Exam 1 - FA Clinical Neurology Exam

Question 1

what 2 general questions should you look to answer in your neuro exam?

Answer 1

1. is it primary neurologic disease? or metabolic?
2. is the lesion rostral to or caudal to the foramen magnum?

Question 2

how do horses normally stand up?

Answer 2

get up with their front limbs first

Question 3

how do cows normally stand up?

Answer 3

lunge forward, get up on back legs, & then front

Question 4

what parts of the history should you pay attention to in your neuro workup?

Answer 4

behavior/mentation

environment

past disease

age

breed

length of illness

past treatment

vaccination status, dehorning, & castration

Question 5

when starting your neuro exam from a distance, what are you looking at in your animal?

Answer 5

gait, mentation, posture, & reflexes

Question 6

T/F: if ataxic, the animal will always have inappropriate posture

Answer 6

true

Question 7

what are the 3 types of ataxia?

Answer 7

cerebellar, vestibular, & proprioceptive

Question 8

how is cerebellar ataxia characterized?

Answer 8

ataxia without any weakness - if you pulled the animal’s tail, you would feel resistance

Question 9

how is vestibular ataxia characterized?

Answer 9

ataxic with a change in posture

Question 10

how is proprioceptive ataxia characterized?

Answer 10

ataxia with weakness of muscle

Question 11

what does mentation assess?

Answer 11

appropriate responses to the environment & stimuli

Question 12

T/F: posture abnormalities may or may not induce ataxia

Answer 12

true

Question 13

what does assessing vision include?

Answer 13

how the animal navigates their surroundings & obstacles

Question 14

why do you need to get small ruminants by themselves to assess their vision?

Answer 14

they are big time prey animals & will stick with their buddies

Question 15

what are the 4 components of your ocular exam?

Answer 15

palpebral reflex, menace reflex, PLR (vision not required), & fundic exam

Question 16

if there is hemorrhage seen in the fundus of the eye, what should be on your differential list?

Answer 16

vasculitis - histophilus somni & malignant catarrhal fever

Question 17

what are 4 differentials for diseases causing cortical blindness?

Answer 17

polio

lead toxicity

salt toxicity

rabies

Question 18

with lesions in the cerebrum, are signs diffuse or focal?

Answer 18

typically diffuse but may see focal

Question 19

what are common clinical signs seen in lesions of the cerebrum?

Answer 19

change in mentation, blindness with intact PLR, compulsive circling, seizures, opisthotonus (star gazing), head pressing, yawning, & bellowing

Question 20

lesions in the cerebrum are going to cause problems with what 2 things?

Answer 20

motor control & coordination

Question 21

with cerebellum lesions, are there proprioceptive deficits?

Answer 21

no

Question 22

what clinical signs are commonly seen with cerebellum lesions?

Answer 22

ataxia without weakness

increased muscle tone

intension tremors

wide based stance

exaggerated forelimb reflexes

hypermetric gait

may lack a menace but vision is intact

Question 23

what clinical signs are associated with peripheral vestibular lesions?

Answer 23

head tilt to the side of the lesion

animal will lean or fall to the side of the lesion

circling to the side of the lesion

ataxia with no proprioceptive deficits

generally horizontal nystagmus that doesn’t change direction with animal positioning

BAR mentation with good appetite

Question 24

what clinical signs are seen with central vestibular lesions?

Answer 24

depression

loss of appetite

ataxia with proprioceptive deficits

ventral nystagmus that changes direction with position of the head

Question 25

if there is a central vestibular lesion, where is it?

Answer 25

CN 8 nuclei/brainstem

Question 26

what clinical signs are seen with lesions in the thalamus/hypothalamus?

Answer 26

changes in behavior

temperature regulation

heat stroke - camelids & young calves

Question 27

what are the general clinical signs seen with lesions in the brainstem?

Answer 27

ataxia

depression/mania

depressed respiratory movements

most CN signs are due to disease in the brainstem on the CN nuclei

Question 28

what are 2 examples of a focal lesion on the spinal cord?

Answer 28

vertebral body abscess & trauma

Question 29

what is an examples of a multifocal lesion on the spinal cord?

Answer 29

meningeal worm

Question 30

what are 3 examples of a diffuse lesion on the spinal cord?

Answer 30

tetanus

delayed organophosphate toxicity

copper deficiency

Question 31

flexor weakness (paresis) causing gait deficits will have lesions where? how would the abnormal gait be described?

Answer 31

brainstem or spinal cord - stilted gait

Question 32

extensor weakness (paresis) causing gait deficits will have lesions where? how would the abnormal gait be described?

Answer 32

spinal cord

buckling, limb dragging, trembling when bearing weight, & worn hooves

Question 33

a spinal cord lesion causing proprioceptive deficits would have what clinical signs associated with an abnormal gait?

Answer 33

LMN signs - buckles or collapses & decreased muscle tone with decreased reflexes

Question 34

what 3 tools can you use to localize a lesion in the spine?

Answer 34

plain film rads

myelogram

clinical signs

Question 35

what 3 nerves are commonly involved in peripheral nerve lesions?

Answer 35

radial

sciatic (peroneal)

obturator

Question 36

how would you determine if there is a metabolic/nutritional cause of your neurologic disease?

Answer 36

serum chem panel

Question 37

how would you determine if there is a cardiovascular cause of your neurologic disease?

Answer 37

physical exam

Question 38

how would you determine if there is a infectious cause of your neurologic disease?

Answer 38

run a CBC with fibrinogen

Question 39

what are the normal parameters for CSF in cows?

Answer 39

protein - <40mg/dL

nucleated cells - <10/uL

pandy (globulins) - negative

CPK - < or = 20IU/dL

Question 40

if there are a lot of eosinophils in your CSF, what parasite are you suspicious of?

Answer 40

meningeal worms