Neuro examination Flashcards
What are the 6 parts of a neurological exam?
1) Observe mental status gait and posture
2) Palpate muscular and skeletal system
3) Evaluate postural reactions
4) Evaluate cranial nerves
5) Evaluate spinal nerves–C6-T2; L3-S3
6) Evaluate sensation
What is the point of lesion localization?
To decrease length of MRI’s and other scans (safer for the animal)
What would you see with a lesion from C1-C5?
Upper signs in all 4 limbs
What lesion is associated with lower motor neuron signs in the forelimbs but upper signs in the hindlimbs?
C6-T2
What signs would you see with a lesion between T3-L3?
Normal forelimbs, upper signs in hindlimbs
If a dog entered your clinic and your neuro exam showed normal forelimbs but lower motor neuron signs in the hindlimbs, where would the lesion most likely be located?
L4-S3
When observing the mental state of an animal, what is the difference between:
- Alert
- Depression
- Stupor
- Coma
1) Alert = Apprehensive (usually), notices sounds, movements, etc.; knows what’s going on in the room
2) Depression = Not taking note of surroundings
3) Stupor = Animal only responds to pain stimulus
4) Coma = Animal doesn’t respond to anything
What is the reticular activating system controlled by?
What will be affected if it stops functioning?
Brainstem
Intelligence, cranial nerves; animal will seem lethargic, somnolent
What will you see with a lesion in the thalamocortex?
Behavioral changes:
Pacing, head pressing, inability to distinguish day/night, incontinence; owner will complain that the animal “isn’t the same,” or “doesn’t know me anymore”
Seizures can also occur
What changes can you see when observing posture during the neuro exam?
Orientation of body parts:
Head tilt, ventroflexion, knuckling
*Often see orientation problems due to muscle weakness in cats with potassium deficiency
Tell me about ataxia
Observed when looking at gait; incoordination
Can be cerebellar problem: important in coordination of movement; animal will sway from side to side (‘drunken’ state)
Can be vestibular problem: no balance information
What do you palpate in the neuro exam?
Musculoskeletal system–atrophy, joints, discs
Palpate up and down spinal cord to look for pain response
What do postural reactions tell?
What are the 6 postural tests?
Mostly only tell if there is a problem or not
1) CP deficits
2) Hopping
3) Placing
4) Wheelbarrowing
5) Extensor postural thrust
6) Hemi-walking
Cranial nerves–which are observed and where do they all come from?
Facial, vestibulocochlear, trigeminal, trochlear oculomotor abducens
They all go through the brainstem
What structure does the facial nerve run through?
Why is this an issue?
How do you differentiate what could be causing issues with the nerve?
The facial nerve runs through the ear.
Problems could easily be due to the ear and not the brainstem
When due to ear issues: animal shakes head, can see problems through otoscope
When due to brainstem issue: animal will not be acting right, will have gait issues, etc.
MOTOR SIGNS (super duper important)
know: function, tone, reflexes, atrophy
- Complete LMN
- Partial LMN
- Complete UMN
- Partial UMN
Perineal reflex
Most reliable reflex
Keep in mind that the spinal cord ends around L4-L5 in the dog (why the cauda equina exists)
Patella
Best and easiest reflex!
Cranial tibial flexor withdrawal
All joints
Sensation
Strength
Crossed?
Extensor carpi radialis flexor withdrawal
Panniculus reflex
Muscle twitch
