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Neuro > Smallies neuro exam > Flashcards

Smallies neuro exam Flashcards

1
Q

What are the regions of the brain that we generally try and divide brain derived disease as originating from?

A

Forebrain (cerebrum and thalamus)

Brainstem

Cerebellum

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2
Q

What are the regions of the spinal cord that we generally try and divide spinal disease as originating from one of?

A

C1-C5

C6-T2

T3-L3

L4-Cd

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3
Q

What are the two things we look at to do with mentaiton?

A

LEVEL of consciousness (alert, obtunded, stupor, coma)

QUALITY of consciousness (whether or not it is appropriate)

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4
Q

What does a head tilt indicate?

A

Vestibular disease

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5
Q

What are the 8 parts of the neuro exam?

A

Mentation

Posture

Gait

Postural reactions

Cranial nerves

Spinal reflexes

Palpation

Nociception

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6
Q

What does a head turn indicate?

A

Forebrain disease

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7
Q

What does a wide based stance indicate?

A

Prioprioceptive loss

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8
Q

What does a narrow based stance indicate?

A

Weakness

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9
Q

What does decreased weight baring indicate?

A

Pain

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10
Q

What is cerebrate posture?

A
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11
Q

What is Schiff-Scherington posture?

A
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12
Q

What are the two kinds of paresis that you can have?

A

Upper motor neuron, lower motor neuron

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13
Q

How do you assess whether a lesion is UMN or LMN?

A

Postural reactions,

Spinal reflexes

Muscle Tone

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14
Q

What happens to muscle tone and spinal reflexes in UMN paresis?

A

Tone and reflexes are normal to increased in limbs caudal to the lesion

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15
Q

What happens to stride in UMN paresis?

A

Stride length is normal to increased, and there may be spasticity

May have a slight sway gait and knuckling

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16
Q

What happens to muscle tone and spinal reflexes in LMN paresis?

A

Muscle tone in limbs with a reflex arc containing the lesion is decreased

Spinal reflexes are decreased to absent in limbs with a reflex arc containing the lesion

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17
Q

What happens to stride in LMN paresis?

A

Stride length is normal to decreased, may see bunny hopping, stiff gait

+/- collapse

‘bunny hopping’

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18
Q

What are the gait signs associated with sensory ataxia?

A

Wide based stance

Increased stride length

Swaying/Floating gait

Knuckling

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19
Q

What does cerebellar ataxia look like?

A

Cerebellum coordinates rate and range of movement, lesions cause

hypermetira (high stepping)

Intention tremor

Postural tremor

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20
Q

What does vestibular ataxia look like?

A

Unilateral: falling/leaning/circling to one side and HEAD TILT

Bilateral: Wide excursions of the head, may have head tilt, crouched posture (poss strabismus/nystagmus)

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21
Q

If an animal was not paw placing on the left side where would you suspect a lesion?

A

right fore brain

22
Q

What is a tendon reflex?

A

Percuss a tendon and look for twitch in coresponding muscle

23
Q

Which nerve does a biceps tendon reflex test?

A

Musculocutaneous

24
Q

Which nerve does a triceps tendon reflex test?

A

radial

25
Q

Which nerve does a patellar tendon reflex test?

A

Femoral

26
Q

Which nerve does a gastroc tendon reflex test?

A

Sciatic

27
Q

Which nerve does a thoracic limb withdrawal test?

A

Multiple (C6-T2)

28
Q

Which nerve does a pelvic limb withdrawal test?

A

Sciatic

29
Q

What nerve does the perineal test do?

A

Pudendal (do with a disposable q tip!)

30
Q

What are the four reasons you may have a decreased or absent spinal reflex?

A

Lesion within the arc

Physical limitation eg joint fibrosis/muscle contracture

Excitement/Fear

‘spinal shock’

31
Q

Why might you get exaggerated reflexes (3)

A

UMN lesion to pathways cranial to the spinal cord segment tested. UMN dictates how much tone is atenuated in arc. If remove inhibition of tone by UMN you get increase

Excitement/Fear

Pseudo-hyperreflexia (loss of antagonism)

32
Q

Which cranial nerve test is a response rather than a reflex?

A

The mennace

33
Q

What tests are there for cranial nerve 2?

A

Vision, Menace (forebrain - cerebellum - brainstem - II), PLR, Fundic exam

34
Q

Why do we get horners?

A

Lack of sympathetic to the orbit -> miosis, ptosis and enopthalmus

35
Q

What is palpebral reflex and what does it test?

A

Touch them around the orbit with end of q tip, tests trigeminal (facial sensation)

36
Q

What nerves are involved in the palpebral reflex?

A

first is V, then brainstem, then VII

37
Q

What nerves are invovled in the corneal reflex?

A

V then brainstem then VI (retraction of globe), VII (blink)

38
Q
A
39
Q

What nerve might be important if muscles of mastication atrophied, or inability to close jaw?

A

V-Trigeminal

40
Q

What nerve might be implicated if there are signs of facial dyssymetry/ paresis?

A

VII-Facial

41
Q

Which nerve innervates the lacrimal glands?

A

VII - Facial

Schrimmer tear test

42
Q

Which nerve is tested by the gag reflex?

A

X - Vagus is sensory and motor to the pharynx

43
Q

Which nerve might be implicated if there are signs of tongue dysfunction:

paresis of the tongue

Atrophy/assymetry of the tongue

Will be seen as deviation of the tongue (bends to one side)

A

XII hypoglossal nerve

44
Q

What are you assessing for with light palaption?

A

Swelling or atrophy

45
Q

What are you looking for with deep palpation?

A

Pain

46
Q

When testing nociception, what do we pinch for superficial pain?

A

Skin

47
Q

When testing nociception what do we pinch when we are looking for deep pain?

A

Bone or periosteum

48
Q

Does withdrawing the limb definitely tell you that the spine is in tact and the message is getting to the brain?

A

No, if the reflex arc is still intact they will probably still withdraw the limb

Limb withdrawal does NOT equal pain perception

49
Q

What are we looking for to say that an animal does have nociception?

A

Behavioural change, looking around at you e.g.

Not just withdrawal of the limb

50
Q

What is a cutaneous autonomous zone?

A

A part of the skin innervated by only one limb

Preferable to use these sites when testing cutaneous nociception so that you can rule out individual nerves

Neuro (13 decks)

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