SAEVA Congress 2018 Proceedings | 12-15 February 2018 | ATKV Goudini Spa
2. Poor physical status; i.e., weight loss
3. Laryngeal paresis and vagal signs if CN X.
4. slap test
- afferent: segmental dorsal thoracic nerves, cervical spinal cord white
matter to the vagal nucleus in the medulla oblongata (contralateral)
- efferent: vagus nerve to recurrent laryngeal n.
I. Hypoglossal (XII - motor to tongue):
Grasp tongue and pull gently to check for weakness and atrophy.
J.
Accessory (XI) – input in swallowing and motor to trapezius and cranial
sternocephalicus
III. Gait and Posture
If evidence of a lesion has been detected in the examination of the head (head
signs), then an attempt is made to explain any abnormalities found in the rest of
the examination by such a lesion above the level of the atlanto-occipital junction.
If this cannot be done, then there must be at least 2 lesions, or a diffuse disease.
If “head signs” are not found, the lesion(s) is assumed to be in the spinal cord,
peripheral nerves, or muscles.
The motor system can be evaluated more objectively than can the sensory
system. Many lesions of the nervous system affect the motor system. Lesions
might be single-focal, single-diffuse, or multifocal. Motor deficit, when present, is
of extreme value in the localization of the lesion(s).
In evaluating the motor system, it is important to understand what is meant
by upper motor neuron disease and lower motor neuron disease, and be
able to recognize the signs associated with each.
The lower motor neuron (LMN) is a neuron whose cell body is in the ventral
gray column or in specific cranial nerve nuclei and whose axon projects into the
peripheral nervous system. It is the final motor unit to the effector organ. It is
responsible for maintaining tone, for reflexes, and voluntary and involuntary
motor function. Lower motor neuron disease would result from lesions involving
spinal cord ventral gray matter, motor cranial nerve nuclei and trunks, ventral
(motor) spinal roots, peripheral nerve trunks, and myoneural junctions.
Signs of LMN disease include:
1. Motor deficit – partial or complete
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