3Rd Year - Neuro - Part One

Front 1

What are the 7 basic parts of the nervous system?

Back 1

(1) Motor Unit
(2) Spinal Cord
(3) Pons and Medulla
(4) Cerebellum
(5) MIdbrain
(6) Thalamus/Hypothalamus
(7) Cerebrum

Front 2

What is a motor unit composed of - name 5 things?

Back 2

(1) lower motor neuron (ventral horn cells, alpha motor neuron)
(2) peripheral nerves (axons)
(3) NM juntions
(4) skeletal muscle fibers
(5) sensory nerves (functionally included)

-damage to any of these gives you Motor Unit or Lower Motor Neuron signs

Front 3

What are the 4 clinical signs associated with motor unit disease (LMN) signs?

Back 3

(1) weak or loss of motor function
(2) rapid loss of muscle tone (atrophy)
(3) altered sensation
(4) DIMINISHED OR ABSENT SPINAL REFLEXES

Front 4

What is the hallmark of LMN disease?

Back 4

DIMINISHED OR ABSENT SPINAL REFLEXES

Front 5

What is a spinal reflex?

Back 5

an unconscious response to stimulation

Front 6

Does a spinal reflex require higher centers?

Back 6

no

Front 7

Thoracic limb reflexes occur between what 2 segments of spinal cord?

Back 7

C6-T2

Front 8

Pelvic limb reflexes occur between what 2 segments of spinal cord?

Back 8

L4-S3

Front 9

Triceps reflex evaluates what?

Back 9

radial nerve

spinal cord segments C7-T2

Front 10

What is a normal response to the triceps reflex?

Back 10

extension of the elbow

Front 11

What does the biceps reflex evaluate?

Back 11

musculocutaneous nerve

spinal cord segments C6-C8

Front 12

What do you percus for the triceps reflex?

Back 12

triceps tendon

Front 13

What is a normal response to the biceps reflex?

Back 13

flexion of the elbow, but often only see a slight contraction of the biceps muscle

Front 14

What do you percuss for the biceps reflex?

Back 14

biceps tendon on the medial aspect of the elbow

Front 15

What doe the extensor carpi radialis response evaluate?

Back 15

radial nerve

spinal cord segments C7-T2

Front 16

What is a normal response to the extensor carpi radialis feflex test?

Back 16

extension of the carpus

Front 17

What efferent pathways does the flexor or withdrawal reflex of the thoracic limb test?

Back 17

-axillary, musculocutaneous, median, ulnar

Front 18

What is a normal response to the withdrawal response of the thoracic limb.

Back 18

flexion of the carpus, elbow, shoulder

Front 19

What does the patellar reflex test?

Back 19

femoral nerve

-spinal cord segments L4-S2

Front 20

What is a normal reflex to the patellar reflex test?

Back 20

extension of the stifle

Front 21

What do you hit to do the patellar reflex test?

Back 21

patellar tendon

Front 22

What does the cranial tibial reflex test evaluate?

Back 22

peroneal branch of the sciatic nerve

spinal cord segments L6-S2

Front 23

What is a normal response to the cranial tibial reflex test?

Back 23

flexion of the hock

Front 24

What does the gastrocnemius reflex test?

Back 24

tibial branch of sciatic nerve

spinal cord segments L6-S2

Front 25

What is a normal response to the gastrocnemius reflex test?

Back 25

extension of the hock

Front 26

With the flexion test of the pelvic limb, what afferent nerves does it test?

lateral digit?

medial digit?

Back 26

lateral - sciatic nerve
most medial - femoral nerve

Front 27

With the flexion test of the pelvic limb, what efferent nerves does it test?

Back 27

sciatic nerve and cranial and caudal gluteal nerves

-L6-S3 segment of spinal cord

Front 28

A crossed extensor response is a sign of what?

Back 28

UMN dysfunction

Front 29

What does a perineal reflex test?

Back 29

evaluated the pudendal nerve

S1-S3 of spinal cord

Front 30

What is a normal response to the perineal reflex?

Back 30

contraction of the external anal sphincter

Front 31

What is a normal reposne to the sciatic response test and what areas does it test?

Back 31

jerk of the entire limb

-sciatic nerve L6-S2/3

Front 32

What is in grey matter?

Back 32

LMNs (cell bodies of neurons)

Front 33

David Hume

Back 33

David Hume: argued that ration is slave to the passions. As such, morality is not based on reason, but on how we feel about certain actions.

Front 34

Are LMNs located in EVERY segment of spinal cord?

Back 34

yes

Front 35

Where are UMNs primarily located?

-What so they do?

Back 35

brain stem

-send axons thru white matter tracts in the brainstem and spinal cord to regulate LMNs

Front 36

What is the hallmark sign of UMN damage?

Back 36

EXAGGERATED and ABNORMAL SPINAL reflexes

Front 37

Whar are the 2 main differences between LMN and UMN damage?

Back 37

UMN damage

- GRADUAL loss of muscle tone due to disuse rather than denervation

-exaggerated and abnormal spinal reflexes

Front 38

What is a crossed extensor response?

Back 38

pinch toes on down limb and get an involuntarry extension of the up limb

Front 39

What is a positive babinski?

Back 39

extension of the digits

Front 40

Injury to the Lumbosacral region (segments L4-S3) shows what type of signs?

Back 40

LMN injury to rear limbs

-dilated bladder and losee of resistance to urine outfle
-any time injury to UMN and LMN, LMN signs predominate

Front 41

Injury to the thoracolumbar region (segments T4-L2) show what type of signs?

Back 41

UMN signs to the rear limbs

-panniculus reflex is absent in segments caudal to the injury

Front 42

What other name doe the panniculus reflex have?

Back 42

cutaneous trunki reflex

impulse travels down white matter tracts

Front 43

What segments of spinal cord are termed the Lumbosacral region?

Back 43

L4-S3

Front 44

What segments of spinal cord are termed the Thoracolumbar region?

Back 44

T4-L2

Front 45

What segments of spinal cord are termed the cervicothoracic region?

Back 45

C6-T2

Front 46

What segments of spinal cord are termed the cervical region?

Back 46

C1-C6

Front 47

What are the clinical signs to damage of the cervicothoracic area (segments C6-T2)?

Back 47

-UMN clinical signs to Pelvic limbs
-LMN signs to thoracic limbs
-absent panniculus reflex
-Horner's syndrome

Front 48

What is Horners syndrom caused by?

Back 48

loss of sympathetic innervation to the eye causing
-misosis, ptosis, enophthalmus

Front 49

What are the clinical signs when the cervical area of the spinal cord is damages (C1-C6)?

Back 49

UMN signs to ALL 4 limbs

Front 50

What do postural reactions tell you?

What does it evaluate?

Back 50

if it is musculo-skeletal or neurological

-evaluated both UMN and LMN
(seonsory and motor)

Front 51

What are postural reactions useful for?

Back 51

evaluating asymetrical lesions

Front 52

How are lesions in the brain most easily evaluated?

Back 52

postural reactions

Front 53

Injury to what tracts will cause a ipsilateral postural reaction?

Back 53

Midbrain, Pons, Medulla

Front 54

Injury to what sections will cause a contralateral response?

Back 54

midbrain or rostral

-thalamus/hypothalamus
-cerebrum

Front 55

Postural reaction deficits on the SAME side as a head tilt point you to either a lesion in the pontomeduallary region or the midbrain - how do you differentiate?

Back 55

pontomedullary region - nerve deficits in nerves V-XII (5-12)

midbrain region - nerve deficits in nerves III - IV (3-4)

Front 56

Postural reaction deficits on the OPPOSITE side as a head tilt point you to either a lesion in the midbrain, thalamus/hypothalamus, or cerebrum- how do you differentiate?

Back 56

midbrain - nerve deficits in nerves III-IV (3-4)

thalamus/hypothalamus - loos for endocrine problems or visual deficits (also seizures)

cerebrum - look for seizures

Front 57

Seizures occur with damage to what area of the brain?

Back 57

thalamus or hypothalamus

cerebrum

Front 58

Where is CN I located?

Back 58

cerebrum -- telencephalon

Front 59

Where is CN II located?

Back 59

thalamus/hypothalamus -- diencephalon

Front 60

Where are CN III-IV located?

Back 60

midbrain -- mesencephalon

Front 61

Where are CN V-XII located?

Back 61

pons and medulla - metencephalon and myelencephalon

Front 62

What is the order of a pupillary light reflex after light enters the retina and is transmitted via the optic nerve to the optic chiasm?

Back 62

-lateral geniculate nucleus of opposite side
-to pretectal nucleus in the midbrain of the same side
-to Back to the same side as the initial light stimulus to the parasympathetic nucleus of CN III
-this mediated the efferent response to constrict the pupil

Front 63

Where does cross over of occur to create the consensual reposne in the opposite eye when doinf the pupillary light reflex?

Back 63

parasympathetic nucelus of CN III

Front 64

What controls motor (efferent) control of constriction of the eye?

What controls dilation of the eye?

Back 64

parasympathetic nuceleus (CN III)

sympathetic innervation (neurons near the pretectal nucleus)

Front 65

what CNs are evaluated together by looking at eye movement?

Back 65

III, IV, VI (3, 4, 6)

0culocephalic reflex

Front 66

When CN III is damaged, what will you see?

Back 66

-ptosis of eye (droopy)
-ventrolateral strabisubus (can't move the eye medial, ventral or dorsal)
-dilated pupil

Front 67

What does CN IV innervate?

-What deficit would you see and in what animals?

Back 67

rotation of the eye

-rotational deviation of the globe -- ONLY in animals without a round pupil

Front 68

What does CN VI innervate?

Back 68

lateral rectus of eye and retractor bulbi

Front 69

What signs would you see with damage to CN 6?

Back 69

ventromedial stabismus (can't move eye laterally)

Front 70

What does CN 3 innervate in the eye specifically?

Back 70

dorsal, ventral and medial muscles of the eye, levator muscle of eye

Front 71

What CNs do you evaluate by touching , pinching or stroking the face?

Back 71

5 and 7

Front 72

What are the 3 branched of the trigeminal nerve (CN 5)?

-which one provides motor function to the muscles of mastication?

-do all provide sensation?

Back 72

-mandibular
-maxillary
-opthalmic

-mandibular - motor to mastication
-yes - all are sensory input

Front 73

What 3 functions does the facial nerve have (CN 7)?

Back 73

1 - motor to facial expression
2 - parasympathetic innervation to lacrimal and salivary glands
3 - taste to rostral 2/3 of the tongue

Front 74

What are clinical signs to damage of CN VII?

Back 74

-ptosis of upper lid
-loss of ability to close the eye
-loss of ability to retract the lips - droopy lip
loss of tear production

Front 75

What are clinical signs due to a lesion in CN 8?

Back 75

-deaf
-head tilt, falling,
- postional strabismus
-nystagmus

Front 76

What are the best ways for determining if a CN 8 injury is from the inner ear or CNS?

Back 76

postural reactions (peripheral is normal, CNS is decreases on the side of the lesion)

- nystagums (CNS - varies with position; peripheral does not)

-horners syndrom is more common with peripheral

Front 77

What does CN 12 do?

Back 77

move tongue

Front 78

Lesions to CN 9,10, 11 have what clinical signs?

Back 78

inability to swallow or weak gag reflex?

Front 79

Pharygeal sensation and motor function tested via a gag reflex tests what 3 CNs together?

Back 79

9,10,11

Front 80

Tremors with damage to the cerebellum are often what?

Back 80

goal directed

Front 81

If head tilt signs are present, where is the lesion?

Back 81

rostral to the foramen magunm

Front 82

If no head tilt is observed, what is the first question to ask?

Back 82

gait deficits?

-all 4 limbs or ONLY pelvic limbs?

Front 83

If the gait deficit is only in the pelvic limbs and there is a posture reaction deficit, where is the lesion?

Back 83

must be caudal to T2

Front 84

If the gait deficit is only in the pelvic limbs and there is a posture reaction deficit with EXAGERATED SPINAL REFLEXES, where is the lesion?

Back 84

T2-L4

Front 85

If the gait deficit is only in the pelvic limbs and there is a posture reaction deficit with DIMINISHED SPINAL REFLEXES, where is the lesion?

Back 85

L4-S3

Front 86

If the gait deficit is only in the pelvic limbs and there is NO posture reaction deficit, where is the lesion?

Back 86

Orthopedic - hip or stifle

- Early lumbosacral lesion

Front 87

If the gait deficit is in ALL 4 limbs, there are postural reaction deficits and EXAGERATED reflexes in all 4 limbs, where is the lesion?

Back 87

C1-C6

Front 88

If the gait deficit is in ALL 4 limbs, there are postural reaction deficits and DIMINSHED reflexes in all 4 limbs, where is the lesion?

Back 88

Generalized motor unit disease

Front 89

If there is no head tilt, the gait deficit is in ALL 4 limbs, there are postural reaction deficits and EXAGERATED reflexes in Pelvic limbs and DIMINSHED throacic limb reflexs, where is the lesion?

What else should you use to help you make the call?

Back 89

C6-T2
-look for Horners and absent Panniculus

Front 90

Where is the rostral and caudal colliculus and what does it do?

Back 90

midbrain
-orient the head in response to sensory input

Front 91

Where is the reticular formation?

Back 91

pons and medulla

Front 92

Where is the optic chiasm located?

Back 92

ventral to the hypothalamus

Front 93

What are clinical signs of lesions in the diencephalon?

Back 93

-abnormal behavior (b/c of limbic system)
-autonomic dysfunction
-endocrine imbalances (Diabetes, cushings)
-gait ans postural deficits contralateral
-CN II deficits
Seizures

Front 94

What are the functional regions of the cerebrum?

Back 94

-prefrontal - aimless wandering
-frontal - motor regions
- temporal - behavior
-occipital - vision

Front 95

Monoparesis due to motor unit disease is most commonly caused by what?

Back 95

disease affecting one or more peripheral nerves in close proximity

Front 96

Quadriparesis (generalized motor unit disorders) - can not tell the difference between what 4 diseases?

Back 96

1 - polyneuropathy
2 - polymyositis
3 - junctionopathy
4 - Diffuse spinal cord disease

Front 97

Are there CN abnormalities with motor unit diseases?

Back 97

yes - except CN 2
CNs are peripheral nerves therefore susceptible to these diseases

Front 98

How do you help localize motor unit disease? What 4 tools?

Back 98

1- electrophysiology (EMG, peripheral nerve conduction velocity)
2 - serum enzymes (CK, LDH, AST)
3 - muscle and nerve biopsy
4 - CSF tap for proximal nerve root or ventral horn cell disorders

Front 99

What are the major causes of monoparesis as related to MUD?

Back 99

1 - trauma
2 - neoplastic - nerve sheath tumor, lymphoma
3 - distemper neurtitis (rare)
4 - fibrocartilaginous infecrt

Front 100

What causes histologic damage and temporary loss of nerve conduction by crush injury?

Back 100

neuropraxia

Front 101

What causes nerve stretch or nerve crush, but has a good prognosis because regeneration is usually effective?

Back 101

axonotmesis

Front 102

What is it called when the nerve is cut all the way thru - poor prognosis?
What differentiates the different classes?

Back 102

Neurotmesis

Class 3 - endoneurium
Class 4 - perineurium
Class 5 - epineurium

Front 103

How fast do axons grow?

Back 103

1-2 mm/day

Front 104

What ancillary aids would you use to diagnose peripheral nerve trauma?

Back 104

EMG, Motor and Sensory NCV

Front 105

How long should you wait before rendering a prognosis for peripheral nerve trauma?

Back 105

2-4 weeks

Front 106

What is the primary nerve in the thoracic nerve to cause it to be functional?

Back 106

radial

Front 107

What is a primary nerve root tumor?

Back 107

neoplastic transformation of cells within the peripheral nerves (Schwann cells or fibroblasts)

Front 108

Are malignant nerve sheath tumors fast or slow?

Back 108

slow

Front 109

Two ancillary aids used with malignant nerve sheath tumors is EMG and radiology? What will EMG differentitate between?

Back 109

neurogenic atrophy and disuse atropy

Front 110

What 4 generalized motor unit diseases are there?

Back 110

1 - peripheral neuropathies
2- NM junction disorders
3 - disorders of skeletal muscle
4 - diffuse spinal cord diseases

Front 111

What type of neuropathy is acute polyradiculoneuritis?

Back 111

-inflammatory peripheral

Front 112

What tools would you use to diagnose coon hound paralysis?

Back 112

EMG, MNCV, CSF

Front 113

What is the pathogenesis of myasthenia gravis?

Back 113

immune-reaction in which antibodies bind to the Ach receptor

Front 114

What are the main clinical signs of myasthenia gravis?

Back 114

exercise intolerance that improves with rest
-megaesophagus and pharyngeal paralysis

Front 115

Are EMG and nerve conduction velocity normally normal in a dog with myasthenia gravis?

Back 115

yes

Front 116

What is a test unique for myasthenia gravis?

Back 116

tensilon test - administer edrophonium chloride to a collapsed dog

-also measure anti-Ac receptor antibodies

Front 117

What drugs can you give a dog with myasthenia gravis?

Back 117

pyridostigmine Bromine
neostigmine
steroids(prednisolone)

Front 118

What is a typical history of dogs with chronic demyelinating neuropathy?

Back 118

remitting and relapsing course

Front 119

What is the treatment for chronic demyelinating neuropathy?

Back 119

steroids

Front 120

What are motor nerve conduction velocity's look like in chronic demyelinating neuropathy and what can this tell you?

Back 120

-velocities are slowed suggesting a primary demyelinating condition with limited axonal degeneration

Front 121

Which ticks cause tick paralysis by blocking release of Ach at neuromuscular junctions with a neurotransmitter?

Back 121

Dermacentor variablis and andersoni

Front 122

Other than LMN signs, what else is affected with Botulism?

Back 122

CNs - mydriasis, decreased jaw tone and gag reflex and poor facial muscle tone

-also GI signs

Front 123

How does renervation occur with botulism and how long does it take?

Back 123

axonal sprouting

-takes 4 weeks

Front 124

What are anomolous musclular dystropy diseases due to?

Back 124

degeneration of skeletal muscle due to abnormal

1 - membrane protein
2 - ion channel
3 - muscle metabolism

Front 125

The is the most common metabolic myopathy?

Back 125

hypokalemic myopathy in cats

Front 126

What are typical clinical signs of cats with hypokalemic myopathy?

Back 126

acute onset of appendicular weakness, marked ventroflexion of the head and neck

Front 127

What breed of cat gets hypokalemic myopathy the most?

Back 127

Burmese cats

Front 128

How do you diagnose hypokalemic myopathy?

Back 128

low serum K
high serum CK

Front 129

What is the treatment for hypokalemic myopathy in cats?

Back 129

-potassium - oral is best
-Kaon (potassium gluconate elixer)
-Tumil-K (potassium gluconate powder)

Front 130

What are the 2 forms of cushings?

Back 130

1 - atrophic myopathy (loss of type II myofibers)
2 - pseudomyotonia

Front 131

What typical sign is seen in puppies with toxo or neospora infections?

Back 131

stiff-stifle

Front 132

What is the main clinical sign of animals affected with toxoplasmosis and neospora?

Back 132

multi-focal neurologic disease with various degrees of encephalisit, myelitits, polyradiculoneuritis and myositis

Front 133

What is the treatment for animals with toxoplasmosis gondii and neospora infections?

Back 133

clindamycin and pyrimethamine and sulfadiazine

Front 134

How do you diagnose toxo or neospora infections?

Back 134

rising titers, rising CK, evidence of organism in muscle biopsy, response to therapy

Front 135

What is happens with masticatory muscle myositis?

Back 135

antigenically different myosins in muscles of mastication may be selectively targeted by immune reaction

Front 136

How is masticatory muscle myositis diagnosed?

Back 136

muscle biopsy or MMM antibody titer

Front 137

How do you treat masticatory muscle myositis?

Back 137

immunosuppresive therapy and PT

Front 138

How do you diagnose immune mediated polymyositis?

Back 138

CK, EMG, Muscle Biopsy
-Rule out inflammatory myositis via tox/neospora titer and clind therapy
-look for other evidence of immune mediated disease

Front 139

What causes malignant hyperthermia?

Back 139

defect in intracellular calcium homeostasis results in intense muscle contraction

Front 140

What genetic mutation is associated with exercise associated myopathy in Labs?

Back 140

Dynamin 1 - important in vesicle release at the NM junction

Front 141

When do clinical signs appear for exercise associated myopathy of labs?

Back 141

7 months to 2 years

-more collaspse during strenuous exercise and normal after 10-20 minutes of rest

Front 142

What are the 2 categories of intervertebral disk disease?

Back 142

1 - chondroid metaplasia
2 - fibrinoid metaplasia

Front 143

What is type 1 and type 2 of intervertebral disk disease?

Back 143

1 - disk extrusion (more commonly associated with chondroid metaplasia)
2 - disk protrusion - material in annulus, but protrudes into the spinal canal (more commonly associated with fibrinous metaplasia)

Front 144

Chondroid metaplasia and type I disk disease most commonly occur in what type of breeds?

Age?

Back 144

chondrodystrophic breeds - dachshund, beagle, pekinese, lhasa, shih tzu, cocker spaniel

>3

Front 145

What are clinical signs of type I IDD?

Back 145

acute onset of spinal cord compression and trauma
- depend on area affected

Front 146

What breed of dogs does type II and fibrinoid metaplasia occur?

age?

Back 146

large breed dogs

older than 5

Front 147

What is needed to localize the lesion of type II lesions?

Back 147

myelography

Front 148

How do you diagnose type I IDD?

Back 148

survery rads, CSF tap, myelogram

Front 149

What is the 5 point scale that evaluates degree of spinal cord dysfunction for type I disk extrusion?

Back 149

1 - pain only
2 - ataxia but effective movement
3 - paraparesis
4 - paraplegia with intact sensation
5 - paraplegia without sensation

Front 150

What is the prognosis for grade 2 spinal cord dysfunction?

grade 3?
grade 4?
grade 5?

Back 150

good

grade 3 - good to fair
grade 4 - fair
grade 5 - grace

Front 151

What is the onset of type II IDD?

Back 151

chronic

Front 152

What is the treatment for type II IDD?

Back 152

surgical decompression

Front 153

What is the prognosis for type II IDD?

Back 153

more guarded than type I