Neuro review

Schiff sherrington

Hyperextension of TLs, paralysis of HLs

Thoracic or cranial lumbar spine

Decerebrate rigidity

Extension of all limbs and opisthotonus, stuporous or comatosed

Rostral brainstem

Decerebellate rigidity

Hyperextension of TLs and opisthotonus, mentation normal

Rostral part of cerebellum

Describing paresis

Tetraparesis - all limbs

Paraparesis - pelvic limbs

Monoparesis - 1 limb

Hemiparesis - both limbs same side

Either ambulatory or non ambulatory

4 aspects of neurological exam

Postural reactions

Spinal reflexes and muscle tone

Spinal pain

Cranial nerve examination

Postural testing

Proprioceptors > contralateral forebrain or ipsilateral cerebellum

Postural tests

Paw position

Hopping

Placing responses

Where is the spinal lesion?

C1-T2 all legs affected

T3-S3 pelvic limbs affected

C6-T2 - spinal reflexes in thoracic limbs

L4-S3 spinal reflexes in pelvic limbs

Types of spinal reflexes

Withdrawals

TL:

- Extensor carpi radialis

- Biceps

- Triceps

HLs:

- withdrawals

- patellar

- cranial tibial

- gastrocnemius

- perineal

Misinterpretation of spinal reflexes

pain causes reduced reflexes

Very subtle lesion may not affect reflex pathway

Patellar reflex reduced in olf age

Spinal shock

CN testing

Menace resposne

input - II

Forebrain, cerebellum, brainstem

Output - VII

Learnt response - learnt response, present from ~12wks

Pupillary light reflex

input - II

Output - III

Where do the menace and PLR pathways overlap?

Gag reflex

Input IX and X brainstem

Output IX and X

Horners