Neurology Flashcards by David James

the different areas of the central nervous system

Forebrain, brainstem, cerebellum, spinal cord and neuromuscular

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how is the spine segmented

C1-C5, C6-T2, T3-L3, L4-CAUDAL

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8 parts to a neurological exam

1 Mentation, 2 Posture, 3 Gait, 4 Postural Reactions, 5 Spinal Reflexes, 6 Cranial Nerves, 7 Palpation, 8 Nociception

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what are you looking for in the first 2 steps of a neurological exam

Mentation: Level (alert/coma), Quality( appropriate or not)
Posture: head tilt (roll) or turn (yaw), stance( wide base) and posture

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decerebrate

neck and limbs extended

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decerebellate

neck and forelimbs extended but hindlimbs flexed

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Schiff-scherrington posture

forelimbs rigid hindlimbs flexed (T3-L3 lesion)

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paresis

decreased voluntary movement
LMN ( decreased to absent reflexes in limb effected and reduced muscle tone) or UMN (normal to increased muscle tone and spinal reflexes caudal to lesion)

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cause of normal to increased stride length with spastic movements

UMN Paresis

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cause of “bunny hopping” (reduced stride length) or collapse

LMN Paresis

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Ataxia

Without coordination:
Sensory: wide base, knuckling, increased stride length
Cerebellar: rate+range, intention tremors, hypermetria
Vestibullar: falling, leaning, head tilt,

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what does a exaggerated spinal reflex show

A lesion in the UMN cranial to the spinal section tested

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what does the patella reflex test

femoral nerve L4-L6

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what does the perineal reflex test

Pudendal nerve S1-S3

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what does cutaneous trunci test for

thoracic nerves C8-T1

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What does the absence of a reflex show

lesion present in the reflex ark or joint/muscle problem

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what does the menace response test

optic nerve , forebrain, cerebellum, brainstem and facial nerve

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what does PLR test

Optic nerve, brainstem and oculomotor

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what are the cranial nerves?

1: Olfactory 2:Optic 3:Occulomotor 4:Trochlear 5:Trigeminal 6:Abducent 7:Facial 8:Vestibulocochlear 9:Glossopharageal 10:Vagus 11;Accessory 12: hypoglossal

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cause of drooped eyelid and miosis (constriction)

Horner’s syndrome: sympathetic supply to eye and face (trigeminal)

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facial sensation

trigeminal, brainstem and facial nerve

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what nerve is effected in nystagmus and strabismus

Vestibulocochlear -> 3,4,+6

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circling shows a problem where

Forebrain

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spastic or exaggerated movements

cerebella dysfunction

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absent or reduced menace

cerebella dysfunction

retractor ocular reflex nerves

trigemninal and abducens

atrophy of masticatory muscles is a problem with what nerve?

trigeminal

how is spinal disease graded

0: normal -> 5 Down

clues of ataxia

Pacing and circumduction

weak limb can be caused my ......

spinal cord damage

hypometria

shorter protraction phase of gait

hypermetria

longer protraction phase to gait

Dysmetria

impaired ability to control the distance, power and speed of movement (combination of hypo/hyper-metria)

abnormal postural reaction and limb paresis

sensory ataxia

head tilt, falling to one side, postural strabismus with normal postural reactions

vestibular ataxia

wide-base stance, tremors, loss of balance, menace deficit

cerebella ataxia

location of lesion in vestibular ataxia

vestibular apparatus or inner ear

tests for vestibular ataxia

occularvestibular reflex (pendulum nystagmus: nystagmus when head is moved)

if mentation if effected where is the lesion

forebrain, brainstem or systemic (hypertension, pyrexia, ECT)

Menace and PLR pathways

Menace: optic, opposite forebrain and cerebella, facial nerve PLR: optic, optic chiasm, oculomotor

3 nerves involved in eye movement

3,4 and 6 oculomotor, trochlear and abducens

what nerves are responsible for which movement of the eye

oculomotor: up down, medial, clockwise, Trochlear: anticlockwise Abducens: lateral and inwards

lesion in Ventrolateral strabismus

Oculomotor

rotation of the globe

Trochlear (cannot see in dog, round pupil)

medial strabismus

abducens

loss of palpebral

trigeminal (afferent) facial (efferent)

change in facial expression

facial nerve

drooping of ear

facial nerve

pendulum nystagmus

nystagmus when head is moved, reduced towards side of lesion

two types of deafness

Sensorineural: failure of sensory organs Conductive: failure of passage of sound

what provides motor innervation of the pharyngeal muscles

9 | glossopharyngeal

causes of megaosophagus

Addison's (Hypoadrencortisism), myasthenia gravis, oesophagitis, botulism or brainstem disease

main difference between ataxia and paresis

Ataxia is loss of sensory pathway (proprioeception) and paresis is loss of motor innervation (UMN or LMN)

what does a spinal reflex test

sensory, central(spine) and Motor(LMN, muscle and NMJ) | UMN indirectly because shows as exaggerated reflex

difference between tetraplegia and paraplegia

tetraplegia: absence of movement in all limbs paraplegia: absence of movement in hind limbs

what are LMN signs

muscle atrophy and reduced spinal reflex

where is lesion if paraplegia, loss of muscle mass in hindlimbs

L4-S3

where is lesion if paraplegia with exaggerated reflexes in hind limbs

T3-L3

location of lesion if tetraplegia with increased muscle tone and exaggerated reflexes in all limbs

C1-C5 or brainstem

location of lesion if tetraparesis, exaggerated reflexes in hind limbs and reduced reflexes in forelimbs

C6-T2

how do you know the severity of spinal lesions based on clinical signs

loss of proprioception then movement then nociception

most important prognostic indicator for spinal lesions

deep pain perception (REMEBER limb withdrawal does not mean pain perception!!)

cause of muscle pain that occurs during or just after exercise

equine rhabdomyolysis syndrome ( Monday morning disease or tying up)

how is equine rhabdomyolysis diagnosed

a >100% increase in CK after a lungs test (take blood CK levels pre and 6 hours post a 20 minute lunge)

cause of equine rhabdomyolysis

overexertion, electrolyte imbalance, inherited

treatment for equine rhabdomyolysis

analgesia, fluids, rest and electrolytes (sodium and potassium)

prevention of regular exercise rhabdomyolysis in TB

oral dantrolene, high fat/low carb diet and regular exercise.

cause and treatment of a limp tail (rudder tail)

coccygeal muscle injury, treatment: rest and NSAIDs

horse with funny kick out placement of hind limb on one side

fibrotic myopathy: rest, ice and NSAIDs

what does the patella reflex test

femoral nerve (L4-L5)

what does the withdrawal reflex test

sciatic (L6-L7)

what does the perianal reflex test

Pudendal nerve (S1-S3)

clinical signs of lumbrosacral syndrome

pain at hips, low tail carriage reluctant to sit/jump, crouched posture

GSD with bladder dysfunction and pain at back

lumbosacral stenosis

horse with tail paresis, dilated anus and perineal loss of sensation

Trauma(sacral fracture) or EHV-1

what are the three muscle involved in bladder voiding

detrusor, urethral muscle (smooth muscle) and external sphincter muscle (skeletal muscle)

type of innervation for storage and voiding phases of the bladder.

Storage: sympathetic Voiding: parasympathetic

drugs used to stimulate bladder emptying

Prazosin and Diazepam

difference between a T1 and T2 MRI

T1w: fluid is dark T2w: fluid is white

what is a cross extension reflex and what does it suggest

when doing withdrawal reflex on one limb the opposite one extends (a UMN sign)

if all 4 limbs are effected where must the lesion be cranial to .....

reduced reflex in thoracic limbs, where is lesion?

C6-T2

what does scuffing on the thoracic feet indicate

sensory loss, chronic nature of disease

typical CS of Neuromuscular disease

weakness, muscle loss, ataxia, reduced spinal reflexes and altered breathing

if paresis without ataxia likely to be

neuromuscular

common causes of neuromuscular disease

myasthenia gravis, hypothyroidism, hyperadrenocorticism, neospora, toxoplasma or neoplasia

normal result of a EMG (electromyogram)

silent

regurgitation with exercise intolerance

myasthenia gravis (causing megaoesopagus and blocked Ach receptors on muscles)

treatment and diagnosis of myasthenia gravis

Ach inhibitor test and serology, treat with pyridostgymine and immunotherapy drugs.

cause of dysphagia, loss of tail, tongue and eyelid tone, general weakness, ileus and pupil dilation in a horse

Botulism: antiserum, broad spectrum antibiotics and fluids

Neurology Flashcards

(90 cards)