SA Head, Neck, and lymph nodes

Question 1

how do you look for evidence for CN VII, facial nerve, paralysis?

Answer 1

drooping of the lip, ear, and eyelid on the affected side.
you may also see a slight deviation of the nasal philtrum to the normal side.

The palpebral reflex will be absent, loss of motor pathway

Question 2

how do you look for evidence for CN V, trigeminal nerve, compromise?

Answer 2

Decreased jaw tone if unilateral, or dropped jaw if bilateral.
atrophy of the muscles of mastication/

palpebral reflex will be absent, loss of sensory pathway

no response when the nasal septal mucosa is touched.

Question 3

how do you look for evidence for CN XII, hypoglossal nerve, lesion?

Answer 3

atrophy and deviation of the tongue to the abnormal side.

there will be a weak withdrawal response when tongue is grasped

Question 4

What are the three components of an oral exam?

Answer 4

1. extraoral assessment
2. superficial oral exam
3. intraoral exam

Question 5

what do you check for in an extraoral assessment?

Answer 5

check for facial symmetry, look for swellings, note any draining tracts

Question 6

what do you check for in a superficial oral exam?

Answer 6

before opening the mouth, lift the lips and move the commissures caudally to evaluate mucous membrane and teeth (incisors, canine, and carnassial pair)

Question 7

what do you check for in an intraoral exam?

Answer 7

open a dogs or cats mouth for intraoral, pharyngeal, and further dental evaluation.
dogs: inspect the tonsillar crypts by depressing the tongue with your index fingers
cat: inspect the sublingual area without placing your fingers inside the mouth.

Question 8

at what age does a puppy or kitten have permanent incisor and canine teeth?

Answer 8

at least 6 months old

Question 9

what is the dental formula for a dog?

Answer 9

3/3 incisors
1/1 canine
4/4 premolars
2/3 molars

42 in total

Question 10

what is the dental formula for a cat

Answer 10

3/3 incisors
1/1 canine
3/2 premolars
1/1 molars

30 in total

Question 11

what is a carnassial pair?

Answer 11

carnassial pair of cheek teeth for shearing flesh off bone, maxillary P4 and mandibular M1

Question 12

what may an absent or reduced gag reflex indicate?

Answer 12

lesion involving- IX, glossopharyngeal nerve, and X, vagus nerve.

Question 13

characteristics of lymph nodes

Answer 13

they should feel somewhat firm, smooth, and non-painful, and they are generally ovoid in shape.
they are also very mobile in the subcutaneous tissue when palpated.

Question 14

how can you tell the difference between a salivary gland and a lymph nodes?

Answer 14

compared to salivary glands, lymph nodes are more mobile. salivary glands are more fixed in place.

Question 15

Identify the three SA palpable lymph node

Answer 15

mandibular lymph node
superficial cervical lymph node
popliteal lymph node

Question 16

where can you find each palpable lymph node?

Answer 16

mandibular lymph node- ventral at the angle of the mandible
superficial cervical lymph node- in front of the cranial border of the scapula
popliteal lymph node- caudal to the stifle joints

Question 16

what are the lymph nodes that should be palpated during a SA PE

Answer 16

palpable:
mandibular lymph node
superficial cervical lymph node
popliteal lymph node

not palpable:
axillary lymph node
superficial inguinal

Question 17

what are the salivary glands that should be palpated during a SA PE

Answer 17

palpable:
mandibular salivary gland- caudal to the angle of the mandible, located between the lingofacial and maxillary veins.

not palpable:
parotid salivary gland - at the base of the ear
sublingual salivary gland - compact and diffuse portions opening into the mouth
zygomatic salivary gland- medial to the zygomatic arch

Question 18

how do you distinguish between the mandibular lymph node and mandibular salivary gland?

Answer 18

the lymph node is more mobile. the salivary glands are adjacent to the lymph node.

Question 19

How big is the mandibular lymph nodes

Answer 19

about 1 to 2 cm

Question 20

How do you palpate for the thyroid glands?

Answer 20

Palpate for the bilateral lobes of the thyroid gland were they normally live, on either side of the trachea over the first few cartilage rings.
they are not palpable in normal SA

Extend the patients head, place your thumb and forefingers caudal to the larynx and gently slide them down the trachea.

Question 21

are you able to palpate the esophagus?

Answer 21

no.
an enlarged esophagus (mesoesophagus) may appear to balloon out at the thoracic inlet.

Question 22

what is the tympanic membrane?

Answer 22

it divides the external and middle ear.

Question 23

what are the three basic cranial nerve exams?

Answer 23

menace response
pupillary light reflex
palpebral reflex

Question 24

how do you perform a menace response? What are you testing?

Answer 24

learned behavior
cover one eye and do a quick movement on the other eye.
the eye should blink or retraction of the eye

IN : CN II (optic nerve) - visual pathway to the occipital bone
OUT: CN VII (facial nerve) - Sensory efferent to the orbicularis oculi muscle to close the palpebral fissure.

Question 25

how do you perform a pupillary light reflex? What are you testing?

Answer 25

light directly to the eye and check for pupil dilation
Both pupils should constrict, with a direct response in the tested eye being slightly stronger than a consensual response in the opposite eye.

IN: CN II - visual pathway to the midbrain
OUT: CN III (oculomotor) - parasym visceral efferent axons synapse in ciliary ganglion. postganglionic axons constrict the pupil

Question 26

how do you perform a palpebral reflex? What are you testing?

Answer 26

Touch the skin around the eyelid, the medial and lateral canthus of the eye. there should be rapid blinking or complete closure of eye.

IN: CN V (trigeminal) - opthalmic branch at medial canthus and maxillary branch at lateral canthus.
OUT: CN VII (facial) - Sensory efferent to the orbicularis oculi muscle to close the palpebral fissure.

Question 27

what cranial nerves are involved with strabismus (abnormal eye position)

Answer 27

CN III (oculomotor) dysfunction results in ventrolateral strabismus

CN IV (Trochlear) dysfunction results in extorsion, external rotation of the globe

CN VI (Abducent) dysfunction results in medial strabismus

Question 28

What cranial nerves are involved with eye moments?

Answer 28

Normal physiologic nystagmus: depends on CN VII, brainstem, CN VI for lateral eye movement, and CN III for medial eye movement

Abnormal nystagmus: results from abnormalities in the peripheral vestibular apparatus, CN VIII (vestibulocochlear), or central vestibular components

Question 29

What cranial nerves are involved palpebral fissure size?

Answer 29

normal size depends on CN III (SE) to levator palpebrae superioris muscle, and on sympathetic postganglionic axons traveling with CN V to orbital smooth muscle

May observe reduced palpebral fissure size with CN V (mandibular branch) dysfunction via atrophy of the masticatory muscles.
May observe reduced palpebral fissure size in horse and farm animals with CN VII dysfunction.

Question 30

Identify

Answer 30

a. cornea
b. anterior chamber
c. iris
d. pupil
e. conductive
f. Sclera
g. third eyelid/ nictitans
h. medial canthus
i. lateral canthus