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BRAIN POWER!. “ Any fool can know. The point is to understand.” -Albert Einstein Chapter 8. DISEASES OF THE NERVOUS SYSTEM. CHAPTER 8. Neurological Diseases. PNS. Anatomy of the Nervous System. Central Nervous System (CNS) Brain, spinal cord

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brain power

BRAIN POWER!

“Any fool can know. The point is to understand.”

-Albert Einstein

Chapter 8

anatomy of the nervous system
Anatomy of the Nervous System
  • Central Nervous System (CNS)
    • Brain, spinal cord
  • Peripheral Nervous System (PNS-Links CNS to body)
    • Cranial nerves (from brain)
    • Peripheral nerves (from spinal cord)
  • Autonomic nervous system controls smooth muscle and cardiac muscle
    • Parasympathetic vs. Sympathetic Nervous system
  • Somatic (voluntary) system – skeletal m.
mneumonics
Mneumonics
  • Olfactory, Optic, Oculomotor, Trochlear, Trigeminal, Abducens, Facial, Vestibulocochlear, Glossopharyngeal, Vagus, Accessory, Hypoglossal
    • “Oh, Oh, Oh, To Touch And Feel Various Girl's Very Angelic Hands”
    • “Some Say Marry Money, But My Brother Says Big Business Makes Money”
neurological exam
Neurological Exam
  • Observe
    • Attitude, mentation (alert, lethargic, coma, etc), Gait
      • Agitation, anxiety
      • Seizures
    • Posture (Higher center)
      • Upright or sternal
      • Head tilt (vestibular?VIII)
      • Wide based stance (ataxia, weakness)
neuro exam
Neuro Exam
  • Gait
    • Walking and running on flat, non-slippery surface
      • Walk slowly back and forth with turns and circles
    • Proprioceptive deficits (knuckling)-spinal cord defect
    • Paresis (weakness)/paralysis (no movement) – cerebral cortex, brainstem, spinal cord or peripheral spinal nerves or muscles
    • Circling/pacing –
      • Tight circling with head tilt – vestibular (VIII)
      • With dementia – ipsilateral cerebral cortex
posterior paresis
Posterior Paresis
  • Reflexes present or exaggerated
  • in the rear legs if lesion is between
  • T3-L3
  • Reflexes are
  • diminished or
  • absent in the rear legs if lesion is between
  • L4-S2
neuro exam1
Neuro Exam

http://www.youtube.com/watch?v=0QOKPFMt0Rc&feature=endscreen&NR=1

  • Ataxia/incoordination – cerebellum, vestibular system, or spinal cord
  • Dysmetria - cerebellar
    • Hypermetria – too long movements
    • Hypometria – movements too short
neurologic exam
Neurologic Exam
  • Cranial Nerves
    • - I (S) Olfactory: ether /alcohol on cotton—will pull away
    • - II (S) Optic: follow moving objects; drop cotton ball
    • - III (M), IV (M), VI (M) Oculomotor, trochlear, abducent: look up, down, sideways
    • - V (B) Trigeminal: sensory to face, motor to muscles of mastication, weakness in jaw muscles
neurologic exam1
Neurologic Exam
  • VII (M) Facial: unilateral droop; drool; no menace
  • VIII (S) Vestibulocochlear: balance (nystagmus, head tilt); hearing
  • IX (B), X (B), XI (M) Glossopharyngeal, Vagus, Accessory: swallowing; muscle atrophy
  • XII (M) Hypoglossal: loss of tongue movement; unilateral atrophy
neuro exam cranial nerves
Neuro Exam – Cranial Nerves
  • Blind II
  • No menace II/VII
  • Anisocoria II, III
  • Atrophy of temporal muscles V
  • Dropped jaw V
  • Nares, lip pinch, cornea V
    • Inside ear
  • Lip/ear droop VII
  • No blink VII
  • Head tilt VIII
neuro exam cranial nerves1
Neuro exam – Cranial Nerves
  • Nystagmus VIII
  • Deafness VIII
  • Difficulty swallowing IX, X
  • Loss of gag reflex IX, X
  • Laryngeal paralysis IX, X
  • Weakness, asymmetry of tongue XII
cranial nerve
Cranial nerve

http://www.youtube.com/watch?v=S8f9-GPW9IE&feature=related

neuro exam2
Neuro Exam

http://www.youtube.com/watch?v=IXpGX6xhJdM

  • Postural reactions
    • Knuckling
    • Hopping
    • Wheelbarrowing
    • Hemiwalking
neuro exam3
Neuro Exam
  • Muscle Tone
    • Atrophy – occurs slowly from disuse
      • Rapidly from nerve damage
    • Lower Motor Neuron signs – decreased reflexes and muscle tone (spinal cord)
    • Upper Motor Neuron – reflexes & muscle tone increased (brain)
    • Test by flexing/extending joints
neuro exam spinal reflexes
Neuro exam – Spinal Reflexes

Thoracic limb withdrawal – pinch toe

Patellar – strike patellar ligament – extension of stifle

Pelvic limb withdrawal – pinch toe

Sciatic – Strike between greater trochanter and ischium – flexion of stifle and hock

Cranial tibial – strike cranial tibial m just below proximal end of tibia – flex hock

Perineal – pinch perineum/anus – anal sphincter contraction, tuck tail

Panniculus – stimulate skin over dorsum just lateral to vertebral column – twitch of cutaneous trunci m.

neuro exam upper motor neuron vs lower motor neuron signs
Neuro Exam: Upper Motor Neuron vs. Lower Motor Neuron signs

UMN LMN

Muscle tone N or I D

Spinal reflexes N or I D

Motor fxn Spastic Flaccid

Muscle atrophy Mild Severe

disuse neuro

Bladder Tense Flaccid

reflex examination
Reflex examination

http://www.youtube.com/watch?v=NFqFABsIa7Q&feature=related