Case 7

Data Base Collection

SIGNALMENT: Canine, mixed breed, 2 years old

HISTORY: Hit by car 12 hours ago. Dog can not use the left thoracic limb. Will not bear weight and stands with its paw knuckled over.

PHYSICAL EXAMINATION:	T	102	HR	90	RR	32
	CRT	<2.0 secs.	MM	Pink	WT	55 lb..
Negative except for neurological and musculoskeletal examination of left thoracic limb.

NEUROLOGICAL EXAMINATION:

A. MENTAL STATUS: Alert and responsive

B. POSTURE: Normal

C. PALPATION: Severe pain and swelling in left antebrachium. Dog does not perceive pain from dorsal surface of left thoracic paw. Pain is perceived from all other areas.

D. GAIT: Monopresis of left thoracic limb. Non-weight bearing on leg. Dog can extend the elbow but does not extend its digits or carpus.

E. POSTURAL REACTIONS:
(0=absent, +1=decreased, +2=normal, +3=increased/exaggerated, NE=not examined)

LEFT
REACTIONS
RIGHT

Proprioceptive Positioning
PL
TL

2 2

0 2

NE Wheelbarrowing NE

Hopping
PL
TL

2 2

1 2

2 Extensor Postural
Thrust 2

NE Hemistand-Hemiwalk NE

NE Tonic Neck NE

Placing, tactile
PL
TL

2 2

1 2

Placing, visual
PL
TL

2 2

1 2

F. SPINAL REFLEXES:
(0=absent, +1=decreased, +2=normal, +3=increased/exaggerated, +4=clonic, NE=not examined)

LEFT
REFLEX, SPINAL
SEGMENT

RIGHT

2
Quadriceps
(L4-L6)
2

2
Flexion, PL
(L5-S1)
2

1
Flexion, TL
(C6-T1)
2

2
Triceps
(C7-T1)
2

0
Crossed
Extensor
0

2
Perineal
(S1-S2)
2

G. CRANIAL NERVES:
(0=absent, +1=decreased, +2=normal, +3=increased/exaggerated, NE=not examined)

LEFT
(Response/Test)
RIGHT

2
Menace
(CN II & VII)
2

2
Palpebral
(CN V & VII)
2

2 Pupil Size 2

PLR’S
Stimulate left eye
Stimulate right eye
(CN II & III)

2 2

2 2

0 Strabismus 0

0 Nystagmus 0

2
Facial Sensation
(CN V)
2

2
Mastication
(CN V)
2

2
Swallowing/Gag
(CN IX & X)
2

2
Tongue
(CN XII)
2

H. SENSATION:
(0=absent, +1=decreased, +2=normal, +3=increased/exaggerated, NE=not examined)

Location
left paw, dorsal surface

Hyperesthesia
not present

Superficial pain
+1

Deep pain
+1

Assessment of Neurological Findings

ANATOMIC DIAGNOSIS:
(Choose those that apply to the findings in this case):

Generalized LMN

Peripheral nerve

Spinal Cord C1-C5

Spinal Cord C6-T2

Spinal Cord T3-L3

Spinal Cord L4-S3

Cauda equina

Peripheral vestibular

Central vestibular

Brainstem

Cerebral cortex

Cerebellum

Cranial neuropathy

Myopathy

Musculoskeletal
Expert's Anatomic Diagnosis

LESION LOCATION: Where is the lesion located?
	Right
	Left
	Bilateral
	Expert's Lesion Location
REVIEW RADIOGRAPHS:
	Lumbosacral:
	Thoracolumbar:
	Cervical:
	Skull:
	Appendicular
WHICH SET ILLUSTRATES THIS CASE?

LEFT	REFLEX, SPINAL SEGMENT	RIGHT
2	Quadriceps (L4-L6)	2
2	Flexion, PL (L5-S1)	2
1	Flexion, TL (C6-T1)	2
2	Triceps (C7-T1)	2
0	Crossed Extensor	0
2	Perineal (S1-S2)	2

LEFT	(Response/Test)	RIGHT
2	Menace (CN II & VII)	2
2	Palpebral (CN V & VII)	2
2	Pupil Size	2
	PLR’S Stimulate left eye Stimulate right eye (CN II & III)
2		2
2		2

0	Strabismus	0
0	Nystagmus	0
2	Facial Sensation (CN V)	2
2	Mastication (CN V)	2
2	Swallowing/Gag (CN IX & X)	2
2	Tongue (CN XII)	2

Lumbosacral, Set A	Lumbosacral, Set B	Thoracolumbar, Set C
Thoracolumbar, Set D	Cervical, Set E	Cervical, Set F
Skull, Set G	Skull, Set H	Appendicular, Set I
Appendicular, Set J	Expert's Explanation

LEFT	REACTIONS	RIGHT
	Proprioceptive Positioning PL TL
2		2
0		2
NE	Wheelbarrowing	NE
	Hopping PL TL
2		2
1		2
2	Extensor Postural Thrust	2
NE	Hemistand-Hemiwalk	NE
NE	Tonic Neck	NE
	Placing, tactile PL TL
2		2
1		2
	Placing, visual PL TL
2		2
1		2

Location	left paw, dorsal surface
Hyperesthesia	not present
Superficial pain	+1
Deep pain	+1

Generalized LMN		Peripheral nerve
Spinal Cord C1-C5		Spinal Cord C6-T2
Spinal Cord T3-L3		Spinal Cord L4-S3
Cauda equina		Peripheral vestibular
Central vestibular		Brainstem
Cerebral cortex		Cerebellum
Cranial neuropathy		Myopathy
Musculoskeletal	Expert's Anatomic Diagnosis

Data Base Collection

Assessment of Neurological Findings

ANATOMIC DIAGNOSIS: (Choose those that apply to the findings in this case):

ANATOMIC DIAGNOSIS:
(Choose those that apply to the findings in this case):