lesions

Question 1

Dorsal horns have CB of ______ neurons

Answer 1

sensory

Question 2

Ventral (anterior) horns have CB of ________ neurons

Answer 2

motor

Question 3

Spinothalamic tract (ALS) Info: Cross:

Answer 3

Pain, temperature, crude touch Crosses: After it ascends or descends via Lasseurs tract, on the dorsal horn

Question 4

DCML Info: Cross:

Answer 4

Propioception, tactile information, vibration Enters dorsal root -> ipsilateral dorsal column (fasciulus cuneatus or gracilis) - > projects up Crosses: caudal medulla (nucleus cuneatus or gracilis) via internal arcuate fibers -> medial lemniscus tract

Question 5

damage to hypoglossal nerve

Answer 5

tongue deviates to lesion

Question 6

damage to vagus nerve

Answer 6

uvula will deviate to contralateral side

Question 7

damage to vestibular cochealr of vestibular nuclei

Answer 7

N/V, nystagmus

Question 8

hemiparesis

Answer 8

weakness on one side of the body

Question 9

Webers syndrome

Answer 9

Damage to the midbrain: CB, corticospinal and CN 3 1. Corticospinal: contralateral UMN; hemiparesis 2. CB: uvula will go to ipsilateral side, tongue will go away from the lesion (because above where it branches), exaggerated gag reflex

Question 10

Oculomotor palsy (CN3)

Answer 10

dialated pupil Eye is down and out eye

Question 11

What are the rule of 4s?

Answer 11

1. 4 CN: A. Above the midbrain (1, 2, 3, 4) B. Pons (5, 6, 7, 8) C. Medulla (9, 10, 11, 12) 2. 4 CN that divide into 12 have motor nuclei in the midline: (CN 3, 4, 6, 12) 3. the 4 that do not divide by 12 are all located laterally: 5, 7, 9, 11. 4. 4 midline columns that all start with M: A. Medial lemniscus B. Motor nucleus of 3, 4, 6, 12 C. MLF D. Motor pathway (corticospinal tract) 4. 4 lateral (side) columns that start with S A. Spinothalamic B. Sympathetic C. Spinal trigeminal (sensory to face) D. Spinocerebellar

Question 12

This will allow you to tell:

Answer 12

1. Is the lesion medial or lateral: which tracts are affected? Then, we can ask: 2. Midbrain, pons or medulla: which CN is affected?

Question 13

medial medullary sundrome can be d/t

Answer 13

occlusion of anterior spinal a.

Question 14

Damage to CN 4 (trochlear):

Answer 14

Eye cannot look down when looking at nose

Question 15

Damage to CN5 (trigeminal)

Answer 15

ipsilateral facial sensory loss

Question 16

Damage to CN6 (abducens)

Answer 16

ipsilateral eye abduction weakness (eye cant abduct)

Question 17

Damage to CN7 (trigeminal)

Answer 17

?

Question 18

Damage to CN8 (ipsilateral )

Answer 18

ipsilateral deafness

Question 19

Damage to CN 9 (glossopharyngeal)

Answer 19

ipsilateral pharyngeal sensory loss

Question 20

Damage to CN 10 (vagus)

Answer 20

ipsilateral palate weakness

Question 21

Damage to CN 11 (spinal accessory)

Answer 21

ipsilateral shoulder weakness

Question 22

Damage to CN 12 (hypoglossal)

Answer 22

ipsilateral weakness of tongue

Question 23

Damage to motor tract (corticospinal) in BS

Answer 23

contrlateral hemiparesis (weakness); UMN signs

Question 24

Damage to medial leminscus in BS

Answer 24

contralteral loss of propioception and vibration

Question 25

Damage to nucleus and nerve

Answer 25

ipsilateral motor loss of 3, 4, 6 ,and 12

Question 26

Damage to spinocerebellar path in BS

Answer 26

ipsilateral ataxia

Question 27

Damage to spinothalamic tract in BS

Answer 27

Contrlateral pain/temp/ crude touch loss in body

Question 28

Damage to sensory nucleus of V (face)

Answer 28

ipsilateral pain/temp loss in face

Question 29

Damage to sympathetic pathway

Answer 29

ipsilateral Homers syndrome

Question 30

If we see : "lost of sensory (pain and temp to the left face", what do we conclude

Answer 30

ipsilalateral sensory (trigeminal) V tract dysfunction -\> Left sided lesion DO NOT USE CN 5 TO LOCALIZE TO PONS, BC CN 5 TRAVELS THROUGHOUT ALL BS

Question 31

only use ______ to pick deficit is CN \_\_

Answer 31

8

Question 32

If cranial nerve is involved, the lesion must be located where?

Answer 32

BRAINSTEM!

Question 33

What causes medial medullary syndrome?

Answer 33

Anterior spinal A.

Question 34

In the midbrain, what a is most responsible for damage?

Answer 34

Posterior cerebral A.

Question 35

In the pons, what as are responsible for damage?

Answer 35

Medial: paramedial branches of basilar (CN6) Lateral: long circumferential branches of basilar a (CN 5, 7, 8)

Question 36

In the medulla, what as are responsible for damage?

Answer 36

Medial: Anterior spinal A (damages CN 12) Lateral: PICA (damages CN 9, 10, 188)

Question 37

Sx: R sided weakness L eye is down and out. Use rules to figure out whats wrong?

Answer 37

1. R sided weakness-\> corticospinal tract -\> medial lesion 2. L eye is down and out -\> oculomotor palsy -\> located in the midbrain Left medial midbrain lesion (webers) d/t PCA.

Question 38

Left eyelid droop (ptosis) and small pupil (miosis) -\>

Answer 38

L Horners syndrome

Question 39

Loss of pain and temp to left face -\>

Answer 39

damage to CN 5

Question 40

Loss of gag reflex in left throat

Answer 40

CN 9 (glossopharnygeal)

Question 41

Palate raised to the right side

Answer 41

CN 10

Question 42

hoarse voice

Answer 42

damage to CN 10

Question 43

corneal reflex

Answer 43

CN 5

Question 44

corneal reflex

Answer 44

CN 5

Question 45

facial spasms is d/t

Answer 45

CN 7

Question 46

How do rule of 4: 1. Look for involvement of midline CN: 3,4,6, 12-\> indicate a midline damage 2. All other CN involvement indicate a lateral involvement 3. Look for involvement of M tracks -\> medial side involvement 4. Look for involvement of S tracks -\> lateral side involvement

Answer 46

Question 47

Complete transection of posterior columns in the cervical region would produce what impairment(s)?

Answer 47

Damage the fascilulus cuneatus and fasciulus gracilis -\> complete loss of propioeption, vibratory, tactile info from cervical down

Question 48

Answer 48

ipsilateral no change decrease/loss of function decrease/ loss of function

Question 49

Answer 49

Contralateral no change no change loss of function

Question 50

Answer 50

1. **contralateral** 2. **no change** 3. **no change** 4. **loss of function**

Question 51

lesion to ## Footnote anterior horn

Answer 51

ipsilateral LMN paralysis

Question 52

damage to Lateral corticospinal tract

Answer 52

ipsilateral spastic paralysis

Question 53

Posterior ______ sulcus is present throughout the entire SC. Posterior _____ sulcus separates the cuneate fasiculus and the gracile fasiculus and disappears. \_\_\_\_\_\_\_\_ column is only present in the thoracic area

Answer 53

**Posterior lateral sulcus** is present throughout the entire SC. ## Footnote **Posteior intermediate** **Lateral column**