Clinical Case. A 45 year old woman complained of pain in her right breast and progressive weakness of her right lower limb for a period of two months, she contacted her Family physician, Her Family physician referred her to a neurologist.
This patient noticed ulcers on the fingers of both of his hands. They were associated with no pain and appeared to be the residua of burns. The probable site of damage responsible for this defect is the
a. Posterior column
b. Anterior horn
c. Clarke’s column
d. Spinothalamic tract
e. Spinocerebellar tract
dorsal T-7 which expanded symmetrically in all directions. It involved the anterior white commissure (spinothalamic fibers) and included portions of the posterior white columns, lateral white funiculus, and anterior gray horns.
pathwayDorsal Colum tracts
Left T-7 which expanded symmetrically in all directions. It involved the anterior white commissure (spinothalamic fibers) and included portions of the posterior white columns, lateral white funiculus, and anterior gray horns.
spinal cord injury
An 85-year-old man is being evaluated for gait difficulties. On examination it is found that joint proprioception is absent in his toes. People with
impaired position sense will usually fall if they stand with their feet together and do which of the following?
The ability to recognize an unseen familiar object placed in the hand depends on the integrity of which pathway
A patient displays a symmetrical loss of pain and temperature on the shoulder area on bothSides of the body with no loss of tactile sensation. Pain and temperature and tactile sensationAre normal over the rest of the body. This condition would be due mostly likely to lesion of :
A 54 year old male presents with complaints of loss of pain and temperature sensation in his arms and chest only. What is the lesion causing these symptoms
1. Which of the following in not characteristic of the Brown-Sequard syndrome.
Provides sensations of “crude” touch, pressure, pain, and temperature
Ascend within the anterior or lateral spinothalamic tracts:
Left Brown-Sequard syndrome.
spinal cord injury
1. Complete loss of conscious proprioception in the right lower limb.
2. Babinski sign on the right.
3. Inability to detect pain and temperature sensation on the medial side of the antecubital fossa (medialepicondyle) on both upper limbs.
4. Inability to detect pain and temperature at the apex of the left axilla, in all the intercostal spaces on the left, and in the left lower limb.
5. The patient could feel a gentle squeezing of both thumbs, right and left middle fingers, and the left little finger.
6. No sensation to squeezing could be detected in the right little finger.
Loss of motor function and pain-temperature sensation below the level of the lesion
Typically seen following hyperflexion injuries with impingement of bone or herniated disc tissue directly on the anterior spinal cord
Due to mechanical compression of the anterior spinal artery and secondary infarction of the anterior spinal cord
Rarely due to aortic dissection interrupting the blood supply to the anterior spinal arteries
posterior column function is not affected (position sense and vibration sense)Anterior cord syndrome
proprioceptive sensory loss. the level of the lesion
Usually due to posterior spinal artery occlusion, chronic atherosclerosis and impaired collateral circulation, tumors or discs compressing the posterior spinal cord, or vitamin B12 deficiency.
Pain and temperature sensory function + motor function not affected.Posterior cord syndrome
Ipsilateral loss of motor function and proprioceptive sensory function + contralateral loss of pain-temperature sensation.
Most commonly due to traumatic hemisection of the spinal cord (eg. stabbing knife thrust)Brown-Sequard syndrome
In this patient, where would you expect the pain and temperature abnormalities to begin?