Bryan - Syspath 2 - Neuromuscular - Winter 2Nd Year

Front 1

How many axons are myelinated by a schwann cell?

Back 1

One!

Front 2

What cell can differentiate into myocytes?

Back 2

Sattelite cell

Front 3

What components of the neuromuscular system are necessary for repair?

Back 3

stem cells (satellite cells)
basal lamina (muscle, schwann cells, axons)

Front 4

Choose denervating or demyelinating disease...
...muscle gets no signal.

Back 4

denervating dz

Front 5

Choose denervating or demyelinating disease...
...muscle gets signal.

Back 5

demyelinating dz

Front 6

A disorder of a(n) __________ motor neuron results in increased tone.

Back 6

UMN dz = increased tone (upper/increased)

Front 7

A disorder of a lower motor neuron results in _________ tone.

Back 7

LMN dz = reduced tone (lower/reduced)

Front 8

What are some ancillary tests used for LMN disease diagnosis?

Back 8

Serum chemistries (CK, AST)
EMG (concentric needle testing, conduction velocity, repetitive nerve stimulation)

Front 9

What enzymes are released when the muscle membrane is damaged?

Back 9

CK = creatine kinase
AST = aspartate aminotransferase

Front 10

What are the common clinical signs of neuromuscular disease?

Back 10

weakness
atrophy
abnormal gait
(hypertorphy is possible but uncommon)

Front 11

T or F:
There will be no proprioceptive deficits in neuromuscular disease.

Back 11

True! This involves lower motor neurons only and not the proprioceptive pathways.

Front 12

What are some general causes of muscle atrophy NOT associated with muscle inflammation, muscle degeneration, or muscle necrosis. Which will be rapid? Which will be symmetric?

Back 12

Denervation (rapid)
Disuse
Cachexia (symmetric)
Metabolic disease (symmetric)

Front 13

What are some neuromuscular DISORDERS that can cause symmetric atrophy?

Back 13

Vitamin E deficiency
Equine Cushing's disease

Front 14

What are some neuromuscular DISORDERS that can cause asymmetric atrophy?

Back 14

EPM (equine protozoal myelitis)
Sweeney (suprascapular n. damage)
Laryngeal hemiplasia

Front 15

What are the types (categories) of muscle hypertrophy?

Back 15

Compensatory
Physiologic
Pathologic

Front 16

What are some species/breeds have well-documented myotonia?

Back 16

Chow
Quarterhorses (HYPP)
Cattle (belgian blue)
Pigs (malignant hyperthermia)
Goats (fainting goats)

Front 17

What does HYPP stand for?

Back 17

HYperkalemic Periodic Paralysis

Front 18

T or F:
Muscle can contract post mortem.

Back 18

True!

Front 19

What causes post-mortem muscle contraction?

Back 19

Release of Ca when membranes are incised, exposed to formalin, or roughly handled

Front 20

What are some procedures that cannot be performed on formalin fixed muscle samples?

Back 20

Enzyme histochem
ATPase typing (some Ab typing can though)
Muscular dystrophy tests

Front 21

What is the preferred muscle biopsy site for Equine Motor Neuron Disease? Why?

Back 21

Sacrocaudalis dorsalis medialis;
EMND is only type I fibers!

Front 22

Which type of muscle fibers are resistant to fatigue? Which are slow-twitch?

Back 22

Type I describes both.

Front 23

Which type of muscle fibers are susceptible to fatigue? Which type are fast-twitch?

Back 23

Type II describes both

Front 24

What type of muscle fiber does EPSSM affect? Which type does EMND affect?

Back 24

Equine PolySaccharide Storage Myopathy affects Type II
Equine Motor Neuron Disease affects Type I

Front 25

What is the preferred muscle biopsy site for EPSSM?

Back 25

Semimembranosis/semitendinosis (type II muscle is affected by Equine Polysaccharide Storage Myopathy)

Front 26

What are some metabolic causes of generalized myopathy? Which species are commonly affected in each example?

Back 26

Hypercorticism (Dawg)
Hypothyroidism (Dawg)
Pituitary tumors (Horseses)

Front 27

T or F:
Myofiber necrosis is present in myodegeneration and degenerative myopathy.

Back 27

True!

Front 28

What is the term for severe acute muscle injury?

Back 28

Rhabdomyolysis

Front 29

What are some differentials for pale streaks or zones in muscle?

Back 29

Lymphoma
Necrosis
Calcification (mineralization)
Protozoal cysts
Fat deposits
Collagen & CT
Fibrosis

Front 30

What are the 2 possible outcomes of muscle repair?

Back 30

Scar (fibrosis)
Regeneration

Front 31

What is the fancy-ass name for the muscle basal lamina?

Back 31

Sarcolemmal tube

Front 32

What are some histologic features of necrotic muscle fibers?

Back 32

Myofiber swelling
Vacuolar degeneration
Fragmentation
Coagulation necrosis

Front 33

What are some histologic hallmarks of regenerating muscle fibers?

Back 33

Smaller size
basophilic myoplasm
chains of large, centrally-located, euchromatic nuclei

Front 34

If damaged fibers are all in the same phase of necrosis or regeneration what does this mean? What is the term for this?

Back 34

"single hit" insult to muscle;
called MONOPHASIC injury

Front 35

If damaged fibers are all in varying phases of necrosis or regeneration what does this mean? What is the term for this?

Back 35

"multiple hits" or chronic insult to muscle;
called POLYPHASIC injury

Front 36

What is the half-life of CK? When is its peak concentration?

Back 36

t 1/2 = 9h
Peak @ 4-6h

Front 37

What is the half-life of AST? When is its peak concentration?

Back 37

t 1/2 = a long time
Peak after a day or two...

Front 38

What tissue sample is submitted to determine nutritional myopathy?

Back 38

LIVA

Front 39

With regard to x-linked myopathies, dogs tend to have muscle ___________ while cats tend to have muscle __________.

Back 39

Dogs = atrophy
Cats = hypertrophy

Front 40

What are some differentials for an adult horse with degenerative myopathy?

Back 40

nutritional myopathy
EPSSM
Purpura hemorrhagica (immune mediated vasculitis due to S. equi)
Clostridial myositis
Toxins

Front 41

The ischemic process of muscle that swells in a nonexpandable space is known as...
What will this condition lead to?

Back 41

Compartment syndrome leads to ischemia

Front 42

What are some GENERAL (eg: DAMNIT) causes of degenerative myopathy?

Back 42

Genetic (x-linked, PSSM, etc)
Degeneration (exertion)
Metabolic (abnormality)
Nutritional deficiency
Ischemia
Toxic
Trauma

Front 43

What are some physical findings associated with myositis? Some blood chemistry findings?

Back 43

Pain
Stiff gait
swelling
atrophy
exercise intolerance
(CK and AST changes in chem)

Front 44

What is a common cause of suppurative myositis?

Back 44

Clostridium infection

Front 45

What is a common cause of non-suppurative myositis?

Back 45

Immune-mediated dz.

Front 46

What is a common cause of granulomatous myositis?

Back 46

Mycobacterium

Front 47

What is a common cause of eosinophilic myositis?

Back 47

Sarcocystis

Front 48

What is a common cause of pyogranulomatous myositis?

Back 48

Corynebacterium pseudotuberculosis

Front 49

What are agents causing myositis in...
...cattle?

Back 49

Clostridium
Pyogenic bacteria
Sarcocystis

Front 50

What are agents causing myositis in...
...horseses?

Back 50

Clostridium (malignant edema)
C. pseudotuberculosis (pigeon fever)

Front 51

What are infectious agents causing myositis in...
...dawgs?

Back 51

Neospora caninum

Front 52

What are agents causing myositis in...
...pigs?

Back 52

Trichinella

Front 53

T or F:
Sarcocystis is generally only an incidental finding.

Back 53

True!

Front 54

How do horses typically develop Clostridial myositis? Cattle?

Back 54

Horses (iatrogenic)
Cattle (blunt trauma)

Front 55

T or F:
Sarcocystis spores can be activated by the anoxic environment caused by blunt trauma leading to infections that rapidly kill cattle.

Back 55

False!
This describes Clostridium spores!

Front 56

Name 3 different immune-mediated canine inflammatory myopathies, yo!

Back 56

Masticatory myositis
Polymyositis
Extraocular muscle myositis

Front 57

Test serum for ______________ to diagnose masticatory myositis.

Back 57

Antibodies to 2M myosin

Front 58

Test serum for ______________ to diagnose polymyositis.

Back 58

Antinuclear antibody

Front 59

Which muscles are affected in polymyositis?

Back 59

Esophagus and respiratory muscle.

Front 60

Test serum for ____________ to diagnose extraocular muscle myositis.

Back 60

NO TEST YET

Front 61

DAMNIT, tell me some general causes of inflammatory myopathy, yo!

Back 61

Immune mediated
Infectious

Front 62

What are some names for tumors of peripheral nerves?

Back 62

Schwannoma
Neurofibroma
Peripheral nerve sheath neoplasm
Lymphoma

Front 63

What are some common sites for tumors of the peripheral nerves?

Back 63

Cranial nn.
Brachial plexus

Front 64

In which species are peripheral nerve sheath neoplasms most common?

Back 64

Dogs (MOSTLY DOGS)
Cattle

Front 65

What are common clinical signs for a dog with a nerve sheath neoplasm?

Back 65

Unilateral gait abnormality
Unresponsive to nSAIDs
Muscle atrophy

Front 66

T or F:
Primary muscle tumors have no correlation with age.

Back 66

False!
They are seen in young animals.

Front 67

What are the types of primary muscle tumors? Which species are commonly affected?

Back 67

Rhabdomyoma/sarcoma
Histiocytic tumor
Round cell tumor
(DOG, cat, horse)

Front 68

IHC can be done for what substance(s) to determine a primary muscle tumor?

Back 68

IHC for desmin, actin, sarcomeric actin, or myoglobin

Front 69

What type of degeneration is indicative of axonal degeneration?

Back 69

Wallerian degeneration

Front 70

Wallerian degeneration = primary __________ degeneration with secondary _____________.

Back 70

primary AXONAL degeneration with secondary DEMYELINATION

Front 71

Wallerian degeneration occurs ________ to the site of injury.

Back 71

DISTAL to the site of injury

Front 72

Damage to which components of the LMN system result in Wallerian degeneration?

Back 72

Cell body
Ventral root ganglion
Axon innervating muscle

Front 73

What is the fancy name for coonhound paralysis? What causes it?

Back 73

Canine polyradiculoneuritis;
autoimmune reaction to raccoon saliva

Front 74

What inflammatory condition causes enlargement of the nerve roots and peripheral nerves in the horse?

Back 74

Neuritis of the cauda equina

Front 75

DAMNIT, give me a general list of primary peripheral nerve disorders!!!

Back 75

Genetic
Degenerative (endocrine)
Autoimmune (coonhound paralysis)
Nutritional
Neoplasia
Inflammatory
Toxic
Trauma