Neuro Exam

Question 1

What are the different levels of consciousness?

And what else do you need to assess in mentation?

Answer 1

Alert
Obtundation
Stupor
Coma

If animal is conscious you need to check the quality of that.
Check that the animal is not displaying signs of compulsion dementia or delirium

Question 2

What are the 8 parts of the neuro exam?

Answer 2

Mentation
Posture
Gait
Postural Reaction
Spinal Reflexes
Cranial Nerves
Palpation
Nocieption

Question 3

What 2 types of posture can the head display?

Answer 3

Tilt (roll) - associated with vestibular disease

Turn (yaw) - associated with forebrain disease

Question 4

What stances can be neurologically abnormal and what can they indicate?

Answer 4

wide based stance - proprioreceptive loss

narrow based stance - weakness (changing the centre of gravity)

Decreased weight bearing - pain or decreased conciousness

Question 5

What is a decerebrate posture?

Answer 5

The mentation is severely impaired or there is none.

the neck and all limbs are extended.

Question 6

What is a decerbellate posture?

Answer 6

Mentation is okay.

The neck and forelimbs are extended and the hind limbs are flexed

Question 7

What is a schiff-sherington posture?

Answer 7

the forelimbs are rigid

and the hindlimbs are flexed. this is usually due to a spinal lesion at T3-L3

Question 8

What does paresis mean?

Answer 8

This is a decrease in voluntary movement. It looks like weakness

Question 9

Ataxia is?

Answer 9

incoordination

Question 10

Paraplegia and tetraplegia mean?

Answer 10

2 limbs paralysed

4 limbs paralysed

Question 11

What do you need to assess to differentiate between UMN and LMN paresis?

Answer 11

Postural reactions
Spinal reflexes
Muscle tone

Question 12

What would you expect to see with UMN paresis?

Answer 12

Muscle tone normal to increased in limbs caudal to the leision
spinal reflexes are normal to increased in limbs caudal to the lesion
Stride length would be normal to increased and have spasticity to it

Question 13

What would you expect to see with LMN paresis?

Answer 13

Muscle tone decreased in limbs containing the reflex arc containing the lesion
Spinal reflexes decreases to absent in limbs with a reflex arc containing the lesion
Stride length normal to decreased
Stiffness
Bunny hopping
+/- collapse
+/_ ataxia (sensory) (knuckling)

Question 14

What are the 3 types of ataxia?

Answer 14

Sensory (Proprioceptive)
Cebebellar
Vestibular

Question 15

What is sensory ataxia and what does the clinical picture look like?

Answer 15

This is a loss of sense of limb or body position.

Wide based stance.
Increased stride length
Swaying/Floating gait
Knuckling

Question 16

What is Cerebellar ataxia and what can it look like?

Answer 16

Disorder of rate and range of movement
hypermetria
intention tremors
postural tremors

Question 17

What are the 2 types of vestibular ataxia?

Answer 17

Unilateral and bilateral

Question 18

Unilateral Vestibular Ataxia can show…?

Answer 18

Falling/Leaning/Circling to one side

Headtilt

Question 19

Bilateral Vestibular Ataxia can show…?

Answer 19

Wide excursions of the head
+/- head tilt
crouched posture

Question 20

Name some postural reactions

Answer 20

paw positioning
hopping
hemiwalking
placing (tactile, visual)
Extensor postural thrust

Question 21

Name the spinal (tendon) reflexes and which nerves they test?

Answer 21

Biceps (musculocutaneous n) C6-8

Triceps (radial n) C7 - T2

Patellar (femoral n) L4-6

Gastronemius (sciatic n) L6-S2

Question 22

name the flexor spinal reflexes? (withdrawl) and what nerves do they test?

Answer 22

thoracic limb (multiple n) C6-T2
pelvic limb (sciatic n) L6 - S2

Question 23

Name some other spinal reflexes?

Answer 23

Perineal (Pudendal n) S1-S3
(this gives a bilateral response to a unilateral stimulus)
Cutaneous Trunci Response - shuddering of skin

Question 24

Name all the cranial nerves

Answer 24

i. Olfactory
ii. Optic
iii. Occulomotor
iv. Trochlear
v. Trigeminal
vi. Abducent
vii. Facial
viii. Vestibulocochlear
ix. Glossopharyngeal
x. Vagus
xi. Accessory
xii. Hypoglossal

Question 25

How do you test the optic nerve?

Answer 25

Vision (drop tissue) - Forebrain
Menace Response - Forebrain - cerebellum - brainstem - VII
PLR - II- brainstem - III
(direct and indirect)

Question 26

How do you the Occulomotor nerve?

Answer 26

PLR - II - brainstem - III

Question 27

What do you look at when testing the occulomotor, trochlear and abducent?

Answer 27

checking the motor innervation to the extra occular muscles.

Stabismus (eye position) - VIII - Central Vestibular/Brainstem - III, IV, VI.

Nystagmus (eye movement) - VIII - Central Vestibular/Brainstem - III, IV, VI.

Question 28

How do you test the Trigeminal nerve?

Answer 28

Facial Sensation tested by: Palprebral Reflex - V - Brainstem - VII
Corneal Reflex - V - Brainstem - VI

Motor to muscles of mastication by : looking for signs of dysfunction (atrophy and the inability to close the jaw)

Motor to muscles of facial expression by : signs of dysfunction (facial paresis/paralysis)(facial asymmetry) 
palpebral reflex V-brainstem-VII
Menace responce (II - forebrain - cerebellum - brainstem - VII)

Question 29

What is the autonomic response of the face? and how would you test this?

Answer 29

the innervation of the lacrimal glands

schirmer tear test

Question 30

How do you test Nocieption?

Answer 30

Need to test deep pain. grab a bone (periosteum)
This is the last thing to dissapear
will get a response of a whimper or a turn of the head.
a withdrawl does not mean there is pain perception