Cranial Nerves and Neurological Functions Quiz

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Questions and Answers

Which cranial nerve is responsible for motor function of the trapezius muscle?

  • CN XII
  • CN XI (correct)
  • CN V
  • CN VII

What is the function of the baroreceptor reflex?

  • Stimulates salivation
  • Regulates blood pressure (correct)
  • Controls muscle movement
  • Controls breathing rate

Which cranial nerve pair is NOT routinely tested during a neurologic examination?

  • CN III
  • CN XI (correct)
  • CN I
  • CN II

Which cranial nerve is associated with the menace response?

<p>CN II and CN VII (B)</p> Signup and view all the answers

What is the primary function of the vagus nerve (CN X)?

<p>Regulates parasympathetic functions (C)</p> Signup and view all the answers

What is the purpose of the 'explode-the-hand' technique used in the menace response test?

<p>To avoid stimulating the whiskers or eyelashes (A)</p> Signup and view all the answers

Which of the following is NOT a cranial nerve routinely tested in a neurological examination?

<p>Olfactory nerve (CN I) (B)</p> Signup and view all the answers

What is the main function of the hypoglossal nerve (CN XII)?

<p>Controls tongue movement (B)</p> Signup and view all the answers

What is the main characteristic that distinguishes an overreaching, long-strided, floating gait caused by an UMN lesion from a gait caused by cerebellar hypermetria?

<p>The degree of flexion or extension of the elbow joint. (B)</p> Signup and view all the answers

Which cranial nerve is responsible for sensory input from the inner pinnae of the ear?

<p>Facial nerve (VII) (B)</p> Signup and view all the answers

What is the primary function of the trochlear nerve (IV)?

<p>Motor control of the dorsal oblique muscle. (A)</p> Signup and view all the answers

Which of the following is NOT a sign of a C6-T2 myelopathy?

<p>Bilateral elbow osteoarthritis. (A)</p> Signup and view all the answers

Which cranial nerve, when damaged, can lead to difficulties with chewing and swallowing?

<p>Glossopharyngeal (IX) (B)</p> Signup and view all the answers

The dorsal, medial, and ventral rectus muscles, as well as the ventral oblique muscle, are all associated with:

<p>The movement and function of the eyes. (B)</p> Signup and view all the answers

Which of the following is NOT a component of the physical examination that should be performed before evaluating cranial nerves?

<p>Assessing pupillary light reflex. (D)</p> Signup and view all the answers

What is the function of the levator palpebrae dorsalis muscle?

<p>Raising the upper eyelid. (D)</p> Signup and view all the answers

Which of the following is a reliable indicator of vestibular dysfunction?

<p>A history of gagging, retching, or coughing while eating or drinking (C)</p> Signup and view all the answers

What is a possible cause of bilateral atrophy of the masticatory muscles?

<p>Masticatory muscle myositis (C)</p> Signup and view all the answers

Which cranial nerve does the author explicitly state is NOT routinely tested during a neurologic examination?

<p>CN I (Olfactory) (A)</p> Signup and view all the answers

What is a potential drawback of using the gag reflex to evaluate CN IX (Glossopharyngeal) and CN X (Vagus)?

<p>It can be unreliable because some normal dogs may not swallow. (D)</p> Signup and view all the answers

Which of these is NOT a characteristic of pathologic nystagmus?

<p>It is always associated with vestibular dysfunction. (C)</p> Signup and view all the answers

What muscles are potentially affected by a CN XI (Accessory) deficiency?

<p>Trapezius and sternocephalicus (A)</p> Signup and view all the answers

Why do the authors not routinely evaluate olfaction, taste, or hearing?

<p>The results can be subjective in animals and difficult to interpret. (D)</p> Signup and view all the answers

What condition can be indicated by difficulty opening the jaw and bilateral atrophy of the masticatory muscles?

<p>Masticatory muscle myositis (C)</p> Signup and view all the answers

What is the term used to describe weakness in one limb of a dog?

<p>Monoparesis (A)</p> Signup and view all the answers

Which condition describes a dog that cannot walk on its own but has voluntary motor control in the pelvic limbs?

<p>Nonambulatory paraparesis (C)</p> Signup and view all the answers

What is the best surface for observing a dog's gait?

<p>Grass (A)</p> Signup and view all the answers

How should a clinician describe a dog's gait if both pelvic limbs are affected?

<p>Paraplegia (D)</p> Signup and view all the answers

Which term refers to the lack of voluntary movement in all four limbs of a dog?

<p>Tetraplegia (B)</p> Signup and view all the answers

What does ataxia refer to in regards to canine gait?

<p>Incoordination of movements (A)</p> Signup and view all the answers

If a dog exhibits symptoms of weakness in both hind limbs but can still move its front limbs normally, which term is appropriate?

<p>Paraplegia (C)</p> Signup and view all the answers

When walking a dog for gait analysis, the leash should ideally be:

<p>Short and taut (D)</p> Signup and view all the answers

What two cranial nerves are tested during the pupillary light reflex?

<p>Cranial nerves II and III (A)</p> Signup and view all the answers

The menace response is considered a learned response in dogs and cats, developing around what age?

<p>10-12 weeks (C)</p> Signup and view all the answers

Which part of the central nervous system (CNS) can be directly evaluated during a fundic examination?

<p>Optic disc (B)</p> Signup and view all the answers

Why do the authors prefer an indirect fundic examination?

<p>It avoids the observer being too close to the patient’s mouth (B)</p> Signup and view all the answers

What two cranial nerves are assessed during the palpebral reflex?

<p>Cranial nerves V and VII (D)</p> Signup and view all the answers

Which of the following is NOT a function assessed during the palpebral reflex?

<p>Pupillary light reflex (D)</p> Signup and view all the answers

What is the primary role of the cerebellum in relation to the menace response?

<p>Exerting some influence over the response (A)</p> Signup and view all the answers

A dog with cerebellar dysfunction may exhibit what abnormal neurological sign?

<p>Absent menace response ipsilateral to the lesion (A)</p> Signup and view all the answers

Which cranial nerves are tested when examining corneal sensation and globe retraction?

<p>CN V, VI, VII (C)</p> Signup and view all the answers

What is the normal response when testing corneal sensation with a cotton swab?

<p>Eyelid closure and eyeball retraction (B)</p> Signup and view all the answers

Why should you not perform a gag reflex on aggressive or nervous dogs?

<p>It may cause additional trauma. (A)</p> Signup and view all the answers

Which cranial nerve is evaluated by assessing jaw tone?

<p>CN V (B)</p> Signup and view all the answers

What indicates a normal nystagmus response during the head turning test?

<p>Fast phase in the direction of head movement (C)</p> Signup and view all the answers

What is the appropriate method to test for tongue deviation or atrophy?

<p>Observing resting tongue position (C)</p> Signup and view all the answers

Which cranial nerves are involved in the action of swallowing?

<p>CN IX and X (B)</p> Signup and view all the answers

What is the role of CN VII during the menace response test?

<p>Eyelid closure (D)</p> Signup and view all the answers

Flashcards

Monoparesis

Weakness in one limb.

Paraparesis

Weakness in both pelvic limbs.

Tetraparesis

Weakness in all four limbs.

Hemiparesis

Weakness in limbs on the same side of the body.

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Monoplegia

Complete paralysis or loss of movement in one limb.

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Paraplegia

Complete paralysis of both pelvic limbs.

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Tetraplegia

Complete paralysis of all four limbs.

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Hemiplegia

Complete paralysis of limbs on the same side of the body.

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C6-T2 Myelopathy

A neurological condition affecting the spinal cord between the C6 and T2 vertebrae, causing gait abnormalities and possible limb weakness.

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Short, Choppy Gait

A wobbly, uneven gait characterized by short, choppy steps, suggesting a problem with the nervous system or musculoskeletal system.

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Overreaching Gait

An exaggerated, long-strided gait with an overreaching motion, often seen in the front limbs, indicating an upper motor neuron (UMN) lesion.

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Cerebellar Hypermetria

An abnormal gait caused by a problem with the cerebellum, leading to exaggerated movements and difficulty coordinating movements.

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Upper Motor Neuron (UMN) Lesion

A neurological condition involving a lesion in the upper motor neuron pathway, affecting limb movement and coordination.

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Cranial Nerve Examination

The examination of the cranial nerves, which control sensory and motor functions of the head and face.

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Extraocular Muscles

A collection of nerves that control eye movement, including muscles responsible for looking up, down, left, and right.

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Hands-on Examination

The physical examination of a patient, including observation of gait, mental status, and neurological functions.

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Menace Response

The menace response is a neurological test used to assess cranial nerves II (optic) and VII (facial).

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Cranial Nerves (CNs)

Cranial nerves, also known as CNs, are 12 pairs of nerves that originate from the brain and control sensory and motor functions in the head and neck.

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Vagus Nerve (CN X)

The vagus nerve (CN X) is the longest cranial nerve, responsible for parasympathetic innervation of the thoracic and abdominal viscera, heart, and other functions, including deglutition, respiration, and vocalization.

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Accessory Nerve (CN XI)

The accessory nerve (CN XI) is involved in motor function of muscles in the neck and shoulder, including the trapezius and sternocleidomastoid.

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Hypoglossal Nerve (CN XII)

The hypoglossal nerve (CN XII) is responsible for motor function of the intrinsic muscles of the tongue.

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Upper Motor Neuron (UMN)

The upper motor neuron (UMN) is a nerve cell whose axon travels from the brain to the spinal cord or cranial nerves. UMNs control voluntary movements.

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Neurologic Examination

The neurologic examination is a systematic assessment of the nervous system, including the cranial nerves, reflexes, and motor function.

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Testing Cranial Nerves

Testing cranial nerves involves evaluating their function by observing specific reflexes, responses, and movements associated with each nerve.

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Pupillary Light Reflex Test

A neurological test that assesses the response of the pupils to light, evaluating the function of cranial nerves II (optic) and III (oculomotor).

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Fundic Examination

A neurological exam that visually inspects the optic disc and retina for abnormalities, providing insight into the health of the central nervous system and the eye.

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Palpebral Reflex Test

A neurological exam that evaluates the blink reflex by tapping the medial and lateral canthus of the eye, testing the function of cranial nerves V (trigeminal) and VII (facial), responsible for sensory and motor responses.

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Pinna Sensory Examination

A neurological exam that assesses the animal's ability to detect stimuli on the inner surface of the pinnae (ears) by touching it, evaluating the function of cranial nerve VII (facial).

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Pinna Motor Examination

A neurological exam that assesses the animal's ability to move the ear muscles, evaluating the function of cranial nerve VII (facial).

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Optic Disc

The part of the central nervous system that can be directly visualized during a fundic examination.

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Corneal Sensation Test

A technique used to evaluate corneal sensation in animals. It involves gently touching the cornea with a sterile cotton swab. The animal should demonstrate eyelid closure and eyeball retraction.

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Physiologic Nystagmus

A neurological test that assesses the extraocular muscles. It involves turning the animal's head from side to side and up and down. This should induce a normal nystagmus with a fast phase in the direction of head movement.

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Gag Reflex

A reflex test that evaluates the function of cranial nerves IX and X. It's performed by gently touching the oropharynx or laryngopharynx. The animal should swallow.

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Nasal Mucosa Touch Test

Testing the function of the trigeminal nerve (CN V) by applying a small blunt object to the nasal mucosa. The animal should pull its head away.

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Jaw Tone and Tongue Evaluation

A specific aspect of the cranial nerve examination that involves assessing the degree of jaw tone by opening the patient's mouth, and checking the tongue for deviation, atrophy, or fasciculation.

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Nystagmus

An involuntary rhythmic movement of the eyes, often associated with vestibular dysfunction.

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Resting Nystagmus

Nystagmus occurring at rest, without any external stimulus or movement.

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Positional Nystagmus

Nystagmus that changes direction or intensity based on the patient's head position, suggesting central vestibular dysfunction.

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Masticatory Muscle Myositis

Inflammation of the masticatory muscles, often causing difficulty opening the jaw.

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Study Notes

Neurologic Examination

  • Five main sections: mental status, gait analysis and body posture, cranial nerves, postural reactions, and spinal and withdrawal reflexes
  • Additional tests: muscle tone, muscle atrophy, perineal reflex, cutaneous trunci reflex, and nociception and neck/back pain
  • Routine is important to prevent errors
  • Using a neurologic examination form is recommended

Mental Status

  • Assess mental status throughout the examination, and patient should be alert and responsive at all times
  • Note interactions with humans and environment, including:
    • Full alertness and responsiveness
    • Difficulty navigating corners or tight spaces
    • Circling behavior
    • Response to name

Gait Analysis & Body Posture

  • Early analysis is essential, especially for nervous or stressed cats
  • Assess gait and posture for weakness (paresis) or paralysis (plegia), ataxia, and lameness
  • Evaluate ambulation (ambulatory or non-ambulatory) and affected limbs/degree of weakness (mono-paresis, para-paresis, tetra-paresis, hemi-paresis)
  • Observe for ataxia (proprioceptive, cerebellar, vestibular)
    • Proprioceptive ataxia: scuffing paws, knuckling, crossing over, or interference (limbs hitting each other)
    • Vestibular ataxia: leaning or falling to one side, uses wall for support
    • Cerebellar ataxia: dysmetria (unequal range/force of each step) or hypermetria (overflexion)
  • Examine for postural abnormalities: head tilt, head turn, torticollis

Cranial Nerve Examination

  • Performed after gait and mental status
  • Method: numerical order or by location (eyes, nose/face, ears, mouth)
  • Twelve pairs of cranial nerves (CNs)
  • Not all are routinely tested
  • Include:
    • Olfactory (I)
    • Optic (II)
    • Oculomotor (III)
    • Trochlear (IV)
    • Trigeminal (V)
    • Abducens (VI)
    • Facial (VII)
    • Vestibulocochlear (VIII)
    • Glossopharyngeal (IX)
    • Vagus (X)
    • Accessory (XI)
    • Hypoglossal (XII)

Cranial Nerve Examination (Step-by-Step)

  • Step 1 (Menace Response): CN II and VII; cover one eye, menace other eye, and check for blinking response
  • Step 2 (Pupillary Light Reflex): CN II and III; use a strong light and check for pupil constriction
  • Step 3 (Fundic Examination): CN II; visual exam of the optic disc
  • Step 4 (Palpebral Reflex): CNs V and VII; tap the medial/lateral canthus of both eyes to check for blinking response
  • Step 5 (Physiologic Nystagmus): CNs III, IV, and VI; turn head from side to side and up/down; check if there's abnormal nystagmus (irregular eye movement)
  • Step 6 (Masticatory Muscles): CN V; palpate for pain or atrophy in the masticatory muscles
  • Step 7 (Sensory/Motor): CN V and VII; stimulate different areas of the head for sensation/motor response
  • Step 8 (Nasal Mucosa): CN V; touch nasal mucosa to check for head withdrawal
  • Step 9 (Jaw Tone): CN V; open and close mouth to observe jaw tone
  • Step 10 (Gag Reflex): CN IX and X; gently touch the oropharynx/laryngopharynx to induce swallowing (use caution with nervous/aggressive animals)

Postural Reactions

  • Assess general proprioception of the limbs
  • Paws are positioned, and patient returns to normal position
  • Additional tests: hopping/wheel-barrowing and extensor postural thrust (additional proprioception testing)
    • For proprioception, failure to return the paw to normal position can be due to the use of a muzzle or owner distraction

Spinal Nerve Reflexes

  • Testing patellar reflex (femoral nerve) by striking straight patellar tendon.
  • Withdrawal reflex using hemostats to induce flexion of all joints in the limb
  • Test for crossed extension (UMN lesion) of contralateral limb

Ancillary Tests

  • Muscle tone and atrophy, cutaneous trunci reflex, perineal reflex, or anal tone, nociception, and neck/back pain

  • Evaluate for conscious nociceptive stimulus (e.g., turning, biting, respiratory rate changes).

  • Palpate along the vertebral column for possible pain/problems; observe neck/tail movement

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