L07: Neurolocalization (Carrera)

Question 1

UMN signs**

Answer 1

Normal or increased reflexes
increase in tone
paresis to paralysis
weak and stiff

Question 2

LMN signs**

Answer 2

loss of reflexes
loss of tone
paresis to paralysis
weak and floppy

Question 3

Brain signs

Answer 3

behavior changes
CN deficits
seizures
CP deficits
ataxia
paresis

Question 4

forebrain includes:

Answer 4

cerebrum, diencephalon

Question 5

brainstem includes:

Answer 5

midbrain, pons, medulla oblongata

Question 6

brain includes

Answer 6

forebrain
cerebellum
brainstem
individual cranial nerves

Question 7

where does cn 1 exit?

Answer 7

cerebrum

Question 8

where does cn 2 exit?

Answer 8

diencephalon

Question 9

which cn come out of midbrain?

Answer 9

3,4

Question 10

which cn come out of pons?

Answer 10

5

Question 11

which cn come out of cerebellum?

Answer 11

none

Question 12

which cn come out of medulla oblongata

Answer 12

6-12

Question 13

FOREBRAIN signs

Answer 13

seizures
circling
compulsion
behavior change (ie. stick in corner)
blindness
postural reaction deficits
normal gait

Question 14

If pupillary light reflex pathways intact but still can’t see, where is lesion?

Answer 14

Cortex

Question 15

4 CS of Horner’s Syndrome in dogs***

Answer 15

loss of sympathetic innervation –>

1) ptosis (drooping eyelid)
2) prolapsed 3rd eyelid
3) miosis (pupil constriction)
4) enophthalmos (posterior displacement of eyeball)

Question 16

CS of Horner’s Syndrome in horses

Answer 16

• eyelashes point down
• unilateral sweating (on affected side)
• inc. temp of face/neck/shoulder –> vasodilation

Question 17

Cerebellum lesion signs

Answer 17

head tilt
nystagmus (involuntary eye movement)
loss of menace
intention tremors
truncal sway
ataxia
hypermetric, spastic gait
NO paresis, behavior changes, CP deficits

Question 18

Brainstem lesion signs

Answer 18

decreased mentation (stupor, comatose)
CN deficits
usually cn8 involvement --> nystagmus
tetraparesis
CP deficits
ataxia

Question 19

how to localize spinal cord lesion

Answer 19

1) presence of myelopathy and change in postural reactions
2) segmental reflexes help you localize it
C1-C5, C6-T2, T3-L3, L4-S3

Question 20

muscle tone: extended, difficult to flex limb implies:

Answer 20

UMN lesion

Question 21

muscle tone: flaccid, unable to support any weight implies:

Answer 21

LMN involvement, spinal shock

Question 22

C1-5 lesions will have what TL/PL postural reactions?

Answer 22

dec. to absent in TL and PL

Question 23

C6-T2 lesions will have what TL/PL postural reactions?

Answer 23

variable TL, dec. to absent PL

Question 24

T3-L3 lesions will have what TL/PL postural reactions?

Answer 24

N TL, dec. to absent PL

Question 25

L4-S3 lesions will have what TL/PL postural reactions?

Answer 25

N TL, variable PL

Question 26

motor unit nerve lesions will have what TL/PL postural reactions?

Answer 26

N to dec. TL and PL

Question 27

NMJ lesions will have what TL/PL postural reactions?

Answer 27

N TL and PL

Question 28

muscle lesions will have what TL/PL postural reactions?

Answer 28

N TL and PL

Question 29

C1-C5 lesion signs

Answer 29

``` +/- ambulatory -knuckling, stumbling, face-planting -tetraparesis -ataxia (uncoordinated movement) worse in PL -N to inc. reflexes in all limbs +/- muscle fasiculations, pain ```

Question 30

C6-T2 lesion signs

Answer 30

``` +/- ambulatory -knuckling, stumbling, face-planting -"two-engine" gait -tetraparesis -ataxia -reflexes N to dec. in TL, N to inc. in PL +/- m. fasiculations, pain ```

Question 31

T3-L3 lesion signs

Answer 31

``` +/- ambulatory -paraparesis -PL ataxia -hunched +/- pain, panniculus cut-off, Schiff-Sherrington posture -reflexes N in TL, N to inc. in PL ```

Question 32

Schiff-Sherrington posture

Answer 32

- extensor hypertonia of the TLs due to loss of ascending inhibition - assoc. with severe TL lesions - NOT diagnostic! - must distinguish from decerebrate posture

Question 33

L4-S3 lesion signs

Answer 33

``` +/- ambulatory, pain, panniculus cut-off PL ataxia paraparesis (PL) N reflexes in TL dec. to absent reflexes in PL +/- anal tone, tail tone/sensation, perineal reflex ```

Question 34

LMN lesion signs

Answer 34

``` +/- ambulatory, facial n. weakness, gag reflex NO ataxia, pain Paresis (generalized) dec. to absent reflexes exercise intolerance ```

Question 35

IVDD can be acute progressive/non-progressive, or chronic progressive

Answer 35

:)

Question 36

painful spinal lesions***

Answer 36

``` IVDD meningitis/meningomyelitis diskospondylitis fracture/luxation neoplasia (bone) *there are no nerve endings within the cord!* ```