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Equine Medicine > Equine Neurologic Examination > Flashcards

Equine Neurologic Examination Flashcards

1
Q

What are some signs of decreased consciousness? What are 4 causes?

A

depression, obtundation, stupor, coma

  1. cerebrum lesion
  2. brainstem lesion
  3. metabolic disturbance
  4. systemic illness
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2
Q

What are some signs of increased consciousness? What are 2 causes?

A

anxiety, mania, aggression, delirium, confusion

  1. cerebral cortical lesion
  2. encephalopathy
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3
Q

What are 3 common causes of seizures?

A
  1. forebrain lesion
  2. encephalopathy
  3. intoxication
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4
Q

What are some signs of lethargy in horses?

A
  • blank facial expression
  • drooping ears and eyelids
  • sluggish responsiveness to stimuli
  • reduced voluntary activity
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5
Q

What are some signs of stupor in horses?

A
  • stands in one place
  • head held low
  • only responds to strong stimuli
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6
Q

What is the difference between semi-comatose and comatose states?

A

SEMI-COMATOSE = recumbent, but responds

COMATOSE = recumbent and unresponsive

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7
Q

What are some behaviors that indicate neurologic disease in horses?

A
  • self-mutilation
  • head pressing
  • compulsive walking
  • yawning
  • head pressing
  • aggression
  • timidity
  • loss of affection
  • excessive flehmen
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8
Q

What are some postures that indicate neurologic disease in horses?

A
  • wide/narrow-based stance
  • tilt (peripheral vestibular)
  • turn/circling (central)
  • leaning
  • recumbency
  • opisthotonos
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9
Q

What are the 12 cranial nerves?

A
  1. olfactory
  2. optic
  3. oculomotor
  4. trochlear
  5. trigeminal
  6. abducens
  7. facial
  8. vestibulocochlear
  9. glossopharyngeal
  10. vagus
  11. accessory
  12. hypoglossal
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10
Q

What is the major function of the optic nerve? What 2 tests are used for assessment?

A

afferent pathway for vision and light

  1. menace
  2. PLR
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11
Q

What are the major functions of the oculomotor nerve? What 2 tests are used for assessment?

A

pupillary constriction and extraocular muscle movement

  1. PLR
  2. medial movement of the globe
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12
Q

What is the major function of the trochlear nerve? What test is used for assessment?

A

extraocular muscle movement (dorsal oblique)

ventrolateral rotation of globe

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13
Q

What are the sensory and motor functions of the trigeminal nerve? What tests are used for assessment?

A

SENSORY - head and face
- ear, eyelid, lip reflexes
- pain perception

MOTOR - mastication muscles
- chewing, jaw tone
- mascle mass (temporal, masseter, pterygoid)

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14
Q

What is the major function of the abducens nerve? What 2 tests are used for assessment?

A

extraocular muscle movement

  1. eyeball retraction (corneal reflex)
  2. lateral movement of globe
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15
Q

What is the major function of the facial nerve? What test is used for assessment?

A

innervates muscles of facial expression

ear, eyelid, and lip tone, reflexes, movements, and symmetry

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16
Q

What are the major functions of the vestibulocochlear nerve? What 6 tests are used for assessment?

A

afferent branch of the vestibular system and hearing

  1. head posture
  2. induced eyeball movement
  3. normal vestibular nystagmus
  4. gait
  5. blindfold test
  6. response to noise
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17
Q

What is the major function of the glossopharyngeal nerve? What 2 tests are used for assessment?

A

sensory/motor pharynx

  1. swallowing (observation, palpation)
  2. endoscopy
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18
Q

What is the major function of the vagus nerve? How is the accessory nerve assessed?

A

sensory/motor pharynx and larynx

slap test

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19
Q

What is the major function of the hypoglossal nerve? How is it assessed?

A

motor to tongue

tongue size and symmetry

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20
Q

Cranial nerve tests:

A
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21
Q

How are the upper eyelashes used to asses neurologic disease?

A

normally, eyelashes with be at an upward angle, but when horses are in pain or have some neurological disease, the eyelashes will begin to turn downward

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22
Q

How is the trigeminal nerve assessed? What are 2 effects when it is not working properly?

A

observe facial symmetry and test facial sensation

  1. atrophy of temporalis, masseter, and pterygoid nerves responsible for mastication
  2. loss of sensation
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23
Q

What is the facial nerve responsible for? What are signs of disease?

A

facial expression

unilateral drooping face —> general anesthesia and halter compression!

24
Q

How is the body assessed for neurological deficits?

A
  • observation
  • palpation
  • manipulation
25
Q

How the body is affected by neurological deficits?

A
  • atrophy
  • asymmetry
  • trembling
  • sweating
26
Q
A
27
Q

How are C1-C5 commonly affected by neurological disease? Where is C-6-C7 found?

A

pain and deformation

deep in front of the shoulder

28
Q

How can the neck be flexed to observe neurologic deficits?

A

have the horse follow a desirable treat to the side of its chest

  • ensure the horse is able to lift and lower its head and neck
29
Q

What other 3 reflexes are used to observe neurological deficits in the neck and thoracic limbs?

A
  1. slap test
  2. cervicofacial reflex
  3. cutaneous trunci (panniculus)

also assess limb strength and sensation, gait, and posture!

30
Q

What is the slap test?

A

thoraco-laryngeal adductor reflex (TLAR) - highest point of the larynx is hooked in one hand and the other is used to slap the wither on the opposite side —> should feel a discrete movement of the arytenoid cartilage

31
Q

What is palpated on the trunk and pelvic limbs to assess neurologic deficits?

A
  • back extension (R)
  • back flexion (G)
  • cutaneous trunci
32
Q

What are 4 parts to the nerurological exam in the rectum, bladder, anus, and tail area?

A
  1. anal reflex - should contract with palpation
  2. perineal sensation
  3. tail tone - should naturally have some resistance
  4. signs of incontinence
33
Q

What are 2 major signs of cauda equina syndrome? Where in the CNS is this affected?

A
  1. flaccid paralysis of the tail, penis, and perineum
  2. spastic paralysis of the anus, rectum, and bladder

any part of the vertebrae past S2

34
Q

How are lesions localized based on gait/posture?

A
  • before T2 = all 4 legs affected
  • past T2 = only hind legs affected
35
Q

What is paresis?

A

weakness of voluntary resulting in inability to support weight and generate gait

  • hemi = one side of the body
  • tetra = all 4 legs
  • para = 2 legs
36
Q

What are signs of LMN and UPN injuries seen in the limbs?

A

LMN = weakness, short stride, narrow base, normal postural reaction

UMN = delayed protraction, long stride, abnormal postural reaction, stiffness

37
Q

How are the limbs’ strength tested?

A
  • hopping
  • tail pull while standing = L3-L5
  • tail pull while walking = cervical
38
Q

What is ataxia? What are the 3 etiologies?

A

lack of voluntary muscle coordination

  1. cerebellar
  2. sensory
  3. vestibular
39
Q

What are the most common signs of ataxia?

A
  • scuffing and dragging
  • delayed protraction, knuckling
  • crossing over
  • stepping on other feet
  • pivoting, circumduction
  • elongated stride
40
Q

What is dysmetria? Hypermetria? Hypometria?

A

lack of coordination of movement

overshoot intended position

undershoot intended position

41
Q

What is the difference between a lame horse and an ataxic horse?

A

LAME = regularly irregular, predictable

ATAXIC = irregularly irregular, unpredictable

42
Q

What maneuvers are used to assess limb strength and gait?

A

LIMB STRENGTH - tail pull, hopping

GAIT - walk straight, trotting away and towards, serpentine, elevate head, blindfold, up and down curb, large and small circles, backing up, up and down hill

43
Q

What is the point of the tail pull, trotting with an elevated head, blindfold, and curb tests?

A

horse should be able to resist and right themselves

can compress cervical canal and highlight neurological deficits

vestibular horses won’t be able to correct themselves

indicated proprioceptive/sight problems; check scuffing of hooves!

44
Q

UMN vs. LMN

A
45
Q

What are possible signs of neurological signs on CBC? Biochem?

A

inflammation and dehydration

  • metabolic disorders
  • electrolyte abnormalities
  • enzymes
  • ammonia
  • vitamin E
46
Q

What are the 3 methods of CSF collection in horses?

A
  1. atlantooccipital - lateral recumbency, GA
  2. C1-C2 - standing and US-guided, sedation
  3. lumbosacral - standing, sedation
47
Q

What are the major complications associated with AO and C1-C2 collection of CSF?

A

AO - possible neurological impairment, anesthetic complications

C1-C2 - bleeding, depression, stiffness

48
Q

What is a major pro and con to lumbosacral collection of CSF?

A

PRO - deep depth allowed

CON - harsh reactions common

49
Q

How is the CSF grossly observed? What lab analyses can be performed?

A

pressure, color, turbidity, xanthochromia (yellow)

  • TP
  • TCC
  • cytology
  • enzymes
  • immune testing
50
Q

What neurological disease uses nasal swabs as a part of diagnosis?

A

EHV1

51
Q

How are plain radiographs used to assess neurological disease?

A

create composites of the spinal column and search for any bone lesions or fractures

52
Q

What sagittal ratios are used to evaluate for cervical vertebral stenotic myelopathy?

A
  • C3-C5 = < 50% (A:B)
  • C6 = < 52%
  • C7 = < 56%
  • any site = < 48% (C:B)
53
Q

What is a myelogram? What are 5 possible complications? Why is this not commonly performed?

A

using contrast dye and X-rays/CT to look for problems in the spinal canal

  1. seizures
  2. blindness
  3. fever
  4. neck pain
  5. horse unable to rise

recovery of neurologic horses from GA is difficult

54
Q

What are some neuroelectrodiagnostics?

A
  • electromyography (EMG) = electrical activity by muscle
  • nerve conduction studies (NCS) = electrical conduction by nerves
  • brainstem auditory evoked response (BAER)
  • electroencephalography (EEG)
55
Q

What are EMGs and NCSs used to evaluate? What are positive responses?

A

electrical activity of muscle and nerve = LMN

  • positive sharp waves
  • fibrillation potential

Equine Medicine (33 decks)

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