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ACVS Phase II 2022 > Neurology > Flashcards

Neurology Flashcards

1
Q

Nakamoto
Progressive Myelomalacia
Vet Surg 2021

A

Extensive hemilaminectomy & Durotomy = 100% survival

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2
Q

Woelfel
Paraplegia in Med-Large dogs
Vet Surg 2021

A

Factors independently associated with outcome included

  • clinical severity = poor
  • number of vertebrae with signal interruption in HASTEi = more extensive epidural hemorrhage
  • ratio of vertebral sites decompressed to HASTEi = better
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3
Q

Fenn
Anesthesia duration and outcome
JVIM 2020

A

Median anesthesia time
Regain ambulation 4 h
Did not 4.5 h

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4
Q

Zidan
Long-term pain
JVIM 2020

A

15% chronic pain

others normalized by 6 months

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5
Q

Longo
MRI assessed disc degeneration recurrence in dogs tx for IVDD
JVIM 2021

A

Finding a completely degenerate disc in the T10 to L3 region (in addition to the operated site) at the time of surgery was associated with a hazard ratio of 2.92 for recurrence of clinical signs.

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6
Q

Bosch
Facetectomy on Biomechanics in C-spine
VCOT 2017

A

Facetectomy increased range of motion of primary motions in all directions.

Axial rotation was significantly influenced by facetectomy.

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7
Q

Schneider
Incidence of abnormalities of C-spine with AA Instability
VCOT 2017

A

The incidence of anomalies affecting the C2/3

  • dogs with AAI was 38.46%
  • control group it was 11.97%

The majority of the observed anomalies involved the intervertebral disc.

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8
Q

Crawford
Compare Hemilaminectomy with anulectomy or partial discectomy
VCOT 2018

A

Early postoperative neurological deterioration
HA group 16/29*
HPD group 7/24

Sustained clinical improvement
HA group 9/22
HPD group 17/23*

Clinical Significance Hemilaminectomy with partial discectomy for decompression of thoracolumbar intervertebral disc protrusion was associated with decreased postoperative neurological deterioration and increased sustained clinical improvement compared with hemilaminectomy with anulectomy.

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9
Q

Conte
T Vertebral Stenosis w/ Screw Tail
VCOT 2021

A

Stenotic ratio of 0.56 associated with clinical signs

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10
Q

Caraty
Tail avulsion
JSAP 2018

A

11/15 cats recovered voluntary tail function and pain sensation within 14 to 90 days (mean 39 days).
5/8 previously incontinent cats recovered urinary continence within a month of surgery.

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11
Q

Skytte
Pre-op neurologic score w/ intervals to regain micturition and ambulation
JAVMA 2018

A

regaining micturition was 4.1 d (3 at 2.9, 2 at 6)

regaining ambulation was 13.8 d (3 at 6.9, 2 at 28.8)

negative correlations with MFS were identified for interval to regaining micturition (r = –0.63) and interval to regaining ambulation (r = –0.64)

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12
Q

Tirrito
Agreement of Sx decompression and PO MRI
JAVMA 2020

A

The correlation between surgeons’ perception and postoperative MRI findings for the degree of spinal cord decompression achieved was only fair.

Unsatisfactory spinal cord decompression as assessed via postoperative MRI was associated with
~severity of preoperative neurologic grade
~preoperative compression, thoracolumbar (vs cervical) IVDE
~ventral (vs ventrolateral or dorsolateral) circumferential distribution of extruded material.

Satisfactory (vs unsatisfactory) decompression as assessed via MRI was associated with
~lower postoperative neurologic grade
~greater likelihood of a successful outcome
~lower mean recovery time.

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13
Q

Spence
MRI related to Body Weight
JAVMA 2021

A

IVDD
< 15 kg 94.7%
≥ 15 kg 58.4%

Dogs weighing < 15 kg had a significantly higher inci- dence of IVDD lesions in the T12-13 segment, compared with dogs weighing ≥ 15 kg.

Dogs weighing ≥ 15 kg were Neoplastic 11.9 times
FCE 7.4 times

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14
Q

Modified Frankel Score

A

0: Tretraplegic with no DP
1: Tetraplegia with superficial sensation
2: Tetraplegia with nociception
3: Nonambulatory tetraparesis
4: Ambulatory tetraparesis
5: Hyperesthesia

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15
Q

Patellar Reflex

A

L4/L6

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16
Q

Biceps Reflex

A

C7/T2

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17
Q

Withdrawal FL

A

C6/T2

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18
Q

Withdrawal HL

A

L6/S1

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19
Q

M-Wave

A

Initial Negative (upward) deflection

Stimulate motor nerve
Travels to muscle
Recorded by sensor in muscle

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20
Q

F-Wave

A

Supramaximal antidromic motor n.

Stimulate motor nerve
Travels up to ventral gray matter, back down to muscle
Recorded by sensor in muscle

21
Q

H-Wave

A

Sensory, efferent arm in ventral horn cells & alpha motor neuron

Stimulate motor nerve
Ravels up to ventral gray mater, through afferent arm of reflex arc, back down to muscle
Recorded by sensor in muscle

22
Q

Hounsfield units

A 
Air
Fat
Water
Brain
Acute Clot
Bone/Mineral
Metal
23
Q

Substances with high signal on T1

A 
Fat
Methemoglobin
Protein binding
Gadnium
Melanin
24
Q

Substances with high signal on T2

A 
CSF
Edema
Necrosis
Inflammation
Demyelination
25
Q

Abs with good BBB penetration

A 
3rd Generation Cephlasporin
Fluoroquinolones
Metronidazole
Sulfonamides
Chloramphenicol
Trimethoprim
26
Q

Perineal Reflex

A

Sacral n.

Pudendal n.

27
Q

Sensory nerves to FL

A

Craniomedial- Radial n
Medial antebrachium- Musculocutaneous n.
Caudolateral- Ulnar n.

28
Q

Surgery for AA lux Dorsal approach

A

AA wiring
Nuchal Ligament
Dorsal Cross Pin
Kishigami AA Tension Band

29
Q

Surgery for AA lux Ventral approach

A

Transarticular screws or pins - 30 degrees
Pins & PMMA - 30 degrees
Screws & PMMA - 90 degrees
Ventral Plating

30
Q

Grades of Nerve Damage

A 
I: Interruption of function, not structure
II: Axon damage, internal preserved
III: Axon and Endoneurm injured
IV: Perineurium
V: Entire nerve severed
31
Q

Cervical IVDD Sx Tx

A 
Ventral Slot
Slanted Ventral Slot
Dorsal Laminectomy
Limited Dorsolateral Approach for Hemilaminectomy
Fenestration
32
Q

Complications associated with Cervical Sx

A 
Respiratory Compromise
Intraoperative Cardiac Dysrhythmias
Blood Loss
Neurologic Deterioration
Ventral Instability and Subluxation
Seroma Formation
33
Q

Components of Disc Associated Spondylomyelopathy

A

Ventral compression by disc protrusion
Dorsal compression hypertrophy of dorsal longitudinal ligament and yellow ligament
Asymmetric disc protrusion causing compression of SC and nerve root compression

34
Q

Components of Osseous Associated Spondylomyelopathy

A

OA proliferation of articular process

Dorsal hypertrophy of yellow ligament

35
Q

Nerves associated with Micturition

A

Hypogastric n - sympathetic
Pelvic n - Parasympathetic
Pudendal n - Somatic

36
Q

Urine storage

A

Sympathetic
~Beta: Detursor Relax
~Alpha: Internal Urethral Tone

Cholinergic
~Parasympathetic- increase detrusor tone
~Somatic- decrease urethral sphincter tone

37
Q

Components of the Lumbar Intumescence

A 
L4/6- Femoral n.
L6/S1- Sciatic n.
S1/3- Pelvic n.
S1/3- Pudendal n.
Cd1/5 Caudal n.
38
Q

Function of Femoral n.

A

Flex hip

Extend Stifle

39
Q

Function of Sciatic n.

A

Extend Hip
Flex Stifle
Flex/ Ext Tarsus

40
Q

Components of LS Stenosis

A 
Bulging annulus & nucleus pulpous
Thinking of dorsal annulus
Spondylosis deformans
Osteophyte within caudal ventral foramen
Thickening of joint capsule & zygapophyseal joint
Thicking of the yellow ligament
41
Q

Position that exacerbates LS Herniation

A

Extension

42
Q

Postion that alleviates LS Herniation

A

Flexion

43
Q

Horner’s syndrome associated with Cervical Spine

A

C6/T2

44
Q

Disc Associated Spondylomyelopathy Distraction-Stabilization

A 
Pins & PMMA
Screw Bar- PMMA
PMMA Plug
Locking Place
Disc Arthroplasty
45
Q

Complications associated with Wobler Sx

A 
Neurologic Deterioration
~Dorsal 70%
~Ventral 42%
Vertebral Foramen & Transverse Foramina Penetration 25-57%
Domino Effect 20%
Laminectomy Membrane 8%
Implant Failure 7-30%
Collapse of Intervertebral Foramina
Insufficient Decompression
46
Q

Fixation of Lumbar Fx/ Lux/ Sublux

A

Pin & PMMA - 30-60 degrees
External Fixator
SOP Plates

47
Q

Fixation of Cervical Fx/ Lux/ Sublux

A

Screws & PMMA

Unilock System

48
Q

3 compartment model of vertebra

A 
Dorsal
~Spinous process
~vertebral laminae
~articular process
~vertebral pedicles
~dorsal ligament complex

Middle
~dorsal longitudinal ligament
~dorsal portion oof annulus fibrosus
~dorsal portion of the vertebral body

Ventral
~vertebral body
~lateral and ventral portions of the annulus fibrosus
~nucleus pulposus
~ventral longitudinal ligament

ACVS Phase II 2022 (43 decks)

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