Exam 4: Neuro Exam Flashcards
What is a two engine gait?
Short choppy gain in thoracic limbs with a long stride gate in the pelvic limbs
What is an ataxic gait?
Incoordination
Proprioceptive: does not know where limbs are in space
Vestibular: Loss of balance, head tilt, drifting, falling to one side
Cerebellar: Uncontrollable limb movements
What is a recumbent gait?
Lying on one side, not able to rise
What is an ambulatory gait?
Walking
What is a non-ambulatory gait?
Not walking
What is kyphotic posture?
Outward curvature of the spine, hunched back
What is lordosis?
Inward curvature of the spine
What is scoliosis?
Lateral curvature of the spine
How do you check CN 1?
Wave a noxious stimuli in front of patient
How do you check CN 2?
Menace response: cover one eye while moving hand towards eye without creating a gust of wind or touching whiskers and checking for blinking
Following response: cover one eye while throwing cotton ball across field of open eye and making sure they follow
How do you check CN 3?
Eye position: check for eye symmetry while looking at patient head on
Pupillary light reflex: Shining transilluminator into one eye, pupil should constrict (direct). Quickly glance into opposite eye to check for constriction (consensual)
How do you check CN 4?
Make sure eyes are not deviated laterally
How do you check CN 5?
Sensory: cover eye and touch the inside of each nostril
Motor: check for symmetry of muscles of mastication and that patient can hold mouth closed
How do you check CN 6?
Take a soft cotton ball into a point and gently touch the eye ball. Eyeball should retract
How do you check CN 7?
Palpebral reflex: gently touch medial and lateral canthus to fully close eye
How do you check CN 8?
Hearing: make a loud noise
Nystagmus:
–Physiologic- slowly turn patient’s head and eyes should track/follow
–Spontaneous- look head on to se if eyes are continuously moving
–Induced- check if eyes continue to click or track
How do you check CN 9 and 10?
Gag reflex
How do you check CN 11?
Check for symmetry of cervical muscles and make sure there is not torticollis (head turn)
How do you check CN 12?
Check tongue movement after gag reflex
What is Horner’s syndrome?
Lack of sympathetic input to the eye
Describe localization/syndrome in the cerebrum
Circling to side of lesion, normal gait with contralateral postural reaction deficits, mental status change, seizures
Describe localization/syndrome in the diencephalon
Can look more cerebral or more midbrain
Describe localization/syndrome in the midbrain
CN 3 and 4 deficits, decreased mental status, contralateral postural reaction deficits
Describe localization/syndrome in the pons/medulla
CN 5-12 deficits, decreased mental status, ipsilateral postural reaction deficits
Describe localization/syndrome in the cerebellum
Cerebellar ataxia, intention tremors, hypermetria
Describe cervical localization/syndrome
C1-5
UMN to all 4 limbs
UMN bladder
Describe cervicothoracic localization/syndrome
C6-T2
LMN forelimbs
UMN hindlimbs
UMN bladder
Describe thoracolumbar localization/syndrome
T3-L3
Normal forelimbs
UMN hindlimbs
UMN bladder
Describe lumbosacral localization/syndrome
L4-S3: normal forelimbs, LMN hindlimbs and bladder
L4-S1: Normal forelimbs, LMN hindlimb, UMN bladder
S1-3: Normal limbs, LMN bladder
Describe neuromuscular localization/syndrome
Neuropathy, junctionopathy, myopathy
LMN to all 4 limbs
Describe multi localization/syndrome
Multifocal
Describe cardiovascular localization/syndrome
Heart disease leading up to syncope, aortic thromboembolism
Describe orthopedic localization/syndrome
Bilateral stifle disease can look like spinal lesion
Describe T3-L3 lesion
UMN hindlimbs: increased reflexes and tone muscles
UMN bladder: difficult to express
Describe L4-S1 lesion
Femoral L4-5: extends stifle, patella reflex, flex hip
Sciatic L6, L7, S1: Extends hock, GST reflex, flex stifle
LMN hindlimbs
UMN bladder
Describe S1-3 lesion
Pelvic nerve: PSANS bladder/colon
Pudendal: Somatic motor and sensory to anal sphincter and EUS
Normal limbs
LMN bladder
Describe C1-5 lesion
White matter to all 4 limbs
UMN to all 4 limbs: increased reflexes and tone
UMN bladder
Describe C6-T2 lesion
Gray matter brachial plexus
LMN forelimbs: decrease reflexes and tone
White matter hindlimbs
UMN hindlimbs: increased reflexes and tone
Two engine gait
UMN bladder
