CCAT Neurological Condition Rehabilitation 5 — Questions and Answers
Question 1: Which reflex is used to evaluate the integrity of the L4-L6 spinal cord segments in the dog?
- Perineal reflex
- Patellar (quadriceps) reflex (Correct answer)
- Gastrocnemius reflex
- Flexor-withdrawal reflex of the forelimb
Correct answer: Patellar (quadriceps) reflex
The patellar reflex tests the femoral nerve and L4-L6 spinal cord segments, making it a key indicator of lumbosacral upper vs. lower motor neuron lesion localization.
Question 2: A dog with a C1-C5 lesion is expected to show which combination of neurological signs?
- UMN tetraparesis or tetraplegia with possible neck pain (Correct answer)
- LMN signs in forelimbs only with normal hindlimbs
- UMN hindlimbs and LMN forelimbs
- Isolated Horner's syndrome with no motor deficits
Correct answer: UMN tetraparesis or tetraplegia with possible neck pain
A C1-C5 lesion produces UMN signs in all four limbs with possible cervical pain, since the lesion is cranial to the brachial intumescence.
Question 3: Low-level laser therapy (LLLT) applied to the spinal cord injury site is theorized to promote neurological recovery primarily through which mechanism?
- Increasing local tissue temperature to accelerate metabolism
- Photobiomodulation enhancing mitochondrial function and reducing inflammation (Correct answer)
- Creating electrical current to stimulate action potentials
- Ablating scar tissue to restore axonal pathways
Correct answer: Photobiomodulation enhancing mitochondrial function and reducing inflammation
LLLT promotes photobiomodulation, which enhances cellular ATP production, reduces oxidative stress, and modulates the inflammatory response to support tissue healing.
Question 4: Which bladder management strategy is MOST appropriate in the immediate post-operative period for a dog with urinary retention following thoracolumbar disc surgery?
- Allow the bladder to fill to capacity to restore normal voiding reflex
- Express the bladder manually or via intermittent catheterization every 6-8 hours (Correct answer)
- Place a permanent indwelling Foley catheter for 4 weeks
- Administer furosemide to increase urine output and flush the bladder
Correct answer: Express the bladder manually or via intermittent catheterization every 6-8 hours
Manual bladder expression or intermittent catheterization prevents overdistension injury while maintaining bladder health until voluntary voiding returns.
Question 5: Which patient characteristic most significantly influences the prognosis for recovery of ambulation following complete loss of deep pain perception after spinal cord injury?
- The breed of the dog
- The duration of loss of deep pain perception prior to decompressive surgery (Correct answer)
- The patient's body weight and obesity status
- Whether spinal cord injury occurred due to trauma vs. disc disease
Correct answer: The duration of loss of deep pain perception prior to decompressive surgery
Duration of loss of DPP is the single most important prognostic indicator; patients decompressed within 24-48 hours of DPP loss have significantly better outcomes.
Question 6: Transcutaneous neuromuscular electrical stimulation (TENS) differs from NMES in that TENS primarily targets which tissue?
- Motor nerve fibers to produce visible muscle contraction
- Sensory nerve fibers to modulate pain perception (Correct answer)
- Deep fascial layers to reduce myofascial restrictions
- Spinal cord dorsal columns to improve proprioception
Correct answer: Sensory nerve fibers to modulate pain perception
TENS uses low-intensity electrical current to activate sensory (A-delta and C) nerve fibers and modulate pain via gate control and endogenous opioid mechanisms.
Question 7: A dog undergoing rehabilitation for cervical spondylomyelopathy (Wobbler syndrome) should AVOID which exercise due to risk of exacerbating dynamic spinal cord compression?
- Slow leash walks on flat surfaces
- Nose-to-floor scent trail exercises requiring sustained neck flexion (Correct answer)
- Gentle passive cervical range of motion within pain-free limits
- Balance exercises on a wobble board
Correct answer: Nose-to-floor scent trail exercises requiring sustained neck flexion
Sustained neck flexion in Wobbler patients increases dynamic cord compression at the affected cervical sites and should be avoided during rehabilitation.
CCAT Neurological Condition Rehabilitation 5
Which reflex is used to evaluate the integrity of the L4-L6 spinal cord segments in the dog?