Motor-Sensory Problem Solving

BASIC CLINICAL NEUROSCIENCE
NEUROANATOMICAL BASIS FOR VOLUNTARY MOVEMENTS AND SENSATIONS

Review I
April 1, 2014
Give the subdivision, level and side and name the damaged structures in the smallest lesion resulting in:
1)
2)
3)
4)
5)
left spastic hemiplegia
__________________________________________
pyramidal tract
left lower face weakness
__________________________________________
corticobulbar
right ptosis and eye turned down and out
__________________________________________
oculomotor nerve
subdivision/level/side
__________________________________________
rostral midbrain/superior colliculus/right
spontaneous shaking of hands, bidirectional

increased resistance to passive stretch, slow and
stooped gait and tendency to fall
basal ganglia (substantia nigra), Parkinsons
pars compacta of substantia nigra
opened jaw deviates to right
__________________________________________
motor trigeminal
loss of pain/temperature in left limbs and trunk
__________________________________________
spinothalamic tract
__________________________________________
midpons/motor trigeminal/right
spastic paralysis in left upper and lower limbs
__________________________________________
pyramidal tract
loss of pain and temperature in both upper limbs
__________________________________________
ventral white commissure
loss of tactile, 2-point, etc., in right lower limb
__________________________________________
right gracile tract
loss of tactile, 2-point, etc., in lower limb and

trunk on left side
__________________________________________
left gracile tract (and perhaps part of the cuneate)
__________________________________________
ventral white commissure/cervical/(central)
right spastic hemiplegia
__________________________________________
pyramidal tract
left upper and lower facial paralysis
__________________________________________
lower motor neurons
paralysis of left eye upon attempting gaze

to the left
abducens
subdivision /level/side
__________________________________________
caudal pons/abducens (VI & VII nuclei)/left
6)
7)
8)
9)
10)
extension of upper and lower limbs upon

appropriate stimulus
decerebrate posturing
comatose state
rostral midbrain (ascending activation system interrupted)
abnormal dolls eyes response
vestibulo-ocular reflex
midbrain/ascending activation system/bilateral
__________________________________________
pyramidal tract
weakness and atrophy of muscles used for

shrugging right shoulder and turning head to the
left
__________________________________________
spinal accessory arising from upper cervical
__________________________________________
upper cervical anterior horn/spinal accessory/right
spontaneous herky-jerky movements of the distal

parts of the limbs as well as the head and mouth
__________________________________________
basal ganglia (striatum)
impaired mental ability and personality

disturbance
__________________________________________
cerebral cortex
__________________________________________
degeneration of striatum and cerebral cortex (Huntingtons)
loss of tactile, vibration and proprioception senses __________________________________________

medial leminiscus system
in left lower limb
esotropia in right eye
__________________________________________
abducens
__________________________________________
caudal pons (medial lemniscus)/abducens (VI & VII nuclei)/right
patient stands on a wide base and trunk sways

from side to side
__________________________________________
truncal ataxia (cerebellum)
__________________________________________
cerebellum/flocculonodular lobe/bilateral
BASIC CLINICAL NEUROSCIENCE

NEUROANATOMICAL BASIS FOR VOLUNTARY MOVEMENTS AND SENSATIONS
Review II
April 1, 2014
Give the subdivision, level and side and name the damaged structures in the smallest lesions resulting in:
1)
left intention tremor, dysmetria, etc.
__________________________________________
posterior lobe or superior cerebellar peduncle (cerebellum)
loss of tactile and proprioception in left trunk

and limbs
dorsal column or medial lemniscus pathway
right ptosis and eye turned down and out
oculomotor nerve
__________________________________________
rostral midbrain, around red nucleus/oculomotor/right
(AKA tegmental syndrome of Benedikt)
2)
loss of proprioception, etc. in lower limbs, has a

wide-based ataxic gait and falls upon standing
with feet together and closing the eyes
__________________________________________
dorsal column (gracile tract)
spontaneous shooting and stinging pains in lower

limbs
3)
4)
(AKA tabes dorsalis)
irritated nociceptive neurons
__________________________________________
gracile tracts/lumbosacral region/bilateral
(has to be above spinal cord or

__________________________________________
pyramidal system
loss of pain/temperature in left limbs and trunk
other side)
__________________________________________
spinothalamic tract
__________________________________________
medulla (medullary pyramid)/dorsal column nuclei/right
left intention tremor, dysmetria, etc.
__________________________________________
posterior lobe (cerebellum) (superior cerebellar peduncle)
loss of tactile, 2-point, etc. in face on left
__________________________________________
principal sensory nucleus
__________________________________________
midpons/motor trigeminal/left
pain/temperature would be on
5)
__________________________________________
pyramidal tract
upon protrusion tongue deviates to the right
__________________________________________
right hypoglossal
loss of tactile, vibration, and proprioception

senses in left limbs and trunk
dorsal column or medial lemniscus
loss of pin prick sensations on left side of face
left spinal trigeminal tract or right trigeminothalamic tract
__________________________________________
medulla/hypoglossal (XII nucleus)/right
(AKA medial medullary syndrome)
6)
7)
8)
9)
head tilt toward right and diplopia when looking

down toward feet
__________________________________________
trochlear nerve (superior oblique muscle)
loss of pain/temperature in right limbs and trunk
__________________________________________
left spinothalamic
__________________________________________
pons/isthmus/left
vertigo
vestibular
loss of pain on right side of face
right spinal trigeminal tract or left trigeminothalamic
loss of pain on left trunk and limbs
right spinothalamic
ataxia in right limbs
__________________________________________
high spinocerebellar
right ear deafness
__________________________________________
cochlear nuclei
__________________________________________
rostral medulla/cochlear nuclei/right
spastic paralysis in left lower limb
__________________________________________
pyramidal tract
loss of pain and temperature below the nipple

on the right side
__________________________________________
left spinothalamic
__________________________________________
spinal cord below upper limb (LCST)/T4/left
left lower limb ataxia
__________________________________________
dorsal spinocerebellar
__________________________________________
left pyramidal tract
loss of pain/temperature in right limbs and trunk
left spinothalamic
loss of tactile, 2-point, etc., in left upper limb
left cuneate tract
loss of tactile, 2-point, etc, in right lower limb
__________________________________________
right gracile or left lower limb part of medial lemniscus
loss of pain/temperature in face on left side
left spinal trigeminal tract
medulla/dorsal column nuclei/left

Motor-Sensory Problem Solving

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Motor-Sensory Problem Solving

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BASIC CLINICAL NEUROSCIENCE

NEUROANATOMICAL BASIS FOR VOLUNTARY MOVEMENTS AND SENSATIONS

left spastic hemiplegia

left lower face weakness

right ptosis and eye turned down and out

spontaneous shaking of hands, bidirectional

basal ganglia (substantia nigra), Parkinsons

pars compacta of substantia nigra

opened jaw deviates to right

loss of pain/temperature in left limbs and trunk

spastic paralysis in left upper and lower limbs

loss of pain and temperature in both upper limbs

loss of tactile, 2-point, etc., in right lower limb

loss of tactile, 2-point, etc., in lower limb and

right spastic hemiplegia

left upper and lower facial paralysis

paralysis of left eye upon attempting gaze

extension of upper and lower limbs upon

rostral midbrain (ascending activation system interrupted)

abnormal dolls eyes response

midbrain/ascending activation system/bilateral

right spastic hemiplegia

weakness and atrophy of muscles used for

spontaneous herky-jerky movements of the distal

impaired mental ability and personality

loss of tactile, vibration and proprioception senses __________________________________________

patient stands on a wide base and trunk sways

BASIC CLINICAL NEUROSCIENCE

left intention tremor, dysmetria, etc.

loss of tactile and proprioception in left trunk

dorsal column or medial lemniscus pathway

right ptosis and eye turned down and out

loss of proprioception, etc. in lower limbs, has a

spontaneous shooting and stinging pains in lower

(AKA tabes dorsalis)

irritated nociceptive neurons

left spastic hemiplegia

(has to be above spinal cord or

loss of pain/temperature in left limbs and trunk

left intention tremor, dysmetria, etc.

loss of tactile, 2-point, etc. in face on left

left spastic hemiplegia

upon protrusion tongue deviates to the right

loss of tactile, vibration, and proprioception

dorsal column or medial lemniscus

loss of pin prick sensations on left side of face

left spinal trigeminal tract or right trigeminothalamic tract

head tilt toward right and diplopia when looking

loss of pain/temperature in right limbs and trunk

loss of pain on right side of face

right spinal trigeminal tract or left trigeminothalamic

loss of pain on left trunk and limbs

ataxia in right limbs

right ear deafness

spastic paralysis in left lower limb

loss of pain and temperature below the nipple

left lower limb ataxia

right spastic hemiplegia

loss of pain/temperature in right limbs and trunk

loss of tactile, 2-point, etc., in left upper limb

left cuneate tract

loss of tactile, 2-point, etc, in right lower limb

loss of pain/temperature in face on left side

left spinal trigeminal tract