Neurological examination of vety patient.

1. Systematic neurological
examination in animals

2. Extension of general
physical examination
Neurological Examination
It is the systematic way of accessing
functioning of nerves

3. NERVOUS SYSTEM
CNS PNS
FORE BRAIN HIND BRAIN
BRAIN STEMBRAIN SPINAL CORD
MID BRAIN
Metencephalon
Myelencephalon
Telencephalon
Diencephalon
Diencephalon
Mesencephalon Metencephalon
Myelencephalon
Mesencephalon

4. PNS
Axons and dendrites send messages to and from the CNS.
SNS (Voluntary) sends
Sensory info to the CNS and
motor messages to the muscles
ANS (Involuntary) serves our
basic life functions
Sympathetic
Nervous System
Parasympathetic
Nervous System
Readies the body
for threat
Calms the body
down and
maintains energy
Afferent Efferent
Sensory Motor
Somatic Nervous System Autonomic Nervous System

5. Aim of neurological examination
Confirm the problem
Lesion localization
Severity and Extent
Determine the Cause
Estimate Prognosis

6. NEUROLOGICAL STATUS
COMPONENTS OF NEUROLOGICAL EXAMINATION
OBSERVATION
POSTURAL
REACTION
TESTING
SPINAL
REFLEX
FUNCTION
CRANIAL
NERVE
FUNCTION
SUPERFICIAL
SENSORY
FUNCTION

7. OBSERVATION Mental Status and
Behaviour
NORMAL Alert with normal response
DEPRESSED Drowsiness with less response
CONFUSED AND
DISORIENTATED
Responsive(inappropriate manner)
STUPOROUS
Unconsciousness with
Reduce response (external stimuli)
but aroused (painful stimuli)
COMATOSE Unconsciousness with absence of
response to any stimuli
LEVEL OF CONSCIOUSNESS

8. OBSERVATION
AGGRESION
HEMI NEGLECTING
SYNDROME
HEAD PRESSING
LOSS OF
LEARNED BEHAVIOUR
BEHAVIOURAL CHANGES
LESION: FORE BRAIN
Mental Status and
Behaviour

9. PostureOBSERVATION
HEAD TILT
SCHIFF
SHERINGTON
SPINAL
CURVATURE
DECEBRATE
RIGIDITY
LESION:
Vestibular lesion
LESION:
Vertebral lesion
LESION:
Thoracic or
cranial spinal
cord lesion
LESION:
Rostral brain
stem lesion

10. PostureOBSERVATION
SCOLIOSIS
LORDOSIS
KYPHOSIS

11. OBSERVATION
Gait
ATAXIA
SENSORY ATAXIA
VESTIBULAR ATAXIA
CEREBELLAR ATAXIA
HYPERMETRIA
HYPOMETRIA
DYSMETRIA

12. OBSERVATION
Gait
PARESIS
MONOPARESIS
HEMIPARESIS
TETRAPARESIS
PARAPARESIS
LESION: Cranial to T-3
LESION:
Caudal to T-2
LESION:
Caudal to T-2
Ipsilateral ( T2- Caudal M.BRAIN )
C / L (Rostral M.Brain / Cerebrum)

13. OBSERVATION
Gait
CIRCLING
• DIRECTION TOWARDS THE SIDE OF LESION
• CIRCLING + TWISTING/HEAD TILT : VESTIBULAR SYSTEM
LESION:
FORE BRAIN
LESION:
VESTIBULAR
SYSTEM
TIGHT CIRCLES WITH
BALANCE LOSS
WIDE CIRCLES WITHOUT
BALANCE LOSS

14. OBSERVATION Involuntary
Abnormal Movements
MYOCLONUS
EPILEPTIC SEIZURES
CATAPLEXY
MYOTONIA
HEAD BOBBING
LESION: FORE BRAIN

15. POSTURAL
REACTION TESTING
• Complex responses maintain normal upright
position of limbs
• Initially we perform proprioceptive positioning reaction
reaction and hopping reaction
IF NORMAL
THEN PROCEED FOR FURTHER REACTIONS

16. Proprioceptive
Positioning Reaction
POSTURAL
REACTIONS
SLIDE PAPER TEST
KNUCKLING TEST
Flex the paw
Immediately returns the paw to
normal position

17. Hopping ReactionPOSTURAL
REACTIONS
RELIABLE TEST
 Lift the limb(opposite to suspected limb)
Assess: weight shifting,
initiation and movement on extended limb

18. Wheelbarrowing
Reaction
POSTURAL
REACTIONS
Lift both pelvic limbs from ground
If normal movement
repeat with head lifted and
Neck extension

19. POSTURAL
REACTIONS
ASSESSMENT
SLOW INITIATION
Caused by lesion of
cervical spinal cord, brain stem, c.cortex
DYSMETRIA
Cervical spinal cord, caudal brain stem
cerebellum
Wheelbarrowing
Reaction

20. Hemistanding and
Hemiwalking Reaction
POSTURAL
REACTIONS
Lift the thoracic and pelvic limb
of one side
(FORWARD AND LATERAL WALKING)
Normal Animal:
support weight by opposite limbs
ABNORMAL : Unilateral disease of motor cortex
Cervical / Thoracic cord lesion (I/L limb unable to support)
Cerebellar lesion (hypermetric response)

21. Tonic
Neck Reaction
POSTURAL
REACTIONS
With animal in normal standing position
Head is elevated
Neck extended
Turning head to side
Normal:
Extends t.Limb
Flexes p.Limb
Lowering the head
Normal:
Flexion of t.Limb
Extension of p.Limb
Normal:
Slight extension of Ipsilateral t.Limb
Slight flexion of Contralateral t.Limb
Frontal lobe lesion: C/L Abnormalities
Vestibular lesion: I/L Abnormalities

22. CRANIAL
NERVES

23. CRANIAL NERVE I
SENSE OF SMELL
HYPOSMIA
ANOSMIA
OLFACTORY NERVE
CARE: DO NOT USE IRRITATING SUBSTANCE
CRANIAL
NERVES

24. CRANIAL NERVE II
VISION
MENANCE RESPONSE
COTTON BALL TEST
PUPILLARY LIGHT REFLEX
OPTIC NERVE
CRANIAL
NERVES
CARE: DO NOT TOUCH EYE LASHES

25. CRANIAL NERVE III AND VI
CRANIAL
NERVES
EYE POSITION AND MOVEMENT
VESTIBULO-OCCULAR REFLEX
STRABISMUS
OCCULOMOTOR NERVE
ABDUCENT NERVE

26. CRANIAL NERVE IV
CRANIAL
NERVES
Dorso-medial Strabismus may
be due to damage to the nerve or
the mid brain
(with CN III and CN VI-USUALLY)
TROCHLEAR NERVE

27. CRANIAL NERVE V
CRANIAL
NERVES
PALPEBRAL
REFLEX
DROPPED
JAW
RESPOND
TO
STIMULATION
OF
NASALMUCOSA
RESISTANCE OF
JAW TO OPEN
THE MOUTH
TRIGEMINAL NERVE

29. CRANIAL NERVE VII
CRANIAL
NERVES
SCHIRMER TEAR TEST
(KERATOCONJUCTIVIS SICCA)
DROPPING
(EAR, LIP)
DEVIATION OF
NOSE
(NORMAL SIDE)
ABSENT
ABDUCTION
OF NOSTRIL
INSPIRATION
FACIAL NERVE

30. NYSTAGMUS INDUCED
BY MOVING OF HEAD
VENTROLATERAL
STRABISMUS
(CENTRAL V.D)
VESTIBULOCOCHLEAR NERVE
CRANIAL NERVE VIII
CRANIAL
NERVES
STARTLE
REACTION
(NOISE)
CLAP/WHISTLE

31. CRANIAL NERVE IX AND X
CRANIAL
NERVES
SWALLOWING
REFLEX
(ABSENT IN X)
GLOSSOPHARYNGEAL NERVE
VAGUS NERVE
GAG REFLEX
(ABSENT IN IX)

32. CRANIAL NERVE XI
CRANIAL
NERVES
TRAPEZIUS MUSCLE
ATROPHY
(CHRONIC)
SPINAL ACESSORY NERVE

33. DEVIATION AND ATROPHY
OF TONGUE
APPLY FOOD PASTE ON NOSE
(ASSESS TONGUE MOVEMENT)
HYPOGLOSSAL NERVE
CRANIAL NERVE XII
CRANIAL
NERVES

34. SUPERFICIAL
SENSORY
FUNCTION
• OBJECTIVES: HYPERESTHESIA , HYPESTHESIA AND
TO ENSURE THAT THE ANIMAL HAS A
CONSCIOUS RESPONSE TO NOXIOUS
STIMULI

35. HYPERESTHESIA
• Testing start from distal to proximal and caudal to cranial
• Increase muscle tension noticed: when painful area is palpated
even under light anesthesia
• S.cord / nerve root lesions: produces an area of hyperesthesia
SUPERFICIAL
SENSORY
FUNCTION

36. PANNICULUS REFLEX
• Evaluation of the cutaneous trunci muscles
• Most prominent at saddle area of the trunk
• Reflex absent caudal to lesion which disrupt the
superficial pain pathway
SUPERFICIAL PAIN
SUPERFICIAL
SENSORY
FUNCTION

37. WITHDRAWL REFLEX OF LIMB
SUPERFICIAL PAIN
SUPERFICIAL
SENSORY
FUNCTION
Thoracic limb
 Evaluate the integrity of spinal cord segment C6-T2 as well as
Brachial plexus and peripheral nerves
 NORMAL REFLEX: Reflex contraction of the flexor muscles
and withdrawal of the tested limb

38.  Evaluate the integrity of spinal cord segment L4-S2 as well as
femoral nerve and sciatic nerve
NORMAL REFLEX: Flexion of hip joint(femoral nerve function)
Flexion of stifle and hock(sciatic nerve)
Pelvic limb

39. DEEP PAIN
• Useful prognostic indicator : SPINAL CORD DISEASE
•Expected Reaction is a behavioral responses: gentle cry
(turning the head, trying to bite or vocalization)
PALPATION
HEAD
SPINE
LIMBS
SUPERFICIAL
SENSORY
FUNCTION

40. SENSORY
(AFFERENT)
AUTONOMIC
(EFFERENT
+
AFFERENT)
CEREBRAL CORTEX IN ALL SPINAL CORD SEGMENTS

41. SENSORY
SYSTEM

42. SENSORY
SYSTEM

43. SPINAL
REFLEXES
PATELLAR REFLEX
MOST RELIABLE TEST
MEDIATED VIA THE CORD
SEGMENTS L4 TO L6
IT ALSO EVALUATE
FEMORAL NERVE
NORMAL: BRISK AND
SLIGHT EXTENSION
OF THE STIFLE
ASSESSMENT: ABSENT(0), DEPRESSED(1), NORMAL(2),
EXAGGERATED(3), EXAGGERATED WITH CLONUS(4)

44. SPINAL
REFLEXES
CRANIAL TIBIAL
REFLEX
STRIKE TO JUST DISTAL
TO PROXIMAL END
OF TIBIA
NORMAL: FLEXION OF HOCK
ABNORMAL: ABSENT / DECREASE REFLEX
EXAGGERATED: LESION CRANIAL TO L6-7

45. SPINAL
REFLEXES
GASTROCNEMIUS
REFLEX
STRIKE AT TENDON JUST
DORSAL TO THE TIBIAL
TARSAL BONE
SLIGHT FLEXION NECESSARY
NORMAL:
EXTENSION OF HOCK
FOLLOWED BY FLEXION
CONTRACTION OF CAUDAL
THIGH MUSCLES
ABNORMAL: ABSENT / DECREASE REFLEX

46. SPINAL
REFLEXES
EXTENSOR CARPI
RADIALIS REFLEX
STRIKE EXTENSOR CARPI
RADIALIS MUSCLE
JUST DISTAL TO ELBOW
NORMAL:
EXTENSION OF CARPUS
ABNORMAL: ABSENT / DECREASE
EXAGGERATED REFLEX (+3): LESION CRANIAL TO C-7

47. SPINAL
REFLEXES
TRICEPS REFLEX
STRIKE AT TRICEPS BRACHII
JUST PROXIMAL TO
OLECRANON
NORMAL: SLIGHT EXTENSION
OF ELBOW OR VISIBLE
CONTRACTION OF TRICEPS
MUSCLE
LESION: RADIAL NERVE (LOSS OF MUSCLE TONE AND
INABILITY TO SUPPORT WEIGHT)
EXAGGERATED REFLEX (+3): LESION CRANIAL TO C-7

48. SPINAL
REFLEXES
BICEPS REFLEX
BY PLACING INDEX FINGER
OVER DISTAL END OF
BICEPS AND BICIPITAL
TENDON AT THE ELBOW
TAPPING THE FINGER
NORMAL: SLIGHT FLEXION
OF ELBOW AND CONTRACTION
OF THE BICEPS MUSCLE
FLEXION OF THE ELBOW ON FLEXOR REFLEX: BETTER
ASSESSMENT OF MUSCULO CUTANEOUS NERVE
EXAGGERATED REFLEX (+3): LESION CRANIAL TO C-6

49. SPINAL
REFLEXES
EXTENSOR THRUST
REFLEX
LATERAL RECUMBENCY OR
WITH ANIMAL SUSPENDED BY
SHOULDERS WITH THE PELVIC
LIMB HANGING FREE
TOE SPREAD, APPLY
PRESSURE BETWEEN PADS
NORMAL: RIGID EXTENSION
OF LIMB
DIFFICULT TO ELICIT (LATERAL RECUMBENCY)
EXAGGERATED REFLEX (+3): LESION CRANIAL TO L-4

50. SPINAL
REFLEXES
PERINEAL REFLEX
ELICIT BY LIGHT STIMULATION
OF PERINEUM WITH FORCEP
NORMAL: CONTRACTION OF
ANAL SPHINCTER WITH
FLEXION OF TAIL
BEST TO CHECK INTEGRITY OF SACRAL S.CORD SEGMENT
IMPORTANT IN ANIMAL (URINARY BLADDER DYSFUNCTION)
ABNORMAL/ DEPRESSED: PUDENDAL NERVE LESION
BULBOCAVERNOSUS REFLEX

51. SPINAL
REFLEXES
CROSSED EXTENSOR
REFLEX
OBSERVED WHEN FLEXOR
REFLEX IS ELICITED
NORMAL: EXTENSION OF
LIMB OPPOSITE TO
STIMULATED LIMB

52. SPINAL
REFLEXES
BABINSKI REFLEX
EXTENSOR TOE REFLEX
FINGER / FORCEP IS USED
TO STRIKE THE LIMB
ON CAUDO-LATERAL
SURFACE FROM HOCK TO
DIGITS
SEEN IN DOG(PELVIC LIMB PARALYSIS ASSOCIATED WITH
EXTENSOR HYPERTONUS AND EXAGGERATED REFLEXES
NORMAL:NO RESPONSE
ABNORMAL: EXTENSION AND
FANNING OF DIGITS