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- Aug 20, 2012
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I don't know how these threads are supposed to be made, so I apologise if I'm doing something wrong here.
UWorld Q. 2125 (I'll paraphrase since I don't know if I can write it word for word).
Man with left sided hemiplegia, dorsal column deficit and cerebellar symptoms including left sided dysmetria, dysdiadochokinesia and gait ataxia. Also has UMN facial palsy (side not mentioned) or "lower facial droop". The question shows an MRI of the brainstem and asks which nerve arises at the given level.
a. VII
b. XII
c. III
d. V
e. IV
UWorld says V. Sure, the UMN facial palsy means it's midpons or above and the MRI shows a section of the pons with the middle cerebellar penduncle (although it looked more like the midbrain than the pons to me, honestly). The explanation is merely, "The patient has a lacunar infarct of the pons at the level of the middle cerebellar peduncle. The trigeminal nerve arises at the level of the middle cerebellar peduncle."
So here's my question. How does this patient have an ipsilateral dorsal column deficit in a lesion above above the medulla?
UWorld Q. 2125 (I'll paraphrase since I don't know if I can write it word for word).
Man with left sided hemiplegia, dorsal column deficit and cerebellar symptoms including left sided dysmetria, dysdiadochokinesia and gait ataxia. Also has UMN facial palsy (side not mentioned) or "lower facial droop". The question shows an MRI of the brainstem and asks which nerve arises at the given level.
a. VII
b. XII
c. III
d. V
e. IV
UWorld says V. Sure, the UMN facial palsy means it's midpons or above and the MRI shows a section of the pons with the middle cerebellar penduncle (although it looked more like the midbrain than the pons to me, honestly). The explanation is merely, "The patient has a lacunar infarct of the pons at the level of the middle cerebellar peduncle. The trigeminal nerve arises at the level of the middle cerebellar peduncle."
So here's my question. How does this patient have an ipsilateral dorsal column deficit in a lesion above above the medulla?
