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Thomadaki lesions
NYCC Neuro I exam 1: lesions from spinal cord to midbrain W01
| Question | Answer |
|---|---|
| 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:
hecutler
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