but tailored toward cortex

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23
Q

How is CN VII tested?

A

Looking at symmetry

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24
Q

What CN does menace test?

A

II and VII
Thalamocortex and cerebellum

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25
Q

What CN does symmetry pupils and PLR test?

A

II and III (parasympathetic)

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26
Q

***What CN does palpebral test?

A

V and VII

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27
Q

What CN does nasal sensation test?

A

CN V

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28
Q

Which nerve closes eyelids?

A

Facial VII!

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29
Q

Is it menace response or reflex?

A

Response

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30
Q

Why is it menace response? (not reflex?)

A

It has cortical involvement

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31
Q

***What are the structures involved in the menace response?

A

CN II, VII, thalamocortex (motor and occipital), cerebellum

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32
Q

What parts of the thalamocortex are involved in the menace response?

A

Motor and occipital

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33
Q

What does a vertical (up and down) nystagmus indicate?

A

Central vestivular disease
(Brainstem, cerebellum)

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34
Q

What are 3 tests for trigeminal nerve?

A

palpebral reflex (3 branches)
Nasal sensation (*thalamocortex)
Muscles of mastication

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35
Q

What is most important part of neurological exam?

A

Gait exam

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36
Q

What does the cranial nerve tests test?

A

II - VIII

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37
Q

What is the knucking exam called?

A

Postural reactions (PRs)

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38
Q

What is the only part of the brain that the postural reaction does not test?

A

cerebellum

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39
Q

What is reflex?

A

Local

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40
Q

What is response?

A

Need cortex

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41
Q

Where does the pudendal nerve go to?

A

Anus

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42
Q

What is the spinal reflex?

A

Pinching of cutaneous truci cranially

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43
Q

**What does EFF stand for?

A

Extension femoral first

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44
Q

**What does SSF stand for?

A

Sciatic second flexion

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45
Q

What are the femoral segments?

A

L4-L6

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46
Q

What are the sciatic segments?

A

L6-S2

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47
Q

When a spinal reflex cutoff is found, where is the lesion?

A

Likely 2 vertebral bodies cranial

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48
Q

What does increased extensor tone mean?

A

Lesion in UMN (stiff leg)

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49
Q

What does decreased extensor tone mean?

A

Lesion in LMN (flaccid)

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50
Q

What are the UMN segments of spinal chord?

A

C1-5
T3-L3

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51
Q

What are the LMN segments of spinal chord?

A

C6-T2
L4-S3

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52
Q

What does a head turn (not tilt) indicate?

A

Forebrain/cortical lesion

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53
Q

What does a head tilt (not turn) indicate?

A

Vestibular (brainstem or ear)

54
Q

Lumbosacral disease/cauda equine syndrome (lesion at L7-S1) will only affect _______ muscles - not extensors - thus weight support is always intact

55
Q

What is most common disc herniation in dogs?

56
Q

Where does spinal chord terminate?

57
Q

What are the 3 regions of the brain?

A

Forebrain (thalamocortex), brainstem, cerebellum

58
Q

What are the 2 regions of the CNS?

A

Brainstem and brain

59
Q

How fast is muscle atrophy in LMN?

A

Very fast!

60
Q

What is special about C6-C8?

A

Thoracic limbs - extensor tone is increased, flexor reflex decreased

Pelvic - normal to increased
(Wobbler!)

61
Q

UMN - flexor is decreased, extensor is increased

62
Q

LMN - flexor is increased, extensor is decreased

63
Q

What parts of the spinal chord are housed in L4-L5?

64
Q

Does lumbosacral disease in dogs cause paraplegia?

65
Q

Where is the lesion typically when all 4 limbs are limp?

A

Outside of the CNS

66
Q

If there are LMN signs in thoracic limbs but UMN signs in pelvic limb, where is lesion?

67
Q

If there are LMN signs in all 4 limbs, where is lesion?

A

Diffuse LMN disease

68
Q

Where are the 3 parts to the brainstem?

A

Mesencephalon, pons, medulla

69
Q

Do cerebellar deficients have proprioceptive deficits?

70
Q

Do cerebellar deficits have weakness?

71
Q

Does C1-C2 have IV disc?

A

NO
Neither does the sacrum

72
Q

What are the 2 parts of the IV disc?

A

Nucleus pulposus
Annulus fibrosus

73
Q

What are the 2 types of IVDD classifications?

A

Hansen Type 1
Hansen Type 2

74
Q

What is Hansen Type 1?

A

Extrusion - Acute

75
Q

What is Hansen Type II?

A

Protrusion - Chronic

76
Q

What breeds get type I?

A

Small breeds normally

77
Q

What discs normally get type I?

78
Q

What protrudes in Hansen type I?

A

Nucleus pulposus

79
Q

What protrudes in Hansen type II?

A

Nucleus pulposus and annulus fibrosis

80
Q

What is ANNPE? stand for

A

Acute non-compressive nucleus pulpous extrusion

81
Q

What is ANNPE caused from?

A

Trauma where a disc hits very fast then comes back

82
Q

What is HNPE? stand for

A

Hydrated nucleus pulpous extrusion

83
Q

What is the most important prognostic indicator for acute spinal chord indicator?

A

Nociception

84
Q

What does Schiff-Sherrington look like?

A

Laying down with legs out

85
Q

What is progressive myelomalacia?

A

Degeneration of spinal chord

86
Q

How do you diagnose progressive myelomalacia?

A

Know cut-off of cutaneous trunci reflex
If its L1 today and T12 tomorrow, it is progressively worsening

87
Q

What is FCEM? stand for

A

Fibrocartilaginous embolic myelopathy?

88
Q

What is the pathogenesis of FCEM?

A

Spinal chord infarct caused by a fragment of fibrocartilaginous material

89
Q

What is FCEM also known as?

A

Spinal stroke

90
Q

What is are distinctive characteristic about FCEM?

A

NO SPINAL PAIN
ASYMMETRIC

91
Q

Will disc extrusion and spinal trauma have pain?

A

YES
FCEM DOES NOT!

92
Q

What does MRI of FCEM look like?

A

Spot of brightness

93
Q

What are the 2 main diseases (acute and chronic) without spinal pain?

A

Acute: FCEM
Chronic: Degeneration myelopathy

94
Q

Does type II IVDD usually occur on only one disc?

A

No, usually >1

95
Q

What type of dogs usually get type II IVDD?

A

Large breed dogs

96
Q

Are radiographs a definitive diagnostic for type II IVDD?

A

No, should use MRI

97
Q

What is the landmark for C7?

A

A medium sized spinous process

98
Q

What are the 3 categories of spinal neoplasia?

A

Extradural
Intramedullary
Intramural-extramedullary

99
Q

What is extradural spinal neoplasia

A

outside spinal cord, compressing

100
Q

What is the one cancer that can be any of the 3?

101
Q

What is intramedullary spinal neoplasia?

A

Inside spinal cord

102
Q

What is intramural-extramedullary?

A

Outside spinal cord but inside dura

103
Q

What diagnostic should you run with spinal neoplasia?

104
Q

What is degenerative myelopathy?

A

Degenerative disease of the spinal cord white matter

105
Q

During degenerative myelopathy, where will LMN paraplegia start first?

A

Thoracic limbs

106
Q

What are the diagnostics for degenerative myelopathy?

A

Histopath (antemortem)
Genetic test (NN, NA, or AA)

107
Q

What is the vertebral canal stenosis?

A

Degenerative lumbosacral stenosis

108
Q

What is degenerative lumbosacral stenosis caused by?

A

Type II IVDD

109
Q

Is degenerative lumbosacral stenosis a myelopathy?

A

NO ITS A RADICULOPATHY

110
Q

What is discospondylitis?

A

Infection of the intervertebral disc and end plates

111
Q

Is discospondylitis painful?

A

VERY PAINFUL!

112
Q

What is common with degenerative lumbosacral stenosis?

A

Incontinence

113
Q

Is there ataxia with degenerative lumbosacral stenosis?

114
Q

What are the 3 main structures of spinal pain?

A

Meninges
Nerve roots
Vertebra

115
Q

What is clinical signs of C-IVDD?

116
Q

What is atlantoaxial subluxation?

A

Failure of structural support ligaments of C1 and C2 (3 ligaments)

117
Q

When does atlantoaxial subluxation occur?

A

When they are young

118
Q

How can AAS be diagnosed?

A

RADIOGRAPHS at clinic!

119
Q

What is SRMA?

A

Steroid responsive meningitis arthritis

120
Q

What is the pathology of SRMA?

A

Immune-mediated response against meninges and arteries

121
Q

What is breed predisposition of steroid responsive meningitis arthritis?

A

BBB-PG
Beagle
Boxer*** (most common)
Burmese mountain dog
Pointer
Golden

122
Q

What are clinical signs of steroid responsive meningitis arthritis (SRMA)?

123
Q

What would you expect if a young boxer came in with neck pain?

124
Q

What age animals get SRMA?

125
Q

What kind of gait do wobbler dogs come in with?

A

2 engine gait

126
Q

What are the 2 breeds that most commonly get wobbler?

A

Great dane
Dobberman

127
Q

Is spondylosis the cause of neurologic signs?

128
Q

What is the nerve block that tests the hoof?

A

Palmar digital nerve block

129
Q

What does the palmar digital nerve block?

A

Palmar 1/3 of hoof

130
Q

What block blocks the entire foot?

A

Abaxial sesamoid nerve block

Diseases and Diagnosis (25 decks)

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