Depressed Mental Statusquiet and unwilling to perform normally but responds to environmental stimuli (most common)Obtunded Mental Statusdull and relatively nonresponsive but consciousDemented Mental Statusunrecoverable loss of higher brain functions.Delerious Mental Statustemporary disturbance of higher brain functions characterized by inappropriate responses or behaviorsStuporous Mental Statusunconscious in the presence of normal environmental stimuli, but can be roused with more intense stimuliComatose Mental Statusunconscious regardless of the intensity of the stimulus applied.Term: AtaxiaLoss of muscular coordinationTerm: HypermetriaExaggerated gait [Tennessee walking horse lookin' ass:( ]Term: Sensory (proprioceptive) Ataxiainstability while walking Effects - Peripheral nerves, spinal cord, brainstem, cerebrum Visual cues can help with compensation. Hyperflexion of joints is a god cueTerm: Vestibular Ataxiainstability while walking Peripheral or central, can be affected by cranial nerve 8Term: Cerebellar Ataxiainstability while walking can be present without loss of motor function, normal strengthTerm: ProprioceptionPerception or awareness of the position and movement of the body, to gravity, rest of body, etcFalseT/F: If you have ataxia, you cannot have proper proprioceptionTrueT/F: Mental status is under the control of the cerebrum and ascending reticular activating system (located in the midbrain)TrueT/F: the largest fibers, like proprioception fibers, are easiest to compress so you lose those first and recover lastFalseT/F: the corticospinal tracts are the conscious motor control over smooth muscle of the GIFalseT/F: Deep pain fibers, like that of the ventral spinothalamic tract, are easy to break and recover because the fibers are so smallUpper Motor NeuronsHyperreflexia is probably due to an __________________ compressionTrueT/F: Big circles are characterized by cerebral diseaseFalseT/F: When circling, they move away from side of mass majority of timesFalseT/F: Small/tight circles are associated with cerebral diseaseTrueT/F: Head tilts are due to Vestibular or Cerebellum diseaseFalseT/F: Head turns are due to Vestibular or Cerebellum diseaseTrueT/F: Head turns and tilts are usually toward the side of the lesionTerm: ProprioceptionIf hind limbs have conscious ________, then lesion is not in spinal cordFalseT/F: Postural reaction is done in both cats and dogs, normal results would be if they put their foot back upTrueT/F: If the patient fails to replace the paw in the appropriate position, there is no need to perform additional tests to evaluate proprioceptionTechnique: Conscious proprioceptionPlace the paw where a footfall would land with the dorsal surface of the paw on the ground while supporting the pet's weight. Don't use in catsTechnique: HoppingLift opposite leg and push toward toward limb being examined. Can use in cats and dogsTechnique: WheelbarrowingFor thoracic limbs: lift head and pelvic limbs while walking patient forward. Don't use in catsTechnique: Hemiwalkinglifting the limbs (fore and rear) on one side of the body and pushing the dog towards the other limbs, want them to keep from losing balance. Don't use in catsTechnique: Extensor Postural Reactionholding the patient vertically and bringing them down to land on the pelvic limbs. The patient will naturally step back so that they can then land on their front feet. Can use in cat and small dogsTechnique: Tabletop Placingholding the patient and bringing their feet to the table while covering eyes. Isolate one foot at a time. Can use in cats and small dogsTerm: Hypertonusincreased muscle toneUpper Motor Neuronslesion @ _____________ : increased muscle tone and normal to exaggerated reflexesLower Motor Neuronslesion @ _____________ : flaccid muscle tone and diminished to absent reflexes.Quadriceps (patellar) reflexmost reliable in dogs and cats, expected response is extension of stifle. May be difficult is P is tense, may do on down relaxed limbTrueT/F: In older dogs and dogs with severe, chronic stifle disease the patellar reflex becomes less reliable.Cranial tibial reflexexpected response is flexion of the hock, might be absent with a very local lesionGastrocnemius reflextwo techniques, to flex or extend the hockFlexor (withdrawal) responsespinch toe in thoracic or pelvic limb, quick reflex arc. does not require higher input to recognize painFalseT/F: Flexor (withdrawal) responses will be lost with UMN lesion and present with LMN lesionBiceps reflexgood one for forelimb, tap hammer on your finger thats wrapped around, response is contraction of muscle (not flexion of elbow)Triceps reflexstretch forelimb tendon, grab antebrachium and rotate -> hammer response should contraction muscleExtensor carpi radialis reflextendon is not tensed, hit hammer onto antebrachium --> extension in carpus (potential false movements)Babinski reflexno real bearing on exam, rubbing bottom of paw. normally toes should curl, toes will splay with UMN lesion (rare to see)FalseT/F: You can assume pain response if you have a dog with no care in the world that you are pinching his toes, they only thing he does is pulls away his pawCrossed extensor reflexpresent if UMN lesion, normal in young animals flex one limb and other is extended, will withdrawal the extendedCutaneous trunci reflexEvaluates sensory pathway to skin, can be paralyzed and still have this reflex intactCN IOlfactory (s)CN IIOptic (s)CN IIIOculomotor (m)CN IVTrochlear (m)CN VTrigeminal (m,s)CN VIAbducens(m)CN VIIFacial (m, s)CN VIIIVestibulocochlear (s)CN IXGlossopharyngeal (m,s)CN XVagus(m,s)CN XIAccessory (m)CN XIIHypoglossal (m)Pupillary Light ReflexSensory pathway: optic nerve (CN 2) Motor pathway: parasympathetic oculomotor nerve (CN 3) done to left eye --> right eye should do too (don't imply it is neuro issue)Pupillary Light Reflexcan be absent due to disease of the cornea, iris (iris atrophy), lens, anterior or posterior chamber, retina, optic nerve, midbrain, and oculomotor nerve pathway (ie may not be a neuro issue)Term: Mydriasisdilated pupil(s)Term: Mydriasiscan happen with fear (ie cats sympathetic), iris atrophy, Parasympathetic denervation (CN 3), Dysautonomia, Intraocular disease, herniationTerm: Miosisconstricted pupil(s)Term: Miosiscan be due to Uveitis, corneal pain, Organophosphate or carbamate poisoining, Sympathetic denervation (Horner's syndrome-one eye), FeLV infections (spastic pupil syndrome), Severe cerebrocortical diseaseTerm: Anisocoriapupils of different sizes, need to identify which pupil is abnormalTerm: PapilledemaSwelling of the optic nerve head, suggests high intracranial pressure (ie brain tumor, inflam dz, trauma)Horner's SyndromeMiosis, Ptosis, Enophthalmos, Elevated (or prolapsed) 3rd eyelid --> dt damage of sympathetic innervation to eye (pre or post ganglionic)Term: Ptosisdroopy eyelidFalseT/F: When smooth muscle is denervated, it will lose tone and atrophyTrueT/F: phenylephrine will cause pupil to dilate normally, in pre-ganglionic horner's syndrome nothing will happen when given dilute phenylephrineTerm: NystagmusInvoluntary rapid movement of the eyesTrueT/F: In nystagmus slow phase is typically toward the lesion and fast phase is away from the lesion.Term: Positional/Pathologic nystagmusNystagmus resent at rest or if placed in an abnormal position (upside down).Term: Physiologic Nystagmusnormal nystagmus, ie with travel--Eyes should repeatedly drift slowly away from the direction of travel and then rapidly in the direction of travel.Term: Physiologic NystagmusSensory component: vestibular component of CN 8 Motor component: Cranial nerves 3,4, and 6.Menace ResponseSensory pathway: CN 2 Motor pathway: CN 7 When threatened or presented with something that suddenly appears close to the eyes/face, the patient will blink.TrueT/F: It is possible for some cats and young puppies/kittens to have an absent menace responsePalpebral ReflexSensory component: CN 5 (trigeminal) Motor component: CN 7 (facial) gently touch the medial and lateral canthus of the eye and look for a blink.Facial Sensory ReflexSensory component: CN 5 Motor component: CN 7 stroke face/retract lipCorneal Reflex and Retractor Bulbi reflexSensory component: CN 5 (trigeminal) Motor component: CN 7 (facial) and CN 6 (abducens) blow into eye, should blink and take back eyeGag ReflexMotor and Sensory: (CN 9 and CN 10). touch lateral pharynx, don't get bitttt

Exam 2 - Neuro Exam

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