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Spinal reflex exam - Coggle Diagram

- - - - C1-C5
    - - C6-T2
      - LMN cell bodies located in the grey matter for the thoracic limbs
        
        lesions at/at the level of these intumescences result in LMN signs of the thoracic limbs
    - - T3-L3
    - - L4-S3
      - LMN cell bodies located in the grey matter for the pelvic limbs
        
        lesions at/at the level of these intumescences result in LMN signs of the pelvic limbs
  - - - best to do passive range of motion prior
- - - - peripheral nerve
      - neuromuscular junction
      - muscles
  - - - Posture
        
        often normal (unless patient paralysed)
        
        Abnormal limb position
        
        knuckling
        
        abducted
        
        adducted
        
        crossed over
      - Gait
        
        stiff and ataxic strides
        
        delayed protraction
      - motor function
        
        spastic paresis/paralysis
      - segmental reflexes are normal to increased
        
        due to release of the inhibitory modulatory effect of the UMN system on the LMNS
      - resting muscle tone is normal to increased
      - slight resistance to passive limb flexion and extension
      - late and mild disuse muscle atrophy
      - NOTE: Animals with severe parachute transverse thoracolumbar spinal cord lesions usually show severe pelvic limb hypotonia and depressed spinal reflexes for a few days following onset
    - - posture
        
        difficulty supporting bodyweight
        
        crouched stance as result of over flexion of joints
      - gait
        
        short strides
        
        tendency to collapse
      - motor function
        
        flaccid paresis/paralysis
      - decreased to absent segmental reflexes
      - decreased to absent resting muscle tone
      - decreased resistance to passive limb flexion and extension
      - early and severe neurogenic muscle atrophy
    - - brain
      - C1-C5
    - - C6-T2
    - - T3-L3
    - - L4-S3
    - - polyradiculopathy
      - polyneuropathy
- - - - spinal cord segments C6-T2 and the associated nerve roots.
      - brachial plexus
      - peripheral nerves
        
        axillary
        
        musculocutaenous
        
        median
        
        ulnar
    - - pinch nail bed or digit with fingers or haemostat
    - - median, ulnar and radial nerves
    - - C6-T2 spinal cord segments
      - nerve roots of the axillary, musculocutaenous, median and ulnar nerves
    - - crossed-extensor reflex
      - UMN lesion cranial to the C6 spinal cord segment
- - - - sensory neuron
        
        spinal cord segment L4-L6
        
        efferent motor neuron
        
        muscle effector
    - - if reflex weak/absent suggests a lesion here
        
        but can be seen with previous stifle disease or age-related change
        
        May not be concerned if no reflex, as if normal gait then femoral nerve should be working okay.
      - a lesion cranial to L4 can cause a normal or exaggerated reflex (means little in absence of other neurological deficits) - can be observed in an excited or nervous animal
        
        patellar reflex can appear hyperreflexic with a sciatic nerve or L6-S2 spinal cord segment lesion
    - - Must be relaxed for reflex, some cats prefer this position
      - or in lateral recumbency