Clin Med - Neuro 1

drraythe's version from 2017-09-30 20:38

Intro + Spinal cord

Question Answer
What are 4 Ddxs for behaviors which might appear to be neurological in nature?Musculoskeletal
Exercise - induced
W/ neurological disorders, fxn can change in what ways?Can be a loss OR a GAIN of fxn
Neuro signs can be due to what 3 different things?(1) Signs due to destruction of fxnal tissue
(2) Signs due to release or loss of inhibition
(3) Signs due to excitation or ↑ stimulation
Manifestation of signs depends on the__Physiologic importance of that location
Tremors is an example of a _ of fxnGain
What 5 areas should you consider when doing Neuroanatomic Localization?Spinal cord
Brainstem/cranial nerves/vision
Cerebellum & vestibular system
Forebrain & neuromuscular
Where are Lower Motor Neurons (LMNs) located?Housed in the ventral grey matter of the spinal cord at intumescences (thickened areas)
Where do LMNs go/do?Axons leave spinal cord & become spinal nerves for the limbs
Where are Upper Motor Neurons (UMNs) located?Housed in the cerebrum & brainstem
Where do UMNs go/do?Axons descend in the ventral & lateral white matter & they give direction to the LMNs (inhibit or facilitate)
What are Intumescences?These are the thickened areas of the spinal cord, which are bigger bc they house the LMNs for the thoracic & pelvic limbs
What is in-btwn the intumescences?The white matter tracks, which house the Descending motor information (from UMNs) & the Ascending sensory information
List the 4 fxnal segments of the spinal cord in order from front to back (& signs)C1-5 (Both UMN)
C6-T2 (Front LMN, Rear UMN)
T3-L3 (Rear UMN, Front Normal)
L4-S3 (Rear LMN, Front normal)
What are the 2 segments related to LMNs?C6-T2 (Front LMN, Rear UMN)
L4-S3 (Rear LMN)
(2nd & last) (intumenscences)
What are the 2 segments related to UMNs?C1-5 (Both UMN)
T3-L3 (Rear UMN, Front normal)
(1st & 3rd)
What should you know about the spinal cord segment numbers?They don't necessarily correlate w/ the vertebral segment they are under
What do LMNs do?Theyre the cells that tell the limbs when/how to move
What are the 3 main fxns of the spinal cord?Houses LMNs (that tell the limbs how/when to move)
Delivers descending UMN information
Integrates incoming sensations & sends the sensory information up to the brain
(Temperature, mechanical, light touch, pain, proprioception)
What are some signs that there is spinal cord dysfxn?Ataxia
Proprioceptive deficits
↓ or absent motor fxn
Urinary/fecal incontinence
↓ or absent nociception
The reflexes & muscle tone vary based on lesion location
How can you determine where the lesion on the SC is, using LMN & UMN signs & sensory ability?You will see LMN deficits AT the level of the lesion & you will see UMN signs CAUDAL to the lesion. you will also see Sensory deficits at the level of & caudal to the lesion
**What are the 3 big UMN signs? (for UMN paresis or paralysis)(1) Normal or exaggerated spinal reflexes
(2) ↑ muscle tone (rigidity, spasticity)
(3) Mild muscle atrophy due to disuse
**What are the 3 big LMN signs? (for LMN paresis or paralysis)(1) Weak or absent spinal cord reflexes
(2) ↓ muscle tone (flaccid)
(3) Marked early muscle atrophy
How would you describe the gait of limbs affected by UMN signs?A long, loping gait
How would you describe the gait of limbs affected by LMN signs?Short, shuffling gait
How would a dog w/ a lesion at T3-L3 present?Long, Loping gait in hind limbs, front limbs normal
Localize the Lesion: Long loping gait in hind limbs, front limbs normalLesion at T3-L3 (Rear UMN, Front Normal)
How would a dog w/ a lesion at C6-T2 present?The front limbs would show LMN gait (short & shuffling) & the back legs would have UMN gait (long & loping)
Localize the Lesion: Forelimbs have a short shuffling gait & hindlimbs have a long & loping gaitC6-T2 (Front LMN, Rear UMN)
How would a dog w/ a lesion at C1-C5 look like?Long, Loping UMN gait in front & hind limbs (GAIN)
Spinal Hyperesthesia → what is occurring in this situation? (list structures involved)The SC can only carry pain signals, not feel pain. However, Some spinal column dzs can cz paraspinal pain, where structures associated w/ the SC CAN feel pain & this pain is xmitted. (structures of this nature incld intervertebral disk, meninges, vertebra, nerve roots)
As you start to lose fxn, what is the 1st thing to go & then list in order until the last thing to go (4 things, 2 clinical sigs associated w/ 2 of the 4 things)1st thing to go is proprioception (you will see ataxia), then loss of voluntary motor control (you will see a loss of voluntary urination), then superficial pain is lost, then deep pain is lost
An animal starts to heal & regain fxn, what is regained 1st & then what is regained last?(This is in opposite order of how things are lost!) Deep pain is regained 1st, then superficial pain, then voluntary motor control (the animal will be able to start urinating voluntarily again), then lastly proprioception will be regained (animal will no longer have ataxia)

Brainstem & Cranial nerves

Question Answer
What are the 3 main things that the midbrain contains? (& what are their basic fxns? covered in separate cards too)(1) Rostral & caudal colliculi (Visual & auditory reflexes)
(2) Cranial nerves III & IV (oculomotor & trochlear nn)
(3) Red nucleus (Important UMN system for quadrupeds)
What is the super Important UMN system for quadrupeds? (where is it?)Red nucleus, in the midbrain
Rostral & caudal colliculi are where & do what?Midbrain, they control visual & auditory reflexes
Cranial nerves III & IV are where? which nerves are these?Midbrain, oculomotor & trochlear
Where is the Red Nucleus & what does it do?Midbrain, Important UMN system for quadrupeds
What are the 3 main things that the pons contains? (What do they do?)Motor tracts
Cranial nerve V (Trigeminal)
Pontine reticular formation (Another important UMN system)
Where do the motor tracks live?In the pons
Where does CN V reside? Which nerve is this?Pons, Trigeminal
Where is the Pontine reticular formation & what does it do?Pons, it is another important UMN system (however not as important as the red nucleus in the midbrain)
What are the 2 important things in the medulla oblongata?(1) CNs VI-XII
(2) Medullary reticular formation (Another important UMN system)
Where are CNs VI-XII?Medulla oblongata
Where is the medullary reticular formation & what does it do?In the medullar oblongata, it is another important UMN system (not as important as the red nucleus in the midbrain tho)
What is CN I & what does it do?Olfactory, sense of smell
What is CN II & what does it do?Optic, sense of sight
What is CN III & what does it do?Oculomotor
Eye position & movements
Pupillary constriction
Which CN of pupillary constriction?CN III, Oculomotor
What is CN IV & what does it do?Trochlear
Eye position & movement
What is CN V (Ophthalmic branch) & what does it do?Trigeminal → The ophthalmic branch does sensation from the eye & nose
What is CN V (Maxillary branch) & what does it do?Trigeminal → The maxillary branch provides sensation from the lower eyelid, nose, cheek
What is CN V (Mandibular branch) & what does it do?Trigeminal → Sensation from the chin & some sensations from the mouth & Motor to all of the masticatory muscles
Which nerve has the 3 branches we care about & what are the 3 branches?TRIgeminal nerve
What is CN VI & what does it do?Abducens (abductent) nerve
Lateral rectus muscle
Retractor bulbi muscle
What is CN VII & what does it do?FACIAL nerve. Motor to muscles of facial expression, as well as has some parasympathetic fxn as it is motor to lacrimal gland & controls taste on the rostral 2/3 of the tongue
What is CN VIII & what does it do?Vestibulocochlear nerve → SPECIAL proprioception → Maintains the position of the eyes, neck & limbs relative to the head
Also pertains to sense of hearing
What is CN IX, what does it do?Glossopharyngeal nerve, it is MOTOR to PHARYNGEAL muscles, has parasympathetic fxn as motor to salivary glands & also helps w/ taste on the caudal 1/3 of the tongue & the rostral pharynx
What is CN X, what does it do?VAGUS nerve. Motor to striated muscle of larynx, pharynx, esophagus. also has parasympathetic fxns w/ cardiac mm, the sm mm of the esophagus & lungs & enteric fxns. also responsible for taste in the caudal pharynx, larynx
What is CN XI, what does it do?Accessory nerve, it is motor to strap muscles in the neck, motor to the larynx, esophagus. Bc of this fxn & it's shared fxns w/ other nerves, Dysfxn is rarely recognized
Which CN is part from w/in the skull, part comes from the spinal cord?Accessory n
What is CN XII & what does it do?Hypoglossal nerve, motor to the tongue
Name the CNs in orderOlfactory
(Oh, Oh, Oh, To Touch And Feel Virgin Girl's Vaginas And Hymens)
What are the 5 major fxns the brainstem does?(1) Motor control
(2) Proprioception
(3) Mentation
(4) Houses CNs III-VII
(5) Cardioresp control
What is the most important part of the brain for motor control in quadrupeds & where is it?Extrapyramidal system in the brain stem
How does the brainstem relate to mentation?The ascending reticular activating system is found diffusely throughout the brainstem (it is responsible for wakefullness)
Dmg here = coma & death
CNs III-XII live where?Brainstem
If there is a deficit in the brainstem, are the signs contra-(opposite) or ipsi-(same side)-lateral?IPSILATERAL
If there is brainstem dmg, what kinda reflexes will you see in the body?UMN reflexes
What kinda paresis/plegias will you see if there is brainstem dmg?Tetraparesis/-plegia (Lesion cranial to T2)
Why do you see Heart rate, blood pressure, respiratory abnormalities in brain-stem dmg?Bc brain-stem houses cardioresp. control centers

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