SA neurology Flashcards

1
Q

what are the three divisions of the brain?

A

forebrain
brainstem
cerebellum

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2
Q

what are the divisions of the forebrain?

A

cerebral cortex

diencephalon

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3
Q

what are the divisions of the brainstem?

A

midbrain
pons
medulla oblongata

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4
Q

what are the functional divisions of the spine?

A

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

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5
Q

is the white matter found on the centre or periphery of the spinal cord?

A

peripheral

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6
Q

what makes up the white matter of the spinal cord?

A

nerve tracts (sensory and motor)

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7
Q

what makes up the grey matter of the spinal cord?

A

interneurons and motor neurons

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8
Q

how many pairs of spinal nerves are there?

A

36

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9
Q

how many pairs of cranial nerves are there?

A

12

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10
Q

where are the motor neurons cell body found?

A

ventral horn of spinal cord

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11
Q

where are the cell bodies of sensory axons found?

A

dorsal root ganglion of spinal cord

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12
Q

what create myelination of the PNS?

A

Schwann cells

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13
Q

what are the three parts of the neuromuscular junction?

A

axon terminal
synaptic cleft
endplate of skeletal muscle

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14
Q

where can brain lesions be localised to?

A

forebrain
brainstem
cerebellar
vestibular

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15
Q

where can neuromuscular system lesions be localised to?

A

peripheral nerve
neuromuscular junction
muscle

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16
Q

what is the ANS responsible for?

A

involuntary actions (visceral functions)

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17
Q

what are the two divisions of the ANS?

A

sympathetic

parasympathetic

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18
Q

where are the cell bodies of the sympathetic nervous system found?

A

thoracolumbar

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19
Q

where are the cell bodies of the parasympathetic nervous system found?

A

craniosacral

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20
Q

what happens to the detrusor and sphincters during bladder filling?

A

detrusor - relax

sphincter - tone increases

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21
Q

what happens to the detrusor and sphincters during bladder emptying?

A

detrusor - contract

sphincters - relax

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22
Q

how can bladder incontinence be classified?

A

UMN

LMN

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23
Q

where are lesions for UMN bladder incontinence seen?

A

cranial to sacral spinal cord

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24
Q

how do bladders with UMN bladder incontinence present?

A

distended and difficult to express

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25
Q

where are lesions causing LMN bladder incontinence seen?

A

sacral spinal cord

sacral spinal nerves

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26
Q

how do bladders with LMN bladder incontinence present?

A

distended, overflow and dribble

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27
Q

where does the 1st order sympathetic neuron of the eye travel?

A

brainstem then caudally in cervical spinal cord

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28
Q

where does the 2nd order sympathetic neuron of the eye travel?

A

exits spinal cord at brachial plexus (T1-T3) the travels rostrally in vagosympathetic trunk to the cranial cervical ganglion

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29
Q

what does the sympathetic supply to the eye innervate?

A

pupil dilator
smooth cilaris muscle
smooth muscle of blood supply and sweat glands of head

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30
Q

what is the function of grey matter?

A

information processing

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31
Q

what does grey matter of the brain contain?

A

cell bodies

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32
Q

where is grey matter found in the brain?

A

peripherally

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33
Q

where is white matter found in the brain?

A

centrally (deep)

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34
Q

what does white matter contain?

A

myelinated axon tracts

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35
Q

what are the three meninges?

A
dura mater (thick)
arachnoid (thin)
pia mater (thin)
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36
Q

what is found in the subarachnoid space?

A

CSF, blood vessels, nerve roots

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37
Q

what direction does CSF travel?

A

caudally

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38
Q

what triggers the flow of CSF?

A

pulsations of blood in choroid plexus

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39
Q

what route does CSF take through the brain?

A
lateral ventricles
intraventricular foramen
3rd ventricle
mesencephalic aqueduct
4th ventricle
lateral apertures
subarachnoid space
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40
Q

what is CN I?

A

olfactory

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41
Q

what is CN II?

A

optic

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42
Q

what is the function of the olfactory nerve?

A

conscious perception of smell

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43
Q

where is the cell bodies of the olfactory nerve found?

A

olfactory epithelium

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44
Q

where do the axons of the olfactory nerve pass through?

A

cribriform plate (synapse in olfactory bulb)

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45
Q

what is the optic nerve myelinated by?

A

oligodendrocytes (surrounded by meninges)

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46
Q

where does the optic nerve enter the skull?

A

optic canal

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47
Q

what is CN III?

A

oculomotor

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48
Q

what is CN IV?

A

trochlear

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49
Q

what does the oculomotor nerve innervate?

A

dorsal, vental, medial rectus
ventral oblique extraocular
levator palpebrae superioris

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50
Q

what does the parasympathetic component of the oculomotor control?

A

pupillary constriction

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51
Q

where is the nucleus of the oculomotor nerve?

A

midbrain

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52
Q

where does the oculomotor, trochlear and abducens nerves exit the skull?

A

orbital fissure

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53
Q

what does the trochlear nerve innervate?

A

dorsal oblique muscle

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54
Q

where is the nucleus of the trochlear nerve?

A

midbrain

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55
Q

what are the functions of the trigeminal nerve?

A

sensory to face

motor to masticatory muscles

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56
Q

what are the branches of the trigeminal nerve?

A

ophthalmic
maxillary
mandibular

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57
Q

where is the motor nuclei of the trigeminal nerve?

A

pons

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58
Q

where is the sensory nuclei of the trigeminal nerve?

A

brainstem

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59
Q

what is CN V?

A

trigeminal

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60
Q

what is CN VI?

A

abducens

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61
Q

what does the abducens nerve innervate?

A

lateral rectus

retractor bulbi

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62
Q

where is the nucleus of the abducens?

A

medulla

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63
Q

what is CN VII?

A

facial

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64
Q

what is CN VIII?

A

vestibulocochlear

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65
Q

what does the facial nerve innervate?

A

muscles of facial expression

sensory - rostral 2/3 of tongue

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66
Q

what is the function of the vestibulocochlear nerve?

A

hearing and vestibular function

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67
Q

what is innervated parasympathetically by the facial nerve?

A

lacrimal, mandibular, sublingual glands

68
Q

what is CN IX?

A

glossoparyngeal

69
Q

what is CN X?

A

vagus

70
Q

what does the glossopharyngeal nerve innervate?

A

motor - pharynx and palate

sensory - caudal 1/3 of tongue

71
Q

where is the nuclei of glossopharyngeal and vagus nerve found?

A

medulla

72
Q

what does the vagus nerve innervate?

A

motor - larynx, pharynx, oesophagus

sensory - larynx, pharynx, thoracic/abdominal viscera

73
Q

what is CN XI?

A

accessory

74
Q

what is CN XII?

A

hypoglossal

75
Q

what is the function of the hypoglossal nerve?

A

motor innervation to tongue

76
Q

where is the nucleus of the accessory and hypoglossal nerve?

A

medulla

77
Q

where do the LMN of the forelimbs originate?

A

C6-T2

78
Q

where do the LMN of the hindlimbs originate?

A

L4-S3

79
Q

what are the stages of a reflex?

A

stimuli
sensory nerve, dorsal root and synapse in grey matter
connects directly or indirectly to motor nerve

80
Q

what is nociception?

A

perception of pain

81
Q

where in the brain is pain perceived?

A

forebrain

82
Q

what is tested by testing reflexes?

A

LMN system

83
Q

what are the functions of the UMN system?

A

initiate voluntary movement

maintain muscle tone

84
Q

what is the pyramidal UMN for?

A

skilled movement (poorly developed in animals)

85
Q

where does the pyramidal UMN system start?

A

cerebral cortex (pass through pyramids in brainstem)

86
Q

what is the functions of the extrapyramidal UMN system?

A

tonic mechanism for support of body against gravity

recruit spinal reflexes

87
Q

where do most extrapyramidal UMN systems start?

A

brainstem (don’t pass through pyramids)

88
Q

what is the function of proprioception?

A

sensory system detecting position/movement of muscles/joints

89
Q

what tracts are involved in unconscious proprioception?

A

spinocerebellar

90
Q

what tracts are involved in conscious proprioception?

A

spinal

91
Q

what is the vestibular system for?

A

maintaining balance
maintains orientation relative to gravity
maintains position of eyes, neck, trunk, limbs relative to the head

92
Q

what are the 2 divisions of the vestibular system?

A

peripheral

central

93
Q

what makes up the peripheral vestibular system?

A

inner ear

vestibulocochlear nerve

94
Q

what makes up the central vestibular system?

A
vestibular nuclei (brainstem)
cerebellum
95
Q

what in the inner ear contributes the the vestibular system?

A

3 ducts orientated at right angles to each other filled with endolymph

96
Q

what is the function of the cerebellum?

A

control motor activity (regulator)

maintain balance

97
Q

what sign associated with walking will be present if the UMN or LMN is damaged?

A

paresis/paralysis

98
Q

what sign associated with walking will be present if the general proprioception, cerebellum or vestibular system is damaged?

A

ataxia

99
Q

where does the optic nerve cross the brain?

A

optic chiasm

100
Q

where is the lesion if an animal has no menace or pupillary light reflex?

A

before optic chasm (eye or optic nerve)

101
Q

where is the lesion if an animal has no menace but a functioning pupillary light reflex?

A

forebrain

102
Q

what is the function of the forebrain?

A

behaviour
decision making
conscious perception of sensory systems

103
Q

what are the functions of the ascending reticular activating system (ARAS)?

A

arouse cortex
awake brain to conscious level
prepare brain to receive sensory information

104
Q

what should be observed on a neurology consult?

A

mentation
behaviour
posture
gait

105
Q

where can lesions be to cause problems with mentation?

A

forebrain

brainstem

106
Q

what ways can mentation be described?

A
alert
disorientated/confused
depressed
stuporous (unconscious but feel pain)
comatose
107
Q

where is a lesion of a disoriented/confused animal usually found?

A

forebrain

108
Q

where is a lesion that effects the behaviour of an animal found?

A

forebrain

109
Q

where is a lesion found that causes circling?

A

forebrain (circle towards the lesion)

110
Q

what are the most common postural defects?

A

head tilt

head turn

111
Q

where is a lesion found that causes a head tilt?

A

vestibular system

112
Q

where is a lesion found causing a head turn?

A

forebrain (brainstem sometimes)

113
Q

what are the two types of rigidity?

A

decerebrate

decerebellate

114
Q

what is a decerebrate rigidity?

A

all limbs extended and rigid

115
Q

where is a lesion found if there is decerebrate rigidity?

A

brainstem

116
Q

what is decerebellate rigidity?

A

extension of forelimbs

117
Q

where is a lesion found if there is decerebellate rigidity?

A

cerebellum

118
Q

what is the difference in mentations between decerebrate and decerebellate rigidity?

A

decerebrate - comatose

decerebellate - normal

119
Q

how do patients with Schiff-sherrington present?

A

hyperextension of thoracic limbs and paralysis of pelvic limbs

120
Q

where are lesions causes schiff-sherrington found?

A

thoracic or cranial lumbar spine

121
Q

how can gait be described?

A

ataxia
paresis
paralysis

122
Q

where will a lesion be found if there is ataxia?

A

spinal
vestibular (off balance)
cerebellar (drunk)

123
Q

what is ataxia?

A

uncoordinated gait

124
Q

what is paresis?

A

weakness/reduced voluntary movement

125
Q

what is paralysis?

A

complete loss of voluntary movement

126
Q

what are the types of paresis?

A

ambulatory

non-ambulatory

127
Q

what are the 4 parts of a neurological clinical exam?

A

postural reaction
spinal reflex/muscle tone
spinal pain
cranial nerves

128
Q

what is being tested during a postural test?

A

awareness of precise position/movement of the body (proprioception)

129
Q

what tests can be done for postural reactions?

A

paw postion
hopping
placing response

130
Q

what is the most important spinal reflex to test?

A

withdrawal

131
Q

what are the two most reliable myotactic reflex tests?

A

patellar

perineal

132
Q

what areas can the cutaneous trunci reflex be used for?

A

brachial plexus

T3-L3

133
Q

what is looked at when observing the reflex response?

A

pain perception

134
Q

how is spinal pain assessed?

A
palpate spine (increasing pressure)
move neck (resistance/reluctance)
move tail
135
Q

what are the cranial nerve tests?

A
palpebral
corneal
physiological nystagmus
menace response
nasal mucosa stimulation
pupillary light response
gag
136
Q

what nerves does the palpebral reflex test?

A

trigeminal (input)

facial (output)

137
Q

what nerves does the corneal reflex test?

A

trigeminal (input)

abducens/facial (output)

138
Q

what nerves does the physiological nystagmus test?

A

vestibulocochlear (input)

oculomotor, trochlear, abducens (output)

139
Q

what is the physiological nystagmus test particularly useful for?

A

patients with raised intracranial pressure (puts pressure on nerves)

140
Q

how can the vestibular system be challenged when assessing nystagmus?

A

put animal upside down

141
Q

what is strabismus?

A

abnormal position of the eyeball that the animal can’t overcome

142
Q

what is nystagmus?

A

rhythmical, involuntary movements of the eye

143
Q

what is horners syndrome a sign of?

A

sympathetic disfunction to the eye

144
Q

what is seen in small animals with horners syndrome?

A

miosis
3rd eyelid protrusion
ptosis of upper eyelid

145
Q

what is seen in horses with horners syndrome?

A

miosis
ptosis of upper eyelid
excessive sweating

146
Q

what is assessed with nasal mucosa stimulation?

A

trigeminal, forebrain, brainstem

147
Q

what is assessed by the menace response?

A

optic, forebrain, cerebellum, brainstem, facial

148
Q

what is tested by the pupillary light response?

A

optic, brainstem, oculomotor

149
Q

what is tested by the gag reflex?

A

glossopharyngeal, vagus, brainstem

150
Q

where is the lesion if the dog having seizures?

A

forebrain

151
Q

what are possible clinical signs of forebrain lesions?

A
disorientation/depression
contralateral blindness
normal gait
circling, head press, pacing
decreased postural response
seizure/behaviour change
152
Q

what are possible clinical signs of brainstem lesions?

A
depression, stupor, coma
CN III-XII deficit
vestibular signs
paresis
decerebrate rigidity
decreased postural response
respiratory/cardiac abnormality
153
Q

what are possible clinical signs of cerebellar lesions?

A
normal mentation
abnormal menace
vestibular signs
hypermetria/ataxia
intention tremors
decerebellate rigidity
154
Q

what are possible clinical signs of vestibular lesions?

A

head tilt
nystagmus
ataxia
positional strabismus

155
Q

what is spinal shock?

A

flaccid paralysis with loss of spinal reflexes

156
Q

when does spinal shock happen?

A

after acute severe injury to spinal cord

157
Q

how long does it take reflexes to return in spinal shock cases?

A

up to 12 hours

158
Q

what is a grade 1 spinal injury?

A

no deficit just spinal pain

159
Q

what is a grade 2 spinal injury?

A

ambulatory paresis

160
Q

what is a grade 3 spinal injury?

A

non-ambulatory paresis

161
Q

what is a grade 4 spinal injury?

A

paralysis

162
Q

what is a grade 5 spinal injury?

A

paralysis and loss of pain sensation

163
Q

what is the main clinical sign of neuropathies?

A

reduced reflex

164
Q

what are neuropathies?

A

damage to nerves

165
Q

how do polyneuropathies effect the forelimb and hindlimb reflexes?

A

reduce both

166
Q

what is the main clinical sign of myopathies?

A

generalised weakness/exercise intolerance