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Large Animal Neurology. Joe Mayhew
Читать онлайн.Название Large Animal Neurology
Год выпуска 0
isbn 9781119477198
Автор произведения Joe Mayhew
Жанр Биология
Издательство John Wiley & Sons Limited
The final concept of clinical neuroanatomy important in interpreting large animal neurologic examinations is that of the specialized areas of relatively well‐developed functional centers that exist in the forebrain, but having brainstem connections, as introduced in Figure 1.8. The frontal and prefrontal cerebral lobes (A) are involved with mentation and behavior, and with fine motor activity at least in primates. As in humans, the parietal lobes (B) integrate conscious proprioceptive and nociceptive input in the large animal species. Certainly, vision appears to require an intact occipital cortex (C). Control of normal learned behavior and perception of sound may be functions of the temporal lobes (D). The hypothalamus and its pituitary gland (E) help control autonomic and endocrine functions of the body, whereas the deeper, old part of the brain known as the limbic system (F) may be involved with innate behavioral patterns. Finally, the basal nuclei (G) do appear to have some motor control at least for cranial nerve function in horses. Irrespective of the regions of the cerebral cortex, large lesions can occur which in their stable state do not result in permanent disability; so‐called silent areas (e.g. Figure 2.5).
Figure 1.8 Functional regions of the forebrain include the frontal cortex A involved with mentation, behavior, and motor activity; the parietal cortex B involved with pain perception particularly from the head and conscious proprioception; the occipital cortex C involved with vision; the temporal cortex D involved with behavior and hearing; the hypothalamus and pituitary E involved with autonomic and endocrine functions; and the deep‐seated limbic system F involved with innate behavior.
With this understanding of functional neuroanatomy and a little practice, a neurologic examination can be readily performed and interpreted. An outline of such a neurologic examination is given in the next chapter.
References
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2 Neurologic evaluation
Disease
Procedure for the neurologic examination
Interpretation of findings Brain and cranial nerve disease Spinal cord disease Peripheral nerve disease
Overview
Traditionally, a detailed neurologic examination follows the collection of information on a patient’s signalment and history, an evaluation of the environment, and a complete physical examination.1–13 However, during the evaluation of a large animal suspected of having a neurologic disorder, most busy practitioners include several components of a neurologic examination during variations of the general physical examination as listed in Table 2.1.
To distinguish between vertebral bodies and spinal cord segments, vertebral bodies and regions will be defined by site and standard numerals, whereas spinal cord segments will be defined by site with subscripted numerals. Thus, the last three cervical vertebrae are C5–7 and the last three cervical spinal cord segments are C6–8.
Sometimes enough evidence is available from this examination to proceed with a tentative diagnosis and therapy. However, if this initial general evaluation is not enough to make an accurate anatomic diagnosis, especially if a thorough case workup is warranted or requested, then a complete neurologic examination should be undertaken that will often uncover further neurologic findings helpful to case workup. In fact, even with second opinion cases, we usually go quite rapidly through a neurologic examination in say 5 min, then return to scrutinize major components of the examination dependent on clues from the history, physical examination, contributory test results, and initial examination. Even then, it can be useful to develop a mental list of further procedures to undertake to assist with this diagnostic process. These may include testing eye responses in dim and bright light, testing nasal and temporal field vision, and spinal reflex testing in