Neurological Exam SA

Question 1

Outline the five finger rule

Answer 1

Signalment
Onset
Clinical Course
Lateralisation 
Pain
Neuroanatomical localisation

Question 2

What are the segments of the spinal cord?

Answer 2

C1-C5
C6-T2
T3-L3
L4-S3

Question 3

What neuro condition gets better with time?

Answer 3

Toxic
Trauma
Vascular
Anomalous

Question 4

What neuro condition gets worse with time?

Answer 4

Inflammatory
Neoplastic
Nutritional
Degenerative 
Anomalous

Question 5

What type of neuro condition is characterised by waxing and waning signs?

Answer 5

Metabolic

Question 6

What should you observe on hands off exam?

Answer 6

Mental status and behaviour
Posture and body position at rest
Evaluation of gait
Involuntary movement

Question 7

What is required for a patient to be BAR?

Answer 7

Forebrain and reticular formation of brain stem

Need the ascending RAS to be awake

Question 8

Describe the scale from stupendous to comatose

Answer 8

Normal
Obtunded
Stuperous
Comatose

Question 9

Describe an obtunded patient

Answer 9

Decreased interest in surroundings, slowed psychomotor response

Question 10

Describe a stuperous patient

Answer 10

Only responds to Pain consciously - i.e, forebrain response

Question 11

Describe a comatose patient

Answer 11

No response to stimuli

Question 12

What can cause a patient to be obtunded?

Answer 12

Forebrain or brainstorm lesion or due to other systemic illness

Question 13

Where can you localise a lesion to if the patient is stuperous or comatose?

Answer 13

Brain stem

Question 14

What is disorientation typically associated with ?

Answer 14

Vestibular system

Question 15

What does wide circling indicate?

What does the direction of the circling indicate?

Answer 15

Forebrain lesion

Circle towards the side of the lesion

Question 16

Why does an animal circle towards the side of the forebrain lesion ?

Answer 16

If they have a left forebrain lesion they won’t be able to perceive stimuli from the right

Therefore they avoid the right and circle left

Question 17

What does head pressing indicate ?

What diagnostics are indicated?

Answer 17

A bilateral symmetrical problem

Likely metabolic problem e.g. hepatic encephalopathy or renal encephalopathy

Systemic bloods

Question 18

What would hemi-neglect of the left side of a bowl indicate?

Answer 18

A right forebrain lesion

Question 19

What system is indicated in head tilt?

Answer 19

Vestibular

Question 20

What is pleurothotonus ?

Answer 20

Head turn

Question 21

What is indicated in a wide based stance posture?

Answer 21

Cerebellum / vestibulocerebellar

Question 22

What causes ventroflexion of the neck in cats ?

Why does this occur?

Answer 22

Loss of muscle tone in the neck

Cats don’t have a nuchal ligament

Question 23

What are the rigidity postures seen in recumbent animals ?

Answer 23

Decerebellate
Decerebrate
Schiff-Sherrington

Question 24

What spinal segment is indicated in schiff-Sherrington rigidity?

Answer 24

T3-L3

Question 25

Describe schiff-Sherrington rigidity

Answer 25

TL - extended and increased tone PL - decreased muscle tone

Question 26

How does the Schiff - Sherrington posture occur?

Answer 26

Border cells tonically inhibit extensors Lesion causes loss of tonic inhibition to thoracic limb = extended forelimb

Question 27

What are the types of ataxia?

Answer 27

Cerebellar Vestibular Proprioceptive

Question 28

Describe what you would expect to see in cerebellar ataxia

Answer 28

Positioning of legs uncoordinated and exaggerated movements

Question 29

What is meant by the term paresis ?

Answer 29

Partial loss of motor function and inability to support weight Can be ambulatory or non-ambulatory

Question 30

What is meant by the term plegia?

Answer 30

Complete loss of motor function

Question 31

What hands on examination is involved in a neuro exam?

Answer 31

Postural reaction testing Spinal reflexes, muscle mass and tone CN assessment Palpation of painful areas

Question 32

Does postural testing assess a reaction or a reflex?

Answer 32

REACTION - have to be conscious to assess

Question 33

What do postural reactions assess?

Answer 33

Afferent, Ipsilateral spinal cord , ipsilateral brainstem contralateral forebrain

Question 34

How can you assess postural reactions?

Answer 34

``` Paw position Hopping Wheel barrow Extensor postural thrust Hemiwalking ```

Question 35

What section of the spinal cord is associated with the patellar reflex ?

Answer 35

L4-L6

Question 36

what does a patellar reflex usually indicate?

Answer 36

Femoral n problem

Question 37

When would you expect menace to be absent?

Answer 37

First 10-12weeks Stressed patients Lethargic patients Disorientated patients

Question 38

What CN Does PLR test?

Answer 38

CNII+III

Question 39

What CN does menace test?

Answer 39

CNII + VII

Question 40

What CN does the vestibule-ocular reflex test?

Answer 40

VIII III+IV+VI

Question 41

What CN does the palpebral reflex test?

Answer 41

CNV + VII

Question 42

What CN does the corneal reflex test?

Answer 42

CNV + VI/II

Question 43

Is facial sensation a reflex?

Answer 43

NO

Question 44

What lesion would be indicated by decreased facial sensation on the left?

Answer 44

Contralateral lesion

Question 45

What CN are tested with the gag reflex ?

Answer 45

CNIX and X