Intro. To Clinical Med - Neurology Intro

Front 1

What is the Vertebral formula = # of vertebrae in each region for cat and dog?

Back 1

For dog & cat = C7, T13, L7, S3, Cd ≈ 20

Front 2

Signs assoc. with C1-6' Cervical lesion?

Back 2

no "head signs"
UMN signs to all 4 limbs

Front 3

Signs assoc. with C6 _ T2 : cervicothoracic lesion?

Back 3

Tetraparesis/paralysis.
(bipedal gait)
- LMN signs to thoracic limbs
- UMN signs to pelvic limbs
• ± Horner's syndrome

Front 4

Signs assoc. with L4-S2: lumbosacral & cauda equina lesion?

Back 4

• LMN signs to rear limb
• Normal thoracic limbs
• UMN signs: bladder, anus & urethra

Front 5

Signs assoc. with T 3- L3, Thoracolumbar cervicothoracic lesion?

Back 5

• UMN signs to rear limbs
• ± Cutaneous trunci
• Nonnal thoracic limb (+/- Schitf-Sherrington)

Front 6

What is Schiff-Sherrington syndrome?

Back 6

Hyperextension of forelimbs with damage/lesions to thoracic spinal cord (T3-L3 / area 3)

Only time a spinal cord injury causes signs cranial to damage/injury

LMN and UMN are still intact to thoracic limb, so this is neither UMN or LMN neuron sign. (hindlimb may show UMN signs)

From Online:
Extensor hypertonia (increased muscle tone ) of the thoracic limbs and paraplegia resulting from acute, severe, compressive lesions of the thoracolumbar spinal cord that REMOVE the inhibitory effects of neurons in the lumbar spinal cord. Seen in dogs, usually caused by trauma or herniated intervertebral disk.

Border cells in L1-4 ascend to inhibit extensors of forelimb to coordinate movement

Front 7

Intervertebral Disk or fibrocartilaginous disks consists of inner jelly like part and outer part known as the _____ and ______?

Back 7

nucleus pulposus

anulus fibrosus

Front 8

What is responsible for consciousness and arousal? Where is it located?

Back 8

Reticular activation system (RAS), brainstem

Front 9

for tards:
difference between vertebral column and spinal cord

Back 9

- vertebrae are actual bone
- protect the spinal cord

Front 10

Intrathecal injection

Back 10

in Lumbar cistern- between L4-5 or L5-6

access to CSF (subarachnoid space)

Front 11

Epidural anesthesia goes where?

Back 11

lumbosacral junction (in small animals) in epidural space

Epidural space: between the dura mater & vertebrae
Filled with fat
Epidural anesthesia is performed within this space

Front 12

Where are upper motor neurons (UMN) located?

Back 12

In the CNS (brain and spinal cord), descending to synapses on LMN (check second portion)

Front 13

List the spaces that are related to the meninges

Back 13

* Epidural: between dura mater and periosteum
* Subdural: potential space between the dura mater and arachnoid
* Subarachnoid space: between the arachnoid and pia (CSF)

Front 14

Cr N 7 Facial

Back 14

Motor to muscle of facial expression

ANS motor to lacrimal gland, salivary glands

Front 15

What is the disease of the cervical vertebrae in large breeds causing STENOSIS of the vertebral canal resulting in ataxia (unsteady gait)?

Back 15

Cervical spondylomyelopathy, canine wobbler disease

Front 16

What is excessive ventral lumbar curvature?

Back 16

Lordosis (swayback)

Front 17

CrN 8

Back 17

Vestibulocochlear
Special sensory
Hearing & equilibrium

Front 18

What is spina bifida?

Back 18

Failure of 1 or more vertebral arches to close

Front 19

Causes dropped jaw

Back 19

Paralysis CrN 5 trigeminal

Front 20

A slipped disc results when the soft ___ ___ is squeezed to one side of the disc, causing the firm ___ ___ to protrude and possibly rupture.

Back 20

* Nucleus pulposus
* Annulus fibrosus

Front 21

Where are CSF taps performed?

~looking for name of region or place, not the layer

Back 21

Cisterna magna or lumbar cistern (subarachnoid space)

Front 22

What is the lumbosacral space?

Back 22

Interarcuate space between last lumbar vertebrae (L7) & sacrum

(where insert needle when giving epidural injection)

Front 23

How is proprioception evaluated clinically?

Back 23

Postural reactions (e.g. knuckle paw)

Front 24

identify thoracolumbar spinal cord

(what is located here?)

Back 24

Of or relating to the thoracic AND lumbar parts of the spinal column.

sympathetic division of the autonomic nervous system
(specifically thoracolumbar: T3 to L3)

Front 25

What arises from spinal cord to FORM a spinal nerve?

What arises from spinal nerve?

Back 25

dorsal and ventral roots (NOT branches)

dorsal and ventral branches; these are formed when spinal nerve "branches"

Front 26

What is the function of most UMN (upper motor neurons)?

Back 26

Inhibit spontaneous activity of LMN until an action is desired

Front 27

Pupils of different size?

Back 27

Anisocoria

Front 28

Are spinal nerves LMN or UMN?

Back 28

LMN (somatic)

Front 29

What is the function of proprioceptive fibers?

Back 29

Sense position of body parts to each other and to the environment

Front 30

Where are the cell bodies of a UMN and LMN located?

What are axons of upper and lower motor neurons?

Back 30

in brain and spinal cord respectively

UMN: brain and spinal c.
LMN: periphery

Front 31

What are the motor parts of reflex arcs?

Back 31

LMN

Front 32

Is musculocutaneous nerve an upper or lower motor neuron?

Back 32

LMN

Front 33

What is the enlargement of the subarachnoid space between the medulla oblongata and cerebellum?

Back 33

Cisterna magna (cerebellomedullary cistern)

Front 34

List three clinically significant parts/region of the BRAIN STEM.

Back 34

1. Cranial nerves 3-12
2. vital centers (in medulla which control heartbeat, rate of breathing, coughing, swallowing and diameter of blood vessels)
3. reticular activation system

Front 35

What is the function of the cerebellum?

Back 35

Coordinate movements, maintain equilibrium and maintain posture

Front 36

Weakness?

Lack of coordination or irregularitys of muscular activity

Back 36

Paresis


Ataxia

Front 37

What does the trigeminal nerve (CrN 5) innervate?

Back 37

Sensory to most of the head by the 3 branches, and motor to the muscles of masticulation.

Front 38

What are the two lower motor neurons of the autonomic nervous system?

Back 38

Preganglionic and postganglionic

Front 39

How does the ANS differ structurally from the somatic nervous system?

Back 39

2 lower motor (efferent) neurons instead of one

Front 40

Spacticity? (what is this a sign of)

Back 40

spastic/altered skeletal muscle performance is one of UMN signs (UMN down), also known as ataxia, can be accompanied by paresis (partial paralysis)

Front 41

Horner’s Syndrome

Back 41

is a clinical syndrome caused by damage to the sympathetic nervous system (e.g. of the eye).
Signs found in all patients on affected side of face include; ptosis (which is drooping of the upper eyelid from loss of sympathetic function), and miosis (constricted pupil),
The site of lesion to the sympathetic outflow is on the ipsilateral side of the symptoms.
* First-order neuron disorder: Central lesions that involve the hypothalamospinal pathway (e.g. transection of the cervical spinal cord).
* Second-order neuron disorder: Preganglionic lesions (e.g. compression of the sympathetic chain by a lung tumor).
* Third-order neuron disorder: Postganglionic lesions at the level of the internal carotid artery (e.g. a tumor in the cavernous sinus).

If someone has impaired sweating above the waist affecting only one side of the body, yet they do not have a clinically apparent Horner's syndrome, then the lesion is just below the stellate ganglion in the sympathetic chain.

Pupillary
Light Reflex, Salivation,
etc.

Front 42

Cerebral lesions

Back 42

-changed behavior
- seizures
- normal gait w/abnormal postural reactions
-loss of vision

Front 43

Diencephalon (hypothalmus + thalmus) lesions produce what signs?

Back 43

-cerebral signs (similar)
-autonomic and endocrine abnormalities (e.g. polyuria, polydipsia (excessive thirst), altered sleep patterns also possible

Front 44

Brainstem lesions

Back 44

-decreased levels of consiousness from R.A.S.
-deficits in CN's III-XII as they arise from brainstem

-proprioreceptive deficits and gait signs (this gets complicated)

Front 45

Brainstem includes?

Back 45

midbrain, pons, medulla obl.

Front 46

Cerebellar lesions:

Back 46

-incoordination of mov't (ataxia), initiation tremors, and abnormal mov't of head
-vestibular disease signs: including nystagmus and head tilt

Front 47

preganglionic and postganglionic fibers are associated with thoracolumbar spinal nerves of ____?

Back 47

Thoracolumbar spinal nerves of sympathetic NS

Front 48

Vestibular system lesions:

Back 48

-affects posture in relation to gravity, eye mov't in relation to head
-head tilt, nystagumus, asymmetric ataxia, w/possibly circling and vestibular strabismus

IF central vestibular disease
in addition to above will have
-paresis/weakness, UMN
-depression

IF have peripheral disease, besides head tilt with NOT produce UMN signs (NO paresis)
-will have postural deficits b/c of balance NOT proprioreceptive disruption

Front 49

Where does PS arise?

Back 49

craniosacral

Front 50

What is autonomic function of oculomotor nerve?

Back 50

-Motor involuntary/smooth mm. of eye (near focus lens & constrict pupil)

Front 51

What nerve is required to bear weight on the pelvic limb?

Back 51

Femoral n. (L4-6) extends the stifle

Front 52

With what does the vestibular branch of the vestibulocochlear nerve deal ?

With what does the cochlear branch of the vestibulocochlear nerve deal ?

Back 52

Special Sensory: equilibrium/ motion

Special Sensory: hearing
- so sensory to auditory portion of the inner ear.
- core component is the Organ of Corti, the sensory organ of hearing

Front 53

Where are the cell bodies of a UMN and LMN located?

What are axons of upper and lower motor neurons?

Back 53

in brain and spinal cord respectively

UMN: brain and spinal c.
LMN: periphery

Front 54

What is path of LMN?

Back 54

Leave CNS over VENTRAL roots (only one motor neuron) & spinal n. or cranial n. to periphery

Front 55

Outline the pathway of the sympathetic innervation to the head.

Back 55

Nerves from hypothalamus (UMN) down cervical cord to lateral (intermediolateral) gray column to T1-T4, preganglionic fibers over communicating branches & up SNS trunk to cranial cervical ganglion; Postganglionic fibers through middle ear, cranial cavity & orbit over CrNs

Front 56

What are the most clinically important ANS fibers in the head?

Back 56

CrN7 to lacrimal gland & sympathetic to eye (Horner's syndrome)

~see page 483

Front 57

What are the signs of Horner's Syndrome? Horner's Syndrome

The classic signs of Horner's Syndrome occur on the same side of the face as the injury, and include:

Back 57

(1)Small pupil size (miosis) (2)Protrusion of 3rd eyelid
(3)Drooping of upper eyelid (ptosis) (4)Sunken appearance to the eye (enophthalmos) (5)Dilation of blood vessels on affected side of the face, which makes the area feel warmer to the touch
>caused by loss of sympathetic innervation to eye, so parasympathetic NS takes over.
>eye constrict, muscle around eye go limp

Front 58

General somatic afferent (GSA) carried over what nerves?

Back 58

spinal nerves (body) and CN5 (head)