Professional Documents
Culture Documents
Sensory Problem Set
Sensory Problem Set
Problem 1
Last Thursday at midnight, Mr. X (your patient) came out of a bar and was attacked in a
dark alley. He suffered a hemisection of the right side of the spinal cord at a high lumbar
spinal level. Upon examination, you discovered that Mr. X lacks vibration and two-point
discriminative sensation in the right lower extremity as well as thermal, pain and
mechanical sensations in the left lower extremity.
R L
Problem 1
R L
R L
Problem 1
_____________________
_____________________
R L R L
RNu RNu
R L
Fasc. gracilis
ALF
Location: ___________________________
Information:
_____________________________________________________________
___________________________________________________
Location: _____________________________
Information:
______________________________________________________________
____________________________________________________
R L
Problem 1
_________________________________________________
Fasc. Nucleus
gracilis gracilis
Internal
Arcuate
fibers
Medial
lemniscus
Problem 1
_______________________________________________
_______________________________________________
RNu
Medial
lemniscus
Nucleus
gracilis
Fasc.
gracilis
Mech. sensations
lower limb
Problem 1
R L
The lesion of the ALF would result in degenerating axons
terminals in what thalamic nucleus? Target?
_____________________
__________________________________________
RNu
___________________________________________________
___________________________________________________
Draw the ALF pathway until you reach the nucleus termination.
Is the nucleus ipsilateral or contralateral to the lesion? ___________
Problem 1
a) The dorsal column lesion would interrupt information b) The ALF lesion would interrupt information
going to the ________ hemisphere in the
going to the ________ cerebral hemisphere. _____________ region of the ___________
Most specifically, the ____________ region of the gyrus.
___________ gyrus.
Problem 1
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
___
R L
R L
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
Problem 2
L R
L R
Lower
open medulla
L R
Open medulla
Problem 2
_________________
L R
______________________________________________________
______________________________________________________
Problem 2
________
___________________________
L R
L R
________________________________
Open medulla
Problem 2
_______________________
_______________________ L R
L R
_________________
_________________
Problem 2
______________________________________________________________________
?
L R
_______________________________________________________________
_______________________________________________________________
_____________________________________________________________
_____________________________________________________________
__
Problem 2
R L
RNu
________________________________________________________________________
________________________________________________________________________
__
Problem 3
Problem 3
_________________________________________
_______________________________
R L R L
Anterolateral fasciculi
Problem 3
_____________________________________________________
__________________________________________________________________________
__________________________________________________________________________
T2
T7
R
L
R
L
R Affected ALF
L AWC Spared ALF
Problem 3
Cervical spinal
cord:_________________________________
_________________________
Thalamus:____________________________
_____________________________________
_
Cerebral cortex:
______________________________________
________________________
Problem 3
___________________________________________________________________________
________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
__