Chapter 26: Neurologic Examination & Neuroanatomic localisation

Question 1

Describe the components of posture & gait analysis

Answer 1

• evaluation of patient’s posture should be performed with patient standing & walking

Patient should be assesed for;
- head tilt (vestibualr disease)
- head or body turn (eg prosencephalic or forebrain disease)
- neck position (eg lowered with cervical spinal cvord or diffuse neurmouscular disorder)
- hock angle (plantigrade with polyneuropathies affecting sciatic nerve) - baring in mind breed specific variations - ie GSD with increased hock flexion angle
- evidence of trembling ( poss. suggetsive of neuromuscular disorders)

POSTURE:
Severe intracranial lesions may lead to TWO possible postures - both of which are associated with opisthotonus
- decerebrate rigidity - opisthotonus with rigid extension of neck AND all four limbs typically associated with midbrain or rostral cerebellar lesions. Lesions resulting in decerebrate rigidity always have a severe impact on mentation and menace reponse
- decerebellate rigidity - severe cerebellar injuries characterised by opisthotonus with extensor rigidity of the libs but hip joint flexion. These lesions do not always affect mentation

GAIT:
-relies on strength and coordination which are key components of the gait ot be analysed
lesions involving nervous system at level of midbrain and/or areas caudal to it (caudal brainstem, spinal cord, or peripheral nervous system) result in hait disturbance that is easily identified by walking the patient
Broad divisions of gait analysis
- ataxia can result from; disturbances to vestibular, cerebellar, or proprioveptive systems;
- weakness
- lameness