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4th year > Neurology > Flashcards

Neurology Flashcards

1
Q

the different areas of the central nervous system

A

Forebrain, brainstem, cerebellum, spinal cord and neuromuscular

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2
Q

how is the spine segmented

A

C1-C5, C6-T2, T3-L3, L4-CAUDAL

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3
Q

8 parts to a neurological exam

A

1 Mentation, 2 Posture, 3 Gait, 4 Postural Reactions, 5 Spinal Reflexes, 6 Cranial Nerves, 7 Palpation, 8 Nociception

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4
Q

what are you looking for in the first 2 steps of a neurological exam

A

Mentation: Level (alert/coma), Quality( appropriate or not)
Posture: head tilt (roll) or turn (yaw), stance( wide base) and posture

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5
Q

decerebrate

A

neck and limbs extended

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6
Q

decerebellate

A

neck and forelimbs extended but hindlimbs flexed

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7
Q

Schiff-scherrington posture

A

forelimbs rigid hindlimbs flexed (T3-L3 lesion)

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8
Q

paresis

A

decreased voluntary movement
LMN ( decreased to absent reflexes in limb effected and reduced muscle tone) or UMN (normal to increased muscle tone and spinal reflexes caudal to lesion)

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9
Q

cause of normal to increased stride length with spastic movements

A

UMN Paresis

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10
Q

cause of “bunny hopping” (reduced stride length) or collapse

A

LMN Paresis

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11
Q

Ataxia

A

Without coordination:
Sensory: wide base, knuckling, increased stride length
Cerebellar: rate+range, intention tremors, hypermetria
Vestibullar: falling, leaning, head tilt,

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12
Q

what does a exaggerated spinal reflex show

A

A lesion in the UMN cranial to the spinal section tested

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13
Q

what does the patella reflex test

A

femoral nerve L4-L6

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14
Q

what does the perineal reflex test

A

Pudendal nerve S1-S3

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15
Q

what does cutaneous trunci test for

A

thoracic nerves C8-T1

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16
Q

What does the absence of a reflex show

A

lesion present in the reflex ark or joint/muscle problem

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17
Q

what does the menace response test

A

optic nerve , forebrain, cerebellum, brainstem and facial nerve

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18
Q

what does PLR test

A

Optic nerve, brainstem and oculomotor

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19
Q

what are the cranial nerves?

A

1: Olfactory 2:Optic 3:Occulomotor 4:Trochlear 5:Trigeminal 6:Abducent 7:Facial 8:Vestibulocochlear 9:Glossopharageal 10:Vagus 11;Accessory 12: hypoglossal

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20
Q

cause of drooped eyelid and miosis (constriction)

A

Horner’s syndrome: sympathetic supply to eye and face (trigeminal)

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21
Q

facial sensation

A

trigeminal, brainstem and facial nerve

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22
Q

what nerve is effected in nystagmus and strabismus

A

Vestibulocochlear -> 3,4,+6

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23
Q

circling shows a problem where

A

Forebrain

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24
Q

spastic or exaggerated movements

A

cerebella dysfunction

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25
Q

absent or reduced menace

A

cerebella dysfunction

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26
Q

retractor ocular reflex nerves

A

trigemninal and abducens

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27
Q

atrophy of masticatory muscles is a problem with what nerve?

A

trigeminal

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28
Q

how is spinal disease graded

A

0: normal -> 5 Down

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29
Q

clues of ataxia

A

Pacing and circumduction

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30
Q

weak limb can be caused my ……

A

spinal cord damage

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31
Q

hypometria

A

shorter protraction phase of gait

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32
Q

hypermetria

A

longer protraction phase to gait

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33
Q

Dysmetria

A

impaired ability to control the distance, power and speed of movement (combination of hypo/hyper-metria)

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34
Q

abnormal postural reaction and limb paresis

A

sensory ataxia

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35
Q

head tilt, falling to one side, postural strabismus with normal postural reactions

A

vestibular ataxia

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36
Q

wide-base stance, tremors, loss of balance, menace deficit

A

cerebella ataxia

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37
Q

location of lesion in vestibular ataxia

A

vestibular apparatus or inner ear

38
Q

tests for vestibular ataxia

A

occularvestibular reflex (pendulum nystagmus: nystagmus when head is moved)

39
Q

if mentation if effected where is the lesion

A

forebrain, brainstem or systemic (hypertension, pyrexia, ECT)

40
Q

Menace and PLR pathways

A

Menace: optic, opposite forebrain and cerebella, facial nerve
PLR: optic, optic chiasm, oculomotor

41
Q

3 nerves involved in eye movement

A

3,4 and 6

oculomotor, trochlear and abducens

42
Q

what nerves are responsible for which movement of the eye

A

oculomotor: up down, medial, clockwise,
Trochlear: anticlockwise
Abducens: lateral and inwards

43
Q

lesion in Ventrolateral strabismus

A

Oculomotor

44
Q

rotation of the globe

A

Trochlear (cannot see in dog, round pupil)

45
Q

medial strabismus

A

abducens

46
Q

loss of palpebral

A

trigeminal (afferent) facial (efferent)

47
Q

change in facial expression

A

facial nerve

48
Q

drooping of ear

A

facial nerve

49
Q

pendulum nystagmus

A

nystagmus when head is moved, reduced towards side of lesion

50
Q

two types of deafness

A

Sensorineural: failure of sensory organs
Conductive: failure of passage of sound

51
Q

what provides motor innervation of the pharyngeal muscles

A

9

glossopharyngeal

52
Q

causes of megaosophagus

A

Addison’s (Hypoadrencortisism), myasthenia gravis, oesophagitis, botulism or brainstem disease

53
Q

main difference between ataxia and paresis

A

Ataxia is loss of sensory pathway (proprioeception) and paresis is loss of motor innervation (UMN or LMN)

54
Q

what does a spinal reflex test

A

sensory, central(spine) and Motor(LMN, muscle and NMJ)

UMN indirectly because shows as exaggerated reflex

55
Q

difference between tetraplegia and paraplegia

A

tetraplegia: absence of movement in all limbs
paraplegia: absence of movement in hind limbs

56
Q

what are LMN signs

A

muscle atrophy and reduced spinal reflex

57
Q

where is lesion if paraplegia, loss of muscle mass in hindlimbs

A

L4-S3

58
Q

where is lesion if paraplegia with exaggerated reflexes in hind limbs

A

T3-L3

59
Q

location of lesion if tetraplegia with increased muscle tone and exaggerated reflexes in all limbs

A

C1-C5 or brainstem

60
Q

location of lesion if tetraparesis, exaggerated reflexes in hind limbs and reduced reflexes in forelimbs

A

C6-T2

61
Q

how do you know the severity of spinal lesions based on clinical signs

A

loss of proprioception then movement then nociception

62
Q

most important prognostic indicator for spinal lesions

A

deep pain perception (REMEBER limb withdrawal does not mean pain perception!!)

63
Q

cause of muscle pain that occurs during or just after exercise

A

equine rhabdomyolysis syndrome ( Monday morning disease or tying up)

64
Q

how is equine rhabdomyolysis diagnosed

A

a >100% increase in CK after a lungs test (take blood CK levels pre and 6 hours post a 20 minute lunge)

65
Q

cause of equine rhabdomyolysis

A

overexertion, electrolyte imbalance, inherited

66
Q

treatment for equine rhabdomyolysis

A

analgesia, fluids, rest and electrolytes (sodium and potassium)

67
Q

prevention of regular exercise rhabdomyolysis in TB

A

oral dantrolene, high fat/low carb diet and regular exercise.

68
Q

cause and treatment of a limp tail (rudder tail)

A

coccygeal muscle injury, treatment: rest and NSAIDs

69
Q

horse with funny kick out placement of hind limb on one side

A

fibrotic myopathy: rest, ice and NSAIDs

70
Q

what does the patella reflex test

A

femoral nerve (L4-L5)

71
Q

what does the withdrawal reflex test

A

sciatic (L6-L7)

72
Q

what does the perianal reflex test

A

Pudendal nerve (S1-S3)

73
Q

clinical signs of lumbrosacral syndrome

A

pain at hips, low tail carriage reluctant to sit/jump, crouched posture

74
Q

GSD with bladder dysfunction and pain at back

A

lumbosacral stenosis

75
Q

horse with tail paresis, dilated anus and perineal loss of sensation

A

Trauma(sacral fracture) or EHV-1

76
Q

what are the three muscle involved in bladder voiding

A

detrusor, urethral muscle (smooth muscle) and external sphincter muscle (skeletal muscle)

77
Q

type of innervation for storage and voiding phases of the bladder.

A

Storage: sympathetic
Voiding: parasympathetic

78
Q

drugs used to stimulate bladder emptying

A

Prazosin and Diazepam

79
Q

difference between a T1 and T2 MRI

A

T1w: fluid is dark
T2w: fluid is white

80
Q

what is a cross extension reflex and what does it suggest

A

when doing withdrawal reflex on one limb the opposite one extends (a UMN sign)

81
Q

if all 4 limbs are effected where must the lesion be cranial to …..

A

T2

82
Q

reduced reflex in thoracic limbs, where is lesion?

A

C6-T2

83
Q

what does scuffing on the thoracic feet indicate

A

sensory loss, chronic nature of disease

84
Q

typical CS of Neuromuscular disease

A

weakness, muscle loss, ataxia, reduced spinal reflexes and altered breathing

85
Q

if paresis without ataxia likely to be

A

neuromuscular

86
Q

common causes of neuromuscular disease

A

myasthenia gravis, hypothyroidism, hyperadrenocorticism, neospora, toxoplasma or neoplasia

87
Q

normal result of a EMG (electromyogram)

A

silent

88
Q

regurgitation with exercise intolerance

A

myasthenia gravis (causing megaoesopagus and blocked Ach receptors on muscles)

89
Q

treatment and diagnosis of myasthenia gravis

A

Ach inhibitor test and serology, treat with pyridostgymine and immunotherapy drugs.

90
Q

cause of dysphagia, loss of tail, tongue and eyelid tone, general weakness, ileus and pupil dilation in a horse

A

Botulism: antiserum, broad spectrum antibiotics and fluids

4th year (8 decks)

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