Neurolocalization

EUROLOCALIZATION NEUROLOGICAL EXAM ATAXIA Behavior changes Proprioceptive Pacing Patients will cross limbs Head pressing and scuff and knuckle Disruption of inhibitory input to red paws Lameness Looking at Ataxia Looking where where the horse places the nucleus no signals from forebrain to Vestibular the horse places the hooves there less weight placed on the affected limb. limbs, unpredictable there crossing the the Imb placement is Patients will drift limbs. wide placement of stop walking predictable the limbs, and scuffing of the hooves (black lines). Circling towards one side Animal will circle toward side with usually has head tilt and lesion due to "hemineglect" nystagmus phenomenon Cerebellar ataxia Animal ignores one side of world since Dismetria to them it no longer exists hypermetria overflexion pathetic Thoracolumbar (C7-L4) Aggression extension of limbs Parasympathetic Cranial Nerves Plexus 1-53) cervical-Sacral Blindness, Not uncommon to have more Obsessiveness, than one type! Incontinence Vagus Nerve Mentation changes POSTURE obtunded not fully aroused Decerebrate Stuporous patient only responsive to Patient is rigid in all limbs often with noxious stimuli opisthotonus Comatose patient has heart beat, Lesion usually in midbrain but not necessarily responsive to Generally stuporous to comatose stimuli Decerebellate Seizures Rigid in thoracic limbs Observe flexed pelvic limbs Lesion to cerebellum Behavior, mentation, gait, posture Tools Alert to obtunded Surface with traction, reflex hammer, Head turn hemostats, light source, funding exam Head no longer in longitudinal axis lens, cotton ball Head tilt Head no longer level along horizontal axis CITY Torticollis Nuciesa Contracture or flexion of cervical UMN= muscles forebrain, Opisthotonus brainstem, Head in dorsoextension cerebellum, Risus sardonicus C1-C5 spinal Lack of inhibition to facial nerve causing contracture of facial muscles C1-C5 Myelopathy C6-T2 Myelopathy T3-L3 Myelopathy L4-S3 Myelopathy Thoracic Limb Normal to increased Decreased to absent Normal Normal schiff Sherrington Reflexes Thoracic limbs have increased extensor Thoracic Limb Tone Normal to increased Decreased to absent Normal to increased Normal Pelvic Limb Normal to increased Normal to increased Normal to increased Decreased to absent tone Reflexes Pelvic Limb Tone Normal to increased Pelvic limbs are paretic to plegic 7 Normal to increased Normal to increased Decreased to absent C1-C5 Upper motor neuron X 4 spasticity C6-T2 Lower motor neuron thoracic, upper motor neuron pelvic limbs Secondary to UMN lesion T3-L3 Normal to increased pelvic, thoracic limbs are normal with the exception of Schiff Sherrington L4-S3 Decreased to absent pelvic, thoracic limbs are normal Flaccid C1-C5 Secondary to LMN lesion T3-L3 Neck guarded Respiratory depression Schiff Sherrington Secondary to cervical pain C6-T2 Spinal Shock Kyphosis Horner syndrome Cuteous Trunci Cutoff Secondary to thoracolumbar, abdominal Nerve root signature L4-S3 pain or malformation Absent Cutaneous Trunci Abnormal anal tone Flaccid tail EUROLOCALIZATION NEUROLOGICAL EXAM ATAXIA Behavior changes Proprioceptive Pacing Patients will cross limbs Head pressing and scuff and knuckle Disruption of inhibitory input to red paws Lameness: Looking: at Ataxia: Looking where where the horse places the nucleus no signals from forebrain to Vestibular the horse places the hooves, there less weight limbs. sunpredictable, placed the affected limb. there crossing the but the mb placement is Patients will drift limbs. wide placement of stop walking predictable the limbs, and scutting of the hooves black lines). Circling towards one side Animal will circle toward side with usually has head tilt and lesion due to "hemineglect" nystagmus phenomenon Cerebellar ataxia Animal ignores one side of world since Dismetria, to them it no longer exists hypermetria->overflexion Sympathetic Thoracolumbar (C7-L4) Aggression extension of limbs Parasympathetic Cranial Nerves II, Plexus (S1 -53) -cervical-Sacral Blindness, Not uncommon to have more Obsessiveness, than one type! Incontinence Vagus Nerve Mentation changes POSTURE obtunded not fully aroused Decerebrate Stuporous patient only responsive to Patient is rigid in all limbs often with noxious stimuli opisthotonus Comatose patient has heart beat, Lesion usually in midbrain but not necessarily responsive to Generally stuporous to comatose stimuli Decerebellate Seizures Rigid in thoracic limbs Observe flexed pelvic limbs Lesion to cerebellum Behavior, mentation, gait, posture Tools Alert to obtunded Surface with traction, reflex hammer, Head turn hemostats, light source, funding exam Head no longer in longitudinal axis lens, cotton ball Head tilt Head no longer level along horizontal axis Torticollis Contracture or flexion of cervical UMN= muscles forebrain, Opisthotonus brainstem, Head in dorsoextension cerebellum, Risus sardonicus C1-C5 spinal Lack of inhibition to facial nerve causing contracture of facial muscles C1-C5 Myelopathy C6-T2 Myelopathy T3-L3 Myelopathy L4-S3 Myelopathy Thoracic Limb Normal to increased Decreased to absent Normal Normal Schiff Sherrington Reflexes Thoracic limbs have increased extensor Thoracic Limb Tone Normal to increased Decreased to absent Normal to increased Normal Pelvic Limb Normal to increased Normal to increased Normal to increased Decreased to absent tone Reflexes Pelvic Limb Tone Normal to increased Pelvic limbs are paretic to plegic 7 Normal to increased Normal to increased Decreased to absent spasticity C1-C5 Upper motor neuron: 4 C6-T2 Lower motor neuron thoracic, upper motor neuron pelvic limbs Secondary to UMN lesion T3-L3 - Normal to increased pelvic, thoracic limbs are normal with the exception of Schiff Sherrington L4-S3 - Decreased to absent pelvic, thoracic limbs are normal flaccid C1-C5 Secondary to LMN lesion T3-L3 Neck guarded Respiratory depression Schiff Sherrington Secondary to cervical pain C6-T2 Spinal Shock Kyphosis Horner syndrome Cuteous Trunci Cutoff Secondary to thoracolumbar, abdominal Nerve root signature L4-S3 pain or malformation Absent Cutaneous Trunci Abnormal anal tone Flaccid tail