Neuro exam

Question 1

Asymmetric vestibular dz causes

Answer 1

Head tilt and turn

Question 2

Symmetric cerebral disease can cause

Answer 2

Head and neck turn without tilting

Question 3

Often seen with vestibular disease

Answer 3

Facial paralysis

-VII and VIII right next to one another

Question 4

Abnormalities of behavior

Answer 4

Dementia

Question 5

Dementia is a sign of

Answer 5

Forebrain disease

Question 6

Obtundation reflects damage in

Answer 6

Rostral half of brain stem (reticular activating system)

Question 7

Cerebellar cortical disease may have normal vision but lack

Answer 7

menace response

Question 8

Weakness or atrophy of mastication m. involves

Answer 8

Motor div of trigeminal, it’s root, or trigeminal motor nucleus in pons

Question 9

If trigeminal damage at the pons may also have

Answer 9

hindbrain dz

• obtundation
• dysphagia
• head tilt
• facial paralysis
• weakness/ataxia limbs on same side

Question 10

In facial paralysis the muzzle deviates away from

Answer 10

affected side

Question 11

Flick reflexes

Answer 11

touch

• commisure of lips
• medial and lateral canthus
• supraorbital fossa
• ear

Question 12

Flick reflexes requires intact

Answer 12

Trigeminal sensory branches, central connections in the brain, and functioning facial nerves

Question 13

Schirmer tear test for lacrimal gland fxn, < 50% fxn

Answer 13

lesion affecting secretomotor fibers proximal to meddle ear

Question 14

Normal Schirmer tear test means lesion

Answer 14

likely at or peripheral to middle ear

Question 15

If flick reflexes normal, reduced resp to finger up nose indicates

Answer 15

involvement of contralateral forebrain

-probably at the level of the parietal lobe of the cortex

Question 16

Hypalgesia and hyporeflexia of flick reflexes on one side indicates

Answer 16

involvement of trigeminal nerve or branches

Question 17

Menace response can be considered abnormal if

Answer 17

less vigorous than response on normal side

Question 18

Optic tract

Answer 18

Optic nerve to
Contralateral optic tract to
Diencephalon to
Internal capsule to
Visual cortex

Question 19

Visual field at tip of nose doesn’t cross over and lesion is

Answer 19

ipsilateral

Question 20

Dazzle reflex is

Answer 20

Subcortical

Question 21

Dazzle reflex mediated via

Answer 21

Afferents through optic nerve to midbrain

Question 22

Dazzle subcortical reflex is distinct from pathway required for

Answer 22

PLR

Question 23

Possible to be cortically blind but still have

Answer 23

Dazzle

Question 24

Possible to have PLR but no

Answer 24

Dazzle

Question 25

A lesion in an optic nerve effects

Answer 25

Direct PLR and menace on the same side

Question 26

A lesion in the optic tract (rostral to the thalamus) affects

Answer 26

Contralateral menace but not direct PLR from either side

Question 27

A lesion in the midbrain or oculomotor nerve affects

Answer 27

Ipsilateral PLR but not menace responses

Question 28

Unilateral mydriasis caused by

Answer 28

1. Increased sympathetic dilator tone | 2. Damage to oculomotor nucleus or nerve

Question 29

Miosis occurs because of

Answer 29

1. removal of sympathetic dilator influence to pupil | 2. excessive stimulation of pupillary constricters

Question 30

Early in cerebral swelling there is often bilateral

Answer 30

miosis

Question 31

In vestibular dz pupil on affected side of head usually

Answer 31

ventrally deviated | -dorsal pupil deviation on unaffected side

Question 32

True strabismus

Answer 32

eye deviation tat can't be corrected by reposition the head

Question 33

Dysphagia can be caused by

Answer 33

1. Involvement of nucleus ambiguus in hindbrain 2. roots or peripheral parts of one/both glossopharyngeal 3. vagus 4. spinal accessory nerves * These things close to guttural pouch

Question 34

Tongue deviation, muscle atrophy and/or fasciculations reflect involvement of

Answer 34

hypoglossal nerve or root

Question 35

Delayed retraction of tongue

Answer 35

Can occur with any brain disease

Question 36

Neck pain or reluctance to turn neck indicate

Answer 36

intervertebral arthritis

Question 37

Neurogenic atrophy of thoracic limb

Answer 37

1. C6-T2 spinal cord segments 2. segment roots 3. brachial plexus 4. peripheral nerves

Question 38

Atrophy of pelvic limb muscles

Answer 38

2. L3-S2

Question 39

Anesthesia of a strip of skin loss of

Answer 39

1. segmental sensory nerve 2. dorsal nerve root 3. connections in the spinal cord * spontaneous sweating may occur

Question 40

Sensory input to larynx

Answer 40

T7-T11 | Slap test to test of arytenoid adduction

Question 41

Hopping test evaluates

Answer 41

1. proprioceptive function (spinocerebellar tracts, cerebellum) 2. limb strength

Question 42

Strength of pelvic limbs evaluated by

Answer 42

tail pull test

Question 43

Dzs causing weakness but not ataxia

Answer 43

1. botulism | 2. equine motor neuron dz

Question 44

Dzs causing ataxia without weakness

Answer 44

1. cerebellar abiotrophy 2. peripheral vestibular dz 3. equine degenerative myelopathy

Question 45

Long spinal reflexes

Answer 45

1. cervicofacial 2. cutaneous trunci 3. slap test

Question 46

Testing tibial reflex

Answer 46

Tap just behind the greater trochanter

Question 47

Testing gastrocnemius reflex

Answer 47

Strike the Achilles tendon close to its insertion

Question 48

Testing anterior tibial reflex

Answer 48

strike meddle of anterior tibial muscle

Question 49

Signs of cauda equina syndrome

Answer 49

Anesthesia/areflexia/paralysis of 1. tail 2. penis 3. perineum 4. anus/rectum 5. bladder