Neurology

Question 1

NAL:
UMN Thoracic
UMN Pelvic

Answer 1

C1 - C5

Question 2

NAL:
LMN Thoracic
UMN Pelvic

Answer 2

C6 - T2

Question 3

NAL:
Normal Thoracic
UMN Pelvic

Answer 3

T3 - L3

Question 4

NAL:
Normal Thoracic
LMN Pelvic

Answer 4

L4 - S3

Question 5

Clinical Signs: C1 - C5

Answer 5

UMN thoracic
UMN pelvic

Question 6

Clinical Signs: C6 - T2

Answer 6

LMN thoracic
UMN pelvic

Question 7

Clinical Signs: T3 - L3

Answer 7

Normal thoracic
UMN pelvic

Question 8

Clinical Signs: L4 - S3

Answer 8

Normal thoracic
LMN pelvic

Question 9

UMN Signs

Answer 9

Normal to increased reflexes
Abnormal postural reactions
Gait: overstepping, crossing over, toe-dragging

Question 10

LMN Signs

Answer 10

Decreased to absent reflexes
NORMAL postural reactions
Gait: short, choppy

Question 11

What is the order in which functional loss of the spinal cord occurs?

Answer 11

Proprioception
Weakness/ataxia
Voluntary motor
Bladder
Nociception

Question 12

What peripheral nerve and spinal cord segments are associated with the thoracic limb flexor reflex?

Answer 12

Median, ulnar nn.

C6 - T2

Question 13

What peripheral nerve and spinal cord segments are associated with the biceps reflex?

Answer 13

Musculocutaneous n.

C6 - C8

Question 14

What peripheral nerve and spinal cord segments are associated with the triceps reflex?

Answer 14

Radial n.

C7 - T2

Question 15

What peripheral nerve and spinal cord segments are associated with the extensor carpi radialis reflex?

Answer 15

Radial n.

C7 - T2

Question 16

What peripheral nerve and spinal cord segments are associated with the thoracic limb flexor reflex?

Answer 16

Sciatic n.

L6 - S1

Question 17

What peripheral nerve and spinal cord segments are associated with the patellar reflex?

Answer 17

Femoral n.

L4 - L6

Question 18

What peripheral nerve and spinal cord segments are associated with the cranial crural reflex?

Answer 18

Peroneal n.

L6 - L7

Question 19

What peripheral nerve and spinal cord segments are associated with the gastrocnemius reflex?

Answer 19

Tibial n.

L7 - S1

Question 20

Define: Schiff-Sherrington Syndrome

Answer 20

Occurs with severe T3-L3 myelopathies

Persistent severe extension of thoracic limbs (NOT IN STANDING POSITION)

Due to disinhibition of extensor motor neurons in cervical intumesense

Question 21

Cutaneous Trunci Reflex

Answer 21

Afferent (sensory) dermatome at level of pinch (L6/L5 area)

Efferent (motor) C8 - T1 = lateral thoracic nn. to cutaneous trunci mm.

“Cutoff” = lesion is cranial (cut off at L5 = lesion is at L3)

Question 22

Clinical Signs: UMN Bladder

Answer 22

Firm bladder, normal to hypertonic/spastic detrusor

Increased pudendal and pelvic nerve tone

Bladder can be difficult to express

Question 23

Clinical Signs: LMN Bladder

Answer 23

Flaccid bladder, hypotonic detrusor

Decreased pelvic and pudendal nerve tone

Bladder easily expressed

Question 24

Treatment: UMN Bladder

Answer 24

Alpha agonists: phenoxybenzamine, prazosin

Striated m. relaxant: diazepam

Question 25

Treatment: LMN Bladder

Answer 25

Parasympathomimetic: bethanechol

Question 26

Hansen Type I IVDD

Answer 26

Question 27

Hansen Type II IVDD

Answer 27

Question 28

Horner's Syndrome

Answer 28

Loss of sympathetic innervation to the eye

Question 29

Clinical Signs: Horner's Syndrome

Answer 29

Miosis Ptosis Enophthalmos Prolapse of the nictitans

Question 30

What are the ways to describe abnormal mentation?

Answer 30

Question 31

What response deficits are seen with forebrain dysfunction?

Answer 31

Question 32

Nystagmus, Head tilt, Strabismus, PR deficits, CN deficits Peripheral Vestibular Disease

Answer 32

Question 33

Nystagmus, Head tilt, Strabismus, PR deficits, CN deficits Central Vestibular Disease

Answer 33

Question 34

Nystagmus, Head tilt, Strabismus, PR deficits, CN deficits Paradoxical Vestibular Disease

Answer 34

Question 35

Clinical Signs: Facial Nerve Dysfunction

Answer 35

Absent palpebral, intact vision Facial droop (ear, lip, muzzle, eyelid)

Question 36

Clinical Signs: Trigeminal Nerve Dysfunction

Answer 36

Mandibular branch: atrophy of mm of mastication

Question 37

What are the 4 top differentials for flaccid paralysis?

Answer 37

Myasthenia gravis Polyradiculoneuritis Botulism Tick paralysis

Question 38

What are differentiating features of Polyradiculoneuritis, Botulism, Tick Paralysis, and Myasthenia Gravis?

Answer 38

Question 39

What CSF abnormalities are associated with granulomatous meningoencephalomyelitis?

Answer 39

Pleocytosis with elevated protein

Question 40

What CSF abnormalities are associated with necrotizing encephalitis?

Answer 40

Mononuclear pleocytosis with elevated protein