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Thomadaki lesions

NYCC Neuro I exam 1: lesions from spinal cord to midbrain W01

QuestionAnswer
Fasiculus Gracilis or Gracile Tubercle Ipsilateral loss of deep sensibility from lower body - T6 and down (proprio for lower body is spinocerebellar)
Fasiculus Cuneatus or Cuneate Tubercle Ipsilateral loss of deep sensibility and PROPRIOCEPTION from upper body - T6 and up
Pyramid Contralateral spastic paralysis
Lateral Corticospinal Tract Ipsilateral spastic paralysis
Pyramidal DECUSSATION BILATERAL spastic paralysis
Inferior olivary nucleus Ataxia
Inferior Cerebellar Peduncle Ipsilateral ataxia
Middle Cerebellar Peduncle Ataxia, Dysmetria
Superior Cerebellar Peduncle Ataxia, Dysdiadochokinesia
Dentate means Dysdiadochokinesia
CN I Olfactory loss of smell
CN II Optic loss of sight
CN III Oculomotor Diplopia (double vision), Mydriasis (pupils always dialated, it's always midday with mydriasis), ptosis (droopy LOWER eyelid), lateral strabismus and all eye muscles except LR6 & SO4)
CN IV Trochlear SCONTRALATERAL -crosses at superior medullary velum. SO4 means superior oblique function so inability to look down and in
CN V Trigeminal Mesencephalic nucleus, Motor nucleus to mastication, Chief Sensory nucleus, Nucleus of spinal tract: inability to chew, facial anesthesia, tic douloureaux (trigeminal neuralgia)
CN VI Abducent LR6 is lateral rectus so medial strabismus and ciliaris muscles?
CN VII Facial Bell's Palsy (LMN so ipsilateral 1/2 of face: all facial expression, cannot raise eybrows, deviation of smile to stronger side- Horner's syndrome) Facial uses Superior Salivatory Nucleus, Facial Nucleus, Solitary Nucleus.
CN VIII Vestibulocochlear vertigo, vomiting, nystagmus (vertical lines), loss of hearing
CN IX Glossopharyngeal nuclei Inferior Salivatory Nucleus: glands, Nucleus Ambiguus: parasym to muscles of larynx, pharynx and palate Solitary Nucleus: taste to posterior 1/3 of tongue
CN IX Glossopharyngeal Dysphonia, dysphagia (stylopharyngeus), loss of taste to posterior tongue
CN VIII Vestibulocochlear nuclie 4 vestibular nuclei, cochlear nuclei
CN X Vagus nuclei Nucleus Acumbens 9-11 for parasymp muscles to larynx, pharynx, and palate + vagal nucleus + Solitary Nucleus (7.9.10)
CN X Vagus loss of parasympathetics to thoracic and abdominal viscera, dysphonia, dysphagia, reduced gag reflex, uvula deviation to strong side, loss of taste to posterior 1/3 of tongue
CN XI Accessory Cranial branch: dysphonia, dysphagiaSpinal branch: ipsilateral paralysis to SCM and traps
CN XII Hypoglossal Ipsilateral tongue paralysis
Corticospinal fibers Contralateral spastic paralysis
Locus Coeruleus makes NE so keeps awake but off during REM:
Vagal Trigone loss of parasympathetics to thorax and abdomen, reduced gag reflex, dysphonia, dysphagia, uvula deviation, loss of taste to post tongue (solitary nucleus 7.9.10)
Hypoglossal Trigone Ipsilateral tongue paralysis
Vestibular area vertigo, vomiting, nystagmus
Facial colliculus (*remember: the facial nerve folds around the Abducens nucleus so both are affected) Bell's Palsy & Medial strabismus (LR6)
Superior Colliculus and Brachium Lateral strabismus (due to oculomotor), ptosis (droopy lower eyelid), mydriasis (dialated pupil)
Nucleus Dorsalis Clarke's column: C8-L2/3 preganglionic- loss of proprioception from lower body
Intermediolateral Cell Column preganglionic sympathetic neurons T1-L2, sympathetic to S2-S4
motor nuclei contains cell bodies of LMN to skeletal muscles so ipsilateral flaccid paralysis
Lesion of spinocerebellar tract ataxia (unsteady, wide gait)
Brown-Sequard Syndrome (hemisection) lesion of white matter on one side: loss of ipsilateral deep sense from lesion down (dorsal columns)/loss of contralateral pain & temp from 2 levels below lesion and down (lateral spinothalamic tract)
DISSOCIATED SENSORY LOSS is associated with ? and means ? Brown-Sequard Syndrome - Loss of 2 different sensations, one on either side. Ie, loss of deep sense/dorsal columns on one side then loss of P&T from 2 levels below lesion on contralateral side)
Brown-Sequard is 5 losses: 1-deep sense, 2-pain and temp (2below), 3-ipsilateral spastic paralysis, 4-proprioception from lower limb, 5-Ipsilateral loss of P&T at level and possibly 2 below (DLF)
Created by: Heather Cutler Heather Cutler on 2010-03-05



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