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Neuro > LA Neuro Exam > Flashcards

LA Neuro Exam Flashcards

1
Q

What does a dropped elbow indicate in horses?

A
  • radial n. damage and paralysis

- d/t scapula avulsion on brachial plexus with trauma

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2
Q

Where does white and grey matter lie within the brain and spinal cord?

A

> Spinal cord
- white matter outside, grey inside
Brain
- grey matter outside, white inside

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3
Q

What is grey and white matter/

A
  • white = myelinated axons

- grey = cell bodies

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4
Q

What clues int he history may help with your dx?

A
  • horse looking or acting clumsy before being found down?
  • respiratoy disease?
  • other horses involved?
  • behavioural abnormlaities/video
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5
Q

What clues in the PE may help with your dx?

A
  • non-neuro reason?
  • icteric hore with depression indicating 1* liver/systemic problem
  • lameness eg. foot abscess?
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6
Q

What is a radiculopathy?

A
  • trapped nerve base of neck leads to problems only when neck is in flexion (eg. with long reins)
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7
Q

How can forebrain function be assessed?

A

> mentation - bright or depressed, responsive ?

> behaviour - bizarre circling, hyperaesthesia, head TURN, odd postures, reversing

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8
Q

Where do seizures occour?

A

FOREBRAIN

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9
Q

Is cerebellar dz common in horses ?

A

No v rare cf. smallies
- BUT high level well bred dressage horses with high floating gate show some abnormalities of the spinal canal that may indicate spinal compression causing the hypermetria - interesting. nb. this is not cerebellar dz/

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10
Q

What cranial nerve response is affected by cerebellar disease?

A

Menace absent or dimished

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11
Q

Is weakness seen with cerebellar disease?

A

NO

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12
Q

What inherited condition is present in arabs?

A

cerebellar abiotrophy

- v rare still

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13
Q

What structures are present int he brainstem? What clinical relevance is this?

A
  • pons and medulla
  • reticular formation (controls levels of consciousness)
  • ascending propriceptive and descending upper motor neuron pathways
  • cranial nerve nuclei
    > dysfunction of a combination of these modalities - suspect brainstem, including
  • altered levels of conciousness
  • weakness (shuffly gait) and ataxia
  • CN deficits
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14
Q

How are acute brainstem lesions gained in horses?

A
  • fx basioccipital and basiethmoid?? bone underlying brainstem when they rear and fall backwards
  • > heamatoma and haemorrhage into the GPs
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15
Q

What is the afferent and efferent limbs of the PLR?

A
  • afferent optic 2

- efferent parasympathetic fibres of occulomotor 3

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16
Q

Pathway of menace?

A
  • optic nerve
  • optic chiasm
  • thalamus
  • OPPOSITE occipital cortex
  • facial n. and nucleus
  • cerebellum
    > FOREBRAIN INVOLVED
17
Q

Which species have the highest proportion of decussation at the optic chiasm?

A
  • prey species d/t no need for binocular vision (85% cf. predators 50%)
18
Q

How is vision best assessed?

A
  • walk around obstacles
  • fundic exam
  • menace (afferent limb)
19
Q

Which nerves control occular position?

A

III, IV, VI

20
Q

afferent and efferent limbs of the retractor oculi reflex?

A

press on cornea through eyelid + feel for retraction

  • afferent trigem V
  • efferent aducens VI
21
Q

What does trigem 5 provide?

A
  • sensory to majority of face

- motor mm. of astication (masseter and temporalis mm.)

22
Q

Which cranial nerves are often affected together?

A

facial VII and vestibular VIII d/t anatomical location

23
Q

Which way do head tilts go wrt the lesion?

A

TOWARDS the lesion d/t loss of innervation of extensor muscles ?? LOOK UP

24
Q

How can central and peropheral vestibular dz be differentiated?

A
  • type of nystagmus (central anything and can change, peripheral always HORIZONTAL)
  • weakness
  • other CNs involved
25
Q

How can lesion be identified from nystagmus?

A
  • fast phase always AWAY from lesion (run away!)
26
Q

How can pharyngeal/laryngeal function be tested?

A
  • swallowing
  • vocalisation
  • slap test for intrinsic laryngeal mm.?? (old, not really used anymore)
  • endoscopy
    > tests IX and X glossopharyngeal and vagus
27
Q

What are extra-pyramidal effects and what are they seen with commonly? Tx?

A
  • behavioural changes at level of midbrain (look Up)
  • can be seen with FLUPHENAZINE toxicity (used illegallly as sedative)
  • Tx: Diphenhydramine
28
Q

How is Horner’s system seen in horses?

A

(interuption of sympathetic nerve pathyway between hypothalamus and eye)

  • ptsosis (eyelashes)
  • miosis
  • enopthalmus and prominent TE
  • conjunctival and nasal hyperaemia
  • patchy SWEATING in the region where nerve supply interrupted (different to other species as PS controlled so vasodialtion -> ^ sweating)
29
Q

Where does sympathetic supplies to the skin and eyes originate? What branches are there?

A
  • hypothalamus, travels down neck to exit C____-C____
  • vagosympathetic trunk from cervical spine to head, 3rd order neurons to eye and skin
  • vertebral n. branch supplies the neck (so if neck not sweating can localise lesion to head)
  • shorter branches supply the dorsal trunk
30
Q

What are the main signs associated with ataxia in the horse?

A
  • hypermetria
  • hypometria
  • dysmetria (combo)
  • TRUNCAL SWAY
  • PACING
  • CIRCUMDUCTION
31
Q

How can neuromuscular and neurological gait defects be distinguished (crudely!)

A
  • irregularly irregular = neuro

- regularly irregular = (neuro??)muscular/musculoskeletal

32
Q

Give an example of lamnesses that can present as ataxia like gait

A
  • bilateral pelvic limb suspensory desmitis
  • sacroiliac pain
    > deficit still usually regular
33
Q

Potential causes of weakness?

A

Neuro or systemic

- eg. granulomatous enteritis v. equine motor neuron disease

34
Q

What does the tail pull test show?

A

> standing
- LMN deficit
walking
- UMN deficit

35
Q

Give some lamenesses caused by muscle disease

A
  • post excercise lamenss
  • exertional rhabdomyolysis
  • polysaccharide storage myopathy
  • ischaemic myopathy d/t parasites (aorto-iliac thrombosis)
  • measure CK and AST
36
Q

Are spinal reflexes tested in horses?

A

> not really
- if horse is standing,a ssume spinal reflexes intact
withdrawal reflexes useful if recumbent
limb weakness can indicate local spinal cord damge

37
Q

What sacral and perineal signs may be seen in horses and what do these indicate damage to?

A
  • perineal reflex
  • sensation
  • tail flaccidity
  • rectal exam
  • urinary incontinence
    > cauda equina damage commonly d/t sacral fx
    > can cause hyperaesthesia, will rub hair off
38
Q

Potential systemiatic methods of neuro exam in the horse?

A
  • systematic modality approach (proprioception, reflexes etc.)
  • anatomic head to tail approach
  • combo?

Neuro (30 decks)

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