Animal Diseases-Lecture 5 (Nervous System)

Front 1

What is the functional unit of the nervous system?

Back 1

Neuron (transmits electrical impulses to and from the brain. Interruption of signals cause signs based on the location of the lesions)

Front 2

Name 2 parts of the central nervous system

Back 2

Brain, spinal cord

Front 3

Name the 2 parts of the peripheral nervous system:

Back 3

Cranial nerves

Peripheral nerves

Front 4

Name 1 disease related to the brain

Back 4

Trauma, Vestibular disease, neoplasia, seizure disorders

Front 5

Name 1 disease related to the peripheral nervous system.

Back 5

Deafness, metabolic neuropathy, megaesophagus, polyradiculoneuritis, facial nerve paralysis

Front 6

Name 1 disease related to the spinal cord.

Back 6

Intervertebral Disc Disease (IVDD), spinal cord trauma, atlantoaxial subluxation, cervical spondylomyelopathy, degenerative myelopathy, discospondylitis, ischemic myelopathy.

Front 7

Traumatic brain injury has acute clinical onset from a ______.

Back 7

traumatic event

Front 8

What are the 2 classes of traumatic brain injury? What is the difference?

Back 8

Primary event: direct injury to the tissues (may disrupt tracts that can't be repaired, or cause repairable cell damage which is reversible).

Secondary event: Intensify the neurologic damage already there from a primary event. (ICP, edema, hypoxia, seizures).

Front 9

What are some of the clinical signs of Traumatic brain injury?

Back 9

Hx of head trauma, seizures, blood in ears, nose, oral cavity, ocular hemorrhage, anisicoria (unequal pupil size), loss of consciousness, decreased response to stimuli, shock, arrhythmias, altered resp. patterns.

Front 10

What can increased ICP (Intercranial pressure) cause?

Back 10

Cushing's reflex (results in bradycardia, hypertension, irregular resp., widening pulse pressures)

Usually seen in the terminal stages of acute head injury!!

Front 11

Hypertension, bradycardia, and widening pulse pressure are all examples of the ______.

Back 11

Cushing triad (this is a sign of ICP, where there is an increase in sympathetic outflow to the heart, where the body is trying to increase arterial BP and total peripheral resistance, this is accompanied by bradycardia).

Front 12

How would you diagnose traumatic brain injury?

Back 12

hx of trauma, clinical signs, chemistries to rule out other possible causes of neuro signs.

Front 13

True or False:

Treatment for traumatic brain injury is very involved. You need to correct metabolic derangements, give oxygen, elevate their head and give drug therapies.

Back 13

True

Front 14

Match the drug therapy used in traumatic brain injury with its class:

1. Osmotic agents (decrease ICP/cerebral edema)

2. Antieleptics

3. Corticosteroids

A. Solu-Delta Cortef

B. Mannitol, Diuretics, Hypertonic saline

C. Valium, phenobarbital

Back 14

1. B

2. C

3. A

Front 15

There are 3 things that you want to check when doing an evaluation of brain trauma. These are:

Back 15

Gait/reflexes, Consciousness, PLR/OVR

Front 16

This disease is an acute disorder of dogs and cats, and is signified by inflammation around the 8th cranial nerve.

Back 16

Vestibular disease (idiopathic in older/middle aged animals, can reoccur)

Front 17

The neurological equipment that is responsible for perceiving one's body orientation relative to the earth is called the ______.

Back 17

Vestibular apparatus

Front 18

What are 2 things that can cause vestibular disease?

Back 18

Idiopathic (unknown cause), middle ear infection, brain lesion, neoplasia, autoimmune inflammation.

Front 19

What are 2 clinical signs of vestibular disease?

Back 19

loss of balance, nystagmus (uncontrollable "shaking" of the eyeballs), disorientation, ataxia, vomiting/anorexia, circling, head tilt.

Front 20

Give two treatment options for vestibular disease.

Back 20

Antihistamines (centrally acting, reduce nausea/vertigo), steroids?, treat underlying ear infection (if present), supportive care, help them up/down/out, etc, it's not a stroke!

Front 21

True or False

With neoplasia, tumors in the brain can cause compression on neurologic tissue and cause acute signs.

Back 21

False.

Can cause progressive signs (symptoms are often VERY progressive, and treatment doesn't cure them).

Front 22

Primary tumors are usually ______.

Metastatic tumors are usually ______.

Back 22

Primary=single

Metastatic/secondary=multiples

Front 23

Clinical signs usually vary depending on the location of the tumor involved in neoplasia. Can you name 2 signs?

Back 23

Worsening seizures in old dogs, endocrine imbalances, vestibular signs, tremors, ataxia.

Front 24

How would you diagnose for neoplasia?

Back 24

screening for tumors in other body regions, CBC/Chem/Lytes, Rads, CSF tap, ophthalmic exam, CT/MRI.

Front 25

Give 2 treatment options for neoplasia

Back 25

sx removal for single masses, radiation/chemo, antieleptics, corticosteroids.

Front 26

How are seizures categorized in cats and dogs?

Back 26

Extracranial vs. Intracranial

Extracranial-outside the body. (Toxins, etc)

Intracranial-inside the body

(progressive (neoplasia) vs. non-progressive (epilepsy)

Front 27

What are 2 extracranial causes of seizures?

Back 27

Hypoglycemia, liver or kidney dz, hypocalcemia, hypothyroidism, hyperthermia, toxicoses (organophosphates/chocolate)

Front 28

What are 2 intracranial causes of seizures?

Back 28

Epilepsy, hydrocephalus, canind distemper encephalitis, thiamine deficiency, neoplasia, cranial trauma, cerebral infarction, degenerative conditions (lysosomal storage dz).

Front 29

Generalized seizures are also called ______ seizures.

Back 29

Tonic-clonic seizures

Front 30

What happens during the tonic phase of a seizure?

Back 30

animal falls, loses consciousness, limb rigidity

Front 31

What happens during the clonic phase of a seizure?

Back 31

paddling of the limbs, chewing, biting.

May also defecate, urinate, mydriosis, hypersalivation.

Front 32

1. Partial seizure

2. Complex partial seizure

A. movements are restricted to one area of the body (usually associated w/ secondary epilepsy)

B. psychomotor or behavioral (associated w/ bizarre/complex behaviors that are repeated during the seizures)

Back 32

1. A

2. B

Front 33

multiple seizures within a short period of time, and only brief consciousness between seizures is called ______.

One seizure lasting 30 minutes or longer, or multiple short seizures with no time in between are called ______.

A. Status epilepticus B. Cluster seizures

Back 33

1. B

2. A

Both should be treated as medical emergencies

Front 34

What are the 4 basic stages of a seizure?

Back 34

Prodrome behavior changes. can occur hours/days before seizure.

Aura sensory/focal onset (percieved smell/deja vu/behavioral changes).

Ictus The seizure event itself.

Post-ictal Neurological status alterations hours/days after the seizure.

Front 35

1.Prodrome

2.Aura

3.Ictus

4.Post-ictal

A. Time after the seizure

B. Signals the start of the seizure

C. Precedes the seizure (restlessness, mood/behavior change).

D. The actual seizure

Back 35

1. C

2. B

3. D

4. A

Front 36

Paroxysmal transient disturbances of brain function are also called ______.

Back 36

seizures

Front 37

What are the two different types of epilepsy (determined by the cause)?

Back 37

Idiopathic (#1 cause in dogs and cats, unknown cause although a hereditary basis has been established)

Secondary (when a cause can be determined)

Front 38

What breeds are predisposed to idiopathic epilepsy?

Back 38

German shepherd, golden retriever, labrador retriever, mini and toy poodles, saint bernard, cocker spaniel, beagle, irish setter.

Front 39

True or False

In order to diagnose idiopathic epilepsy, you want to run a CBC and chemistries to rule out other possible causes, also a CT/MRI to rule out lesions in the brain.

Back 39

True

Front 40

Why would you want to wait to treat idiopathic seizures?

Back 40

because you want to establish a pattern of frequency(so you aren't treating them if it is only going to occur every 6 months), then start treatment when seizures occur every 4-8 weeks.

Front 41

What is one drug therapy that is used in idiopathic seizures?

Back 41

Potassium bromide, phenobarbital

Front 42

True or False

Status epilepticus is not an emergency situation.

Back 42

False

It is an emergency situation (can lead to irreversible brain damage and death, and high temps)

Front 43

Status epilepticus can cause high temps, and irreversible brain damage and death. What are some treatment options?

Back 43

Diazepam, Phenobarbital, Mannitol/Prednisone (if cerebral edema is suspected), Cool bath (for temps).

Front 44

Is epilepsy a curable disease?

Back 44

No. Medications will need to be given for the rest of their lives, and monitored/adjusted often. The can live a normal life once the seizures are controlled though.

Front 45

What is the outer fibrous layer of the intervertebral discs called?

Back 45

Annulus fibrosus

Front 46

What is the inner gel-like nucleus of the intervertebral discs called?

Back 46

Nucleus pulposus

Front 47

One of the most common disk disorders are called ______.

Back 47

intervertebral disk disease (IVDD)

Disks become dislodged, protruded, herniated, and ruptured

Front 48

What are the 3 most common areas for disc protrusion in IVDD?

Back 48

Cervical

Caudal Thoracic

Lumbar

Front 49

What are the 2 types of disc herniations in IVDD?

Back 49

Hansen type I(right)

(acute rupture, more common in small breed, younger dogs).

Hansen type II (left) (less acute, more common in large breed dogs >5 years).

Front 50

What are 2 clinical signs of IVDD?

Back 50

Apparent pain, presence/absence of motor and sensory deficits, acute onset (type I), paresis or paralysis (can be unilateral), decreased panniculus reflex (quick twitch in sq muscle along back due to a pinprick), altered deep pain response.

Front 51

When diagnosing for IVDD, what is one thing that you may see on a radiograph.

Back 51

Narrowed intervertebral space at location of the lesion (C7-T1, T9-10, L7-S1), Opacity of the "horse's head" of intervertebral foramen.

Myelogram is required for definitive location of the lesion.

Front 52

Give a way to treat IVDD.

Back 52

With pain, can be managed medically. Confinement, corticosteroids, muscle relaxers, pain meds, intensive care nursing, PT.

If you have multiple episodes of ataxia, paralysis, and an absence of deep pain, that may require surgical intervention ASAP.

Front 53

Give one way to prevent IVDD.

Back 53

Prevent excess weight gain, avoid standing on hind legs, prognosis=poor if animals lack deep pain for 24 hrs.

40% have recurrence with more severe signs.

Front 54

There are two types of effects due to spinal cord trauma, what are they?

Back 54

Direct effects-due to primary disruption of pathways

Indirect effects-result from edema, hemorrhage, inflammation, ischemia, neuronophagia causing autodissolution of the cord.

Front 55

Give a way to diagnose spinal cord trauma.

Back 55

History of trauma, Schiff-Sherrington (rigid hypertonicity of fron legs), lack of panniculus reflex, paresis or paralysis.

Front 56

How can you treat spinal cord trauma?

Back 56

Corticosteroids (Dexamethasone, Solu-Delta Cortef), Mannitol, treat other injuries, strict confinement for 8 weeks (if mild dislocation or fractures), surgical treatment, daily PT, bladder expression/catheter, nursing care.

Front 57

What type of dogs usually have atlantoaxial subluxation?

Back 57

Young toy/mini breeds.

(cranial portion of axis is displaced into spinal column)

Front 58

What are the two possible causes of atlantoaxial subluxation?

Back 58

congenital (birth defects)

trauma

or it can be both.

Front 59

What are some clinical signs of atlantoaxial subluxation?

Back 59

Young toy/mini breeds, reluctant to be patted on the head, tetraplegia(total paralysis of all limbs) or tetraparesis(weakness of all limbs), sudden death due to respiratory paralysis.

Front 60

What is the medical treatment for atlantoaxial subluxation? What is the surgical treatment?

Back 60

medical-Splint neck in extension (strict cage confinement for 6 weeks, steroids, pain meds)

Surgical-stabilization/decrompression, stainless steel wire, bone grafts/cross pinning, hemilaminectomy to relieve compression.

Front 61

What is cervical spondylomyelopathy also known as?

Back 61

wobbler syndrome

(common in large breed dogs) Great dane (onset before 1 year of age), doberman (onset before 2 years old), borzoi, basset hound

Front 62

What are some clinical signs of cervical spondylomyelopathy?

Back 62

pelvic limb ataxia, dragging toes, crossing limbs, abnormal proprioception, swinging/wobbly gait in hind end, worse on rising, atrophy of scapular muscles, rigid neck flexion without pain.

Front 63

How can you diagnose cervical spondylomyelopathy?

Back 63

Rule out metabolic defects (esp. hypothyroidism), radiographs (may indicate malalignment or sliiping of vertebrae, narrowing of spinal canal, myelography, CT/MRI

Front 64

What is the medical treatment for cervical spondylomyelopathy? Surgical?

Back 64

Medical-cortisone, neck brace, cage confinement (3-4 weeks)

Surgical-decompression and stabilization

prognosis is guarded (inherited defect)

Front 65

With IVDD, once deep pain is lost there is a....

____% chance of recovery with sx w/in 24 hrs

After ____ hours, prognosis is poor.

____to____% chance of progressive myelomalacia leading to respiratory paralysis.

Back 65

50% if sx w/in 24 hours

after 48 hours, prognosis=poor

5-10% chance of progressive myelomalacia

Front 66

There are several different techniques/approaches for IVDD surgery, and they depend on the site of IVD rupture, what are 2 techniques?

Back 66

cervical spine-dorsal laminectomy or ventral spondylectomy (aka slot)

thoracolumbar spine-dorsal laminectomy or hemilaminectomy

Front 67

Diffuse degeneration of white matter in all segments of the spinal cord is called ______.

Back 67

Degenerative Myelopathy (may be autoimmune)

Front 68

What type of dogs can get degenerative myelopathy?

Back 68

german shepherds, belgian shepherds, OES, Weimaraner

all are generally older that 5-6 years

Front 69

What is a clinical sign of degenerative myelopathy?

Back 69

slowly hind limb ataxia and paresis, loss of proproiception, muscle wasting, unable to support weight with rear limbs.

Front 70

What would a neurologic exam show with degenerative myelopathy?

Back 70

Decreased or absent proprioception and placing, increased to normal patellar reflexes, lack of pain, normal sphincter tone, normal panniculus reflex.

Front 71

What would radiographs show with degenerative myopathy?

Back 71

ossification and narrowed disc spaces

Front 72

Is there any treatment that is helpful when dealing with degenerative myelopathy?

Back 72

No treatment is helpful, irreversible damage to the spinal cord, and it is time to consider quality of life when they cannot support their weight.

Front 73

Inflammation of IV disk and/or vertebral bodies (vertebral osteomyelitis) is also called ______.

Back 73

Discospondylitis

Front 74

True or False

Discospondylitis is usually caused by the hematogenous spread of bacterial or fungal infections from penetrating wounds, abscesses or infection, surgery, and grass lawns.

Back 74

True

Front 75

Discospondylitis can be caused by common infections such as what?

Back 75

UTI, bacterial endocarditis, dental extraction (immunosuppresion may play a role)

Front 76

What are some clinical signs of discospondylitis?

Back 76

Often vague and non-specific, wt. loss, fever, depression, reluctance to exercise, spinal pain, hyperesthesia.

Front 77

How would you diagnose discospondylitis?

Back 77

radiographs (may show lysis of bony end plates, osteophytes, decreased disk space), myelography (spinal compression), CBC (high WBC count), CSF (may show high WBC's and elevated protein), Culture and Sensitivity of blood, CSF, and urine, sx biopsy/tissue culture are definitive.

Front 78

How can you treat discospondylosis?

Back 78

long term antibiotic therapy (6 weeks to 6 months), analgesia, guarded prognosis

also, brucellosis can cause it (caution! zoonotic)

Front 79

Ischemic Myelopathy is caused by ______.

Back 79

Fibrocartilagenous Emboli (Necrosis of the spinal cord due to obstruction of veins and arteries, and have an acute onset, and severe neurologic deficit)

Front 80

What type of dogs get ischemic myelopathy?

Back 80

Giant/large breed dogs between 1 and 9 years old (less common in cats and small dogs).

Front 81

What is a clinical sign of ischemic myelopathy?

Back 81

acute onset of neurologic signs, lack of spinal pain, paresis or spastic paralysis, reluctance to move.

Front 82

How would you diagnose ischemic myelopathy?

Back 82

rule out all other causes, rads and labs are usually unremarkable, myelogram (spinal cord edema).

Front 83

What is a treatment option for ischemic myelopathy?

Back 83

administer corticosteroids (shock dose), good nursing care, most recover in a few months, prognosis is guarded but good, keep them comfortable and prevent further injury.

Front 84

______ is often associated with trauma to peripheral nerves.

Back 84

Neuropathic syndrome (reduced or absent muscle tone, wekness, or paralysis of affected limb or muscle).

Front 85

True or False

Neuropathic syndrome may involve a single nerve or multiple nerves, and the cause is easily diagnosed.

Back 85

False, the cause is often unknown, so it is not easily diagnosed.

Front 86

Deafness resulting from central/peripheral (pick one) origin results from damage to CNS and auditory pathways.

Back 86

central origin

Front 87

Deafness resulting from central/peripheral (pick one) origin results from cochlear abnormalities.

Back 87

Peripheral origin

Front 88

Conductive/neural (pick one) deafness is usually associated with chronic otitis, rupture of the membrane, or damage to the middle ear.

Back 88

Conductive deafness

Front 89

Conductive/neural (pick one) deafness can be hereditary or congenital, drug therapy, or aging changes.

Back 89

Neural deafness

Front 90

True or False

Congenital defects are partial or total agenesis (failure of organ to develop) of the hearing organ, organ of Corti, siral ganglion, or cochlear nuclei.

Back 90

True

Front 91

Name 2 ototoxic drugs.

Back 91

Aminoglycosides (e.g. gentocin), polymyxin B, chloramphenicol

Front 92

What are 2 breeds that are predisposed to deafness?

Back 92

Dalmations, Bull terriers, dobermans, rottweilers, pointers, australian shepherds, english setters, cattle dogs, blue-eyed white cats.

Front 93

What are 2 clinical signs of deafness?

Back 93

lack of response to auditory stimuli, excessive sleeping, typical breed.

Front 94

How would you diagnose deafness?

Back 94

inability to arouse a sleeping patient with loud noises, evaluate responses to multiple auditory stimuli, specialty diagnostics (typanometry, acoustic reflex testing, auditory evoked responses)

Front 95

True or False

Hearing loss in deaf animals is not permanent, and hearing aids are easy fixes.

Back 95

False (it is permanent, and most animals don't tolerate hearing aids).

Front 96

When dealing with Metabolic Neuropathy, polyneuropathy is caused by underlying diseases. Can you name one underlying disease?

Back 96

diabetes, hypothyroidism, hyperadrenocorticism

Front 97

This disease results in dilation of esphagus and regurgitation of food, and is a lack of effective peristalsis.

Back 97

Megaesophagus (risk of aspiration pneumonia with this disease)

Front 98

There are many causes of the acquired form of aspiration pneumonia, can you name 2?

Back 98

distemper, tick paralysis, lead poisoning, polymyositis, myasthenia gravis.

Front 99

When is the congenital form of megaesophagus usually noticed?

Back 99

Around the time of weaning

Front 100

What are 2 breeds that are predisposed to megaesophagus?

Back 100

Great Dane, German shepherd, irish setter, newfoundland, shar-per, greyhound.

Front 101

What are the management goals of megaesophagus?

Back 101

prevent aspiration pneumonia and nutritional deficiencies. (elevated feedings, small frequent meals, soft diet with high caloric density).

Front 102

What is tick paralysis associated with?

Back 102

neurotoxin in saliva (common with dog tick, and rocky mountain wood tick) cats are resistant to this.

Front 103

How long after removal of a tick, will a dog recover from tick paralysis?

Back 103

1-3 days once the tick is removed

Front 104

How would you diagnose/treat tick paralysis?

Back 104

rule out the other causes of neuromuscular disease, remove all ticks, supportive care.

Front 105

What is acute Idiopathic Polyradiculoneuritis also called?

Back 105

Coonhound paralysis (it is passed on from a raccoon bite 7-14 days prior to onset) only sensitive dogs develop this disease.

Front 106

What does polyradiculoneuritis cause?

Back 106

Demyelination and degeneration of myelin and axons in nerve roots

Front 107

What are two signs of polyradiculoneuritis?

Back 107

Weakness in hind limbs, progresses to flaccid, systemic tetraplegia, absence of spinal reflexes, loss of voice, labored breathing, inability to lift head, conscious

Front 108

How would you diagnose polyradiculoneuritis?

Back 108

rule out all other infectious and metabolic causes, CSF analysis (increased TP, normal cell count), electromyography (denervation, slowed nerve conduction).

Front 109

What is one way to treat polyradiculoneuritis?

Back 109

Supportive nursing care, corticosteroids are not beneficial, respiratory support, may or may not regain total function, recovery can take 2-6 months.

Front 110

Facial nerve paralysis affects what breeds of dogs/cats?

Back 110

Cocker spaniels, corgis, boxers, english setters, longhaired cats.

Front 111

What are 2 clinical signs of facial nerve paralysis?

Back 111

Ear droop, lip paralysis, sialosis (excessive flow of saliva), deviation of the nose, absence of menace and palpebral reflexes.

Front 112

Give two ways to treat facial nerve paralysis.

Back 112

Corticosteroids, artificial tears, cause is unknown and complete recovery does not occur.

Front 113

What is something that may develop with facial nerve paralysis?

Back 113

May develop dry eye, and require lifelong supportive care.