Exam 6: Neuro continued

Question 1

Less-under movements usually equal:

Answer 1

1) pain
OR
2) “weakness” - LMN disease

Question 2

Conscious Proprioception

Answer 2

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

Question 3

Animal lifting their head?

Answer 3

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

Question 4

Remember

Answer 4

“DOWN on SOUND”

Question 5

Less tone in a limb?

Answer 5

Indicates a LMN problem

Question 6

Remember, less =

Answer 6

Pain or weakness

-eliminate pain..

Question 7

If you don’t get good at anything else….

Answer 7

Get good at assessing conscious proprioception!

Question 8

Increased to NORMAL reflexes

Answer 8

= Central (UMN) disease!

Question 9

Increased to NORMAL TONE

Answer 9

= Central (UMN) disease!

Question 10

Remember

Answer 10

Evaluate: is the animal painful?

Question 11

Decreased to absent reflexes

Answer 11

LMN disease!

Question 12

Decreased to absent tone

Answer 12

LMN disease!

Question 13

Evaluate:

Answer 13

Does the animal have (conscious) pain sensation?

- Don’t confuse reflex function with conscious pain sensation!

Question 14

Is the movement…

Answer 14

Voluntary? Or involuntary?

Question 15

Classification of seizures (animals)

Answer 15

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

Question 16

Causes of seizures

Answer 16

1) metabolic
2) structural
3) idiopathic

Question 17

Clinically important factors

Answer 17

• *Age at onset of first seizure**

* *Interictal neurological deficits**

Question 18

The animal less than one year of age!

No interictal neurologic deficits!

Answer 18

1) METABOLIC
2) Structural
3) Idiopathic

Question 19

Metabolic causes of seizures

Answer 19

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

Question 20

The animal less than 1 year of age!

Interictal neurologic deficits!

Answer 20

1) STRUCTURAL
2) metabolic
3) idiopathic

Question 21

Structural brain disease

Answer 21

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

Question 22

The animal greater than 5 years of age!

No interictal neurologic deficits!

Answer 22

1) METABOLIC
2) structural
3) idiopathic

Question 23

The animal greater than 5 years of age!

With interictal neurologic deficits!

Answer 23

1) STRUCTURAL
2) metabolic
3) idiopathic

Question 24

The animal between 1 and 4 years of age!

No interictal neurologic deficits!

Answer 24

Idiopathic, metabolic, structural

Question 25

Types of "diagnosis":

Answer 25

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

Question 26

Suspected differential diagnoses

Answer 26

Leads to: diagnostic testing, treatment, prognosis

Question 27

Remember

Answer 27

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

Question 28

Common intracranial diseases

Answer 28

1) trauma (external) 2) neoplasia 3) encephalitis/meningitis 4) hydrocephalus 5) vascular

Question 29

Common spinal diseases

Answer 29

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

Question 30

The "big 3" diffuse LMN diseases

Answer 30

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

Question 31

Remember

Answer 31

When it is obvious, think of something else

Question 32

Remember also

Answer 32

Clinical signs suggest location, but not specific disease

Question 33

Localized muscle atrophy

Answer 33

… More likely neurogenic? | … Primary myopathic?

Question 34

"Mental status" is often determined by:

Answer 34

Behavior

Question 35

Mental status

Answer 35

… Normal ==> stupor ==> coma

Question 36

Behavior is often determined by…

Answer 36

1) appearance | 2) movement

Question 37

Hint

Answer 37

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

Question 38

Examine toenail wear

Answer 38

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

Question 39

More =

Answer 39

Central nervous system problem

Question 40

Less =

Answer 40

Pain or peripheral problem

Question 41

Reflexes

Answer 41

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.

Question 42

Crossed extensor reflex

Answer 42

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.

Question 43

Excessive muscle tone

Answer 43

Extensor posture

Question 44

Decreased tone

Answer 44

Indicates a problem with the local reflex arc; LMN problem

Question 45

Remember

Answer 45

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

Question 46

Flexed posture?

Answer 46

It may be a manifestation of pain

Question 47

If an animal is paralyzed…

Answer 47

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

Question 48

Tremor

Answer 48

To and fro movement of a body part or body

Question 49

Fly-biting

Answer 49

Lots of things can cause it

Question 50

Myoclonis

Answer 50

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

Question 51

Seizures

Answer 51

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

Question 52

Management of the seizures

Answer 52

Medical management aggressive and sooner

Question 53

Three big causes of seizures

Answer 53

1) metabolic 2) structural 3) idiopathic

Question 54

Peripheral nerve problem

Answer 54

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