Bilateral atonia, areflexia and flaccid paralysis involving th C7-T1 motor dermatomes indicates involvement of?
Anterior horn neurons
Unilateral lesion of the corticobulbar fibers to the facial nucleus results in?
Paralysis of the contralateral LOWER quadrant of the face (supranuclear facial palsy)
Supranuclear facial palsy indicates involvement of?
Lesions of the ventral roots causes a ______ paralysis of the associated motor dermatome.
Leads to what finding?
- Lesions of the ventral roots causes a LMN paralysis of the associated motor dermatome.
- Atonia, areflexia, fasciculation, and flaccid paralysis (everything turned down!)
Proprioceptive and 2-point tactile discrimination loss below the L3 dermatome indicates involvement of which part of dorsal column?
Fasciculus graciLis = Lower body, Legs
Which nucleus is responsible for motor innervation of pharynx, larynx, upper esophagus (i.e., swallowing, palate elevation)?
Which CN’s involved?
Nucleus aMbiguus – Motor – CN IX, X, XI
Lesion of the spinal lemniscus results in?
Contralateral loss of pain/temp (body)
Lesions of the genu of the internal capsule affect fibers of the _________ tract
Corticobulbar tract –> Supranuclear facial palsy
Bilateral atonia, areflexia and flaccid paralysis involving the C7-T1 motor dermatomes indicates involvement of which neurons in the spinal cord?
Anterior horn neurons
Lesion to the spinal lemniscus would result in?
Contralateral hemianalgesia and thermal hemianesthesia (loss of temperature and pain)
Lesion to the medial lemniscus would result in?
Contralateral loss of proprioceptive, vibratory, and 2-point tactile discrimination
Lesion to the trigeminal lemniscus would result in what deficit
Contralateral loss of pain, temperature, and crude tactile sensation from face
Alternating hemianalgesia is due to a lesion of?
Descending tract of V and Spinal lemniscus
What’s the arrow pointing to?
Thrombosis of the PICA results in?
Lateral Medullary (Wallenberg) Syndrome
What is seen clinically in Lateral Medullary (Wallenberg) Syndrome?
- Destruction of spinal lemniscus –> contralateral hemianalgesia
- Destruction of descending tract of V = ipsilateral loss of pain + temp from face
- ALTERNATING HEMIANALGESIA
Cerebellopontine Angle (CPA) syndrome is due to what?
What symptoms seen?
- Acoustic neuroma (Schwannoma) enlarges and compresses lateral aspect of pons, cerebellum and medulla
- Deafness and vestibular disturbances
- Alternating hemianalgesia
Which syndrome is characterized by ipsilateral oculomotor palsy, and contralateral motor dysfunction such as tremor, ataxia, or choreiform movements also contralateral loss of proprioception and 2-point tactile discrimination of the body and limbs?
Lesion is where in brainstem?
Benedikt’s syndrom = lesions of midbrain tegmentum
When answering a lesion question what will indicate the level and side of the lesion?
Highest CN involved
*Use the rule of 4’s!
Parinaud’s Syndrome is due to what lesion?
How does it present?
Often caused by?
- Lesion of superior colliculus
- Paralysis of upward gaze
- May be due to pineal tumor or varix of the great vein of Galen
Which syndrome is characterized by a state of constant spontaneous pain w/o appropriate external stimulus, extreme mood swings, and may also involve contralateral hemihypalgesia (“crawling ant” sensations)?
Thalamic syndrome (Dejerine-Roussy Syndrome)