ClinNeuro- Part 1

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  1. What 4 questions should you strive to answer with your neuro exam?
    • 1- is the problem neurologic?
    • 2- where is the lesion?
    • 3- what caused the problem
    • 4- what can be done?
  2. What is the most common neurologic disease of dogs?
    disc disease
  3. Etiologic categories of neurologic disease? (8)
    • Vascular
    • Inflammatory
    • Traumatic/Toxic
    • Anomalous
    • Metabolic
    • Immune/Idiopathic
    • Neoplastic/ Nutrition
    • Degenerative
  4. Trauma does not have a(n) ____________ onset.
  5. 6 components of the neurologic exam.
    mental status, gait and posture, postural reactions, cranial nerve exam, spinal reflexes, pain sensation
  6. What is the primary goal of the neuro exam?
    to localize the lesion
  7. What 2 hands-off assessments that you begin a neuro exam with?
    level of consciousness and behavior
  8. Level of consciousness is an evaluation of the ___________.
    reticular formation activating system- brainstem function
  9. Behavior is an evaluation of ______________ function.
  10. How do you determine if there is  head tilt?
    there should be a horizontal line that passes through both pupils
  11. What are 3 abnormal spine postures, and what do they mean?
    lordosis (concave curvature of the back), kyphosis (hunched up), scoliosis (lateral deviation of the spine)
  12. You a dog that looks at you out of the corner of his eye; what does this mean?
    guarded neck posture- painful to move then neck/turn the head
  13. 3 key questions of the gait examination.
    • 1- is the gait normal or abnormal?
    • 2- if abnormal, where is it abnormal? (all limbs, some of the limbs)
    • 3- what is the problem? (ataxia, paresis, paralysis, lameness)
  14. Lameness is usually a sign of ______________.
    orthopedic disease (not neuro dz)
  15. What are 3 types of ataxia, and how does each present?
    • vestibular ataxia- head tilt
    • cerebellar ataxia- tremors, dys/hyper-metria
    • proprioceptive ataxia- paresis
  16. Proprioceptive ataxia is typically associated with ___________ injury/trauma.
  17. Flexor reflex should always be present if __(2)__ are intact.
    peripheral nn. and local spinal cord
  18. A pain reflex is processed in _________, which must be intact for a pain reflex to be present.
    the brain
  19. Which CNs are usually tested during your neuro exam?
  20. The _________ must be involved with the menace response.
  21. What structures does the menace response test?
    CN II, CN VII, thalamocortex, cerebellum
  22. What must be kept in mind regarding the menace response in young animals?
    animals <4 months old do NOT menace b/c the cerebellum is not developed enough yet
  23. What are you testing with the pupillary light reflex?
  24. The pupillary light reflex should be ___________; otherwise, it is abnormal.
  25. 4 signs of Horner's syndrome.
    miosis, ptosis, enopthalmus, protrusion of 3rd eyelid
  26. Horner's syndrome is ___________ dysfunction.
  27. Lesions anywhere along the _____________ will cause Horner's syndrome.
    tectotegmentospinal tract
  28. What 3 CNs are purely sensory?
    CN I, II, VIII
  29. What are you testing when you evaluate the oculocephalic reflex?
    motor function of CN III, IV, VI, VIII
  30. What is physiologic nystagmus?
    eye tracking along with the head
  31. The oculocephalic reflex is evaluating ____________.
    physiologic nystagmus
  32. 2 types of nystagmus?
    physiologic (oculocephalic reflex), pathologic (spontaneous or induced)
  33. Vertical pathologic nystagmus is specific for what lesion?
    central vestibular lesion
  34. 3 branches of the trigeminal nerve?
    ophthalmic, maxillary, mandibular
  35. What are the general functions of the branches of the trigeminal nerve? [sensory, motor, or both]
    • ophthalmic- sensory
    • maxillary- sensory
    • mandibular- mixed
  36. 3 tests to evaluate the function of the trigeminal nerve.
    palpebral reflex, nasal sensation, muscle of mastication (palpate for symmetry)
  37. The palpebral reflex tests the function of...
    sensory function of CN V, motor function of CN VII
  38. Why must CN VII be functional in order to get a palpebral reflex (even if CN V is fully functional)?
    because CN VII is motor function responsible for blinking
  39. Nasal stimulation test evaluates...
    sensory function of CN V and VII, thalamocortex function
  40. Bilateral atrophy of the masticatory muscles is usually ___________ in dogs.
    masticatory myositis
  41. Unilateral atrophy of masticatory muscles is commonly a __________ in dogs.
    trigeminal nerve sheath tumor
  42. Dysfunction of CN VIII often presents as... (4)
    head tilt, ataxia, disequilibrium, nystagmus
  43. Dysfunction of CNs IX and X is usually accompanied by a history of... (4)
    dysphonia, dysphagia, inspiratory dyspnea, stertorous breathing
  44. Tongue symmetry is an indication of the integrity of _________.
    CN XII
  45. CN deficits usually indicate a disease affecting the ___________.
    brain or CNs
  46. Normal postural reactions require __________, but they have little ________ value.
    cortical integration; localizing
  47. What are 3 postural reactions that should routinely be performed on neuro exams?
    Proprioception, hopping, tactile positioning
  48. The __________ is NOT involved in conscious proprioceptive reactions.
  49. Decreased or absent spinal reflexes suggest a lesion in the...
    sensory or motor component of the reflex arc.
  50. Normal or increased spinal reflexes indicate a lesion...
    cranial to the spinal cord segments being tested.
  51. Patellar reflexes are an evaluation of the...
    femoral n., L4, L5, L6 spinal cord segments.
  52. Extensor tone in the thoracic limb in controlled by _________ in the _________ segment of the spinal cord.
    radial nerve; C7-T1
  53. Flexor reflexes in the thoracic limb are controlled by _________ in the _________ segment of the spinal cord; the ___________ nerve plays an important role in the in the __________ segment of the spinal cord.
    all nerves in the brachial plexus; C6-T2; musculocutaneous; C6-C8
  54. Extensor tone in the pelvic limb is controlled by the ________ in the ________ segment of the spinal cord.
    femoral n.; L4-L6
  55. The flexor reflex of the lateral digit of the pelvic limb is controlled by the ___________ in the _________ segment of the spinal cord.
    sciatic nerve; L6-S1
  56. The flexor reflex of the medial digit of the pelvic limb is controlled by the ___________ in the __________ segment of the spinal cord.
    femoral nerve; L4-L6
  57. The motor component of the flexor reflex of the pelvic limb is ALWAYS ALWAYS the ___________; if that is non-functional, there will be no flexor reflex.
    sciatic nerve
  58. The perineal reflex is controlled by the __________ in the _________ segment of the spinal cord.
    pudendal n.; S1-S3
  59. The cutaneous trunci reflex is controlled by the ____________ in the _________ segment of the spinal cord.
    lateral thoracic n.; C8-T1
  60. Spastic muscle tone is ____________; flaccid muscle tone is _____________.
    UMN dysfunction; LMN dysfunction
  61. The cutaneous trunci reflex should be __________.
  62. With the cutaneous trunci reflex, when a cut-off is found, the lesion is typically ______________ to the cutoff point.
    2 vertebral bodies cranial
  63. Spinal palpation is used to differentiate...
    painful vs non-painful diseases.
  64. With spinal palpation, you should put pressure over the ________ in the ___________ direction.
    dorsal root ganglia; cranio-caudal
  65. In what animals do you test nociception?
    ONLY paralyzed animals
  66. What is nociception?
    "deep pain" perception
  67. How do you test nociception?
    squeeze digits with hemostat forceps and look for a behavioral (conscious) response; ie. yelping, trying to bite
  68. ________ is a common place to have nerve compression pain; therefore, start cranially so you decrease the likelihood of upsetting the patient at the beginning of the exam.
  69. What is the most reliable reflex?
    patellar reflex
  70. How do you differentiate b/w flexor reflex and nociception?
    with nociception, there is a conscious response, like vocalizing or trying to bite (cortical integration in the brain)
  71. __________ reflexes have great localizing value.
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ClinNeuro- Part 1
2015-11-04 16:16:38
clinneuro vetmed

vetmed clinneuro
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