A&P Neurology 2 Flashcards

Vertebral infections
Terms Definitions
soothing
palliative
Zovirox cream
acyclovir
Zovirox cream
HSV
Degenerative Myelopathy--prog
poor
CNS
Central Nervous System
Posterior Column Tract
(blank)
Dysautonomia--prog
GRAVE, mortality >90%.
Inflammation of the brain.
Encephalitis
dysphonia
voice volume disorder

laryngeal disorders or impairment of cranial nerve X (vagus nerve)
Reflexes
Biceps, Triceps, Patellar, Achilles
Intramedullary
in the spinal cord
Gyrus (Gyri)
Ridges in the cerebrum
demyelinating
Exacerbation and remissions of symptoms suggest what etiology?
parietal
interprets tactile sensations =touch and paintemperature, shapes, and two point discrimination
dendrites
receive stimuli or impulses
short, multibranched
inability to perform coordinated movements or use objects properly: not associated with sensory or motor impairment or paralysis
apraxia
CN IX
Glossalpharyngeal Mixed motor( phonation and swallowing) sensory (taste (outer third), gag reflex) parasympathetic (parotid gland, carotid reflex)
Dysautonomia--def
idiopathic, widespread degeneration of the autonomic nervous system.
Immune-mediated PNS
Acute idiopathic polyradiculoneuritis (coonhound paralysis) and Acquired myasthenia gravis
Lentiform nucleus abnormality with...
Wilsons disease
Are parkinsonism or essential tremors worsened by anxiety or action?
Essential
Carbamazepine
First choice of drug therapy for partial, generalized tonic-clonic and mixed seizures?
are fasciculations a normal or abnormal finding ?
abnormal
inability to close eyes,
wrinkle forehead,
w. paralysis to the lower part of the face on the affected side is associated with ?
Bell's palsy
severe, sharp, spasmlike pian that extends along the course of one or more nerves
neuralgia
Reflex Grading
0 No response
Steroid-responsive meningitis-arteritis--path
Idiopathic: inflammation of the meningeal arteries and, less commonly, extraneural arteries. High levels of IgA in the serum and CSF of affected dogs suggests an immune-med. cause. predisposition in boxers, beagles, and Bernese mountain dogs suggests a genetic component
Polmyositis--def
diffuse inflammation of skeletal m., most commonly accurring as an immune mediated paraneoplastic disorders, but can also be caused by infectious agents.
Bacterial Meningitis--CS
Generalized or focal spinal hyperpathia--most consistent sign. Cervical rigidity, stiff stilted gait, reluctance to move, pain on palpation/manipulation of the spine. May seem painful all over. Fever. Neuro deficits: ataxia or paresis, depression, seizures. Signs of brain edema and increased ICP: deterioriating levels of consciousness, tetraparesis prgressing to tetraplegia, opisthotonus, cranial nerve abnormalities.
Dysautonomia--incidence
Horses: Grass sickness, cats and dogs
Parkinsonism
A heterogeneous group of conditions that share some of the clinical features of idiopathic PD but differ partially in their clinical expression, response to L-dopa therapy, and their underlying pathological substrates.
Hemiballismus
Unilateral violent large jerking or shaking choreic movements. Vascular disease in the contralateral subthalamic nucleus and commonly resolves spontaneously in the weeks following the onset.
Voltage-gated channel
Opens/closes to channels in membrane potential
Is essential tremor considered a pathology?
No, benign
Stuporous
A pt which requires physical stimuli to awaken is described as what?
0-4: +2 = Normal
How are reflexes graded?
Trauma: Nerve Injuries: Superficial Peroneal Nerve
Trauma: Nerve Injuries: Superficial Peroneal Nerve
 
source:
pocket ntoebook EM p.261
Parkinson's gait
shuffling gait, turns accomplished in very stiff manner.stooped over posture w. flexed hips and knees.seen in Parkinson's because of effect on basal ganglion
WHAT IS KORSAKOFF'S PSYCHOSIS?
CHARACTERIZED BY DISORIENTATION, MUTTERING, DELIRIUM, INSOMNIA, DELUSIONS, AND HALLUCINATIONS. SYMPTOMS (CHRONIC ALCOHOLISM, THIAMINE DEFICIENCY). INCLUDE PAINFUL EXTREMITIES, BILATERAL WRIST DROP AND PAIN ON PRESSURE OVER THE LONG NERVES. 100MG THIAMINE (Tx)
afferent nerves
conduct nervous impulses towards the CNS. Sensory
a projection that extends from the nerve cell body; it receives impulses and conducts them on to the cell body
dendrite
small, neuroglial calls found in the intnerstitial tissue of the nervous system that engulf cellular debree, waste products, and pathogens within nerve tissue
microglia
Sensory function
Superficial pain and light touch, Vibration, Position sense, Stereognosis, graphesthesia, two
Vertebral infections--def
Spondylitis = infection of the vertebral body; discitis = infection of the disc space; discospondylitis = infections of the disc space and adjacent vertebral body
Acquired myasthenia gravis--dx
Generalized weakness that resolves quickly after IV administration of edrophonium chloride (Ach-esterase inhib.)
Infectious/Inflammatory myelitis--path
Canine distemper, FIP, N. caninum, Toxoplasma gondii, systemic mycoses. GME and tick-born infections can cause myelitis or meningomyelitis in dogs and cats.
Concussion--dx
Exam: limit in nonambul. pats. to voluntary movement, palpation of the spine, spinal cord relfexes, deep pain perception, and cr. n. examination until an unstable fracture/luxation is excluded by RDX. deep pain perception is most important.
Compression--dx
RDX: only after life thret. problems have been addressed and stable. LAT. view of area where lesion is localized. DV may be obtained by horizontal beam
Bacterial Meningitis--DX
CSF analysis: indicated early in evaluation--cytology: marked increase in cell count, predominately neutrophils degenerate appearance of neutrophils; +/- intracellular bacteria. cultures: aerobic and anaerobic are submitted if there is an increase in neutrophils, but false negatives are common. Hematology: normal or inflammatory leukogram. Blood culture: indicated if bacterial meningitis a consideration. Diff Dx: polyarthritis, polymyositis, diskospondylitis, cervical intervertebral disk disease, encephalomyelitis
Tick Paralysis--path
female ticks produce salivary toxin that interferes w/ Ach release at the neuromusc. Jxn. Dermacentor variabilis and D. andersoni are most common.
Degenerative Lumbosacral stenosis--CS
history: stiffness, pain, difficulty with stairs and jumping, incontinence, chewing at tail; CS: *pain on palpation of lumbosacral region, exclusion of the lumbosacral joints or elevation of the tail; weak flexor and perineal reflex
MRI brain abnormalities associated with major depression
Related to cortical-striatal-pallidal-thalamus-cortical pathways including: Frontal lobes, caudate, and putamen.
Describe a migraine
Unilateral, pulsating, moderate to severe pain, aggravated by routine physical activity, may have nausea/vomitting, and/or photophobia. More common in females.
Balints syndrome
From bilateral watershed areas. Optic ataxia and apraxia, and simultanagnosia.
Removal of Neurotransmitters
Diffusion away from the synaptic cleft
Re-uptake by presynaptic neuron
Phagocytosis by microglial cells
Enzymatic Breakdown (Acetylcholinesterase, Monoamine Oxidase)
Meds are effective at tx essential or parkinsonism tremors?
Parkinsonism
What ages does Pick's dz or frontotemporal dementia MC occur?
50-60 yo
Stereognosis
 
What is it called when the patient is asked to identify a key, coin, or paperclip in each hand, with eyes closed?
thiamine
What drug might you consider giving a pt with a history of alcoholism who is experiencing status epilepticus?
S. pnemoniae
What is the most likely organism causing meningitis in people 30y/o and older?
What is a hemorrhagic Stroke?
·Interruption of vessel integrity·Bleeding occurs into tissue/spaces Ventricular, subdural, subarachnoid
HOW MANY PAIRS OF CRANIAL NERVES ARE THERE?
12
What is an important factor in myopathic lesions?
Family hx
An extramedullary anterior cord lesion will that impacts the R lateral spinothalamic pathway will effect fibers from which extremity first?
L Lower extremity
the outermost of the 3 membranes (meninges) surrounding the brain and spinal cord
dura mater
Hypothalamus
A major control center with many vital functions: temperature, heart rate, and blood pressure control, sleep center, anterior and posterior pituitary gland regulator, and coordinator of autonomic nervous system activity and emotional status
Vertebral infections--dx
Radiographs show collapse of teh disk space and lysis of adjacent vertebral end plates with varying degrees of osteophyte production. CBC may be normal or inflammatory. Blood cultures are successful in recovering the causative organism in ~50% of cases. Positive urine cultures are significant only if Staph is isolated. Always screen for Brucella.
Secondary injury--CS
Signs of other injuries may be present. neuro. deficits depend on location and severity of the lesion. Focal hyperesthesia is expected in acute inj.
Suprascapular n. injury--def
instability of the shoulder joint (shoulder sweeney)
Feline Hypokalemic Polymyopathy--tx
K+ administration, initially IV then oral elixir and K+ gluconate powder for long term supplementation.
Canine Cervical Spondylomyelopathy--DX
Signalment, history, exam; rads are non-specific; need MRI or myelogram
Treatment of eating disorders
Antidepressants/SSRIS of some benefit, but not during weight restoration. Neuroleptics have some use. Estrogen reverses osteoporosis if there is weight gain. Psycho and behavioral therapy.
5 nonspecific acute migraine drug classes
Opioids, neuroleptics/antiemetics, NSAIDS, corticosteriods, combination analgesia.
Fetal alcohol syndrome prevalency
0.5-3 cases per 1000 births.
meperidine
use for less than 48 hrs, low dose advantages: little bile duct spasms disadvantages: frequent dosing, toxic metabolite -> tremor, seizure DDI: MAOI and drugs that increase serotonin
What med, is used to tx substance abuse (detox)?
Oral methadone
Abx for meningitis if significant immunosuppression, h/o CSF leak, recent neurosurgery, head trauma, or potential sepsis?
Add cefepime or meropenem
Angular Gyrus
Which part of the brain deals with understanding metaphors and out-of body experiences (a sensation of floating outside of one's body).
Papilledema
What is a sign of an epidural hematoma which would cause you to rethink your idea of a lumbar puncture?
Tension type headache
What type of headache would be described as "tight and constricting"?
What type of brain injury do you usually get from a deceleration force?
Subdural Hematoma
Optic CA-II sensory
carries visual impulses from eye to eye.
WHAT IS EFFERENT?
CARRYING IMPULSES AWAY FROM THE BRAIN OR SPINAL CORD TO THE PERIPHERY. MOTOR NERVES ARE EFFERENT.
Optic

CA-II sensory
carries visual impulses from eye to eye.
Organophosphate toxicity will cause which of the following?
Acute of subacute motor weakness
the part of the brain that is located between the cerebrum and the midbrain. its main structures consists of the thalamus, hypothalamus, and pineal gland
diencephalon
Vertebral infections--tx
At least 8 weeks of abx administration based on C/S. If cultures are negative, treat for staph with cephalosporin or penicillinase-resistant penicillin (oxacillin, cloxacillin). If no improvement within 10 days, re-evaluate therapy. Surgery to obtain tissue for culture and perform curettage is indicated in cases refractory to medical therapy. Decompressive surgery may be necessary in cases with substantial meurological deficits.
Fibrocartilagenous Embolism (FCE)--CS
onset is invariably sudden and is often asoc. w/ exercise. May progress during the first few hours but are usu. Static. Neuro deficits are usu. Bilat. And often asymmetrical. Any area of the spinal cord can be affected. Pain may be noted by owners at onset, focal areas of pain can not be identified on examination; this is helpful in differentiating FCE from many other causes of acute spinal cord dysfxn.
Acquired myasthenia gravis--inci
fairly common in mature dogs, esp. GSD, golden retrievers, and labrador retrievers. Uncommon in cats.
Aortic Thromboembolism (Saddle Thrombus)--path
Usu. Secondary to cardiomyopathy in cats. Aortic thromboembolism causes ischemia to the nn. And mm. of the pelvic limbs, causing paraparesis or paraplegia that must be differentiated form spinal cord disease.
Vertebral infections--incidence
large breed dogs most commonly. Rare in cats and horses
What are the spinal cord segments?
Cervical: C1-C5; Cervicothoracic: C6-T2; Thoracolumbar: T3-L3; Lumbosacral: L4-S3
Primary treatment modality for depression
Medications. ECT if severe.
Fragile x syndrome
CGG repeat, more common in males, heriditary (FMR-1 gene on X chromosome)
CIDP (chronic inflammatory demyelinating polyradiculopathy) treatment
Steroids, plasmapharesis and IVIG for many years.
The most severe pathology of Alzheimer's dz is usually found in what areas of the brain?
Hippocampus, temporal cortex, and nucleus basalis of Meynert
Describe the nuchal rigidity present in bacterial meningitis.
Problem of forward flexion only
PET scan
What type of scan would be used to look for extra-cranial metastatic disease?
Guillian Barre
What would you suspect with a pt that presents with rubbery legs that has now progressed up to his arms and face?
Signs and symptoms of schizophrenia
Eccentric moods not appropriate to the situation. poor hygiene or inappropriate dressbizarre body movements and behaviorrepetition of phrasesreduced degree of orientationhallucinationsinability to compare/contrast itemsimpaired judgment
What type of aphasia would you have if the frontal lobe is involved?
Expressive or Broca's
WHAT IS AN ABSENCE SEIZURE?
TYPE OF GENERALIZED SEIZURE WITH SUDDEN ONSET, CHARACTERIZED BY A BREIF LOSS OF AWARENESS AND RAPID RECOVERY.
Prescription and nonprescription drugs could cause ?
tremors or dizziness
altered level on consciousness
decreased response times and mood and temperament changes
Which sensory exam diff with LMNL, peripheral neuron ds?
LMN = dermatomal/myotomal pattern
Peripheral = territorial, usually distal
Level of Consciousness
*** A change in the level of consciousness is the single most important factor ***
Suprascapular n. injury--path
trauma to shoulder region = atrophy of the supraspinatus m and infraspunatus m.
Acute idiopathic polyradiculoneuritis (coonhound paralysis)--tx
No effective tx other than nursing care and corticosteroids are NOT helpful.
Hemaetology findings of someone with anorexia nervosa
Leukpenia with relative lymphocytosis, reduced bactericidal capacity in leukocytes, and low erthrocyte sedimentation rate.
Asterixis is caused by?
(AKA flapping tremor) Delerium. May be secondarily due to liver, pulmonary, or renal failure.
The pathophysiology of HD is a gross atrophy of the what accompanied by neuronal loss?
Caudate nucleus and putamen
Name 3 bacterial infections that may precipitate GBS.
Mycoplasma pna, Campylobacter jejuni, or enteritis
Subarachnoid Space
In which layer of the skull is the CSF located?
What causes pure hemiplegia with no sensory dysfuction or pure hemisensory loss with no motor dysfuction?
"Lacunes" stroke...from Chronic HTN... small artery disease; small necrotic regions form cysts or "lacunes".
A present corneal reflextemporal and masseter muscles contract bilaterally.able to identify light, sharp, and dull touch to forehead, cheek and chinis an assessment of what cranial nerve?
cranial nerve 5- trigeminal- sensory and motor
WHAT IS CEREBROSPINAL FLUID?
WATERY, CLEAR FLUID THAT ACTS AS A CUSHION, PROTECTING THE BRAIN AND SPINAL CORD FROM PHYSICAL IMPACTS. THE CSF ALSO SERVES AS AN ACCESSORY CIRCULATORY SYSTEM FOR THE CNS.
Your pt is complaining of his weight-lifting routine getting shorter and shorter. This "plate-head" figures he's just getting stronger and doesn't need to work-out long and hard. He tell's you he is also feeling very weak after his gym routine b
Suffers from a NMJ ds
Crossed extensor reflex is d/t lesion where?
UMN lesion and is ABNORMAL
Most common sexual dysfunction in a young person
Performance anxiety (tensing ones muscles)
Normal pressure hydrocephalus has a triad of symptoms
Gait impairment, dementia and urinary incontinence.
Describe the resting tremor seen in PD.
"pill-rolling" motion of hand, 3-5 cycles/sec.
Finding on CT scan of brain abscess?
Outer ring surrounding a low-density core
Calcium-channel blockers for long term, Steriods for acute attacks
What type of medication should be used in prevention of cluster headaches?
According to the GCS define the range for a mild, Mod and severe HEAD injury.
Mild- 13-15Mod 9-12 includes LOCSevere: <9 require critical care & monitoring
WHAT IS A SIMPLE PARTIAL SEIZURE?
TYPE OF SEIZURE THAT INVOLVES LOCAL MOTOR, SENSORY OR AUTONOMIC DYSFUNCTION OF ONE AREA OF THE BODY. THERE IS NO LOSS OF CONSCIOUSNESS. ALSO CALLED JACSONIAN, FOCAL MOTOR OR FOCAL SENSORY.
If a client scores less than a 7 on the Glasgow Coma Scale the client is considered to be ?
in a coma
X-linked Muscular Dystrophy of Dogs and Cats--def
a hereditary myopathy casued by a mutation in the gene that encodes for the muscle protein, dystrophin. Identical to Duchenne muscular dystrophy, affecting yound boys.
What are some types of cord changes?
1. mechanical derangement 2. ischemia 3. edema 4. break down of endothelium 5. hemorrhage within spinal cord 6. release of free radicals and other inflammatory mediator 7. can lead to irreversible spinal cord damage
5 ways HIV can cause mania in patients
Exacerbation of premorbid mood disorder, brain lesions from HIV infection, opportunistic pathogens such as toxoplasma gondii or cryptococcus neoformans, AIDS-related neoplasm (Kaposi's sarcoma), medications like AZT.
Treatment for periodic limb movement
Ropinirole. If doesnt work can try clonazepam or opiates.
What is the classic triad of sx in bacterial meningitis?
Fever, nuchal rigidity, and AMS
constricted fixed pupils could be the result of ?
narcotic abuse or damage to the pons.
constricted fixed pupils could be the result of ?
narcotic abuse or damage to the pons.
What are a few characteristics of a frontal lobe lesion?
Aphasia, Bladder incontinence and mood changes
What is the pathway when you check the patellar reflex?
tap the patellar ligament-->stretches the mm spindles of the quadriceps mm-->sensory fibers ascend via the femoral nerve and dorsal roots to synapse on LMN located in L4-6-->motor fibers exit via the ventral roots and are carried by the femoral nerve to the quadriceps
Critical period for vision
Birth to 2 years old (up to 8 years old)
Name 5 expected findings on PE of a pt w/ ICH.
1)Bruising 2)Hepatomegaly 3)AV nicking 4)LVH 5)Renal bruits
A corneal reflex may be absent in clients with?
trigeminal nerve or lesions of the motor part of cranial nerve VII.

may be absent or reduced in clients who wear contacts
What meds are used to tx HD pts w/ chorea that is interfering w/ function?
Benzos (clonazepam or diazepam) or valproic acid (depakote)
The patellar reflex can be exaggerated with lesions where?
lesion in UMN cranial to L4 and a lesion of the sciatic nerve or L6-S2
True or False: A Clear LP Rules Out a Sub Arachnoid Bleed?
FALSE...It may take HOURS after the onset of the bleed before RBC's show up in the CSF!
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