Neuro - Single/Double Limb Flashcards
What is neuropraxia?
temporarily cut off blood supply
What is axonotmesis?
axon of nerve dies, but schwann cells and cell bodies are still intact
- nerves can regenerate
What is neurotmesis?
lost axon and myelin
nerves cannot regenerate
What is hyperpathia?
stretched peripheral nerve
What are the clinical signs of a peripheral nerve injury?
LMN signs
- hypo/anesthesia
- decreased reflexes
- decreased tonicity
- atrophy
What is the treatment for peripheral nerve injury?
- may take up to 6 months to recover
- glucocorticoids to reduce inflammation
- physiotherapy
- amputation if no change after 6 months
What is brachial plexus avulsion?
- trauma causing extensive abduction
- tears the nerve roots of C6-T2
What could be affected in a brachial plexus avulsion?
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)
Where do most nerve sheath tumors occur?
in the caudal cervical area (brachial plexus)
What are the signs of nerve neoplasia?
- progressive monoparesis
- atrophy
- “root sign” hyperpathia with palpation
What is the treatment for nerve neoplasia?
- resection is best
- radiation with chemotherapy
What is a fibrocartilaginous emboli?
emboli originating from the nucleus pulposus, and move to the spinal cord causing ischemic myelopathy
Describe the clinical presentation of a fibrocartilaginous emboli
- peraute, usually during or after exercise
- no trauma, non-progressive
- lateralizing paresis/paralysis
- not painful after initial event
- often LMN signs
What is the treatment for fibrocartilaginous emboli?
- do not use steroids
- physiotherapy, rest, express bladder
What is degenerative myelopathy?
degeneration of axons + myelin in thoracolumbar spinal cord
What are the clinical signs of degenerative myelopathy?
- progressive paresis and ataxia
- knuckling, dragging, crossing, dysmetria, ataxia of hind limbs
- CP deficits
- UMN signs: hyper-reflexia, normal pain sensation
When both hind legs are not working, but the fore limbs seem fine, where could the lesion be?
caudal to T2
What is the treatment for degenerative myelopathy?
- none
- care, physiotherapy
What happens in lumbosacral malarticulation-malformation?
- type 2 disc degeneration of L7/S1
- compression of the cauda equina
- proliferation of interarcuate ligaments and formation of osteophytes
What are the clinical signs of lumbosacral malarticulation-malformation?
- hunched over, difficulty rising and using stairs
- flaccid tail incontinence
- pain on palpation
- paresis (sciatic, flexor of hock, pudendal, tail)
What are the treatments for lumbosacral malarticulation-malformation?
- cage rest and NSAIDs
- dorsal laminectomy +/- stabilization
Describe Hansen type 1 intervertebral disc disease
- in chondrodystrophic breeds
- explosive extrusion of calcified nucleus puplosus, compressing the spinal cord
Describe Hansen type 2 intervertebral disc disease
- 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
What are the clinical signs of thoracolumbar intervertebral disc disease?
decrease in:
- conscious proprioception
- voluntary motor + continence
- superficial pain
- deep pain
What are the grades for intervertebral disc disease?
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
How are grades 1-3 intervertebral disc disease treated?
- strict cage rest for 2 weeks
- NSAIDs, prednisone, tramadol, diazepam
- corticosteroids + no cage rest
- physiotherapy
How is grade 4 intervertebral disc disease treated?
- 50-70% improve with cage rest
- empty bladder every 4 hours
- dorsolateral hemilaminectomy + fenestration
How is a grade 5 intervertebral disc disease treated?
- often irreversible
- dorsal hemilaminectomy and durotomy
- intensive nursing, physiotherapy
Describe a hemilaminectomy with fenestration
- 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
What is diskospondylitis?
- infection of end plates and disc
- S. intermedius, B. canis, Strept
What are the clinical signs of diskospondylitis?
- hyperesthesia, fever, depression ,weight loss
- back pain
- if untreated, can get proliferation and neurological signs
What is Shiff-Sherington?
inhibitory fibers from back legs to front legs are lost, so they have stiff front legs and floppy back legs
