Sensory

Question 0

Fibers that carry proprioception, vibration, light touch?

Answer 0

A-alpha and A-beta (heavily myelinated)

Second order: nuclei gracilis and cuneatus

Third order: medial lemniscus

Question 1

Fibers that carry pain and temperature sensation?

Answer 1

First order: A-Delta (Myelinated) and C fibers (unmyelinated)

Second order: spinothalamic tract (ALS)

Question 2

Spinothalamic tract and trigeminal tract terminate where?

Answer 2

Ventroposteriolateral and ventroposteriomedial thalamus

Question 3

Paresthesias versus dysesthesias?

Answer 3

Tingling/pricking/pins and needles

versus

unpleasant sensations triggered by painless stimuli

Question 4

Patient presents with loss of light touch, temperature, proprioception and distal muscle weakness – site of lesion? Other abnormalities?

Answer 4

Peripheral nerve lesions

atrophy, areflexia

Question 5

Patient presents with loss of all sensory modalities in dermatomal distribution – site of lesion? Other abnormalities?

Answer 5

Root (radiculopathies)

Weakness in a myotomal distribution, atrophy, segmental hyporeflexia

Question 6

Patient presents with sensory loss in the distribution two or more peripheral nerves – site of lesion? Other abnormalities?

Answer 6

Plexopathy

Muscle weakness that cannot be localized to a single nerve or root

Question 7

Sensory Symptoms from spinal cord injuries?

Answer 7

#Bilateral loss of all sensory modality
#Contralateral hypesthesia and ipsilateral loss of proprioception (Brown-Sequard syndrome)
#Proprioceptive loss and corticospinal tract involvement
#Saddle anesthesia

Question 8

She presents with areflexia than hyperreflexia below lesion – location?

Answer 8

Spinal cord lesion

Question 9

Patient presents with ipsilateral facial numbness and contralateral body numbness – site of lesion? Other abnormalities?

Answer 9

Brainstem lesion

#Hemiplegia
#INO
#ataxia
#cranial nerve findings

Question 10

Example of stroke that causes brain stimulation?

Answer 10

Posterior circulation stroke

Question 11

Patient with hemibody anesthesia with motor symptoms – location of lesion? Ddx?

Answer 11

Thalamus

Lacunar stroke, hemorrhage

Question 12

Patient with hemibody anesthesia and hemiplegia – location of lesion? Ddx?

Answer 12

Posterior limb of internal capsule

Lacunar stroke/hemorrhage