neurology 1 Flashcards
Mental Status
- what anatomy does this address?
- Thalamocortex
- Reticular Activating System
depression can be due to what?
- how do we differentiate?
- Brain abnormality
- Systemic problem
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Differentiation - Complete physical examination
- Neurologic evaluation
- Ancillary testing
> Routine blood analysis
> Cerebrospinal fluid analysis
> Diagnostic imaging – radiographs, CT scan, MR imaging
CSF Collection methods for horse
- Lumbosacral space – horse restraint
- Atlanto-occipital space – general anesthesia
- Atlantoaxial Aspiration -
Heavily sedated, standing horse, sterile procedure
CSF Collection
* Lumbosacral space
- landmarks? how do we do this?
– horse restraint
* Cranial aspect of tuber sacrale
* Caudal aspect of tuber coxae
* Highest point of rump
* Aseptic preparation, lidocaine block – SC
* Spinal needle – 6”, 8” (10”)
CSF Collection
* Atlanto-occipital space
- how we do this?
- landmarks?
- materials?
– general anesthesia
- Neck flexion – moderate
- Occipital protuberance
- Wings of the Atlas - ~5 cm cranial to line drawn between cranial borders.
- Spinal needle – 3 ½”
Euthanasia – intrathecal
lidocaine
> what anatomic spot do we use?
Atlanto-occipital space
- Atlantoaxial Aspiration method for CSF collection
- how do we do this?
- Heavily sedated, standing horse, sterile procedure
- Ultrasound-guided – C1-C2, 3 cm below midline
> Dorsoventral oriented beam (transverse plane)
> Insert needle (20 or 18 g, 3.5 inch) to subarachnoid space
CSF Analysis
- what can we do?
- normal values?
Routine analysis
- Protein level (normal <0.8-1.0 g/L)
- Nucleated cell count (normal <0.004 cells/L)
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Specialized testing
- Equine Protozoal Myeloencephalitis (EPM)
- Other
Upper Motor Neurons – spinal
- signs of issues
- Ataxia, paresis
- No brain signs (depression, tremors, cranial nerve signs)
Lower Motor Neurons
- what are these?
- what do we see with issues
- Peripheral neuron, ventral nerve root, ventral gray column
- Weakness, paresis, paralysis
- Lack of reflexes
- Muscle atrophy
Cerebellar signs
- Truncal ataxia
- Hypermetria
- Nystagmus
gait abnormalities
- Loss of conscious proprioception
- Inconsistent motion (phase of stride) and/or placement of
the limbs - Dragging toes, knuckling
- Swaying, ataxia
- Step on itself (interference, forging, cross-firing)
- Circling - especially tight circles
circling gait abnormalities we should watch out for?
- Circling – especially tight circles
- Step on itself
- Abnormal, inconsistent foot placement
- Pivoting
- Circumduction
- Inability to keep trunk on course
what reflexes are important to test? is it always easy to do?
- Limited testing in the adult large animal when standing
- Cervicofacial
- Panniculus
cranial disease due to trauma
- why they are disposed
- common type of injuries we see?
Temperament, fast gait, thin calvarium
* Poll injuries – basisphenoid & basioccipital bones. Often separated at
synchondrosis connection (usually closes 2 – 5 years)
Hemorrhage into midbrain, brainstem
Hemorrhage between or into guttural pouches (rectus capitus
ventralis muscle(s)
* Side of head – petrosal bones. Hemorrhage or fragment disruption of
inner ear
