Neurology

Question 1

What is the telencephalon better known as?

Answer 1

Forebrain

Question 2

Which clinical signs may a patient present with if they have a lesion of their parietal lobe ?

Answer 2

Proprioceptive deficits as the parietal lobe is the centre for interpretation of the surrounding environment and the animals orientation in space.

Question 3

What clinical signs would you expect to see in a patient with a lesion of the occipital lobe?

Answer 3

Bumping into things, stumbling over steps or following very close to owner in walks. On clinical exam will have absent menace, as the occipital lobe is the centre for interpreting visual stimuli.

Question 4

What clinical signs would you expect a patient to exhibit if they had a lesion of the frontal lobe?

Answer 4

Compulsive pacing, circling, partial or generalised seizuring. Frontal brain deals with motor activity.

Question 5

Which anatomical structures make up the Diencephalon?

Answer 5

Thalamus, subthalamus, epithalamus, hypothalamus

Question 6

Which anatomical structures make up the brain stem?

Answer 6

Medulla oblongata, pons and midbrain

Question 7

How would you assess cranial nerve one (Olfactory) in a patient

Answer 7

Obscure vision and offer food

Question 8

How would you assess cranial nerve 2 (optic) and cranial nerve 7 (Facial)?

Answer 8

Menace, run forceps over face and see if any reflex or discomfort

Question 9

Where would you expect a lesion if a patient had a peripheral versus central blindness? How could you assess this in the clinic?

Answer 9

Peripheral blindness more likely an issue with optic chiasm, optic nerve or retina. Central blindness would be occipital lobe. PLR would distinguish if retina are able to react to light by adjusting pupil size.

Question 10

Strabismus results in deficits of which cranial nerves?

Answer 10

III, IV, VI

Question 11

Which of the three branches of the trigeminal nerve (V) has mixed motor and sensory nerve fibres?

Answer 11

Mandibular. Sensory to bottom part of face below lip and motor for mastication.

Question 12

Deficits in which cranial nerve may be associated with reduced tear production and therefore predispose patients to corneal ulcers?

Answer 12

Cranial nerve VII (Facial)

Question 13

What does cranial nerve VIII innervate? What abnormalities would you expect if there was a lesion leading to a deficit in this nerve?

Answer 13

Vestibular and cochlear. Vestibular deficits would present with head tilts, leaning to one side. Cochlear would impact hearing, so an absence in response to auditory stimuli

Question 14

Which cranial nerves are being assessed during an oculocephalic reflex ?

Answer 14

Vestibular portion of VIII will coordinate ratcheting of the eye as the head position moves. As cranial nerves III IV and VI move the eye, inducing this reflex will evaluate these cranial nerves too

Question 15

If a patient has a nystagmus (horizontal, vertical, pendulous or rotatory), which cranial nerve pathway is affected by pathology?

Answer 15

Vestibular part of VIII. If this nerve is diseased, it will be sending inappropriate stimuli to III IV and VI, resulting in eye movement without head movement.

Question 16

How can you assess a patient for a functional cranial nerve IX ?

Answer 16

This is glossopharyngeal. Inducing gaging by touching caudal 1/3 of tongue, or inducing a swallow by palpating pharynx externally will indicate if this is working.

Question 17

What clinical signs would you expect in a patient with a cerebella lesion?

Answer 17

Ataxia, intention tremors, hypermetric gait with good muscle quality and tone.

Question 18

Describe the impact on a spinal arc reflex if a lesion is present in the upper motor neuron

Answer 18

Exaggerated spinal reflex.

Question 19

Describe the impact on a spinal reflex where there is a lower motor neurone lesion

Answer 19

Depressed or absent spinal reflex

Question 20

If a patient were to have a lesion in the C6 to T2 region of the spinal cord, how would you expect the forelimbs and hind limbs to be different on clinical exam?

Answer 20

The forelimbs would show lower motor neurone signs, which would be depressed or absent spinal reflexes. The hind limbs would show upper motor neurone signs, and have exaggerated spinal reflexes. This is because the interruption of the action potential occurs at contrasting parts of the neural pathway (one pre ganglionic and one post)

Question 21

In discospondilitis, which anatomical structures are affected by infection?

Answer 21

Infection of the vertebrae and intervertebral disc space

Question 22

Repeated activation of nocioceptors results in either sensitisation or habituation. Describe these outcomes for the patient

Answer 22

Sensitisation is an enhanced response
Habituation is a lessened response