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RUSVM Small Animal Medicine I 2016 > Neurological Examination > Flashcards

Neurological Examination Flashcards

1
Q

Upper Motor Neuron Signs

A

Paralysis
Normal or Hyperreflexia
Normal to Increased Muscle Tone
Disuse Muscle Atrophy

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2
Q

Lower Motor Neuron Signs

A

Paralysis
Hyporeflexia or areflexia
Muscular hypotonia
Severe, rapid muscle atrophy

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3
Q

Upper motor neuron location

A

composed of cell bodies (in the cerebral cortex or brain stem) and their axons in the brain stem or spinal cord

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4
Q

Upper Motor Neuron

A

responsible for the initiation of voluntary movements and maintenance of tone in extensor muscles for posture

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5
Q

Lower Motor Neuron locations

A

cell bodies in the brain stem (cranial nerves) or ventral horn of the spinal cord (Peripheral nerves) supplying muscles and glands of the body

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6
Q

Lower Motor Neurons

A

are under voluntary control (via UMNs) and can also be controlled by reflex activity in the spinal cord

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7
Q

Where do signs occur with UMN lesion in the spinal cord or brain stem?

A

ipsilateral

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8
Q

Where do signs occur with UMN lesion in the cerebral cortex or diencephalon?

A

contralateral

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9
Q

Where do signs occur with LMN lesion?

A

ipsilateral

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10
Q

Where is conscious proprioception conveyed?

A

Cerebellum

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11
Q

What do Long tract sensory neurons carry?

A

conscious proprioceptions
pain
touch

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12
Q

Lesions to the long tract sensory neurons results in?

A

Anesthesia or hypoesthesia caudal to the lesion
Normoreflexia
abnormal positioning of feet
dysmetria (usually hypermetria: steps are longer and higher than normal)
Ataxia

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13
Q

Lesions between C6-T2:

A

LMN of the forelimbs
UMN of the hindlimbs
Long tract sensory signs of the hind limb

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14
Q

Lesions between T3-L3:

A

Normal front limbs
UMN and long tract sensory signs in the hindlimbs
UMN Bladder

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15
Q

Lesions caudal to L3:

A

Normal front limbs
LMN signs of the hind limbs
LMN bladder

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16
Q

What is located at C6-T2

A

Cervical Intumnescence

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17
Q

What is located at L4 to S3

A

Pelvic Intumnescence

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18
Q

Lesions between C1 - C3:

A

UMN signs to all limbs

UMN Bladder

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19
Q

Lesions between L4-S3:

A

Normal Fore limbs
LMN of hindlimbs
LMN Bladder

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20
Q

Lesions caudal to L7:

A

minimal pelvic limb dysfunction

Fecal and Urinary Incontinence

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21
Q

Lesions of the caudal to S1

A

only tail dysfunction

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22
Q

Lesions of the brain

A 
unilateral or bilateral UMN signs in the limbs
Seizures
Changes in behavior 
cranial nerve deficits
decreased consciousness
cerebellar signs
vestibular signs
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23
Q

What are the 9 steps to approaching a patient with neurological dysfunction

A
  1. Determine case signalment and owners complaint
  2. Obtain History
  3. general physical exam
  4. neurological exam and localize lesion/s
  5. DDx
  6. Collect Minimum database
  7. Do special diagnostic tests
  8. Establish prognosis with and without treatment
  9. Initiate therapy if necessary
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24
Q

What is the sequence of a neurological exam?

A
  1. Observation of mental status, posture, and gait
  2. Palpation of muscular and skeletal systems
  3. Evaluation of postural reactions
  4. Evaluation of cranial nerves
  5. Evaluation of spinal nerves
  6. Evaluation of sensation
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25
Q

Depression

A

lack of responsiveness to nornal environmental stimulation.

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26
Q

Stupor

A

the animal is severely depressed but can be aroused with painful stimuli

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27
Q

Coma

A

when the animal is severely depressed and cannot be aroused by stimuli

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28
Q

Reticular Activating System

A

responsible for the arousal of the cerebrum

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29
Q

What controls goal directed behavior?

A

Cerebrum

Thalamus

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30
Q

Site of Intelligence and goal-direct behaviors

A

Thalamocortex

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31
Q

What are signs of a lesion in the Thalamocortex?

A

circling
head pressing
a decrease and absence of awareness of what is going on around the animal

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32
Q

Ataxia

A

lack of coordination indicated by lack of awareness of limb position

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33
Q

What are the 3 forms of Ataxia?

A
  1. Sensory (conscious proprioception
  2. Cerebellar
  3. vestibular
34
Q

What are signs of a cerebellar lesion?

A

Broad based stance
dymetria (exaggerated advancement of limbs): Hypometria or Hypermetria
Intention tremors
signs seen on the opposite limbs

35
Q

Signs of vestibular lesions

A 
falling
circling
rolling toward the affected side
head tilt
nystagmus
36
Q

How do you tell which side has the lesion with Nystagmus?

A

Slow phase is always towards the lesion

37
Q

What are signs of cranial nerve I damage?

A

unable to smell

38
Q

What are signs of cranial nerve II damage?

A

inability to see

39
Q

What are signs of cranial nerve III damage?

A

paralysis of eyeball

strabismus

40
Q

What are signs of cranial nerve IV damage?

A

lateral rotation of the eyeball (slanted pupil in cats)

rotation of the dorsal retinal vein

41
Q

What are signs of cranial nerve V damage?

A

atrophy of the masseter muscle and temporal muscles
decreased jaw tone with bilateral lesion
does not respond to tactile sensation such as twitching of nose or ear

42
Q

What are signs of cranial nerve VI damage?

A

medial strabismus

inability to retract the globe

43
Q

What are signs of cranial nerve VII damage?

A 
dropped lip 
drooping ear
loss of palpebral reflex
dry eyes
decreased salivary production
44
Q

What are signs of cranial nerve VIII damage?

A 
Does not respond to auditory stimuli
Head tilt
circling 
falling to affected side
Nystagmus
45
Q

What are signs of cranial nerve IX damage?

A

Loss of gag reflex

dysphagia

46
Q

What are signs of cranial nerve X damage?

A

Loss of gag reflex

47
Q

What are signs of cranial nerve XI damage?

A

Atrophy of the neck muscles

deviation of the neck to one side

48
Q

What are signs of cranial nerve XII damage?

A

Lack of tongue tone
deviation of tongue to one side
atrophy and fibrosis of the tongue

49
Q

Cranial Nerve I

A

Olfactory

50
Q

Cranial Nerve II

A

Optic

51
Q

Cranial Nerve III

A

Oculomotor

52
Q

Cranial Nerve IV

A

Trochlear

53
Q

Cranial Nerve V

A

Trigeminal

54
Q

Cranial Nerve VI

A

Abducens

55
Q

Cranial Nerve VII

A

Facial

56
Q

Cranial Nerve VIII

A

Vestibulocochlear

57
Q

Cranial Nerve IX

A

Glossopharyngeal

58
Q

Cranial Nerve X

A

Vagus

59
Q

Cranial Nerve XI

A

Accessory

60
Q

Cranial Nerve XII

A

Hypoglossal

61
Q

What does the perineal reflex test?

A

the pudendal nerve

62
Q

What should happen in the perineal reflex test?

A

contraction of the anus
lifting of the vulva
dropping of the tail

63
Q

What does the patellar reflex test?

A

Femoral nerve

64
Q

What does the cranial tibial reflex test?

A

Sciatic nerve

65
Q

What does the Flexor withdrawal reflex test in the hindlimbs?

A

Sciatic and Femoral nerve

66
Q

What does the Flexor withdrawal reflex test in the fore limbs?

A

Musculocutaneous and median/ulnar nerves

67
Q

What does the Extensor Carpi radialis reflex test?

A

Radial nerve

68
Q

What are the 4 things tested for with the Flexor Withdrawal reflex?

A
  1. Withdrawal of the limb- flexion of all joints
  2. strength to withdrawal
  3. behavioral reaction to stimulus
  4. no cross extensor reflex present
69
Q

What disease process decreases the strength of the flexor withdrawal reflex?

A

Myopathies

70
Q

What are the clinical signs of a UMN Bladder?

A

small easily palpable
urethral sphincter is closed
brief forceful expulsions of urine
not easily expressed manually

71
Q

What are clinical signs of a LMN Bladder?

A 
atonic 
markedly dilated
no sphincter tone
urine exits freely by gravity 
bladder is easily expressed
72
Q

What drugs do you treat an UMN bladder with?

A

Phenoxybenzamine
Prazosin
Flomax

73
Q

What drugs do you treat an LMN bladder with?

A

phenylpropanolamine

bethanecol

74
Q

What is a sign of a grave prognosis?

A

absence of deep pain

75
Q

Hyperesthesia

A

touch causes immense pain usually due to stretching of the nerve roots

76
Q

What causes elevated CSF pressure?

A 
Neoplasia
severe metabolic and toxic disturbances
abscesses
meningitis
status epilepticus
77
Q

What causes low CSF pressure?

A

poor technique
hydrocephalus
severe dehydration

78
Q

Yellow or xanthochromic CSF

A

old hemorrhage
vascular disorders
infection
systemic icterus

79
Q

Cloudy or turbid CSF

A

Bacterial infection

80
Q

Pink or red CSF

A

Blood contamination

Recent Hemorrhage

81
Q

Elevated CSF Protein levels

A

trauma
vascular disorders
primary or secondary neoplasia
spinal cord degeneration

RUSVM Small Animal Medicine I 2016 (9 decks)

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