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Equine Surgery and Medicine > Nervous system > Flashcards

Nervous system Flashcards

1
Q

General considerations

A

Is it necessary to use life-saving methods
Is it a nervous system problem or is it a kindey/ liver problem
Is it cerebral, spinal or a peripheral dysfunction
Acute or chronic
Infectious disease? herpes type 1, rabies, WNV

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2
Q

Types of neurological diagnosis

A

Functional or symptomatic
Anatomical
Pathological
Aetiological

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3
Q

The importance of history

A

Because of the limitations of the examination
Characteristic of neuropathies e.g epilepsy the clinical signs are not always present– put in cameras
Missing subjective info
Infectious diseases! vaccines and epidemics

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4
Q

The disturbing factors that could change the horses behaviour and therefore the clinical signs

A

Restraints
Sedatives
Environment

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5
Q

Methods of physical exam

A 
Inspection
Palpation
Postural reactions 
Vertebral reflexes 
Cranial nerves 
Sensitivity
Pain perception: supf vs deep
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6
Q

Ancillary diagnostic methods

A 
Neuroradiography
Nuclear scintigraphy
Computed tomography 
MRI
Electroencephalography 
Lab tests
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7
Q

Neuroradiography

A

Plain
Myelography- compression of SC
Angiography- bvs both cerebral and vertebral

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8
Q

Lab tests

A

Blood is NB to see if another organ system is involved
Urine
CSF!!! NB can do cultures and PCR

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9
Q

Structure of the physical exam

A 
Head!! always start here and check:
Behaviour 
Mental status 
Head posture and coordination
Cranial nerves 
Gait and posture 
Neck and forelimbs 
Trunk and hindlimbs 
Tail and anus 
Cerebrum
Brain stem 
Cerebellum
SC
Peripheral nerves and the muscles they supply
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10
Q

Lesion at C1-C5

A

Tetraparesis and neck pain

Normal-exaggerated spinal reflexes

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11
Q

Lesion at C6-T2

A

Tetraparesis and neck pain
Decreased/absent thoracic limb spinal reflexes
Normal-exaggerated spinal cord reflexes on the pelvic limbs

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12
Q

Lesion at T3-L3

A

Paraparesis and back pain
Normal thoracic limb spinal reflexes
Normal- exaggerated pelvic limb spinal reflexes

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13
Q

Lesion at L4-S3

A

Paraparesis and lower back pain
Normal thoracic limb spinal reflexes
Decreased/absent spinal reflexes on the pelvic limbs

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14
Q

Caudal lesions

A

Paresis of tail
Decreased tail tone
Decreased tail sensation

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15
Q

Localisation of lesions

A

Use the foramen magnum as a gauge
Anything cranially will be a brain issue

Assume central lesion and look at clinical sign, check if they are explicable with lesions in front of the FM.. if not, go one level caudally and try again until you can explain the signs.

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16
Q

What can cranial nerve signs be an indication of?

A

Cerebral, cerebellar or brainstem disease

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17
Q

Cerebral disease

A

Seizures
Blindness
Dementia
Mild ataxia or weakness

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18
Q

Cerebellar disease

A

Hypermetria
Intention
Tremors
Weakness

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19
Q

Brainstem disease

A

Gait deficits
Altered consciousness
Tetraparesis

20
Q

Head posture and coordination

A

Movements at the antlantooccipital joint

Control of the cerebrum, cerebellum and vestibular system

21
Q

Head posture and coordination: vestibular lesion

A

Head tilt

22
Q

Head posture and coordination: cerebral lesion

A

Deviation toward the side of the lesion

Head and neck are not in the body axis so there is circling

23
Q

Head posture and coordination: cerebellar lesion

A

jerky movements during voluntary movements and fine tremor when at rest

24
Q

What does a left head tilt usually indicate?

A

skull injury

25
Q

Cranial nerves

A 
Olfactory
Optic 
Oculomotor 
Trigeminal
Facial
Vestibulocochlear 
Glossopharyngeal, vagus and acc
Hypoglossal
26
Q

Olfactory

A

use food to examine

27
Q

Optic

A

Menace: rapidly approaching- should blink

Test for vision: different obstacles

28
Q

Oculomotor

A

Pupillary light reflex
Simple: light in one eye and see how same pupil reacts
Consensual: light in one eye and check the pupil of the other eye, the nerve crossing the optic chiasm– anisocoria if different pupil sizes

29
Q

Disturbances of the oculomotor nerve

A

Strabismus: abnormal position of the eyeball

Nystagmus: abnormal movement of the eye can be physio during movement of the head and superficial anaesthesia

Horner's syndrome: Damage of sympathetic nerves 
miosis
ptosis (hanging upper lid)
enophthalmos 
Localized sweating in the cervical area
30
Q

What is the normal position of the eye

A

line btw medial and lateral canthus to angle of the pupil

31
Q

Trigeminal nerve

A

Facial cutaneous sensation- stick fingers into nares
Palpebral reflex- the sensory component- touch upper eyelid
Corneal reflex- sensory- use cotton to touch
Chewing and movements of the jaw

32
Q

Facial nerve

A

Facial symmetry and movement so paralysis is easy to see

Palpebral and corneal reflexes- the motor activity

33
Q

Vestibulocochlear nerve

A

hearing and balance

34
Q

Vagus group (glossopharyngeal, vagus and acc)

A

Swallowing reflex
Thoraco-laryngeal adductor test= slap test to diagnose laryngeal nerve paralysis
Slap withers on one side and then palpate larynx on the opposite side, more common left-sided paralysis

35
Q

Hypoglossal nerve

A

Tongue function

36
Q

Ataxia

A

lack of coordination

graded from 1-5, 5 being lateral recumbency

37
Q

Dysmetria

A

hypo or hypermetria due to abnormal range or force of motion

38
Q

Hypometria

A

voluntary movement shorter than intended goal
too little joint movement
dragging of hooves

39
Q

Hypermetria

A

voluntary movements overreaching the intended goal
excessive joint movement
e.g WNV encephalitis with held-up tail

40
Q

Paresis

A

muscle weakness resulting from neurologic dysfunction

41
Q

Paralysis

A

cannot move voluntarily

42
Q

Evaluation of the neck and forelimbs

A
  1. With food
  2. Cervicoauricular reflex- tap neck at C2 and ear on the same side moves
  3. Cervical cutaneous sensation- hemostat
  4. Deep pain perception- press coronary band- not reliable
  5. Sway reaction- lateral pressure on withers
  6. Dorsal pressure on withers- stability and balance
  7. Postural reactions/ Correction tests:
    crossing limbs
    put legs into wider stance
    sideways hopping if safe! lift up one leg
43
Q

Evaluation of the trunk and hind limbs

A

similar to forelimb!
Sway reaction- push tuber coxae laterally, if doing it while walking pull the tail
pressure on the lumbar region

44
Q

Recumbent horses: forelimb tests

A

flexor reflex: thermostat pinching
biceps reflex: hammer in front of shoulder joint
Triceps reflex: just above olecranon

45
Q

Recumbent horses: hindlimb flexors reflexes

A

Tibial- plantar aspect of the metatarsus
Peroneal- dorsal part of tarsus and metatarsus
Femoral- medial thigh

Patellar: lift leg a bit and tap on the ligament

46
Q

Recumbent: ability to lift head, neck and limbs used for localization of the lesion

A

Can only lift head: cranial cervical region
Head and neck: caudal cervical region
‘Dog-sitting’- lesion in cervical cord
Functional thoracic limbs- caudal to T2
Deficit in trunk/hindlimbs- between T2 and S2
Localised sweating- desc symp tracts

Equine Surgery and Medicine (10 decks)

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