Neurologic Exam

Question 1

Mentation

Answer 1

Depends greatly on owner input. Deficit implies damage to cerebrum or brainstem (reticular activating system)
Mentation can be normal, obtunded, stuporous, or comatose

Question 2

Schiff-Sherrington Posture

Answer 2

T3-L5 Lesion- often severe or acute
Ascending “self” spinal pathway disrupted, leads to disinhibition of LMNs of neck and thoracic limbs. UMNs to thoracic limbs intact, voluntary movement is still possible
Opisthotonus at rest

Question 3

Menace Response

Answer 3

Menacing gesture to eye to cause blinking
Afferent: CNII Optic
Efferent: CNVII Facial
Contralateral cerebrum and ipsilateral cerebellum also involved for recognition and coordination of movement respectively

Question 4

Visual Tracking

Answer 4

Drop cotton in front of animal, see if if sees and react to object
Afferent: CNII Optic
Uses contralateral cerebrum for recognition and reaction

Question 5

Pupillary Light Reflexes

Answer 5

Shine light in eye
Afferent: CNII Optic
Efferent: CNIII Oculomotor
Bilateral due to decussation at optic chiasm

Question 6

Corneal Reflex

Answer 6

Touch damp cotton tipped applicator to corneal surface to draw blink or globe retraction
Afferent: CNV Ophthalmic
Efferent: CNVII & CNVI Facial and Abducens

Question 7

Palpebral Reflex

Answer 7

Touch medial and lateral canthus of eye to draw blink
Afferent: CNV Ophthalmic and Maxillary
Efferent: CNVII Facial

Question 8

Physiological Nystagmus (Vestibulo-ocular reflex)

Answer 8

Normal Response. Eyes should move conjugately to head movement (forced by clinician).
Afferent: CNVIII Vestibulocochlear
Efferent: CNIII, IV, VI Oculomotor, Trochlear, Abducens

Question 9

Pathologic Nystagmus

Answer 9

Slow eye movement in one direction with rapid snapback in the other

Question 10

Lip Pinch

Answer 10

Afferent: CNV Maxillary and Mandibular
Efferent: CNVII Facial

Question 11

Nasal Stimulation

Answer 11

Could just be q-tip in nostril
Afferent: CNV Trigeminal
Looking for animal to draw back/react (contralateral cerebrum)

Question 12

Gag Reflex

Answer 12

Afferent: CNIX/X Glossopharyngeal and Vagus
Efferent: CNIX/X/XII Gp, Vagus, and Hypoglossal

Question 13

Postural Reactions

Answer 13

Abnormality is sensitive for neurological disease (but patient can simply choose not to move limb back in place) but not specific for localization (many steps in pathways for proprioception, lesion anywhere can cause abnormality).
Include: Proprioceptive placing, hopping, Wheelbarrowing, Extensor postural thrust, and visual and tactile placing

Question 14

Patellar Reflex

Answer 14

Test for femoral nerve (L4-6).

Percuss patellar tendon-> Quad should contract extending stifle

Question 15

Gastrocnemius Reflex

Answer 15

Test for Sciatic nerve (L6,7,S1)

Percuss common calcaneal tendon-> contraction of caudal thigh

Question 16

Flexion/Withdrawal Reflex

Answer 16

Mostly sciatic

Stimulate interdigital skin-> Flexion of limb

Question 17

Perineal Reflex

Answer 17

Test for Pudendal nerve S1-3

Stimulate skin next butthole, contraction of anal sphincter

Question 18

Crossed Extensor Reflex

Answer 18

Abnormal Reaction. Flexor/Withdrawal reflex during lateral recumbency

Question 19

Biceps Reflex

Answer 19

Test musculocutaneous nerve

Percuss biceps tendon-> Contraction of biceps

Question 20

Triceps Reflex

Answer 20

Test Radial nerve (main weight bearing)

Flex elbow then percuss triceps tendon-> contraction of triceps

Question 21

Cutaneous Trunci Reflex

Answer 21

Test musculocutaneous
Afferent: T3-L3 cutaneous nerves
Efferent: Lateral thoracic nerves-> C8 and T1
Bilateral
Afferent Lesion: T3-L3 Myelopathy- absence of reflex caudal to lesion (high water mark)
Efferent Lesion: C6-T2 Myelopathy- Ipsilateral loss of cutaneous trunci contraction, regardless of side of stimulation

Question 22

Flexion/Withdrawal Reflex

Answer 22

Stimulate interdigital skin-> Flexion of limb

Mostly musculocutaneous