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EQUINE MED > II - Neuro > Flashcards

II - Neuro Flashcards

1
Q

Cranial Nerve I name, function, and assessment

A

Olfactory
Smell
Response to odor without visual cues - hidden treats!

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2
Q

Cranial Nerve II name, function, and assessment

A

Optic
Vision
Menace response, pupillary light reflex, obstacle course, dazzle reflex, ophthalmic cam including retinal evaluation

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3
Q

Cranial Nerve III name, function, and assessment

A

Oculomotor

Motor function to most of the extra-ocular muscles of the eye; motor to constrictor muscles of the pupil; motor to elevator palpebrae superior is (upper eyelid)

Pupillary light reflex, assessment of pupil size, eye position; lesion causes ventral lateral strabismus

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4
Q

Cranial Nerve IV name, function, and assessment

A

Trochlear

Motor function to dorsal oblique (extra-ocular) muscle.

Eye position; lesion causes dorsomedial strabismus.

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5
Q

Cranial Nerve V name, function, and assessment.

A

Trigeminal

Motor function to the major muscles of mastication and sensory function to most skin and mucous membranes of the head.

Response to tactile stimulation of palpebral area, ear, and nostril; assessment of masticatory muscle size and tone.

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6
Q

Cranial Nerve VI name, function, and assessment

A

Abducens

Motor function to the lateral recuts and retractor bulbs (extra-ocular) muscles of the eye.

Eye position, globe retraction, corneal reflex; lesion causes medial strabismus

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7
Q

Cranial Nerve VII name, function, and assessment

A

Facial

Motor function to most of the muscles of the head; parasympathetic to salivary and lacrimal glands

Facial symmetry (look for ear droop, muzzle deviation); response to tactile stimulation of palpebral area, ear, and nostril; decreased lacrimation and secondary corneal ulceration is common

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8
Q

Cranial Nerve VIII name, function, and assessment

A

Vestibulocochlear

Vestibular function (posture and balance) and hearing

Head and eye position; assessment for nystagmus, head tilt, balance; deficits exacerbated by blindfolding; evaluation of hearing by response to auditory stimuli or BAER testing.

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9
Q

Cranial Nerve IX name, function, and assessment

A

Glossopharyngeal

Motor function to muscles of the pharynx; sensory to pharynx

Evaluation of swallowing, laryngeal movement (observation, palpation, endoscopy); endoscopy to assess laryngeal function. Dysphagia often present.

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10
Q

Cranial Nerve X name, function, and assessment.

A

Vagus

Sensory and motor function to pharynx and larynx

Evaluation of swallowing, laryngeal movement (observation, palpation, endoscopy); endoscopy to assess laryngeal function. Dysphagia often present.

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11
Q

Cranial Nerve XI name, function, and assessment

A

Accessory

Motor function to cervical muscles

Muscle atrophy; not routinely assessed

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12
Q

Cranial Nerve XII name, function, and assessment

A

Hypoglossal

Motor function to tongue

Tongue strength, symmetry; tongue replacement response

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13
Q

Define paresis.

A

Decreased strength in the limbs.

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14
Q

Define ataxia.

A

Unconscious, general proprioceptive deficit causing poor coordination when moving the limbs and body

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15
Q

Define spasticity.

A

Stiff or spastic movement of the limbs with little flexion of the joints, increased extensor tone

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16
Q

Define dysmetria.

A

Abnormality in rate, range, or force of a movement; may seem both hypometric and hypermetric

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17
Q

Describe signs of paresis.

A

Dragging of toes
Knuckling at the fetlock
May be more easily observed when walking on hills

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18
Q

Describe signs of ataxia.

A

Swaying or weaving of the body or limb
Abducted or addicted foot placement
Crossing of the limbs
Stepping on a foot

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19
Q

Describe signs of spasticity.

A

Short-strided, stiff gait
Tin soldier appearance

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20
Q

Describe signs of dysmetria.

A

High stepping gait with limited movement of distal joints

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21
Q

Paresis lesion Iocations

A
  • Can be UMN or LMN but generally have more severe muscle atrophy with LMN
  • Peripheral nerves
  • Musculoskeletal
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22
Q

Ataxia lesion locations

A
  • General proprioceptive sensory pathways (spinal cord white matter)
  • Vestibular
  • Cerebellar
  • Peripheral disease
23
Q

Dysmetria lesion locations

A
  • Cerebellum
  • Spinocerebellar tracts
24
Q

Clinical evidence for lesion in the brain, cranial to the foramen magnum

A

Abnormal behavior, seizures, abnormal mental status, aimless wandering or circling, head pressing, sleep alterations, central blindness

25
Q

Clinical evidence for a brain stem lesion

A

Cranial nerve deficits, weakness, ataxia, altered mental status (obtunded, stuporous, comatose)

26
Q

Clinical evidence for a cerebellar lesion

A

Intention tremors, hypermetria of limbs, ataxia, possible menace deficits

27
Q

Clinical evidence of cervical (C1-C7) lesion

A

Gait and proprioceptive deficits in all four limbs with no sign of brain, brain stem, or cranial nerve deficits; generally UMN deficits of thoracic and pelvic limbs; often pelvic limbs show more severe deficits than thoracic limbs

28
Q

Clinical evidence of C6-T2 lesion

A

LMN signs (weakness, paresis, decreased to absent muscle tone and reflexes) to thoracic limbs with UMN of pelvic limbs

29
Q

Clinical evidence for lesion of the thoracolumbar spine (T2-L3)

A

Gait deficits confined to the pelvic limbs with normal thoracic limbs

30
Q

Clinical evidence for lesion in L4-S1 region

A

Normal thoracic limbs with LMN signs to pelvic limbs

31
Q

Clinical evidence for lesion at the sacral and coccygeal spine

A

Normal thoracic limbs; pelvic limbs normal or LMN; cauda equina signs including deficits in perineal sensation, poor tone, poor anal tone

32
Q

Clinical evidence for peripheral nerve lesion

A

Neurogenic atrophy, loss of sensation in affected areas, weakness, loss of muscle tone

33
Q

Clinical evidence for multifocal/disseminated disease

A

Signs of lesions in more than one neuroanatomical location

34
Q

Clinical evidence for lesion of the sympathetic nervous system

A

Horner’s syndrome: miosis, ptosis, prolapsed third eyelid, enophthalmos, unilateral sweating

35
Q

Normal mentation
Normal cranial nerves
Normal sacral nerve segments
Ataxia, proprioceptive deficits in all limbs

Lesion localization:

A

Cervical spinal cord

36
Q

Treatment for head trauma

A

Osmotic diuretics for edema - Mannitol, hypertonic saline
Anti-inflammatories, analgesics - NSAIDs
Anti-convulsants if indicated - diazepam
Supportive care
Advanced critical care

Corticosteroids controversial

37
Q

Three-week-old Arabian colt
Normal parturition
Physically normal since birth
Normal baseline physical exam
Excellent farm management
Acute onset of “falling over”

Possible DFDX:

A

Juvenile idiopathic epilepsy
- seizures stop between 1-2 years
- excellent long-term prognosis

38
Q

Seizures can be difficult to distinguish from: (5)

A
  • syncope due to heart disease
  • electrolyte disorders, muscle fasciculations
  • muscle diseases (e.g. HYPP)
  • anaphylaxis
  • sleep deprivation
39
Q

What are the most common causes of seizures in horses?

A

Intracarotid injection
Hepatoencephalopathy
Trauma
Infectious diseases - viruses
Toxins

40
Q

Neonates are most susceptible to what conditions that can cause seizures?

A

Hypoxia-ischemic damage
Metabolic derangement
Inherited/congenital abnormalities

41
Q

Treatment for seizures

A

Treat underlying disease

Anti-convulsants
- acute: diazepam
- maintenance: phenobarbital

Other anti-convulsants: potassium bromide, phenytoin, primidone

42
Q

Neuro non-infectious DFDX

A
  • Trauma
  • Seizure disorders
  • Leukoencephalomalacia
  • Nigropallidalencephalomalacia
  • Sleep disorders
  • Neoplasia, mass lesion
  • EDM
43
Q

Neuro infectious DFDX

A
  • Encephalitis viruses (Eastern, Venezuelan)
  • West Nile virus
  • Rabies
  • EPM
  • Migrating parasites
  • Meningitis (primarily foals)
  • Other viruses
44
Q

Twelve-year-old warmblood mare

  • Kicked by another horse, laceration, swelling, pain
  • Flunixin meglumin and enroflaxin administered IV
  • Immediate seizure episode
  • Unresponsive, recumbent
  • HR 20-24 beats/min
  • RR 4-6 breaths/min
  • No PLR
  • Hypothermic

Possible DFDX:

A

Intracarotid injection

Jugular vein and common carotid artery are right next to each other at the distal portion of the neck. The further up the neck you go, the thicker the omohyoideus muscle becomes, separating the two vessels.

  • Cortical blindness may improve with time
  • Self-trauma during seizure activity
  • Brain trauma
45
Q

What causes equine leukoencephalomalacia?

A

“Moldy corn disease”

Corn contaminated with Fusarium moniliforme while growing; toxin fumonisin B1 produced

46
Q

What are the clinical signs of equine leukoencephalomalacia?

A

Acute onset (3-4 weeks post ingestion)

Anorexia, depression, ataxia, circling, blindness, head pressing

Recumbency, seizures, death in 2-3 days

47
Q

Ante-mortem diagnosis of equine leukoencephalomalacia

A

Clinical signs, history
Fumonisin in feed
CSF - xanthochromia, increased protein, pleocytosis

48
Q

Postmortem diagnosis of equine leukoencephalomalacia

A

Necropsy - focal liquefactive necrosis; sometimes hepatic involvement

49
Q

Treatment of equine leukoencephalomalacia

A

Symptomatic, supportive
Check other horses
Remove from feed as soon as suspected

50
Q

Etiologic agent for nigropallidal encephalomalacia

A

Yellow star thistle (Centaurea soltitialis)
Russian knapweed (Acroptilon repens)

Ingestion of large amounts over weeks to months

51
Q

Premortem diagnosis of nigropallidal encephalomalacia

A

Clinical signs and confirmed access to plants

52
Q

Clinical signs of nigropallidal encephalomalacia

A

Sudden onset
Retracted lips, continuous chewing movements
Aimless walking, circling, ataxic, tetra-acetic
Impaired eating and drinking
Unable to chew and propel food to larynx

Usually able to swallow

53
Q

Treatment of nigropallidal encephalomalacia

A

No treatment
No recovery

54
Q

Factors limiting recumbent sleep / contributing to sleep deprivation

A

Pain associated with recumbency
Don’t feel safe: environmental, social-behavioral factors

EQUINE MED (13 decks)

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