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Y4 Equine - Neurology > Neurological exam and intro to diagnostic testing > Flashcards

Neurological exam and intro to diagnostic testing Flashcards

(63 cards)

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1
Q

What are changes in mentation due to?

A
  • abnormalities of cerebral function
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2
Q

How can you induce somnolence in foals?

A
  • Madigan squeeze
    — only works in v young foals
    — mimics their movement through the birth canal
    — squeezing over their thorax and between their legs
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3
Q

What type of tremor does cerebellar disease cause?

A
  • Intention tremor
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4
Q

What breed of horse are intention tremors more common in?

A
  • Arabs
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5
Q

What are the 12 CNs?

A

I. Olfactory
II. Ophthalmic
III.Oculomotor
IV. Trochlear
V. Trigeminal
VI. Abducens
VII. Facial
VIII. Vestibulocochlear
IX. Glossopharyngeal
X. Vagus
XI. Accessory
XII. Hypoglossal

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6
Q

Can we test the olfactory cranial nerve?

A
  • no
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7
Q

What are the two ways for testing optic nerve?

A
  • menace response
  • PLR
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8
Q

What is the best thing to use for PLR?

A
  • Phone torch
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9
Q

Is PLR faster or slower in horses than small animal species?

A
  • slower
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10
Q

Is the menace response a natural or learned response?

A
  • Learnt
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11
Q

When does the menace response become learnt?

A
  • Within 2 weeks of age
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12
Q

What three cranial nerves are tested together?

A
  • 3 + 4 + 6
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13
Q

If the oculomotor is damaged, what clinical sign is seen?

A
  • ptosis
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14
Q

What innervation does the oculomotor nerve provide?

A
  • Motor to extrinsic muscles, ciliary body, levator palpebrae muscles
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15
Q

What innervation does the trochlear nerve provide?

A

Motor to extrinsic muscles

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16
Q

What innervation does the abducens nerve provide?

A

Motor to extrinsic muscles

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17
Q

What medical state is nystagmus seen in and is normal?

A
  • Under GA
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18
Q

Is nystagmus without movement normal?

A
  • no
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19
Q

Which CN are being tested when looking for nystagmus when moving the head horizontally?

A
  • III & VI
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20
Q

Which CN are being tested when looking for nystagmus when moving the head vertically?

A
  • III & IV
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21
Q

What are the three branches of the trigeminal nerve?

A
  • ophthalmic
  • mandibular
  • maxillary
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22
Q

Is the trigeminal nerve responsible for motor or sensory innervation only?

A
  • sensory only
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23
Q

How can you test facial sensation?

A
  • Stimulate skin over the face
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24
Q

What muscle does the facial nerve run over?

A
  • Masseter muscle
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25
If the facial nerve is damaged, what is the common clinical sign?
- asymmetry
26
How can you tell if the facial problem is left or right sided using the muzzle?
- the muzzle is pulled to the side that has normal muscle tone
27
How can you test the vestibulocochlear nerve?
- noise stimulus
28
Is peripheral or central vestibular disease more common in the horse?
- central is more common than peripheral
29
What does the glossopharyngeal innervate?
- taste - motor to tongue - motor to pharyngx
30
How can you test the glossopharyngeal nerve?
- grab the tongue - if the horse retracts/avoid, its intact
31
How can you test the accessory spinal nerve?
- general movement and stretches
32
What does the hypoglossal innervate?
- intrinsic muscles of the tongue - pharynx
33
How is the hypoglossal tested?
- pull the tongue
34
What are some examples of spinal reflexes?
- Cutaneous reflex (e.g when horses vibrate to flick off flies) - Anal tone and movement e.g with rectal thermometer - Tail movement
35
How can we best mimic a patellar reflex in the horse?
- throw the horse's weight via tail to one side - the quadricep should contract to respond
36
Use of foot placement
- can be useful if abnormalities are asymmetrical - can be misleading in cases that are very obedient
37
What is the most common cause of neurological disease?
- spinal ataxia
38
What is grade 1 ataxia?
- Abnormalities are not consistent, present in only one part of the neurological examination
39
What is grade 2 ataxia?
- Abnormalities are consistent in all parts of the neurological examination but are mild
40
What is grade 3 ataxia?
- Abnormalities are consistent and moderate in all parts of the neurological exam, exacerbation may not be indicated
41
What is grade 4 ataxia?
- Truncal sway is evident when the horse is stood still, signs at walk are likely severe
42
What is grade 5 ataxia?
- The horse is recumbent and unable to stand
43
Why is walk better for assessing neurological issues?
- slower
44
Why is trot not useful for neurological assessments?
- Tendon spring is required for trot locomotion which is not impacted by neurological problems
45
Use of circling
- looking at the horse to lift its leg, neuter it has the cognitive ability to realise it needs to change direction mid air and put it in an appropriate place in relation to its new trunk position
46
What are we looking for during dynamic neurological assessment?
- Stride height - Length consistency LOOK FOR INCONSISTENCY FROM EACH STRIDE RATHER THAN A LIMB COMPARISON
47
What is the benefit of blindfolding horses during a neuro exam?
- increases sensitivity (i.e. takes away normal visual compensation for any ataxia) - is basically an exacerbation test -> can make mild tests more obvious
48
Other than blindfolding, what are other methods of making mild disease more obvious and consistent
- using difference surfaces and obstacles
49
What is the benefit of blood work in neuro assessments?
- differentiate between infectious and inflammatory conditions - serology for specific infectious diseases
50
What is xanthochromia caused by?
- Breakdown of RBC - Infectious disease and trauma
51
Does normal CSF have high or low cellularity?
- low
52
What does xanthochromia look like?
- yellowish discolouration of CSF
53
Where can you sample CSF in the horse?
- AO (under GA) - C1-2 (standing with US) - LS (standing, blind)
54
If you have neurological signs, what other structure should you always investigate?
- guttural pouch
55
What cranial nerves pass through the GP?
- IX + X + XI + XII
56
How is the GP investigated?
- endoscopy
57
What is the gold standard imaging diagnostic for neuro assessment?
- CT
58
Does head CT need GA?
- no
59
What are the indications for radiography of the neck?
- all cases of bilateral and quadrilateral ataxia
60
Does CT of the neck require GA?
- yes
61
What is the benefit of adding contrast to neck CT?
- identification of spinal cord compression
62
What are significant findings in a neck myelogram?
- 50% reduction in dorsal dye column or 25% reduction in dural diameter
63
What would be the gold standard diagnostic imaging if available?
- MRI

Y4 Equine - Neurology (6 decks)

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