tommyk
10-05-2006, 01:55 PM
Hy 2425 Neuroanatomy recall
90-year-old woman named Uma Thurman experiences the sudden onset of lower extremity weakness and collapse on getting out of bed. She has been previously healthy and has not taken any medications. She has no history of back pain. On examination, she is alert and oriented to time, place and date. Her upper extremity sensation and strength are intact. Her legs are weak bilaterally, with loss of pain and temperature sensation and areflexia. Her bladder is distended. Which of the following is the most likely diagnosis? [Note: It was a sort of hard question in my opinion] (Reminder: You MUST know why each of the answers below are right or wrong) (Note: if shown a CT, can you point to the structure affected?)
1-Posterior cerebral artery occlusion
2-Anterior cerebral artery occlusion
3-Anterior spinal artery occlusion
4-Slipped disk compression
5-Cauda equine syn.
6-Sciatica syn.
7-Gullain-Barre
a) Pick number 3. The perfusion territory of the anterior spinal artery includes the anterior horn cells and part of the pain and temperature pathways. Thrombosis of this artery causes flaccid paralysis, loss of bowel and bladder function and loss of pain and temperature sensation. Anterior cerebral artery occlusion can cause leg weakness but there should be no sensory loss. Upper motor neuron signs are present in the leg.Cauda equina syndrome can cause flaccid paraplegia but somatic sensation should be compromised since sensory nerve roots are involved in the disease process. Guillain-Barré syndrome rarely develops this acutely. If loss of pain and temperature sensation occurs, it presents with concurrent loss of position and vibration sense. I think a slipped disk is associated with low back pain and produces upper motor neuron dysfunction in the legs. Can you point to the ant.spinal artery?
90-year-old woman named Uma Thurman experiences the sudden onset of lower extremity weakness and collapse on getting out of bed. She has been previously healthy and has not taken any medications. She has no history of back pain. On examination, she is alert and oriented to time, place and date. Her upper extremity sensation and strength are intact. Her legs are weak bilaterally, with loss of pain and temperature sensation and areflexia. Her bladder is distended. Which of the following is the most likely diagnosis? [Note: It was a sort of hard question in my opinion] (Reminder: You MUST know why each of the answers below are right or wrong) (Note: if shown a CT, can you point to the structure affected?)
1-Posterior cerebral artery occlusion
2-Anterior cerebral artery occlusion
3-Anterior spinal artery occlusion
4-Slipped disk compression
5-Cauda equine syn.
6-Sciatica syn.
7-Gullain-Barre
a) Pick number 3. The perfusion territory of the anterior spinal artery includes the anterior horn cells and part of the pain and temperature pathways. Thrombosis of this artery causes flaccid paralysis, loss of bowel and bladder function and loss of pain and temperature sensation. Anterior cerebral artery occlusion can cause leg weakness but there should be no sensory loss. Upper motor neuron signs are present in the leg.Cauda equina syndrome can cause flaccid paraplegia but somatic sensation should be compromised since sensory nerve roots are involved in the disease process. Guillain-Barré syndrome rarely develops this acutely. If loss of pain and temperature sensation occurs, it presents with concurrent loss of position and vibration sense. I think a slipped disk is associated with low back pain and produces upper motor neuron dysfunction in the legs. Can you point to the ant.spinal artery?