Neuro - Single/Double Limb

Question 1

What is neuropraxia?

Answer 1

temporarily cut off blood supply

Question 2

What is axonotmesis?

Answer 2

axon of nerve dies, but schwann cells and cell bodies are still intact
- nerves can regenerate

Question 3

What is neurotmesis?

Answer 3

lost axon and myelin

nerves cannot regenerate

Question 4

What is hyperpathia?

Answer 4

stretched peripheral nerve

Question 5

What are the clinical signs of a peripheral nerve injury?

Answer 5

LMN signs

• hypo/anesthesia
• decreased reflexes
• decreased tonicity
• atrophy

Question 6

What is the treatment for peripheral nerve injury?

Answer 6

• may take up to 6 months to recover
• glucocorticoids to reduce inflammation
• physiotherapy
• amputation if no change after 6 months

Question 7

What is brachial plexus avulsion?

Answer 7

• trauma causing extensive abduction

- tears the nerve roots of C6-T2

Question 8

What could be affected in a brachial plexus avulsion?

Answer 8

C6+C7: ext/flex of shoulder
C8+T1: ext/flex of elbow/carpus
Lateral thoracic nerve: panniculs reflex
T1 ventral nerve roots: Horner’s (loss of symp to eye)

Question 9

Where do most nerve sheath tumors occur?

Answer 9

in the caudal cervical area (brachial plexus)

Question 10

What are the signs of nerve neoplasia?

Answer 10

• progressive monoparesis
• atrophy
• “root sign” hyperpathia with palpation

Question 11

What is the treatment for nerve neoplasia?

Answer 11

• resection is best

- radiation with chemotherapy

Question 12

What is a fibrocartilaginous emboli?

Answer 12

emboli originating from the nucleus pulposus, and move to the spinal cord causing ischemic myelopathy

Question 13

Describe the clinical presentation of a fibrocartilaginous emboli

Answer 13

• peraute, usually during or after exercise
• no trauma, non-progressive
• lateralizing paresis/paralysis
• not painful after initial event
• often LMN signs

Question 14

What is the treatment for fibrocartilaginous emboli?

Answer 14

• do not use steroids

- physiotherapy, rest, express bladder

Question 15

What is degenerative myelopathy?

Answer 15

degeneration of axons + myelin in thoracolumbar spinal cord

Question 16

What are the clinical signs of degenerative myelopathy?

Answer 16

• progressive paresis and ataxia
• knuckling, dragging, crossing, dysmetria, ataxia of hind limbs
• CP deficits
• UMN signs: hyper-reflexia, normal pain sensation

Question 17

When both hind legs are not working, but the fore limbs seem fine, where could the lesion be?

Answer 17

caudal to T2

Question 18

What is the treatment for degenerative myelopathy?

Answer 18

• none

- care, physiotherapy

Question 19

What happens in lumbosacral malarticulation-malformation?

Answer 19

• type 2 disc degeneration of L7/S1
• compression of the cauda equina
• proliferation of interarcuate ligaments and formation of osteophytes

Question 20

What are the clinical signs of lumbosacral malarticulation-malformation?

Answer 20

• hunched over, difficulty rising and using stairs
• flaccid tail incontinence
• pain on palpation
• paresis (sciatic, flexor of hock, pudendal, tail)

Question 21

What are the treatments for lumbosacral malarticulation-malformation?

Answer 21

• cage rest and NSAIDs

- dorsal laminectomy +/- stabilization

Question 22

Describe Hansen type 1 intervertebral disc disease

Answer 22

• in chondrodystrophic breeds

- explosive extrusion of calcified nucleus puplosus, compressing the spinal cord

Question 23

Describe Hansen type 2 intervertebral disc disease

Answer 23

• in large breed dogs
• slow protrusion of nucleus pulposus
• nucleus develops into fibrocartilage, bulges out, tears annulus, and compressed cord
• pain from stretching or dorsal ligaments

Question 24

What are the clinical signs of thoracolumbar intervertebral disc disease?

Answer 24

decrease in:

• conscious proprioception
• voluntary motor + continence
• superficial pain
• deep pain

Question 25

What are the grades for intervertebral disc disease?

Answer 25

grade 1: spinal esthesia, no neuro deficiencies
grade 2: paresis but ambulatory
grade 3: paresis and non-ambulatory
grade 4: paralysis, but deep pain intact
grade 5: paralysis with loss of deep pain

Question 26

How are grades 1-3 intervertebral disc disease treated?

Answer 26

• strict cage rest for 2 weeks
• NSAIDs, prednisone, tramadol, diazepam
• corticosteroids + no cage rest
• physiotherapy

Question 27

How is grade 4 intervertebral disc disease treated?

Answer 27

• 50-70% improve with cage rest
• empty bladder every 4 hours
• dorsolateral hemilaminectomy + fenestration

Question 28

How is a grade 5 intervertebral disc disease treated?

Answer 28

• often irreversible
• dorsal hemilaminectomy and durotomy
• intensive nursing, physiotherapy

Question 29

Describe a hemilaminectomy with fenestration

Answer 29

• remove muscles off the dorsal spinal processes
• cut off articulation facets
• drill away dorsal lamina on either side of disc space involved to expose cord
• scoop disc material out
• fenestration: remove discs on either side to prevent future occurrences

Question 30

What is diskospondylitis?

Answer 30

• infection of end plates and disc

- S. intermedius, B. canis, Strept

Question 31

What are the clinical signs of diskospondylitis?

Answer 31

• hyperesthesia, fever, depression ,weight loss
• back pain
• if untreated, can get proliferation and neurological signs

Question 32

What is Shiff-Sherington?

Answer 32

inhibitory fibers from back legs to front legs are lost, so they have stiff front legs and floppy back legs