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Flashcards in Exam 6: Neuro continued Deck (54):
1

Less-under movements usually equal:

1) pain
OR
2) "weakness" - LMN disease

2

Conscious Proprioception

Tests the entire nervous system, including lower motor neuron and upper motor neuron

3

Animal lifting their head?

When an animal moves a painful limb, they often LIFT their head as they swing that limb forward

4

Remember

"DOWN on SOUND"

5

Less tone in a limb?

Indicates a LMN problem

6

Remember, less =

Pain or weakness
-eliminate pain..

7

If you don't get good at anything else....

Get good at assessing conscious proprioception!

8

Increased to NORMAL reflexes

= Central (UMN) disease!

9

Increased to NORMAL TONE

= Central (UMN) disease!

10

Remember

Evaluate: is the animal painful?

11

Decreased to absent reflexes

LMN disease!

12

Decreased to absent tone

LMN disease!

13

Evaluate:

Does the animal have (conscious) pain sensation?
- Don't confuse reflex function with conscious pain sensation!

14

Is the movement…

Voluntary? Or involuntary?

15

Classification of seizures (animals)

1) focal
2) generalized
3) limbic, temporal lobe, or behavioral

16

Causes of seizures

1) metabolic
2) structural
3) idiopathic

17

Clinically important factors

**Age at onset of first seizure**
**Interictal neurological deficits**

18

The animal less than one year of age!
No interictal neurologic deficits!

1) METABOLIC
2) Structural
3) Idiopathic

19

Metabolic causes of seizures

1) liver disease/PSS
2) hypoglycemia
3) toxins
4) parasites
5) anemia

20

The animal less than 1 year of age!
Interictal neurologic deficits!

1) STRUCTURAL
2) metabolic
3) idiopathic

21

Structural brain disease

1) brain tumor
2) (acquired) hydrocephalus
3) encephalitis
4) cerebrovascular disease
5) trauma

22

The animal greater than 5 years of age!
No interictal neurologic deficits!

1) METABOLIC
2) structural
3) idiopathic

23

The animal greater than 5 years of age!
With interictal neurologic deficits!

1) STRUCTURAL
2) metabolic
3) idiopathic

24

The animal between 1 and 4 years of age!
No interictal neurologic deficits!

Idiopathic, metabolic, structural

25

Types of "diagnosis":

1) definitive
-only one
2) presumptive
-some, but one predominates
3) differential
-more than one (many)

26

Suspected differential diagnoses

Leads to: diagnostic testing, treatment, prognosis

27

Remember

"You are only as good as your differential list!"

28

Common intracranial diseases

1) trauma (external)

2) neoplasia
3) encephalitis/meningitis
4) hydrocephalus
5) vascular

29

Common spinal diseases

1) trauma
2) neoplasia
3) myelitis/meningitis
4) intervertebral disc disease
5) vascular
6) discospondylitis/osteomyelitis

30

The "big 3" diffuse LMN diseases

1) botulism
-CRANIAL NERVE SIGNS
2) Coonhound paralysis (polyradiculoneuritis)
-HYPERESTHETIC (a condition that involves an abnormal increase in sensitivity to stimuli of the sense)
3) tick paralysis

31

Remember

When it is obvious, think of something else

32

Remember also

Clinical signs suggest location, but not specific disease

33

Localized muscle atrophy

… More likely neurogenic?
… Primary myopathic?

34

"Mental status" is often determined by:

Behavior

35

Mental status

… Normal ==> stupor ==> coma

36

Behavior is often determined by…

1) appearance
2) movement

37

Hint

There is more often than not, more than one problem!

38

Examine toenail wear

1) are the toenails worn down? ==> is he dragging his toes?

39

More =

Central nervous system problem

40

Less =

Pain or peripheral problem

41

Reflexes

There are 3 we can interpret:
1) patellar reflex:
- percuss patellar tendon and look for slight extension of limb

2) withdrawal reflex:
- light pinch on the toe and look for animals to pull foot away, flex joints to pull foot away from stimulus

3) Crossed extensor reflex:
- the crossed extensor reflex is a normal reflex in a standing animal. The reflex causes extension of one limb when the contralateral limb is flexed. In a recumbent animal, this reflex is normally inhibited by descending inhibitory pathways. To elicit the reflex the animal is placed in lateral recumbency, and the flexor reflex is evoked from the upper limb. Extension of the contralateral limb while the patient is in lateral recumbency signals a lesion in the inhibitory pathways or pathologic condition of the UMN.

42

Crossed extensor reflex

the crossed extensor reflex is a normal reflex in a standing animal. The reflex causes extension of one limb when the contralateral limb is flexed. In a recumbent animal, this reflex is normally inhibited by descending inhibitory pathways. To elicit the reflex the animal is placed in lateral recumbency, and the flexor reflex is evoked from the upper limb. Extension of the contralateral limb while the patient is in lateral recumbency signals a lesion in the inhibitory pathways or pathologic condition of the UMN.

43

Excessive muscle tone

Extensor posture

44

Decreased tone

Indicates a problem with the local reflex arc; LMN problem

45

Remember

In a normal animal you should be able to turn their head and touch their thoracic area
-be very careful moving their head through the range of motion if you suspect neck/spine problem

46

Flexed posture?

It may be a manifestation of pain

47

If an animal is paralyzed…

You MUST determine if they have pain sensation!
-Pain is the last thing to go in a nervous system area (if pain is gone it is a poor prognosis)
-but, don't mistake reflex function with conscious pain sensation

48

Tremor

To and fro movement of a body part or body

49

Fly-biting

Lots of things can cause it

50

Myoclonis

1) episodic depolarization (pathognomonic!) ==> Like a heartbeat
-Pacemaker cells set up in the muscle
- it never goes away during the day or at night
-almost always associated with DISTEMPER

51

Seizures

1) Might see salivation, urination, defecation
2) most seizures last less than 90 seconds
3) sometimes vomiting can be associated with seizures
4) we want to know if the patient was conscious, but owner may have difficulty differentiating this
5) grand mal clonic/tonic seizures: patient is NOT conscious during this
6) the first seizure can cause changes in the brain that predispose to the next seizure

52

Management of the seizures

Medical management aggressive and sooner

53

Three big causes of seizures

1) metabolic
2) structural
3) idiopathic

54

Peripheral nerve problem

Decreased tone, decreased or absent reflex, short and choppy movements