Neuro Exam Flashcards
What needs to be observed with a neuro exam?
- Mentation
- Behaviour
- Posture
- Gait
What can be seen as wrong with mentation? Abnormalities
*Alert
*Disorientated / confused
*Depressed / obtunded
*Stuporous - unconscious but can be roused by painful stimuli
*Comatose - unconscious and unresponsive
What location of lesion is seen with stuporous / comatosed mentation?
Brainstem problem
usually more severe
no response
What is abnormal behaviour observed?
*Aggression
*Compulsive walking / circling
*Loss of learnt behaviour
*Vocalisation
*Hemineglect syndrome - ignore half of their environment - e.g only eat half of the food
What can be seen abnormal with posture? Where is the disease likely to be?
*Head tilt - vestibular disease
*Head +/or body turn - forebrain disease
What posture abnormalities are seen with advanced disease?
*Decerebrate rigidity - extension of all limbs - usually comatose / stuporous
*Decerebellate rigidity - hyperextension of Thoracic limbs
What is Schiff-sherington
- hyperextension of Thoracic Limbs (maintaining voluntary movement and normal CP) and paralysis of PLs
- interference with Border cells –inhibitory neurons in cranial lumbar spinal cord that inhibit the TL extensor muscles
- lesion in thoracic or cranial lumbar spine
What lesions can cause ataxia (uncoordinated gait)
- spinal or less commonly peripheral nerve disease
- vestibular disease (“off balance”)
- cerebellar lesions (“drunken gait”)
What does spinal ataxia cause?
*Decreased sensory information arriving from the limbs to CNS
-legs don’t know where they are
What is vestibular ataxia?
What does vestibular ataxia cause?
- loss of orientation of the head with the eyes, neck, trunk and limbs and results in loss of balance
-typically = falling, rolling towards side of lesion
What is cerebellar ataxia?
- typically with inability to regulate rate, range or force of movement –
dysmetria:
– hypometria (shorter protraction phase)
– hypermetria (longer protraction phase)
What is paresis?
-Usually from problem affecting spine
-weakness, reduced voluntary movement of limbs
What is paralysis?
Complete absence of voluntary movement
What are the 4 sections of the neuro exam?
- Postural reactions
- Spinal reflexes and muscle tone
- Spinal pain
- Cranial nerve examination
What is observed with postural reactions?
– paw position; hopping; hip sway; wheelbarrow; extensor
postural thrust; placing responses
What is observed with spinal reflexes + muscle tone?
– withdrawals; extensor carpi radialis; biceps; triceps
– withdrawals; patellar; cranial tibial; gastrocnemius;
perineal (pinch and they should withdraw)
– cutaneous trunci - start at bottom of the back - if it works no need to move up
What is observed with cranial nerve examination?
– palpebral; corneal; physiological nystagmus; menace
response; nasal mucosa stimulation; PLR; gag
What is a pain perception responose?
*Turning of head
*Vocalising
*Trying to bite
-from squeezing / pinching skin
How do you check for spinal pain?
- palpate all spine, starting gently and progressively increasing the degree of pressure
- move neck in all directions; look for pain and resistance/reluctance to move
- move tail and palpate lumbosacral region
If a dog doesnt retract the globe with a corneal reflex what is the problem?
Abducens
If a dog doesn’t blink with corneal what is the problem?
Facial N
When is nystagmus loss seen?
When raised intra cranial pressure
What is nystagmus?
Involuntary movement of the eye
What is horner’s syndrome?
*constriction of eye
*drooping of upper eyelid
*protrusion of 3rd eyelid
