lab final

A 68-year-old man suffered a stroke caused by an occlusion of the medial striate artery of Heubner that supplies the head of caudate nucleus, putamen and the anterior limb of the internal capsule. This artery is a branch of which major artery?

ACA

A 68-year-old man suffered a stroke caused by an occlusion that supplies the gyrus shown with the arrow. Which of the following artery is most likely to be affected?

ACA - arrow pointing to the cingulate gyrus (limbic system regulator) emotion formation and processing, learning, and memory

A 45 year old woman with a history of hypertension experienced a brief "blackout". She had complained of severe headaches, nausea, dizziness and a roaring sound in the left ear during the previous day. She also had difficulty walking and called a cab to take her to the hospital. Which blood vessel was occluded?

AICA

A 45-year-old woman presents with difficulty walking. Her neurological examination indicates the presence of a lateral caudal pontine syndrome. An occlusion which blood vessels is most likely to account for this presentation?

AICA

A 47 year-old woman presents to the emergency department following a sudden illness. Her face is expressionless on the left side. When asked, the patient smiles on the right side of her face, but the left side does not move. When asked to frown, the patient can only corrugate her forehead on the right side. Taste has been lost on the anterior portion of the left side of her tongue. She is deaf on the left side, but her hearing is intact on the right side. The patient exhibits nystagmus, nausea, vomiting and vertigo. Further testing reveals anesthesia for pain and temperature on the left side of her face and the right side of her body. The patient walks with a wide-based poorly coordinated gait, and has difficulty in standing on her left leg. She has a tendency to fall to the left, especially when she turns to the left. The patient's left eyelid tends to droop, but does not obscure the cornea. Anisocoria is present. The left pupil is miotic. The patient sweats only on the right side of her face.

AICA

A 54 year old man presents with weakness that was progressive over 2 years. Following the initial examination , the patient is unable to move his legs. Several months later, his arms began to show weakness as well. Recently, he couldn't move his limbs at all. Fine touch and pain sensation seemed to be relatively intact. Examination reveals the fig below. The patient is suffering from which condition?

ALS

Imaging results of a 34 year old man reveals an isolated stroke due to an occlusion of the Medial striate artery. Which of the following structures will be affected?

Anterior limb of internal capsule

A 68-year-old man suffered a stroke caused by an occlusion of the superficial branches of the right anterior cerebral artery (ACA). Which of the following is most likely to be associated with the patient's condition? A Loss of discrimination touch from the right side of the face B. Spastic weakness of the left lower limb C. Inability to look to the left with both eyes D. Loss of pain and temperature sensation in the left upper limb E. Lower facial weakness on the left

B. Spastic weakness of the left lower limb

A 16 year-old male has been shot with a small caliber bullet in the occiput. A CT scan shows that the bullet has damaged the left pyramid of the medulla. Which of the following would be the most prominent neurological deficit in this person?

Babinski (extensor) reflex on the right side of his body and Hyperreflexia on the right side of his body

The anterior inferior cerebellar artery is a direct branch of:

Basilar

A 24 year-old man was shot in the back during a bar fight. He was immediately taken to the emergency department where he was given neurologic examination. Examination reveals that the patient could not detect tactile stimulation of the left, while sensation in the right arm was intact. A pinprick sensation was applied to all four limbs, and the patient did not feel sensation in the right leg, whereas the sensation was present in his left leg, and both arms. A subsequent follow-up examination indicates that the patient could not move his left leg.

Right Hemisection (Brown-Sequard syndrome)

A 63-year-old golfer suddenly dropped his golf stick from his left hand, and as he left the spot he dragged his left foot. He was taken to the hospital where examination reveals left hemiplegia with severe weakness in the arm than the leg. Occlusion of which artery is responsible for the patients condition?

Right MCA

A 67 year-old woman presents with tremor and ataxia on the left side of the body excluding the head. Her right eye is closed (complete ptosis). When the examining physician lifts her eyelid, he notices that her eye is depressed and abducted. The patient exhibits anisocoria. The pupil of her right eye is mydriatic (dilated). No sensory losses are observed.

Benedikts

A 79- year-old man suffers a stroke resulting in weakness of his left limbs, reduced reflexes in those limbs, inability to gaze to the left and loss of facial expression on the left side, and failure to verbally acknowledge that anything was wrong with the left arm or leg. Which blood vessel is most likely occluded in this patient?

Right MCA (proximal)

A 75 year-old woman is brought to the emergency department by her daughter. The patient's right eyelid exhibits complete ptosis. When the eyelid is raised manually, the eyeball is abducted and slightly depressed. The pupil of her right eye is mydriatic. The patient exhibits hemiparesis with hypertonia and hyperreflexia on the left side of her body involving the arm, trunk and lower limb but sparing the face. A Babinski reflex is noted on left

Right Webers

Following a gunshot wound, a 56-year-old man is unable to stand or walk because he is unable to move or bear weight on his right leg. Examination reveals that light touch, position and vibration sense are intact in the left lower extremity but absent in the right below the crest of the ilium. Active range of motion and strength are normal in the left lower extremity but absent in the right (hip, knee, and ankle). Pain and temperature sensation are intact in the right lower extremity but absent in the left below T12. Where is the lesion?

Right brown-sequard at L1

A 10 year-old boy has ataxia of his right arm and leg, and hoarseness. His right pupil is smaller than the left (anisocoria). His right eyelid droops but does not cover the cornea. He has lost the ability to sweat on the right side of his body. His palate deviates to the right. Where is the likely site of the

dorsolateral medulla (lateral medullary syndrome of wallenberg) *central horners syndrome *weak cocaine administration--> dilation of pupil

One week prior to admission, a 65-year-old hypertensive man complained of weakness on the left side, with the leg affected more than the arm and trunk. The patient is now experiencing difficulty walking with the left leg, and urinary incontinence. Examination reveals left-sided hypertonia, hyperreflexia, and a Babinski (extensor plantar) reflex. The upper limb is not affected. Occlusion of which blood vessel accounts for this patient's symptoms?

Right ACA

A bilateral loss of pain and temperature sensation of the body is due to a lesion of

the second order fibers ( in the commissures) crossing the midline prior to ascending.

A 47 year old man presents with clumsiness in his hands, while working in the yard. He recently burned his hand on a hot iron without feeling any pain. Examination reveals bilateral weakness of his shoulder girdle, arm and hands, including loss of pain and temperature sensation in areas covering the shoulder and upper extremity. Severe atrophy is present in the intrinsic muscles of the hands.

Syringomyelia

A 48-year-old woman presents with a loss of vibratory sense in the lower limb on the right, weakness and hypereactive reflexes in the lower limb on the right, and a loss of pain and temperature that begins below the T8 dermatone on the left. Where is the lesion?

T6

Secondary to untreated syphilis Presentation: Decreased reflexes, unsteady gait, episodes of intense pain and disturbed sensation, personality changes, dementia, deafness, visual impairment, impaired response to light Hyptonia due to destruction of the sensory limb of the spindle reflex "Westphal's sign" - loss of patellar reflex Argyll Roberston pupil

Tabes Dorsalis

A 56 year old man presents with sharp pains (Pain), altered vibratory and pressure or tingling sensations in both legs (Paresthesis), and an increased tendency to urinate (Polyuria). Examination reveals a constrict of pupils in response to a near stimulus but not in response to light. What is his clinical condition, and where is the lesion?

Tabes dorsalis

substituting fetter for better

conductive aphasia, arcuate fasiculus lesion

A 56-year-old woman presents with a sudden illness. Her MRI reveals lacunar infarcts, caused by occlusion of the deep perforating arteries. What are the likeable clinical conditions? Would any of the following; Aphasia, Praxia, Visual field deficit constitute a clinical condition? If yes, why? If no why not?

*Classic lacunar syndromes include pure motor hemiparesis, ataxic hemiparesis, clumsy hand-dysarthria characterized by lesions either in the internal capsule or basis pontis and pure sensory loss caused by a lesion in thalamus. *lacunar strokes are NOT associated with cortical findings such as aphasia, apraxia, neglect or visual field abnormalities.

Unilateral blockage of the posterior cerebral artery, and the resulting brainstem damage, often produces a loss of fine touch and pain sensation on the which side?

Contralateral

cortical lesions generally result in what types of deficits

Cortical lesions generally result in in deficits that starts with letter A, including apraxia, can't perform actions in sequence agnosia, can't recognize things aphasia, can't understand/express speech alexia, can't read agraphia, can't write acalculia, can't perform simple math abulia, no willpower anopsia, visual field defect

lesion of right dorsal column at L1

Damage to the right dorsal column at L1 causes the absence of light touch, vibration, and position sensation in the right leg. Only fasciculus gracilis exists below T6.

right brown sequared at L1

Damage to the right dorsal columns at L1 causes the absence of light touch, vibration, and position sense in the right leg. Damage to the lateral corticospinal tract causes upper motor neuron signs in the right leg (Monoplegia), and damage to the lateral spinothalamic tract causes the absence of pain and temperature sensation in the left leg.

LESION OF right fasiculus cuneatus at C3

Damage to the right fasciculus cuneatus at C3 causes the absence of light touch, vibration, and position sensation in the right arm and upper trunk.

In a medial medullary syndrome that involves a left-sided branch of the anterior spinal artery, which of the following deficits is seen?

Deviation of tongue to the left and hemiplegia on the right

Blockage of the paramedian branches of the basilar artery usually affects the abducens nerve. If the lesion grows laterally, what other cranial nerve is likely to be affected as well.

Facial

Cerebellar: Nystagmus, truncal ataxia, dysarthria, dysmetria LMN: Absent reflexes Pyramidal: Up going toes, Distal weakness Dorsal column: Loss of vibratory sensation and proprioception Cardiac: Cardiomegaly and conduction defects Musculoskeletal: scoliosis and pes cavus

Friedreichs Ataxia

A 57 year-old man is being examined by a neurologist. The patient exhibits a spastic hemiplegia on the right side of his body. The right patellar tendon reflex is augmented when compared to the left. Stroking the bottom of the foot elicits a Babinski (extensor) reflex on the right side, but not on the left. A sensory hemianesthesia for fine touch, proprioception, and vibratory sense affecting the right side of the body is noted. When the patient attempts to look to the left, diplopia is noted. Further examination reveals loss of abduction of the left eye. All other ocular movements are normal.

LEFT MEDIAL CAUDAL PONTINE SYNDROME (ALTERNATING ABDUCENT HEMIPLEGIA) Vessel: paramedian branches of the basilar artery

A 58 year-old man presents to the emergency department following a sudden illness. The patient is unable to smile on the left side of his face. He cannot frown on the left side of his forehead. When he attempts to look to the left, he experiences diplopia. Testing reveals that the left lateral rectus muscle is paralyzed. The patient exhibits a spastic hemiplegia on the right side of his body. When the left cornea is stroked with a piece of cotton wool, the right orbicularis oculi contracts, but the left does not. Similar results are obtained when the left cornea is stroked with cotton wool.

LEFT MILLARD-GUBLER SYNDROME (VENTRAL CAUDAL PONTINE SYNDROME). Paramedian and short circumferential branches of the basilar artery

A 46 year-old man is diagnosed with a motor neuron disease that affects the ventral horn at L1 to L4. Where is the deficits likely to be present?

LMN symptoms- leg

A 68-year-old woman with a 12 year history of high blood pressure and diabetes is brought to the emergency department following a sudden illness. The patient presents with pure motor hemiparesis, ataxic hemiparesis, clumsy hand and dysarthria. Her MRI is shown in the figure. Describe the patient's condition?

Lacunar stroke

A 34 year-old-woman presents with difficulties in swallowing, hoarseness, dizziness, nausea and vomiting, rapid involuntary movements of the eyes (nystagmus), and problems with balance and gait coordination. What causes this condition? What is this condition?

Lateral Medullary Syndrome of Wallenberg

Ipsilateral flaccid paralysis of the muscles of mastication (loss of trigeminal motor fibers) Ipsilateral facial hypoesthesia, analgesia, and thermanesthesia (loss of trigeminal sensory fibers) Ipsilateral hemiataxia and asynergia (loss of corticopontine and pontocerebellar fibers) Contralateral spastic paralysis (due to interruption of the corticospinal fibers in the basis pontis)

Lateral midpontine syndrome

A 45 year old woman with a history of hypertension experienced a brief "blackout". She had complained of severe headaches, nausea, dizziness and a roaring sound in the left ear during the previous day. She also had difficulty walking and called a cab to take her to the hospital. What is this syndrome?

Lateral pontine syndrome

A 68-year-old woman presents with a sudden onset of aphasia and right hemiparesis in which the arm and face are more severely affected than the leg. Where is the lesion?

Left MCA

A 79- year-old woman with a history of controlled hypertension was reaching for a jar of flour to make an apple pie, when her right side suddenly became weak, and she collapsed. While trying to get up from the floor, she noticed that she was unable to move her right arm, with a severe weakness in the arm much more than the leg. She cried for help because she was unable to reach the telephone with the right hand. Upon examination the patient's speech is fluent. She is aware of pinprick sensation on her left hand, but cannot localize the sensation on the right. She presents loss of fine touch, proprioception, and vibratory sense involving the right arm and trunk with sparing of the right leg. Examination reveals an occlusion of a cortical blood vessel. Which blood vessel was occluded in this patient?

Left MCA

A 54-year-old woman is diagnosed with pure Alexia. What caused this problem, which artery was occluded ?

Left PCA

A 62-year-old female teacher with a long history of hypertension was astonished to find that she could not read the book on her desk. She tried to read small printed items then large printed items but could not comprehend them. At her neurologic exam she was intelligent, alert, and well oriented. She demonstrated a right homonymous hemianopsia. She understood information presented orally or auditorily but could not name letters of the alphabet shown to her visually though she could identify and name them by touch. Her response to letters presented visually was to describe their shape but she could not name them. When asked to write her insurance information she did so accurately but couldn't read back what she wrote. Occlusion of which blood vessel explain the patient's condition?

Left PCA

A 62-year-old female teacher with a long history of hypertension was astonished to find that she could not read the book on her desk. She tried to read small printed items then large printed items but could not comprehend them. At her neurologic exam she was intelligent, alert, and well oriented. She demonstrated a right homonymous hemianopsia. She understood information presented orally or auditorily but could not name letters of the alphabet shown to her visually though she could identify and name them by touch. Her response to letters presented visually was to describe their shape but she could not name them. When asked to write her insurance information she did so accurately but couldn't read back what she wrote. Occlusion of which of the following would explain the patient's condition?

Left PCA

A 62-year-old female teacher with a long history of hypertension was astonished to find that she could not read the book on her desk. She tried to read small printed items then large printed items but could not comprehend them. Her neurological examination demonstrated the presence of a homonymous hemianopsia. An occlusion of which of the following blood vessels is most likely to account for this presentation?

Left PCA

A 79 year-old man presents to the emergency department following a sudden illness. The patient's left eyelid is completely closed. When the examining physician elevates the eyelid manually, the eyeball is seen to be abducted and slightly depressed. The pupil is mydriatic. An ataxic gait is seen on the right side of the body, with a tendency to fall to the right. Examination reveals the presence of an intention (action) tremor in the right upper limb. Testing reveals a hemianesthesia for fine touch, conscious proprioception, and vibratory sense affecting the right half of the body.

Left benedikts. midbrain branches of the posterior cerebral artery and berry aneurysms of the circle of Willis.

A 23-year-old man can neither comprehend written language nor write it. He understands spoken language. His MRI reveals a lesion of a cortical region. Where is the lesion?

Left inferior parietal - angular gyrus

A 34 year old man presents with difficulty in reading but understands what is being said to her/him. The patient presents with difficulty in writing , and unable to pick up a pen using the thumb and index finger of the right hand. Further examination indicates that the patient may lost the ability to add and subtract despite being able to understand the request to do so. Where is the lesion

Left inferior parietal gyrus - including angular gyrus Gerstemanns syndrome

A 47 year old man is diagnosed with Gerstemann syndrome. The patient can neither perform simple arithmetric nor distinguished the fingers om his hand. Alexia with agraphia was present. Where is the lesion?

Left inferior parietal lobule

A 23-year-old woman can't identify objects felt in her right hand, without looking at it. She is diagnosed with astereognosis. Where is the lesion?

Left superior parietal

79- year-old woman with a 10 year history of high blood pressure and diabetes was reaching for a jar of flour to make an apple pie, when she experienced weakness on her right side, and collapsed. While trying to get up from the floor, she noticed that she was unable to move her right arm or leg. When the EMT arrived, she attempted to tell him what happened, but her speech was too slurred to be comprehensible. She was taken to the hospital where examination revealed that she followed commands very well. Although her speech was very slurred, it was logical in organization. The lower two thirds of her face drooped on the right. Her tongue pointed to the right side when she was asked to protrude it. Her right arm and leg were severely, but equally weak, and her left side had normal strength. She felt a pin and a vibrating tuning fork equally on both sides. An occlusion of which blood vessels accounts for this presentation?

Lenticulostriate

A 55-year-old woman presents with a sudden onset of upper motor neurons signs with severity involving the face, arm and legs. A vascular lesion is identified. Where is the lesion?

Lenticulostriate

A 67 year old stroke patient (man) presents with a weakness of his left limbs, reduced reflexes in those limbs, inability to gaze to the left and loss of facial expression on the left side, and failure to verbally acknowledge that anything was wrong with the left arm. Which blood vessel is affected?

Lenticulostriate

A 79 year-old man was seen by a third-year medical student. The patient was apparently in a coma. The student asked the patient's wife why the patient was In a coma. The wife replied "Oh, Paul isn't in a coma, but he did have a stroke." The student asked the patient to open his eyes, and he complied. When he was asked to lift his arm or speak, the patient did nothing. His wife explained that she could communicate with him by having him blink his eyes - once for yes and two times for no. The student asked him to move his eyes, and he was able to do so in all directions. When asked whether he could move his arms and legs, the patient blinked twice. When asked if he could smile, the patient blinked his eyes twice. Where is the patient's lesion?

Locked in syndrome- cause: bilateral occlusion of the paramedian and short circumferential branches of the basilar artery

a localized tumor in the dorsal column of the spinal cord at L2.

Loss or reduction in proprioception, vibratory, and tactile sensations of the right leg. The lesioned area is the Fasciculus gracilis

Imaging results of a 34 year old man reveals an isolated stroke in the anterior limb of the internal capsule, which blood vessel will be affected?

Medial striate artery

Blockage of what artery is likely to produce damage to the visual cortex, oculomotor nerve and the corticospinal tract?

PCA

Which of the following are NOT a branch of the internal carotid artery?

PCA

A 34 year-old-woman presents with difficulties in swallowing, hoarseness, dizziness, nausea and vomiting, rapid involuntary movements of the eyes (nystagmus), and problems with balance and gait coordination. What causes this condition? Which blood vessel was occluded?

PICA

A 57-year-old man presents with difficulties in swallowing, hoarseness, dizziness, nausea, vomiting, nystagmus (rapid involuntary movements of the eyes), and problems with balance and gait coordination. He is diagnosed with Wallenberg syndrome. An occlusion of which blood vessel is most likely to account for this presentation?

PICA

MGA of a 34 year old man reveals an occlusion of a major blood vessel in the medulla. Occlusion of which of the following vessels affects the entire dorsolateral part of the rostral medulla (level of the restiform body) and produces the lateral medullary Wallenberg) syndrome?

PICA

Occlusion of which of the following vessels affects the entire dorsolateral part of the rostral medulla (level of the restiform body) and produces the lateral medullary Wallenberg) syndrome?

PICA

Which of the following arteries supply the lateral medulla with blood?

PICA

Following a mild hemiparesis, this hypertensive patient had lost the ability to look upward, but developed lid retraction when trying to do so (Collier's lid retraction sign). The pupils did not respond to light, but convergence was normal. These findings are indicative of a lesion in the tectum of the midbrain

Parinauds

A 45 year old man had a cortical stroke, and presents with a disruption of patterning and execution of learned motor movements Individual movements are intact, and there is no weakness, but the patient is unable to perform learned movements in the correct sequence. Where is the lesion?

Premotor area

A 45 year old man had a cortical stroke, and presents with a paralysis of the right limbs , motor functions are paralyzed as well. Where is the lesion?

Primary motor cortex

Upon awakening, a young school teacher went to her class and was astonished to find that she could not read the materials on her desk. She was able to identify the letters, and read small printed items than large printed items but could not comprehend them.

Pure alexia

A 76-year-old woman presents with a sudden. Her MRI reveals lacunar infarcts, caused by occlusion of the deep perforating arteries. Which of the following is most likely to be associated with the patient's condition?

Pure motor hemiparesis

A 65 year-old man presents with paresis on the left, in which the leg is more affected than the arm and trunk. There was hypertonia, hyperreflexia, and positive Babinski signs. Obvious motor signs in the upper limb were not demonstrated. The patient began to experience difficulty walking with the left leg and urinary incontinence and sought medical advice from his primary physician. Examination reveals occlusion of the superficial branches of?

Right ACA

A 48 year-old woman is being examined by a neurologist. The patient exhibits loss of pain and temperature on the right side of her face and the left side of her body. Loss of fine touch, proprioception, and vibratory sense on the right side of the face is noted. The masseter and temporalis muscles exhibit weakness, atrophy and fasciculations on the right. When the patient attempts to protrude her jaw, it moves to the right. When the patient walks, her movements are poorly coordinated on the right side of her body, and she tends to fall to the right. The heel-to-shin test is performed poorly on the right. The patient's right eyelid droops, but does not obscure the cornea. Anisocoria is present. The right pupil is miotic. Sweating occurs only on the left side of the patient's head.

Right lateral midpontine syndrome. Short circumferential branch of the basilar artery

A 60 yr old anatomist was demonstrating a dissection when he suddenly dropped the forceps from his left hand. At the same time his speech became slurred and as he left the room he dragged his left foot. In the emergency room his wife related his history which included high blood pressure which was elevated; other vital signs were normal. He was alert and well oriented with respect to time and place and his comprehension was good. In spite of some slurring of speech he was coherent and the content was good. On examining the cranial nerves it was obvious that his eyes were consistently directed to the right and when asked to look to the left his eyes would not pass the midline. The visual exam showed a left homonymous hemianopsia. He could wrinkle his brow on both sides but in attempting to blow out his cheeks only the right side responded. There was a spastic paresis of the left arm and leg. Pain, temperature, and light touch were preserved over the body and face on both sides but discriminative touch and proprioception were impaired on the left and he was unable identify objects placed in his left hand.

Right total MCA occlusion

A 48 year-old man is being examined by a neurologist. The patient exhibits a spastic hemiparesis on the left side of his body. The left patellar tendon reflex is increased compared to the right. Stroking the bottom of the foot elicits a Babinski (extensor) reflex on the left but not on the right. The patient's right eyelid is completely closed. When the neurologist raises the lid manually, the right eye is seen to be abducted and perhaps slightly depressed. The right pupil is dilated.

Right webers. Midbrain branches of the posterior cerebral artery and berry aneurysms of the circle of Willis.

A 64 year old woman presents to the emergency unit with severe low back pain. The pain which started two weeks ago has been keeping her awake at night. The pain has acutely worsened over the past two days as he is not relieved with over the counter pain medications. He takes no other medication. He has no drug allergies. He does not use tobacco, alcohol or illicit drugs. His vital signs are within normal limits. Examinations reveals pain in the low back region with flexing of the back and raising of the legs. Pinprick in the perinanal does not cause rapid contraction of the anal sphincter. Which of the following nerve roots or dermatomes are most likely to be involved in her condition T12 (2%) L2 (5%) CL4 (5%) L5 (7%) S1 (30%)

S4 (51%)

A 45 year old man presents with a bilateral spastic paresis(Exaggerated tendon reflexes and muscle hypertonia), and a bilateral alteration of touch, vibration and pressure sensations below the lesion sites. Examination reveals ( see fig) demyelination and degeneration of the white matter at thoracic levels of the spinal cord. Pain and temperature sensation are not affected.

Subacute combined degeneration

non-fluent aphasia

brocas

Saddle anesthesia and loss of the anocutaneous reflex

cauda equina syndrome, which is associated with damage to the S2 through S4 nerve roots.

A 62-year-old patient diagnosed with prostate carcinoma complains of a right-sided headache worsening over 4 days and displays a drooping right upper eyelid. Examination reveals a right third nerve palsy. An MRI reveals a single metastasis of the prostatic carcinoma in the right side of the midbrain, causing Benedikt'ssyndrome. Which of the following signs would also be seen in this patient? (A) complete paralysis of facial expression musculature on the left side (B) deviation of the tongue to the right (C) intention tremor in the left upper and lower extremity (D) ipsilateral hemiplegia (E) vertical gaze palsy

intention tremor in the left upper and lower extremity

A 55 year-old man presents to the emergency department (ED) in the month of August with sudden onset of dysphagia, hoarseness (dysphonia), vertigo, nausea, vomiting and nystagmus. Examination reveals a loss of pain and temperature to the left side of the face and the right side of the body. The patient exhibits a wide-based gait ataxia affecting the left side of the body. Dysmetria, intention tremor and dysdiadochokinesia, are present on the left upper limb. The gag reflex is absent on the left side of the body. The uvula is deviated to the right, and the soft palate fails to elevate on the left side. Incomplete drooping of the eyelid is present on the left, and the left pupil is constricted. The patient notes that he was sweating because of the heat, but only on the right side.

left lateral medullary syndrome of wallenberg- PICA

A 46 year old man presents pain sensation in his arms or legs. Examination indicates the presence of a viral disorder that selectively affected sensory fibers that enter the spinal cord . Which fiber will it affect?

lissauers tract

Lesion of the right lateral corticospinal tract at L1 produces what impairment

umn symptoms in right leg

A 45 year old man was involved in auto crash, and sustained a peripheral nerve injury. The damage involved some of the axons that enter the spinal at L1, which affected mainly fibers that innervate the nucleus dorsalis of Clarke . What will be the functional loss?

unconcious proprioception

About 75% of the blood supply of the spinal cord is derived from the anterior spinal artery. This artery arises from which of the following?

vertebral arteries

fluent aphasia

wernickes

angular gyrus

written comprehension inferior parietal