Exam 1 - FA Clinical Neurology Exam Flashcards
what 2 general questions should you look to answer in your neuro exam?
- is it primary neurologic disease? or metabolic?
- is the lesion rostral to or caudal to the foramen magnum?
how do horses normally stand up?
get up with their front limbs first
how do cows normally stand up?
lunge forward, get up on back legs, & then front
what parts of the history should you pay attention to in your neuro workup?
behavior/mentation
environment
past disease
age
breed
length of illness
past treatment
vaccination status, dehorning, & castration
when starting your neuro exam from a distance, what are you looking at in your animal?
gait, mentation, posture, & reflexes
T/F: if ataxic, the animal will always have inappropriate posture
true
what are the 3 types of ataxia?
cerebellar, vestibular, & proprioceptive
how is cerebellar ataxia characterized?
ataxia without any weakness - if you pulled the animal’s tail, you would feel resistance
how is vestibular ataxia characterized?
ataxic with a change in posture
how is proprioceptive ataxia characterized?
ataxia with weakness of muscle
what does mentation assess?
appropriate responses to the environment & stimuli
T/F: posture abnormalities may or may not induce ataxia
true
what does assessing vision include?
how the animal navigates their surroundings & obstacles
why do you need to get small ruminants by themselves to assess their vision?
they are big time prey animals & will stick with their buddies
what are the 4 components of your ocular exam?
palpebral reflex, menace reflex, PLR (vision not required), & fundic exam
if there is hemorrhage seen in the fundus of the eye, what should be on your differential list?
vasculitis - histophilus somni & malignant catarrhal fever
what are 4 differentials for diseases causing cortical blindness?
polio
lead toxicity
salt toxicity
rabies
with lesions in the cerebrum, are signs diffuse or focal?
typically diffuse but may see focal
what are common clinical signs seen in lesions of the cerebrum?
change in mentation, blindness with intact PLR, compulsive circling, seizures, opisthotonus (star gazing), head pressing, yawning, & bellowing
lesions in the cerebrum are going to cause problems with what 2 things?
motor control & coordination
with cerebellum lesions, are there proprioceptive deficits?
no
what clinical signs are commonly seen with cerebellum lesions?
ataxia without weakness
increased muscle tone
intension tremors
wide based stance
exaggerated forelimb reflexes
hypermetric gait
may lack a menace but vision is intact
what clinical signs are associated with peripheral vestibular lesions?
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
what clinical signs are seen with central vestibular lesions?
depression
loss of appetite
ataxia with proprioceptive deficits
ventral nystagmus that changes direction with position of the head
if there is a central vestibular lesion, where is it?
CN 8 nuclei/brainstem
what clinical signs are seen with lesions in the thalamus/hypothalamus?
changes in behavior
temperature regulation
heat stroke - camelids & young calves
what are the general clinical signs seen with lesions in the brainstem?
ataxia
depression/mania
depressed respiratory movements
most CN signs are due to disease in the brainstem on the CN nuclei
what are 2 examples of a focal lesion on the spinal cord?
vertebral body abscess & trauma
what is an examples of a multifocal lesion on the spinal cord?
meningeal worm
what are 3 examples of a diffuse lesion on the spinal cord?
tetanus
delayed organophosphate toxicity
copper deficiency
flexor weakness (paresis) causing gait deficits will have lesions where? how would the abnormal gait be described?
brainstem or spinal cord - stilted gait
extensor weakness (paresis) causing gait deficits will have lesions where? how would the abnormal gait be described?
spinal cord
buckling, limb dragging, trembling when bearing weight, & worn hooves
a spinal cord lesion causing proprioceptive deficits would have what clinical signs associated with an abnormal gait?
LMN signs - buckles or collapses & decreased muscle tone with decreased reflexes
what 3 tools can you use to localize a lesion in the spine?
plain film rads
myelogram
clinical signs
what 3 nerves are commonly involved in peripheral nerve lesions?
radial
sciatic (peroneal)
obturator
how would you determine if there is a metabolic/nutritional cause of your neurologic disease?
serum chem panel
how would you determine if there is a cardiovascular cause of your neurologic disease?
physical exam
how would you determine if there is a infectious cause of your neurologic disease?
run a CBC with fibrinogen
what are the normal parameters for CSF in cows?
protein - <40mg/dL
nucleated cells - <10/uL
pandy (globulins) - negative
CPK - < or = 20IU/dL
if there are a lot of eosinophils in your CSF, what parasite are you suspicious of?
meningeal worms
