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Fel Med > Neurology > Flashcards

Neurology Flashcards

1
Q

Describe oculomortor nerve parasympathetic involvement in eye

A

Provides parasympathetic fibers to iris that reduces iris size

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2
Q

Which cranial nerves provide parasympathetic innervation?

A

CNs 3, 7, 9, & 10

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3
Q

List CNs responsible for opening & closing eyelids

A

Oculomotor (III) opens and facial (VII) closes

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4
Q

Describe facial nerve parasympathetic involvement

A

Provides parasympathetic innervation to lacrimal and salivary glands

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5
Q

This CN, b/c of its many branches, can be damaged with prolonged lateral recumbency

A

CN VII, facial

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6
Q

Facial nerve sensory component serves

A

Lingual mucosa (taste)

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7
Q

Syndrome whereby myoclonic seizures and generalized tonic-clonic seizures (GTCSs) are instigated by high frequency sounds

A

Feline audiogenic reflex seizures (FARS)

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8
Q

FARS has reportedly responded better…

A

To levetiracetam than phenobarbital

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9
Q

“Chewing” muscles innervated by

A

CN V, trigeminal nerve (mandibular branch)

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10
Q

Provides motor input to tongue

A

CN XII, hypoglossal

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11
Q

Provides motor input for muscles of throat, neck, and cranial back/shoulder

A

CN XI, accessory nerve

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12
Q

The recurrent laryngeal nerve branches from the __ nerve

A

Vagus, CN X

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13
Q

The fibers of the vagus nerve are primarily __, providing for functions such as ___ & ___

A

Motor; vocalization; swallowing

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14
Q

The vagus nerve is associated with the __ branch of the autonomic nervous system.

A

Parasympathetic

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15
Q

Stimulation of the vagus nerve causes

A

Decreased heart rate and increased gut motility

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16
Q

The sensory fibers of the vagus nerve are associated with

A

Areas of the throat, thoracic, and abdominal viscera

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17
Q

Inhibitory neurotransmitter that is a derivative of glutamic acid

A

Gamma-aminobutyric acid (GABA)

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18
Q

Amino acids that are excitatory in the CNS

A

Glutamic acid and aspartic acid

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19
Q

One subtype of EPSP glutamate receptor (named for other molecule it binds)

A

N-methyl D-aspartate (NMDA) receptor

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20
Q

Inhibitory amino acid neurotransmitters

A

Glycine
Gamma-aminobutyric acid (GABA)

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21
Q

Neurons of the peripheral nervous system (PNS) that conduct impulses away from the CNS are known as

A

Motor or efferent neurons

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22
Q

The 2 major categories of motor/efferent neurons are

A

Somatic and autonomic

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23
Q

The spinal cord white matter is composed of __ & __ fiber tracts

A

Ascending & descending

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24
Q

The spinal cord white matter fiber tracts are named to indicate whether they are ___ or __

A

Ascending (sensory) or descending (motor) tracts

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25
Q

The names of the ascending spinal cord tracts usually start with ___ and end with __

A

Spino-; name of the brain region where the spinal cord fibers first synapse

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26
Q

The names of descending motor (spinal) tracts start with __ and end with __

A

The brain region that gives rise to the fibers and end with the suffix -spinal

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27
Q

Catecholamines are

A

Derived from tyrosine and are epinephrine, norepinephrine, and dopamine

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28
Q

Describe the relationship between ACh and myasthenia gravis

A

Muscle weakness in MG is due to the autoantibody-mediated ACh receptor destruction

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29
Q

The 2 types of ACh receptors

A

Nicotinic & muscarinic

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30
Q

Acetylcholine (ACh) is the neurotransmitter of all

A

Parasympatheic and sympathetic preganglionic fibers and all somatic motor neurons

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31
Q

The neurotransmitter released by most parasympathetic postganglionic fibers at their synapse with effector cells

A

Acetylcholine (ACh)

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32
Q

The neurotransmitter released by most postganglionic sympathetic nerve fibers is

A

Norepinephrine

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33
Q

In the sympathetic division of the autonomic nervous system, preganglionic fibers exit

A

The spinal cord from T1 to L2

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34
Q

In the parasympathetic division of the autonomic nervous system, the preganglionic fibers originate in

A

The brain and S2-S4

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35
Q

The 2 major classes of receptor proteins for catecholamine neurotransmitters

A

Alpha- and beta-adrenergic receptors

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36
Q

The 2 subtypes of the 2 adrenergic classes of receptors

A

Alpha-1 & alpha-2, beta-1 & beta-2

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37
Q

Adrenergic effect associated with alpha-1 receptors in the eye

A

Contraction of the radial fibers of the iris dilates the pupils

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38
Q

Adrenergic effects of beta-1 (primarily) receptor in the heart

A

Increase heart rate and contraction strength

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39
Q

Adrenergic effects of alpha-1 receptor in skin and visceral vessels

A

Arterioles constrict due to smooth muscle contraction

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40
Q

Adrenergic effects of alpha-1 receptor on skeletal muscle vessels

A

Arterioles constrict due to sympathetic nerve activity

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41
Q

Adrenergic effects of beta-2 receptor on skeletal muscle vessels

A

Arterioles dilate due to hormone epinephrine

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42
Q

Adrenergic effects of beta-2 receptors in lungs

A

Bronchioles dilate due to smooth muscle relaxation

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43
Q

Adrenergic effects of alpha-1 receptor on stomach and intestine

A

Contraction of sphincter slows passage of food

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44
Q

Adrenergic effects of alpha-1 & beta-2 receptors on liver

A

Glycogenolysis and secretion of glucose

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45
Q

The effects of ACh are always excitatory when released by

A

Somatic motor neurons and by preganglionic autonomic neurons

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46
Q

The effects of ACh released by post-ganglionic parasympathetic axons are

A

Usually excitatory but in some cases, inhibitory

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47
Q

Nicotinic ACh receptors are always

A

Excitatory

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48
Q

Some postganglionic autonomic axons do not involve ACh or norepinephrine, are called __, an example of which is__

A

Nonadrenergic/noncholingergic fibers; axons innervating the blood vessels of the penis

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49
Q

Atropine (belladonna) specifically blocks

A

Muscarinic ACh receptors

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50
Q

Stimulation of the radial muscles in the eye by ___ nerves causes __

A

Sympathetic; contraction of the radial muscles, which causes pupil dilation

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51
Q

Stimulation of the eye circular muscles by __ nerves causes __

A

Parasympathetic; causes circular muscle contraction, which constricts the pupils

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52
Q

The effects of the sympathetic and parasympathetic stimulation on the urinary and reproductive tracts are __

A

Cooperative

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53
Q

Organs without dual innervation (by sympathetic & parasympathetic nerves)

A

Adrenal medulla
Arrector pili muscles in the skin
Sweat glands in skin
Most blood vessels

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54
Q

Thermoregulatory responses to heat (and cold) rely on this autonomic system

A

Sympathetic

55
Q

Disturbances in the state of consciousness are classified in order of severity as

A

depression, lethargy, obtundation, stupor (semicoma), coma

56
Q

As a rule, altered states of consciousness relate either to a

A

Diffuse lesion or widespread multifocal lesions of both cerebral hemispheres, or a focal lesion affecting the ascending reticular activating system (ARAS) of the brainstem

57
Q

The ascending reticular activating system (ARAS) of the brainstem functions to

A

Arouse the cerebral cortex and maintain the state of wakefulness

58
Q

Paresis is defined as __ and implies __

A

A loss of ability to support weight (LMN disease) or inability to generate a gait (UMN disease); implies that some voluntary movement is still present

59
Q

The term paralysis refers to a more severe __, with __

A

Paresis; with compete (-plegia) loss of voluntary movement

60
Q

The cerebrum’s contribution to the gait is less important __

A

Less important in in cats compared with primates

61
Q

Cats often carry their tail elevated straight dorsally when

A

When they are suffering a significant loss of balance

62
Q

A normal gait requires intact function of

A

Requires intact function of the brainstem, cerebellum, spinal cord, and sensory and motor peripheral nerves, neuromuscular junctions, and muscles

63
Q

Ataxia definition

A

Is an uncoordinated gait

64
Q

Ataxia can arise from

A

From a peripheral nerve or spinal cord lesion (general proprioceptive ataxia), a vestibular lesion (vestibular ataxia), or a cerebellar lesion (cerebellar ataxia)

65
Q

Contrary to UMN peresis, disorders of the LMN do not cause __, only __

A

Ataxia, only paresis

66
Q

Preferred postural reaction tests in felines

A

Wheelbarrowing and tactile placing

67
Q

The hopping test is performed by

A

Restraining 3 limbs and suddenly lowering cat to floor. As soon as extended limb hits the floor, cats should be moved laterally to force him/her to hop on that limb. The thoracic limbs should be carefully compared.

68
Q

A hopping movement should be

A

Smooth and fairly rapid, not irregular or excessive

69
Q

Wheelbarrowing is performed with

A

The neck extended and the pelvic limbs elevated

70
Q

In tactile placing, when the __ makes contact with ___, the cat should___

A

Campus makes contact with the edge of the table, the cat should immediately place his/her foot on the surface (neck extended to obscure view of table)

71
Q

Postural reaction pathways (afferent & efferent)

A

Afferent arm: joint proprioceptor, peripheral sensory nerve, spinal cord and brainstem ascending pathways, contralateral forebrain
Efferent arm: contralateral forebrain, descending motor pathways within the brainstem and spinal cord, peripheral motor nerve and skeletal muscle

72
Q

The UMN/LMN arrangement

A

The UMN system is confined to the CNS; the cell body of an UMN is in the cerebral cortex, basal nuclei, brainstem, or spinal cord. Nerve impulses travel through the brain &/or spinal cord white matter and synapse indirectly (via interneuron) with a LMN
The LMN cell body lies within the ventral horn of the spinal cord grey matter or within the cranial nerve nucleus of the brainstem. Its axon leaves the CNS by the ventral nerve roots to join successively a spinal nerve and a peripheral nerve before it synapses with an effector muscle

73
Q

During gait generation, the UMN synapses indirectly with the LMN to

A

Modulate (essentially inhibit) its activity

74
Q

Paraparesis/-plegia affects

A

Pelvic limbs affected

75
Q

Monoparesis affects

A

Only 1 limb

76
Q

Hemiparesis/-plegia affects

A

Limbs on 1 side

77
Q

As. a continuation of the gait and postural reaction assessment, __ should be considered

A

Spinal reflex evaluation, but not as a sole entity

78
Q

Following gait and postural reactions testing, the clinician should be able to

A

Narrow down the lesion localization to being Cr to T3 spinal cord segments, Cd to the T3 spinal cord segments, , or within the PNS (peripheral nerve, neuromuscular junction, or muscles)

79
Q

Spinal reflex evaluation helps to narrow the lesion localization by

A

Testing the integrity of the C6 toT2 and L4 to S3 intumescences, as well as the respective segmental sensory and motor nerves that form the peripheral nerve, and the muscles innervated

80
Q

Postural reaction tests

A

Hopping, wheelbarrowing, tactile placing (paw position/knuckling less preferred in cats)

81
Q

Neuroanatomical diagnosis if gait/postural reactions decreased to absent in all 4 limbs

A

Generalized polyneuropathy/junctionopathy/myopathy

82
Q

Neuroanatomical diagnosis if gait/postural reactions are decreased to absent bilaterally in pelvic limbs

A

L4-S3 spinal cord segments, peripheral nerve roots/nerves of pelvic limbs affected

83
Q

Neuroanatomical diagnosis if gait/postural reactions decreased to absent in unilateral thoracic limb

A

Spinal cord segments C6-T2, or nerve roots, brachial plexus or peripheral nerves of affected limb

84
Q

Spinal reflexes do not require __ & are __

A

Consciousness; segmental

85
Q

The most reliable spinal reflex tests in cats

A

Withdrawal reflex and patellar reflex

86
Q

In the thoracic limb, the withdrawal reflex test evaluates

A

C6-T2 & associated nerve roots, brachial plexus, peripheral nerves (radial, axillary, musculocutaneous, median and ulnar) & muscles innervated

87
Q

In pelvic limb the withdrawal reflex test evaluates

A

L4-S1 spinal cord segments and associated nerve roots, femoral and sciatic nerves and muscles innervated

88
Q

In nociception testing, limb withdrawal is only the flexor reflex and should not __

A

Should not be interpreted as evidence of pain perception

89
Q

The patellar reflex test evaluates the integrity of

A

The L4-L6 spinal cord segments, associated nerve roots, and femoral nerve

90
Q

Cats with stifle disease can exhibit a weak or absent __

A

Patellar reflex

91
Q

An exaggerated patellar reflex can appear

A

With a lesion cranial to the L4 spinal cord segment
In an excited/nervous cat (in absence of other neurologic signs)

92
Q

A pseudo-hyperreflexia of the patellar reflex can occur

A

In a cat with a sciatic nerve or L6-S1 spinal cord segment lesion (due to decreased muscle tone in the muscles that flex the stifle and normally counteract stifle extension during the patellar reflex)

93
Q

The menace response can be

A

Particularly difficult to elicit in a normal cat and its absence should be interpreted with caution

94
Q

When the menace response is questionable, try

A

Visual placing response

95
Q

Anisocoria and dyscoria definitions

A

Anisocoria: pupils of unequal size
Dyscoria: pupils of unequal shape

96
Q

The motor function of CN V can be assessed by __

A

Evaluating the size and symmetry of the masticatory muscles and testing the resistance of the jaw to opening the mouth

97
Q

The palpebral reflex test evaluates

A

Sensory function of CN V ophthalmic branch (medial canthus) and maxillary branch (lateral canthus)

98
Q

The Schirmer tear test can evaluate the (neuro)

A

Parasympathetic supply to the lacrimal gland associated with CN VII

99
Q

The motor innervation of CN VII can be assessed by ___

A

Observing for movement of the ears, eyelids, lips, and nostrils and lip symmetry

100
Q

As with the menace response, the response to nasal stimulation requires an intact

A

Contralateral forebrain

101
Q

CN VIII can be evaluated by ___, and more specifically by __

A

Observing the cat’s body and head posture at rest, and evaluation of his/her gait, and more specifically by testing the oculovestibular reflex and looking for pathologic nystagmus

102
Q

Nystagmus is defined as __ and is either __ or ___

A

An involuntary rhythmic movement of the eyeballs; it is either physiologic or pathologic

103
Q

The oculovestibular reflex can be evaluated by

A

By rotating the head from side to side (in a cat, hold him/her at arm’s length and rotate side to side)

104
Q

In the absence of any head movement, nystagmus should __

A

Never be present in a normal animal

105
Q

The 2 types of observable nystagmus in a cat are __

A

Spontaneous (when head is at rest) and/or positional (when the head is held in different positions)

106
Q

Nystagmus is classified based on

A

Its direction (the fast movement), as horizontal, vertical, or rotatory

107
Q

In disorders of the peripheral components of the vestibular system in the inner ear, the direction of the nystagmus is always __

A

Always opposite to the side of the lesion and is usually horizontal or rotatory

108
Q

Lesions of the central components of the vestibular system can cause pathologic nystagmus in __

A

In any direction, and occasionally it changes direction with different positions of the head

109
Q

A vertical nystagmus is most commonly due to

A

A central lesion

110
Q

Common changes in a patient’s level of awareness and behavior include ___, signs which reflect disturbances in the __

A

Disorientation, aggression, vocalizing, circling, compulsive walking or head pressing reflect disturbances in the ascending reticular activatiing system (ARAS) and limbic system components of the cerebrum or postural brainstem

111
Q

Circling can be caused by lesions in the

A

Vestibular system as well as an asymmetrical or focal lesion in the forebrain

112
Q

A head tilt is associated with

A

A vestibular disorder

113
Q

A head turn is associated with

A

An ipsilateral forebrain lesion

114
Q

Ventroflexion of the neck is associated with

A

A neuromuscular disorder or severe cervical spinal cord grey matter lesion

115
Q

Evaluation of a patient with an abnormal gait should be done with the aim of determining if the patient is __

A

Ataxic, paretic, or lame (neuromuscular or orthopedic disorder)

116
Q

The neuroanatomical localization in all cats with seizures (regardless of the cause) is

A

The forebrain: seizures are the manifestation of hyper synchronous abnormalmneuronal activity originating in the cerebral

117
Q

The features of focal seizures in cats are more variable than __ and include

A

Those in dogs and include drooling, facial movements, hippus, excessive vocalization/growling, random skittish behavior, and abnormal head, neck, or limb movements

118
Q

The vital phase of a generalized seizure generally lasts __ in cats

A

1 to 3 minutes

119
Q

Focal seizures may occur ___ and may progress to

A

Several times throughout the day; progress to generalized seizurez

120
Q

Generalized seizures may progress

A

To a state of status epilepticus

121
Q

Cats with idiopathic epilepsy tend to be ___ than cats with secondary epilepsy and have a __

A

Younger (~3.5 years, vs ~8 years with secondary epilepsy); longer median survival time

122
Q

In cats presenting for seizures, normal neurologic exam findings do not rule out __

A

Structural brain disease, especially if the lesion is in a “silent” region of the brain

123
Q

Cats with large cerebral masses and increased cranial pressure may have __

A

Cerebellum herniation through the foramen magnum

124
Q

Cats with a cerebellum herniation through the foramen magnum may present with __

A

Acute onset of cerebellar signs including a hypermetric/ataxic gait with normal general proprioception, intention tremors, and a decreased menace response with normal vision

125
Q

Abnormalities in CSF are very sensitive __

A

Indicators of intracranial disease, but are often not specific.

126
Q

Normal CSF is __

A

Clear and colorless with < 5 cells/uL and < 27 mg/dL protein (cisterns mag a tap)

127
Q

An antiepileptic drug is considered effective if it __

A

Reduces seizure activity by 50% or more

128
Q

Oral diazepam in cats is

A

Contraindicated (AAFP) because of associated potentially fatal hepatotoxicosis

129
Q

Eicosanoids are

A

Mediators of peripheral sensitization

130
Q

Central sensitization occurs when

A

Pain thresholds are reduced following tissue damage, caused by repeated stimulation that alters the nociceptive pathways.

131
Q

The main sites of central sensitization are

A

The dorsal horn, and higher centers of the brain, especially the cerebral cortex

132
Q

Hyperalgesia

A

Increased pain due to stimulation of damaged tissue by a stimulus that would normally be perceived as painful. The stimulation is felt as more painful than it normally would (if the tissue were not damaged).

133
Q

Clinical signs of central and peripheral sensitization

A

Hyoeralgesia and allodynia

134
Q

Allodynia

A

Pain due to stimulation of damaged tissue by a stimulus that would not normally be perceived as painful. The stimulation is felt as painful because the tissues are damaged

Fel Med (24 decks)

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