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BVM 3 Neurology > Neurological Exam Small Animals > Flashcards

Neurological Exam Small Animals Flashcards

1
Q

Why do we perform a neurological examination?

A

Confirm that the problem is neurological (vs. musculoskeletal, etc)
Localize the lesion in the nervous system
Severity and extent of the lesion

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2
Q

Most lameness will be _______ (system) in origin?

A

Musculoskeletal

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3
Q

What is the 5/6 finger rule?

A
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4
Q

What are the 4 spinal cord segments?

A

C1-C5
C6-T2
T3-L3
L4-S3

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5
Q

What are the 4 intracranial structures? What kind of pathology is associated with disease of intracranial structures?

A

Cerebrum, Thalamic area, Cerebellum, Brainstem
Encephalopathy

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6
Q

What part of the body is “Myelopathy” associated with?

A

Spinal cord (C1-S3)

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7
Q

What is disease of a peripheral nerve called?

A

Neuropathy

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8
Q

What is disease of the NM junction called?

A

Junctionopathy

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9
Q

What is disease of the muscle called?

A

Myopathy

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10
Q

What is the name for the nerve plexus surrounding the forelimb?

A

Brachial plexus

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11
Q

What is the name for the nerve plexus surrounding the hind limb?

A

Lumbosacral alplexus

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12
Q

What are the 2 parts of the neurological examination?

A

Hands-off exam (observation) + history
Hands-on exam + physical examination

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13
Q

What are the tools required for performing a neurological examination on small animals?

A
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14
Q

What should you be observing about the patient during the “hands off” segment of the neurological exam?
What kinds of patients is this part of the exam particularly helpful for?

A
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15
Q

What part of the brain controls mentation/mental status?

A

Cerebrum and brainstem

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16
Q

What is the ARAS? What is it made of? What structure in the brain is it a part of? What is the function?

A

Ascending Reticular Activating System - neuronal projections from brainstem into the cerebral cortex (part of the reticular formation)
Function - arouse the cerebral cortex, to awaken the brain (cortex) to a conscious level, and to prepare the cortex to receive the rostrally projecting impulses from any sensory modality

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17
Q

What is the reticular formation? What is it made from? What is the function?

A

The reticular formation is a complex meshwork of brainstem nuclei and neurons that serve as a major integration and relay center for many vital brain systems to coordinate functions necessary for survival

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18
Q

What type of abnormality should you see with issues in the ARAS?

A

Abnormalities with mentation

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19
Q

What does activating the cerebral cortex achieve?

A

Awake state + level of consciousness

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20
Q

What are the 4 levels of mental status/consciousness (from least to most concerning)?

A

Normal
Obtunded
Stuporous
Comatose

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21
Q

Stuporous/Comatose mentation is most likely associated with disease in which part of the brain?

A

Brainstem > Forebrain

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22
Q

What is the difference between Obtunded and Stuporous mentation?

A

Obtunded - dulled or reduced level of consciousness/alertness, difficult to arouse
Stuporous - awakens once stimulated, otherwise in very dull/sleep-like state, VERY difficult to arouse

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23
Q

What do wide circles vs. tight circles indicate?

A

Wide circles = forebrain
Tight circles = vestibular system

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24
Q

Do patients circle toward or away from the side of the lesion? How can this be explained?

A

TOWARD the side of the lesion

If patient has LESION on RIGHT side of the brain, the nerve impulse decussates, so the patient cannot acknowledge the LEFT side of the body, leading to CIRCLING toward the RIGHT

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25
Q

What part of the brain is headpressing associated with?

A

Forebrain

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26
Q

What is hemi-neglect syndrome? What part of the brain is this abnormal behavior associated with?
How do you localize a lesion based on this condition?

A

Patient does not acknowledge half of their space (either right or left) due to forebrain lesion.

Patient with lesion in left forebrain will only acknowledge the left side of their world due to decussation of nerve impulses to the right.

Ex. patient with right forebrain lesion (decussates to the left) only eats the food in right side of bowl, leaves left side of the bowl full

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27
Q

What part of the brain is head tilt associated with?

A

Vestibular system

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28
Q

What is pleurothotonus?

A

Head turn and body turn

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29
Q

In pleurothotonus which way does the patient turn in association with the lesion? What part of the brain is pleurothotonus associated with?

A

Patient will turn TOWARD the side of the lesion
Associated with thalamocortex/forebrain

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30
Q

What type of stance is this? What part of the brain is this type of stance associated with?

A

Wide based stance
Cerebellum

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31
Q

What is this spinal conformation?

A
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32
Q

What is this spinal conformation?

A
33
Q

What is this spinal conformation?

A
34
Q

What is this neck position called and why does this specifically occur in cats?

A

Cats do not have nuchal ligament (unlike dogs) which means that musculature is the only thing holding up the neck (no passive assistance from nuchal ligament)
In times of weakness the neck will flex ventrally (indication of significant weakness)

35
Q

What is this neck position called? What does this indicate in dogs?
What kind of body position will the animal usually have and how will they be looking around the room?

A

Animal does not want to hold the head up due to pain/discomfort around the cervical spine
Patient will stand very still and only use eyes to look around

36
Q

What is this posture?
What part of the brain can you localize this lesion to?
What is the patient’s mentation?

A

Schiff Sherrington Posture
Rigid extension of thoracic limbs, flaccid/plegic pelvic limbs
Rigidity lost/gait is normal in forelimbs upon forelimbs touching the ground
Localization - T3-L3 spinal cord segment
Mental status - normal (spinal cord does not control mentation)

37
Q

What is this posture?
What part of the brain can you localize this lesion to?
What is the patient’s mentation?

A

Decerebellate rigidity
Rigid extension of thoracic limbs, extended neck, pelvic limbs tucked under the body
Localization - cerebellum
Mental status - normal (cerebellum does not control mentation)

38
Q

What is this posture?
What part of the brain can you localize this lesion to?
What is the patient’s mentation?

A

Decerebrate Rigidity
Rigid extension of all extensor muscles, stretched out head and neck
Forebrain is functionally disconnected from the rest of the body
Localization - loss of activation of forebrain from ARAS (severe lesion at level of midbrain)
Mental status - comatose (loss of forebrain activity)

39
Q

What is the muscle tone of the thoracic limbs in schiff sherrington posture?

A
40
Q

What is the muscle tone of the pelvic limbs in schiff sherrington posture?

A
41
Q

How do you describe the gait of a patient with schiff sherrington posture?

A
42
Q

Does schiff sherrington posture affect the patient’s prognosis?

A

No - it does not have prognostic value

43
Q

What is the term for uncoordinated gait?

A

Ataxia

44
Q

What is the difference between paresis and plegia?

A

Paresis - partial reduction in motor function, inability to support weight, can be ambulatory/non-ambulatory
Plegia - complete loss of motor function

45
Q

What are the 3 types of Ataxia?

A

Cerebellar
Vestibular
General proprioceptive

46
Q

Describe cerebellar ataxia

A

Uncoordinated gait, wide-based stance
Reluctance to move, hyperflexion
Falling to the ground

47
Q

Describe vestibular ataxia

A

Uncoordinated gait
Tendency to circle (tight circles)

48
Q

Describe general proprioceptive ataxia. What type of lesion is this associated with?

A

Spinal cord ataxia
Thoracic limbs work well, pelvic limbs uncoordinated

49
Q

What are the differences between tetra, para, mono and hemi (plegia/paresis)?

A

Tetra = all 4 limbs
Para = pelvic limbs only
Mono = 1 limb only
Hemi = 1 side of body

50
Q

What is the difference between ambulatory and non-ambulatory paraparesis?

A

Ambulatory - still able to generate gait on affected limb, still able to take steps voluntarily
Non-ambulatory - Unable to put weight on affected legs, unable to generate gait independently (will do so with support)

51
Q

What is the main difference between non-ambulatory paresis and plegia?

A

Non-ambulatory paresis = can generate gait when supported, attempts to correct postural reaction (even if unsuccessful)
Plegia = unable to generate any gait, complete loss of all motor function, no attempts made to correct postural reactions

52
Q

If an animal has a seizure, what part of the brain is the lesion localized to?

A

Forebrain

53
Q

What part of the brain are generalized tremors localized to?

A

Cerebellum or Forebrain

54
Q

What are the 4 parts of the hands-on portion of the neurological exam?

A

Postural reaction testing
Spinal reflexes, muscle mass and tone
Cranial nerve assessment
Palpation focusing on areas of pain/discomfort

55
Q

Are postural reactions conscious perception or reflex? What does this mean about which organ is involved?

A

Conscious perception (proprioception)
Brain is involved

56
Q

Postural reactions will be absent ________ to the lesion? (cranial or caudal)

A

Caudal

57
Q

Are spinal reflexes decreased or increased at the level of an intumescence (swelling)/with neuromuscular diseases?

A

Decreased to absent at the site of injury/swelling

58
Q

Are spinal reflexes increased or decreased with UMN lesion?

A

Normal to Increased

59
Q

Are spinal reflexes increased or decreased with LMN lesion?

A

Decreased

60
Q

What does the cutaneous trunci reflex evaluate?

A

This reflex is commonly used in your small breed, intervertebral disc disease dogs helping to localize a spinal cord lesion.

61
Q

What is another name for the cutaneous trunci reflex?

A

Panniculus reflex

62
Q

How do you perform the cutaneous trunci reflex test? What does a positive/negative result mean?

A

This reflex is evaluated by pinching the skin just lateral to the vertebral spines bilaterally, often with your fingers in a firm manner or hemostat. A positive response is seen by a skin twitch. If the response is absent or diminished, the spinal cord lesion is 1-2 vertebrae cranial to this level would be a concern.

63
Q

Is vision a conscious or unconscious process?

A

Conscious

64
Q

Is menace response conscious or unconscious?

A

Conscious

65
Q

Is facial sensation conscious or unconscious?

A

Conscious

66
Q

Where does PLR originate?

A

Brainstem

67
Q

List the cranial nerves

A
68
Q

What are the 8 components of the cranial nerve assessment?

A
69
Q

How can you assess a patient’s vision?

A

Watch patient move in unfamiliar environment (vet office)
How does patient navigate obstacles
Visual placing
Menace response
Cotton test (tracking)
Laser (cats)
Assess in both dim and normal light

70
Q

Which cranial nerves are involved in the menace response? Which of these is sensory vs. motor?

A

CN II (sensory) and CN VII (motor)

71
Q

Which cranial nerves are involved in PLR? Which of these is sensory vs. motor?

A

CN III (oculomotor) and CN II (sensory)

72
Q

Is menace a response or a reflex?

A

Menace is a learned response

73
Q

Describe the pathway of menace response starting at the retina

A

Threat detected at retina → optic nerve II (sensory information) → optic chiasm → optic tract → visual cortex → facial nerve VII (motor information) → eye closes

74
Q

How do animals develop the menace response? What does this mean about kittens/puppies and other young animals? What is special about farm species?

A

Menace is learned from an animal’s environment
Animals <12 weeks of age have no menace response and this is normal
Ruminants/horses develop menace response much earlier as they are prey animals who need to develop much quicker in order to survive

75
Q

What types of patients can menace response be absent in (aside from neurological conditions)?

A

Stressed patients (high sympathetic tone)
Obtunded/disoriented patients

76
Q

Describe the PLR pathway

A
77
Q

Which cranial nerves are involved in the palpebral reflex? Which of these is sensory vs. motor?

A

CN V (sensory) and CN VII (motor)

78
Q

What is the order of loss of function on damage of the spinal cord?

A
  1. Loss of proprioception
  2. Loss of movements
  3. Loss of nociception
79
Q

Why is it so important to test deep nociception in a patient with a spinal cord lesion?

A

The nociception pathway lies deeper within the spinal cord than the pathways for proprioception/motor control, so a loss of nociception can indicate a very deep spinal cord lesion. This can be a poor prognostic indicator.

BVM 3 Neurology (3 decks)

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