Neurological Exam SA Flashcards
Outline the five finger rule
Signalment Onset Clinical Course Lateralisation Pain Neuroanatomical localisation
What are the segments of the spinal cord?
C1-C5
C6-T2
T3-L3
L4-S3
What neuro condition gets better with time?
Toxic
Trauma
Vascular
Anomalous
What neuro condition gets worse with time?
Inflammatory Neoplastic Nutritional Degenerative Anomalous
What type of neuro condition is characterised by waxing and waning signs?
Metabolic
What should you observe on hands off exam?
Mental status and behaviour
Posture and body position at rest
Evaluation of gait
Involuntary movement
What is required for a patient to be BAR?
Forebrain and reticular formation of brain stem
Need the ascending RAS to be awake
Describe the scale from stupendous to comatose
Normal
Obtunded
Stuperous
Comatose
Describe an obtunded patient
Decreased interest in surroundings, slowed psychomotor response
Describe a stuperous patient
Only responds to Pain consciously - i.e, forebrain response
Describe a comatose patient
No response to stimuli
What can cause a patient to be obtunded?
Forebrain or brainstorm lesion or due to other systemic illness
Where can you localise a lesion to if the patient is stuperous or comatose?
Brain stem
What is disorientation typically associated with ?
Vestibular system
What does wide circling indicate?
What does the direction of the circling indicate?
Forebrain lesion
Circle towards the side of the lesion
Why does an animal circle towards the side of the forebrain lesion ?
If they have a left forebrain lesion they won’t be able to perceive stimuli from the right
Therefore they avoid the right and circle left
What does head pressing indicate ?
What diagnostics are indicated?
A bilateral symmetrical problem
Likely metabolic problem e.g. hepatic encephalopathy or renal encephalopathy
Systemic bloods
What would hemi-neglect of the left side of a bowl indicate?
A right forebrain lesion
What system is indicated in head tilt?
Vestibular
What is pleurothotonus ?
Head turn
What is indicated in a wide based stance posture?
Cerebellum / vestibulocerebellar
What causes ventroflexion of the neck in cats ?
Why does this occur?
Loss of muscle tone in the neck
Cats don’t have a nuchal ligament
What are the rigidity postures seen in recumbent animals ?
Decerebellate
Decerebrate
Schiff-Sherrington
What spinal segment is indicated in schiff-Sherrington rigidity?
T3-L3
Describe schiff-Sherrington rigidity
TL - extended and increased tone
PL - decreased muscle tone
How does the Schiff - Sherrington posture occur?
Border cells tonically inhibit extensors
Lesion causes loss of tonic inhibition to thoracic limb = extended forelimb
What are the types of ataxia?
Cerebellar
Vestibular
Proprioceptive
Describe what you would expect to see in cerebellar ataxia
Positioning of legs uncoordinated and exaggerated movements
What is meant by the term paresis ?
Partial loss of motor function and inability to support weight
Can be ambulatory or non-ambulatory
What is meant by the term plegia?
Complete loss of motor function
What hands on examination is involved in a neuro exam?
Postural reaction testing
Spinal reflexes, muscle mass and tone
CN assessment
Palpation of painful areas
Does postural testing assess a reaction or a reflex?
REACTION - have to be conscious to assess
What do postural reactions assess?
Afferent, Ipsilateral spinal cord , ipsilateral brainstem contralateral forebrain
How can you assess postural reactions?
Paw position Hopping Wheel barrow Extensor postural thrust Hemiwalking
What section of the spinal cord is associated with the patellar reflex ?
L4-L6
what does a patellar reflex usually indicate?
Femoral n problem
When would you expect menace to be absent?
First 10-12weeks
Stressed patients
Lethargic patients
Disorientated patients
What CN Does PLR test?
CNII+III
What CN does menace test?
CNII + VII
What CN does the vestibule-ocular reflex test?
VIII
III+IV+VI
What CN does the palpebral reflex test?
CNV + VII
What CN does the corneal reflex test?
CNV + VI/II
Is facial sensation a reflex?
NO
What lesion would be indicated by decreased facial sensation on the left?
Contralateral lesion
What CN are tested with the gag reflex ?
CNIX and X