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SS - Exam 1 > Neuro Lesion - Lesion 1 > Flashcards

Neuro Lesion - Lesion 1 Flashcards

1
Q

Efferent system analogy

A

Brain is light switch
Nerves are wires
Effector organ is lightbulb
Break in wire = no lightbulb on

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2
Q

Localization in brain

A

Forebrain
Brainstem
Cerebellum
Vestibular system

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3
Q

Localization of spinal cord

A

C1-5
C6-t2
T3-L3
L4-S3

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4
Q

Localizing within forebrain

A

Cerebrum - telencephalon
Thalamus - diencephalon

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5
Q

Localization within brainstem

A

Mid brain - Mesencephalon
Pons - ventral metencephalon
Medulla - myelencephalon

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6
Q

Localization within cerebellum

A

Dorsal metencephalon

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7
Q

Localization within vestibular system

A

Central - cerebellum, myelencephalon
Peripheral - vestibular apparatus and CNVII

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8
Q

Decusation

A

Idea that everything in the forebrain crosses over or descusates before making its way to the rest of the body
Brainstem and spinal cord are ipsilateral

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9
Q

Central vs PNS lesions

A

CNS lesions are often mixed motor or sensory deficits
PNS lesions are often sensory or motor

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10
Q

Encephalopathy

A

Lesions of the brain

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11
Q

Myelopathy

A

Lesions of spinal cord

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12
Q

Myopathy

A

Disease of muscle
Not to be confused with myelopathy

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13
Q

ANS

A

Originates from hypothalamus & ventral diencephalon
Two main divisions - SNS & PsNS

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14
Q

Branches of SNS and PsNS in spinal cord

A

Symp - branches from c7-L4
Parasympathetic - branches from CN 3,7,9,10 & sacral plexus - minus vagus nerve (doesn’t run in spinal cord)

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15
Q

Horner syndrome

A

Lack of sympathize innervation to head and head specifically in horses
Lesion location: hypothalamus, cervical myelopathy, cervical thoracic cavity lesion, trauma to neck, middle ear or guttural pouch = pupil dilation

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16
Q

Upper vs lower motor neuron

A

UMN - cells that arise from forebrain, brainstem & cerebellum
LMN - arise from spinal cord segment
Ventral nerve roots are form by axons of LMN
Nerve roots combine w other nerve roots to form named nerves
Lower are more hyperexcitable /spastic

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17
Q

Assessing lesions upper vs lower

A

Reflex, tone, atrophy

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18
Q

Reflexes

A

Reflexes intact - LMN are not affected
Decreased or absent reflex - LMN affected

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19
Q

UMN lesion

A

Normal to increased reflexes in affected limb
Normal to increased tone in affected limbs

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20
Q

LMN lesion

A

Decreased to absent reflexes in affected limb
Decreased to absent tone in the affected limbs

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21
Q

One purpose of UMN

A

Is to decrease spasticity of LMN, without influence of UMN the LMN become more spastic

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22
Q

C1-5 myelopathy

A

Thoracic limb reflex - normal to increased
Thoracic limb tone - normal to increased
Pelvic limb reflex - normal to increased
Pelvic limb tone - normal to increased

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23
Q

C6-t2 myelopathy

A

TLF and TLT - decreased to absent
PLR & PLT - normal to increased

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24
Q

T3-l3 myelopathy

A

TLR - normal
TLT - normal to increased
PLR & PLT - normal to increased

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25
Q

L4-s3 myelopathy

A

TLR & TLR - normal
PLR & PLT - decreased to absent

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26
Q

Spinal cord segments vs vertebra

A

Don’t always correlate (C8 spinal cord segments but 7 Cv)
Wherever there’s a nerve root = spinal cord segments

27
Q

Exits for nerves in cervical regions

A

Nerve roots exit cranial to the respective vertebra

28
Q

Exits for nerves in thoracic and lumbar region

A

Nerve roots exit caudally

29
Q

**thoracic and cranial lumbar region

A

Spinal cord segments and vertebra line up with corresponding numbers

30
Q

Observation and tools fro neurological exam

A

Behavior, mentation, gait, posture
Traction, plexor, hemostats, light, exam lens, cotton balls

31
Q

Which nerve is actually visual ?

A

Cranial nerve 2

32
Q

Behavior changes

A

Common behaviors for forebrain lesions
Pacing
Head pressing
Circling
Aggressive
Blind
Obsessive
Incontinent
Distant
Seizures

33
Q

Source of head pressing

A

Red nucleus in mid brain = gait generator
Forebrain lesions = inhibitory effects of forebrain
Lack of higher cognition from forebrain = head pressing to wall bc input from red nucleus = go

34
Q

Source of circling

A

Circling with occur towards the side of the lesion due to hemineglect = ignoring one side of world /doesn’t exist

35
Q

Source of mentation

A

Level of consciousness in patient
3 degrees of abnormal mentation
Dull, depressed,lethargy could be secondary to intercranial or systemic disease

36
Q

3 degrees of abnormal mentation

A

Obtunded - abnormal response to stimulus & not fully aroused (vague)
Stuporous - patient only responsive to strong/noxious stim
Comatose - patient has a heart beat, +/- breathing, not responsive to stim

37
Q

Sources for mentation changes

A

Obtunded - could be secondary to diffuse forebrain lesion or from brainstem lesion
Stuporous & comatose - secondary to brainstem lesion affecting ARAS

38
Q

ARAS

A

Ascending reticular activating system - responsible for keeping patient alert. Located in brainstem

39
Q

Modified Glasgow coma scale

A

Specifically for encephalopathy esp when secondary to head trauma
6 point scale, higher score = better prognosis

40
Q

Categories for modified Glasgow coma scale

A

Motor activity
Brainstem reflexes
Level of consciousness

41
Q

Gait abnormalities

A

Ataxia
Paresis - weakness
Paralysis - absence of movement
Ambulatory vs nonabulatory - 10 unassisted steps
Tetra or quad
Para - pelvic limbs only
Hemi - only one side of the body
Mono - only one limb

42
Q

3 types of ataxia

A

Proprioception
Vestibular
Cerebellar ataxia

43
Q

Proprioceptive ataxia

A

Spinal or sensory ataxia
Cross limbs, scuff/knuckle
UMN component w proprioceptive ataxia

44
Q

Vestibular ataxia

A

Drift towards one side
Head tilt

45
Q

Cerebellar ataxia

A

Diametria or hypermetria
Over flexion or over extension of one limb

46
Q

Lameness vs ataxia

A

Lameness is predictable with every step - localized pain to limb
Ataxia is irregular - neurological deficits

47
Q

Posture

A

Decerebrate
Decerebellate
Head turn/tilt
Torticollis
Opisthotonus
Schiff Sherrington
Risus sardonicus
Spastic
Flaccid
Neck guarded
Kyphosis

48
Q

Decerebrate

A

Rigid in all limbs - opisthotonus
Lesion within brainstem (midbrain)
Patient is Stuporous or comatose

49
Q

Decerebellate

A

Rigid in thoracic limb, flexed pelvic limbs
Lesion to cerebellum or cerebellar peduncles
Alert to obtunded

50
Q

Head turn

A

Secondary to forebrain lesion
Head outside longitudinal axis

51
Q

Head tilt

A

Secondary to vestibular disease
Head is out of horizontal axis

52
Q

Torticollis

A

Secondary to cervical lesion causing flexion of neck or malformation
Contracture or flexion of cervical muscles

53
Q

Opisthotonus

A

Head in Dorso extension, often referred as star gazing
Secondary to intracranial lesion or cranial cervical lesion

54
Q

Risus sardonicus

A

Due to lack of inhibition to facial nerve causing contracture of the facial muscles
Secondary to tetanus infection

55
Q

Schiff Sherrington

A

Secondary to T3-L3 myelopathy
Thoracic limbs have increased extensor tone (spasticity), pelvic limbs are paretic to plegic

56
Q

Spasticity

A

Secondary to UMN lesion (except for Schiff Sherrington)
All 4 limbs are spastic, C1-5 myelopathy is suspected
If pelvic limbs the T3-L3 lesion is suspected

57
Q

Flaccid

A

Secondary to LMN lesion
Lesion can be diffuse or at intumescense of spinal cord

58
Q

Neck guarded

A

Secondary to cervical pain

59
Q

Kyphosis

A

Secondary to thoracolumbar pain, abdominal pain or malformation

60
Q

C1-5 myelopathy

A

Respiratory depression

61
Q

C6-T2 myelopathy

A

Horner syndrome
Nerve root signature
Absent cutaneous trunci

62
Q

T3-L3 myelopathy

A

Schiff Sherrington
Spinal shock
Cutaneous trunci cutoff

63
Q

L4-S3

A

Abnormal anal tone
Flaccid tail

SS - Exam 1 (33 decks)

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