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Clinical > CNS > Flashcards

CNS Flashcards

1
Q

GENERAL RULES/STEPS OF NEUROLOGICAL EXAMINATION

A
  1. ASK - history!!! (more important than in any other examinations)
  2. WATCH - general aspects (no physical contact to the patient)
    • inspection(instandingandmovinganimals)
  3. TOUCH - examinations by direct contact to the patient without causing pain
    • palpation
    • postural reactions, reflexes (cerebral and spinal),
    sensitivity of skin and mucous membranes)
  4. PAIN - examination of pain perception
    * manipulation
    * percussion
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2
Q

HISTORY/NATIONALE - Common questions to be asked

A
  • Onset of signs (motor activity i.e. ataxia/muscular weakness, or behavior, or pain sensation)
  • Environmental/housing conditions
  • Vaccinations
  • Breed-predisposition, age
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3
Q

Minimal necessary instruments

A
  • reflex hammer
  • arterial clamp, needle
  • penlight
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4
Q

Additional examinations

A
  • X-ray
  • EEG (electro-encephalography)
  • CT (computed tomography),
  • MRI (magnetic resonance imaging)
  • laboratory examinations (CSF, blood count/chemistry, detection of pathogens)
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5
Q

Head and body position/posture - disorders/anomalities

A

• abnormal head position (lateral turn, tilted, stargazing: opisthotonus)
• curved spine (these are NOT primary neurological disorders):
1. (pseudo)kyphosis (being humpbacked, dorsal deviation)
2. lordosis (concave curvature of the spine, ventral deviation)
3. scoliosis (lateral curvature of the spine)

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6
Q

examination of the head/skull

A
  • shape (symmetrical - asymmetrical changes)
  • mobility
  • ears (drooping or pointing)
  • (signs of pain by palpation)
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7
Q

Examination of the face

A
  • facial expression (eyelids, nostrils, ears: function of the of facial muscles; bilateral or unilateral changes)
  • detailed examination of the eyes (position and mobility of the eye balls & pupils)
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8
Q

Head/Face - disorders/anomalities

A
  • Bulging skull - Hydrocephalus
  • Drooping ears and lips - Right/Left-sided facial paralysis
  • Physiological drooping of the left ear (young dog)
  • Anisocoria (unequal size of the eyes’ pupils)
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9
Q

Examination of the vertebral column

A
  • Inspection: abnormal shape or position (luxation)

* Sensitivity (pain provocation by palpation, careful bending or percussion)

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10
Q

Part of the brain responsible for mental status is the…?

A

Thalamocortex

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11
Q

List types of reduced mental state

A
  • Dementia: alert, but inappropriate reactions; stupidness
  • Stupor: responds only to strong stimuli
  • Indolentia: not interested in surroundings
  • Somnolentia: drowsiness
  • Delirium: as if drunken
  • Coma: loss of consciousness, cannot be awaken
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12
Q

List types of increased mental state

A
  • Excitatio: excitement
  • Aggressive: attacking
  • Furor: rage
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13
Q

List the changes in behavior and in the level of consciousness

A

a) Decreased reactivity:
- Standing in the manger - Lead poisoning
- Pushing the head to the wall - Hydrocephalus
- Dementia
b) Increased reactivity:
- Excitation
- Jumping into the manger
c) Involuntary (compulsive) postures
• head tilt
• opisthotonus
• lateral turn of the head
• circling, walking in circles
• clockwise/anti-clockwise
• compulsive walking (pacing)
d) Special behavior abnormalities
• hallucination
• paraesthesia (psychogenic dermatitis)
• automutilation (semimutilation)

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14
Q

Seizure (convulsion, ictus, fit) - Definition

A

A state with involuntary musle contractions

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15
Q

Seizure - Classification

A
  1. according to the characteristics of muscle function

2. according to the origin of seizure

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16
Q

List the types of seizures according to the muscle function

A
  • tonic: characterised by spasm of the muscle (group)
  • clonic: characterised by rapid alternate muscular contractions and relaxations
  • tonico-clonic: mixture of the above forms
17
Q

List the types of seizures according to the origin of seizure

A
  • Generalized cerebral: having diffuse origin within the cortex, thalamus, brainstem followed by “general” symptoms (alterations of consciousness)
  • Focal (partial) cerebral: the focus of the convulsions could be localised (e.g. “temporal/parietal lobe epilepsy”) followed by “special” symptoms (e.g. tail-chasing)
  • Extracerebral: metabolic or transduction origin
18
Q

Epilepsy + Status epilepticus - Classification

A
  • Epilepsy: a syndrome of recurring seizures of cerebral origin.
  • Status epilepticus: a condition when seizures occur continuously with minimal or no normal periods
19
Q

Other forms of convulsions

A
  • tetanus: sustained tonic contraction of muscles without twitching
  • tetany: violent muscle twitching over the whole body
  • tremor: regular, rhythmic trembling (oscillation) of muscles
  • tic: repetitive contractions of one muscle
  • myoclonia: rhythmic contraction of one muscle group
  • fibrillation: uncoordinated twitching of individual muscle fibres
20
Q

Signs of tetanus

A
  • Tail lifting
  • Opisthotonus
  • Spastic tetraparesis

Clinical (8 decks)

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