Lecture: Neurolocalization Flashcards
1
Q
Brain and Cranial nerves
A
- Forebrain
- Cerebrum: I
- Diencephalon: II
- Cerebellum
- Brainstem
- Midbrain: III-IV
- Pons: V
- Medulla oblongata: VI-XII
2
Q
Forebrain
A
INHIBITORY
CS
- Seizures
- Circling
- Compulsion
- Behavior changes
- inappropriate
- getting stuck in corners
- Blindness (amaurosis)
- Postural reaction deficits
- Gaint should be normal
3
Q
Amaurosis
A
Non-ocular blindness
4
Q
Horner’s Syndrome
A
Loss of sympathetic innervation to eye
CS
- Ptosis
- Prolapsed 3rd eyelid
- Miosis
- Enopthalmos
*Horses with Horner’s are hyperthermic and sweat unilaterally
5
Q
Cerebellum Signs
A
- Intention tremors
- Head tilt
- Nystagmus
- Loss of menace
- Truncal sway
- Ataxia
- Hypermetria
6
Q
NOT Cerebellar signs
A
- Paresis
- Behavior changes
- CP deficits
7
Q
Cerebellar Ataxia
A
- Hypermetria
- ‘spastic’
- NO PARESIS
8
Q
Brainstem Signs
A
- Decreased mentation (ARAS)
- reticular activating system runs through brainstem
- obtunded to stuporous to comatose
- CN deficits
- Usually some CN VIII involvement
- Check for physiologic nystagmus
9
Q
Brainstem: Gait
A
- Vestibular or proprioceptive ataxia
- if ambulatory
- may seem cerebellar depending on lesion
- Tetraparesis (will always be seen w/ brainstem lesions)
- Proprioceptive deficits
10
Q
Neurolocalization: Spine
A
- C1-C5: All 4 limbs (equally affected)
- C6-T2: All 4 limbs (thoracic [LMN] different to pelvic [UMN] limbs)
- T3-L3: Only pelvic limbs affected
- L4-S3: Only pelvic limbs affected (LMN)
11
Q
Segmental Reflexes
A
- Can sever spinal cord cranial or caudal to the intumescense and reflex will still be intact
12
Q
Withdrawel reflex is NOT
A
Conscious
13
Q
Extended, difficult to flex limb
A
Implies UMN lesion
14
Q
Flaccid, unable to support any weight
A
- Implies LMN involvement
- Consider spinal shock
15
Q
Localization: C1-C5
A
- +/- ambulatory
- knuckling, stumbling, ‘face-planting’
- Tetraparesis
- Ataxia
- TL signs more subtle than PL
- Reflexes: N to inc on all limbs
- +/- muscle fasciculations
- +/- Pain
16
Q
Localization: C6-T2
A
- +/- ambulatory
- knuckling, stumbling, ‘face-planting’
- ‘two-engine’ gait
- Tetraparesis
- Ataxia
- Reflexes
- TL: N to dec
- PL: N to inc
- +/- muscle fasciculations
- +/- Pain
17
Q
Localization: T3-L3
Classic Dachshund
A
- +/- ambulatory
- Paraparesis
- increased PL tone
- PL ataxia
- +/- Kyphosis
- Reflexes:
- TL: N
- PL: N to inc
- +/- Panniculus cut-off
- +/- pain
- usually painful
18
Q
Kyphosis
A
hunched back
19
Q
Spinal shock
A
- Not prognostic
- Localization T3-L3
- Physiologic or anatomic transection of spinal cord
- causes temporary loss or depression in muscle tone and spinal reflex below injury
- associated with acute injury
- Patellars return within hours in dogs
- Withdrawel can take days to return
20
Q
Schiff-Sherrington posture
A
- Not prognostic
- Localization to T3-L3
- Extensor hypertonia of TLs
- due to loss of ascending inhibition
- Associated with severe TL lesions
- plegia +/- pain perception
- Distinguish from decerebrate and decerebellate postures
- mentation, CNs
21
Q
Localization: L4-S3
A
- +/- Ambulatory
- PL Ataxia
- +/- pain
- Paraparesis
- Decreased PL muscle tone
- Reflexes
- TL: N
- PL: dec to absent
- +/- panniculus to cut-off
- Anal tone?
- Perineal reflex?
- Tain tone?
- Tail sensation?
22
Q
Localization: LMN
A
- +/- ambulatory
- NO ATAXIA
- NO PAIN
- +/- CN weakness
- gag, facial
- Paresis
- decreased muscle tone all over
- Reflexes
- dec to absent
- +/- panniculus affect
- Exercise intolerance
- hallmark for myasthenia gravis
23
Q
DDX
Chondrodystrophoid
A
- IVDD
24
Q
DDX
Acute non-progressive
A
- Vascular
- Trauma
- IVDD
25
DDX
Acute Progressive
* Trauma
* IVDD
* Neoplasia
* Inflammatory
* Infectious
26
DDX
Chronic progressive
* Neoplasia
* Degenerative
* IVDD
* Inflammatory
* Infectious
27
There are no nerve endings within
Spinal cord
28
Painful spinal lesions
* IVDD
* Meningitis/meningomyelitis
* Diskospondylitis
* Fracture/luxation
* Neoplasia (bone)
