Podcast
Questions and Answers
Which cranial nerve is responsible for motor function of the trapezius muscle?
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?
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?
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?
Which cranial nerve is associated with the menace response?
What is the primary function of the vagus nerve (CN X)?
What is the primary function of the vagus nerve (CN X)?
What is the purpose of the 'explode-the-hand' technique used in the menace response test?
What is the purpose of the 'explode-the-hand' technique used in the menace response test?
Which of the following is NOT a cranial nerve routinely tested in a neurological examination?
Which of the following is NOT a cranial nerve routinely tested in a neurological examination?
What is the main function of the hypoglossal nerve (CN XII)?
What is the main function of the hypoglossal nerve (CN XII)?
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?
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?
Which cranial nerve is responsible for sensory input from the inner pinnae of the ear?
Which cranial nerve is responsible for sensory input from the inner pinnae of the ear?
What is the primary function of the trochlear nerve (IV)?
What is the primary function of the trochlear nerve (IV)?
Which of the following is NOT a sign of a C6-T2 myelopathy?
Which of the following is NOT a sign of a C6-T2 myelopathy?
Which cranial nerve, when damaged, can lead to difficulties with chewing and swallowing?
Which cranial nerve, when damaged, can lead to difficulties with chewing and swallowing?
The dorsal, medial, and ventral rectus muscles, as well as the ventral oblique muscle, are all associated with:
The dorsal, medial, and ventral rectus muscles, as well as the ventral oblique muscle, are all associated with:
Which of the following is NOT a component of the physical examination that should be performed before evaluating cranial nerves?
Which of the following is NOT a component of the physical examination that should be performed before evaluating cranial nerves?
What is the function of the levator palpebrae dorsalis muscle?
What is the function of the levator palpebrae dorsalis muscle?
Which of the following is a reliable indicator of vestibular dysfunction?
Which of the following is a reliable indicator of vestibular dysfunction?
What is a possible cause of bilateral atrophy of the masticatory muscles?
What is a possible cause of bilateral atrophy of the masticatory muscles?
Which cranial nerve does the author explicitly state is NOT routinely tested during a neurologic examination?
Which cranial nerve does the author explicitly state is NOT routinely tested during a neurologic examination?
What is a potential drawback of using the gag reflex to evaluate CN IX (Glossopharyngeal) and CN X (Vagus)?
What is a potential drawback of using the gag reflex to evaluate CN IX (Glossopharyngeal) and CN X (Vagus)?
Which of these is NOT a characteristic of pathologic nystagmus?
Which of these is NOT a characteristic of pathologic nystagmus?
What muscles are potentially affected by a CN XI (Accessory) deficiency?
What muscles are potentially affected by a CN XI (Accessory) deficiency?
Why do the authors not routinely evaluate olfaction, taste, or hearing?
Why do the authors not routinely evaluate olfaction, taste, or hearing?
What condition can be indicated by difficulty opening the jaw and bilateral atrophy of the masticatory muscles?
What condition can be indicated by difficulty opening the jaw and bilateral atrophy of the masticatory muscles?
What is the term used to describe weakness in one limb of a dog?
What is the term used to describe weakness in one limb of a dog?
Which condition describes a dog that cannot walk on its own but has voluntary motor control in the pelvic limbs?
Which condition describes a dog that cannot walk on its own but has voluntary motor control in the pelvic limbs?
What is the best surface for observing a dog's gait?
What is the best surface for observing a dog's gait?
How should a clinician describe a dog's gait if both pelvic limbs are affected?
How should a clinician describe a dog's gait if both pelvic limbs are affected?
Which term refers to the lack of voluntary movement in all four limbs of a dog?
Which term refers to the lack of voluntary movement in all four limbs of a dog?
What does ataxia refer to in regards to canine gait?
What does ataxia refer to in regards to canine gait?
If a dog exhibits symptoms of weakness in both hind limbs but can still move its front limbs normally, which term is appropriate?
If a dog exhibits symptoms of weakness in both hind limbs but can still move its front limbs normally, which term is appropriate?
When walking a dog for gait analysis, the leash should ideally be:
When walking a dog for gait analysis, the leash should ideally be:
What two cranial nerves are tested during the pupillary light reflex?
What two cranial nerves are tested during the pupillary light reflex?
The menace response is considered a learned response in dogs and cats, developing around what age?
The menace response is considered a learned response in dogs and cats, developing around what age?
Which part of the central nervous system (CNS) can be directly evaluated during a fundic examination?
Which part of the central nervous system (CNS) can be directly evaluated during a fundic examination?
Why do the authors prefer an indirect fundic examination?
Why do the authors prefer an indirect fundic examination?
What two cranial nerves are assessed during the palpebral reflex?
What two cranial nerves are assessed during the palpebral reflex?
Which of the following is NOT a function assessed during the palpebral reflex?
Which of the following is NOT a function assessed during the palpebral reflex?
What is the primary role of the cerebellum in relation to the menace response?
What is the primary role of the cerebellum in relation to the menace response?
A dog with cerebellar dysfunction may exhibit what abnormal neurological sign?
A dog with cerebellar dysfunction may exhibit what abnormal neurological sign?
Which cranial nerves are tested when examining corneal sensation and globe retraction?
Which cranial nerves are tested when examining corneal sensation and globe retraction?
What is the normal response when testing corneal sensation with a cotton swab?
What is the normal response when testing corneal sensation with a cotton swab?
Why should you not perform a gag reflex on aggressive or nervous dogs?
Why should you not perform a gag reflex on aggressive or nervous dogs?
Which cranial nerve is evaluated by assessing jaw tone?
Which cranial nerve is evaluated by assessing jaw tone?
What indicates a normal nystagmus response during the head turning test?
What indicates a normal nystagmus response during the head turning test?
What is the appropriate method to test for tongue deviation or atrophy?
What is the appropriate method to test for tongue deviation or atrophy?
Which cranial nerves are involved in the action of swallowing?
Which cranial nerves are involved in the action of swallowing?
What is the role of CN VII during the menace response test?
What is the role of CN VII during the menace response test?
Flashcards
Monoparesis
Monoparesis
Weakness in one limb.
Paraparesis
Paraparesis
Weakness in both pelvic limbs.
Tetraparesis
Tetraparesis
Weakness in all four limbs.
Hemiparesis
Hemiparesis
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Monoplegia
Monoplegia
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Paraplegia
Paraplegia
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Tetraplegia
Tetraplegia
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Hemiplegia
Hemiplegia
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C6-T2 Myelopathy
C6-T2 Myelopathy
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Short, Choppy Gait
Short, Choppy Gait
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Overreaching Gait
Overreaching Gait
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Cerebellar Hypermetria
Cerebellar Hypermetria
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Upper Motor Neuron (UMN) Lesion
Upper Motor Neuron (UMN) Lesion
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Cranial Nerve Examination
Cranial Nerve Examination
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Extraocular Muscles
Extraocular Muscles
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Hands-on Examination
Hands-on Examination
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Menace Response
Menace Response
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Cranial Nerves (CNs)
Cranial Nerves (CNs)
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Vagus Nerve (CN X)
Vagus Nerve (CN X)
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Accessory Nerve (CN XI)
Accessory Nerve (CN XI)
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Hypoglossal Nerve (CN XII)
Hypoglossal Nerve (CN XII)
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Upper Motor Neuron (UMN)
Upper Motor Neuron (UMN)
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Neurologic Examination
Neurologic Examination
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Testing Cranial Nerves
Testing Cranial Nerves
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Pupillary Light Reflex Test
Pupillary Light Reflex Test
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Fundic Examination
Fundic Examination
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Palpebral Reflex Test
Palpebral Reflex Test
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Pinna Sensory Examination
Pinna Sensory Examination
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Pinna Motor Examination
Pinna Motor Examination
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Optic Disc
Optic Disc
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Corneal Sensation Test
Corneal Sensation Test
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Physiologic Nystagmus
Physiologic Nystagmus
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Gag Reflex
Gag Reflex
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Nasal Mucosa Touch Test
Nasal Mucosa Touch Test
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Jaw Tone and Tongue Evaluation
Jaw Tone and Tongue Evaluation
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Nystagmus
Nystagmus
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Resting Nystagmus
Resting Nystagmus
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Positional Nystagmus
Positional Nystagmus
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Masticatory Muscle Myositis
Masticatory Muscle Myositis
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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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