Neuro exam of SA Flashcards by Maude Tanguay

What is the 5 finger rule?

onset
clinical course
lateralisation
pain
neuroanatomical localisation

signalment

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What ddx categories worsen over time?

inflammatory
neoplastic
nutritional
degenerative
anomalous

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What ddx categories are severly acute and get better over time?

toxic
trauma
vascular

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What do we observe at the start of a neuro exam?

mental status
behaviour
posture
body position at rest
evaluation of gait
abnormal involuntary movements

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What is the ascending reticular activating system ARAS?

activates the forebrain
keeps the awake state
controls level of consciousness

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What neuroanatomical location is affected with an obtunded animal?

forebrain

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What neuroanatomical location is affected with a stuporous animal?

brainstem

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What neuroanatomical location is affected in a comatose animal?

brainstem

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What neuroanatomical location is affected in an animal making wide circles?

forebrain on the side they are circling towards
they are ignoring the side they can’t control

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What neuroanatomical location is affected in an animal making tight circles?

vestibular system

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What neuroanatomical location is affected in an animal doing head pressing?

forebrain

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What abnormalities can be observed with the posture and body position at rest?

head tilt
wide based stance
pleurothotonus (head + body turn)
abnormalities of trunk/ curvatures
rigidity postures

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What neuroanatomical location is affected in an animal with head tilt?

vestibular system

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What neuroanatomical location is affected in an animal with pleurothotonus?

thalamocortex
forebrain

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What neuroanatomical location is affected in an animal with a wide based stance?

when trying to not fall over

cerebellum

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What is the difference between scoliosis, kyphosis and lordosis?

scoliosis: sideway curve
kyphosis: hunchback (pain?)
lordosis: arched

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What does low head carriage indicate?

cervical hyperaesthesia?

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What is schiff-sherrington?

rigidity posture when recumbent
t3-l3 myelopathy
thoracic limbs: extended and increased tone
pelvic limbs: decreased muscle tone
paraplegic or severely non ambulatory paraparetic
*not of prognostic value

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What are the characteristics of gait analysis that we should be observing in a neuro exam?

coordinated vs uncoordinated (ataxia)
loss of motor function? paresis vs plegia
lame? othopaedic vs neurologic

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What are the types of ataxia?

uncoordinated gaits, sensory function affected

cerebellar ataxia
vestibular ataxia
general proprioceptive ataxia

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What is decerebellate rigidity?

rigidity posture when recumbent
cerebellar affected
normal mentation
tilted pelvis, extention of legs and neck
usually fine w/thoracic but not pelvic limbs when asked to walk

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What is decerebrate rigidity?

rigidity posture when recumbent
brainstem/disconnected forebrain affected
commatose patient
increase in tone of extensor muscles go very stiff

What is a cerebellar ataxic gait?

problem with cerebellum

wide base
struggle to coordinate
high steps
decerebellar rigidity when recumbent?

What is a vestibular ataxic gait?

problem with vestibular system

slightly tilt
tendency to fall

What is a proprioceptive ataxic gait?

nerve problem UMN/LMN? very uncoordinated crossing and overstepping legs

What is paresis?

partial loss of motor function inability to support weight can be ambulatory (can still move on its own for a few steps) or non-ambulatory (can't move on its own, has some flexion capabilities)

What is plegia?

complete loss of motor function

What is the difference between non-ambulatory tetraparesis and tetraplegia?

non-amb. tetraparesis: when the weight is supported, can still swing all 4 legs tetraplegia: when weight is supported, can't move any legs

What neuroanatomic location is affected to cause seizures?

forebrain

What neuroanatomical location is affected to cause generalised tremors?

cerebellum or forebrain

What should we test hands-on in a general neuro exam?

postural reaction testing spinal nerve reflexes, muscle mass and tone cranial nerve assessment palpation vs areas of pain/discomfort

What does postural reactions test?

conscious perception (brain is involved, not a reflex) tests sensory (long pathway), animal needs body weight supported foot placement, hopping, wheelbarrow, table/wall

What spinal reflexes can we test and where?

thoracic limbs: withdrawal reflex pelvic limbs: withdrawal reflex, patellar reflex cutaneous trunci reflex perianal reflex

What are the key points to remember when interpreting spinal reflexes?

UMN modulates the LMN LMN feeds info to muscles in spinal cord conditions the deficits are caudal to the lesion

When c1-c5 is affected, what is the muscle tone and spinal reflexes?

all 4 limbs affected normal to increase in all 4 limbs

When c6-t2 is affected, what is the muscle tone and spinal reflexes?

all 4 limbs affected reduced to absent in thoracic limbs normal to increase in pelvic limbs

When t3-l3 is affected, what are the muscle tone and spinal reflexes?

thoracic limbs not affected normal to increase in pelvic limbs

When l4-s3 is affected, what are the muscle tone and spinal reflexes?

thoracic limbs not affected reduced to absent in pelvic limbs

What are the CN and brain part assessed with vision?

conscious CNII and forebrain

What are the CN and brain parts assessed with menace response?

conscious CN II and CN VII forebrain and cerebellum

What are the CN and brain part assessed with facial sensation?

conscious CN V forebrain

What are the CN assessed with PLR?

CN III

What are the CN assessed with palpebral reflex?

CN V and CN VII

What are the CN assessed with facial symmetry?

CN VII

What are the CN assessed with vestibulo-ocular reflex?

CN VIII CNIII CN IV CN VI

What are the CN assessed with jaw tone?

CN V

What are the CN assessed with swallowing reflex?

CN IX CN X

What are the CN assessed with tongue symmetry?

CN XII

What are the CN?

1: olfactory 2: optic 3: Oculomotor 4: trochlear 5: trigeminal 6: abducent 7: facial 8: vestibulocochlear 9: glossopharyngeal 10: vagus 11: accessory 12: hypoglossal One Of Our Three Tigers Acts For Very Gross Vegans After Hours

How can we assess vision?

dim light vs normal moving in unfamiliar environments obstacle course visual placing menace response cotton test/tracking laser (cats)

What is important to consider with the mence response?

learnt response absent in first 10-12w. for dogs and cats absent in stressed, obtunded or disoriented ptx