Neurology

Question 1

Menace response

Answer 1

Response not reflex as involves recognition and processing in the cerebral cortex (so not a reflex!)

Afferent: ipsilateral CN II, contralateral thalamus and occipital cortex

Efferent: contralateral motor cortex, ipsilateral cerebellum, ipsilateral CN VII

Question 2

Pupillary light reflex

Answer 2

Midbrain
Afferent:CN II
Efferent: CN III parasympathetic

Question 3

Trigeminofacial reflex

Answer 3

(Palpebral, vibrissae, lip pinch)
Pons
Afferent: CN V
Efferent: CN VII

Question 4

Corneal reflex

Answer 4

Pons
Afferent: CN V ophthalmic branch
Efferent: CN VI (globe retraction), CN VII (blink)

Question 5

Physiologic nystagmus
Where does it test and what CNs?

Answer 5

Pons, midbrain
Afferent: CN VIII
Efferent: CN III, IV, VI

Question 6

Gag reflex
Where does it test and what CNs?

Answer 6

Medulla
Afferent: CN IX,X
Efferent: CN IX,X,XII

Question 7

List the Cranial nerves

Answer 7

I- olfactory
II- optic nerve
III- oculomotor
IV- trochlear
V- trigeminal
VI- abducens
VII- facial
VIII- vestibulocochlear
IX- glossopharyngeal
X- vagus
XI- (spinal) accessory
XII- hypoglossal

Question 8

Spinal cord segments

Answer 8

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

Question 9

Decerebellate

Answer 9

Secondary to acute cerebellar lesion
Pelvic limbs can be flexed or extended

Question 10

Decerebrate

Answer 10

Secondary to severe midbrain lesion
Extensor rigidity of all 4 limbs and patient is comatose

Question 11

Clinical signs of upper motor neuron lesion

Answer 11

Normal to increase reflexes
Normal to increased tone
Disuse atrophy (weeks/months)
Paresis/paralysis
Proprioceptive placing deficits

Question 12

Cutaneous trunci reflex

Answer 12

Afferent: T3-L3 spinal nerves/cord
Efferent: C8-T1 spinal nerves forming lateral thoracic nerve

Question 13

Older lab with right head tilt, nystagmus slow phase to right, reduced rhs postural reactions and depression. Where do you localise to?

Answer 13

Central right vestibular

Question 14

“Two engine” gait most likely associated with which neuro localisation?

Answer 14

C6-T2

Question 15

A 7 year old dog presents with acute onset LHs head tilt, rhs hypermetria, an absent right menace response. Where do you localise it?

Answer 15

Right cerebellum

Question 16

Young labradoodle presents with persecute onset of paraplegia with reduced withdrawal reflexes in pelvic limbs and shiff-Sherrington posture in thoracic limbs. Cutaneous trunci cut off at L2. No back pain and deep pain is present in pelvic limbs. What are the most likely diagnoses

Answer 16

Traumatic disc extrusion or FCE

Question 17

What is normal intracranial pressure?

Answer 17

5-12mmHg

Question 18

Modified Glasgow Coma scale assesses 3 main groups

Answer 18

1. Motor activity
2. Brainstem reflexes
3. Level of consciousness
   Each one out of 6, normal dog 18

Question 19

Name the parts of a ICP waveform

Answer 19

ICP monitoring waveform has 3 upstrokes in one wave
P1= Percussion wave representing arterial pulsation

P2= Tidal wave representing intracranial compliance

P3= Dicrotic wave representing aortic valve closure

Question 20

Summarise Monro-Kellie doctrine

Answer 20

V intracranial = Vbrain + V csf + V blood + V mass lesion

Question 21

What are the most common causative agents of discosponylitis?

Answer 21

Staphylococcus
Streptococcus
Brucella
E.coli

Question 22

Name the three types of brain odema

Answer 22

Vasogenic
Cytotoxic
Interstitial

Question 23

Name the bacteria associated with tetanus and the 2 exotoxins

Answer 23

Clostridium tetani
Gram-positive, non-encapsulated, anaerobic, spore forming bacteria

Produces 2 exotoxins
1. Tetanospasmin
2. Tetanolysin

Question 24

Name the 4 groups of brain herniation

Answer 24

Subfalcine
Transtentorial
Transforaminal
Craniotomy/fracture site