Idara C.E.
Mrs. sauna was rushed to the ER after a motor
vehicle accident in which she sustained severe
injuries with spinal cord involvement.
On examination, the physician noticed that she didn’t
respond to pin- prick from the level of the umbilicus
downwards on the left and touch, vibration
sensations were lost on the right at some
segments above the umbilicus downwards.
1.
What tracts are involved?
2.
Where is the injury site (what level and side)?

a.
b.
c.
d.
One of these sensations is not conveyed by
the dorsal column?
Proprioception
Vibration
Heat
Discriminative touch

a.
b.
c.
d.
e.
During a neurologic examination, a patient
cannot tell with her eyes closed if the
neurologist flexed or extended her fingers.
There is likely damage to
Anterior spinothalamic tract
Anterior spinocerebellar tract
Cuneocerebellar tract
Fasciculus gracilis
Fasciculus cuneatus

A 25 year old male presented to the emergency room,
transported by ambulance. He was stabbed in the
posterior mid-thoracic region. Admission blood
pressure was 90/60. Pulse was 120 per minute. He
was ashen and appeared to be in shock. Chest x-ray
showed a left sided pneumothorax (collapsed lung)
and associated left sided hemothorax (bleeding in the
chest). Examination revealed a 2 inch stab wound to
the back at about the level of the T6. Neurologic exam
revealed complete loss of left sided motor function
below T6 and loss of sensation on the right below T6.
Admission hemoglobin was 9.6 gms% and hematocrit
is 37. He began to show signs of respiratory distress.
The patient was intubated (breathing tube) and placed
on an assisted ventilation respirator
A 4o year old man was brought to the clinic with
bilateral weakness of both arms, he was
involved in a motor vehicle accident and he
stated that his head was thrown backwards.
Physical examination revealed flaccid paralysis of
his arms with absent deep tendon reflexes but
his lower extremities was normal.
Weeks later, his upper limbs showed signs of
spasticity, hyperreflexia but there was no return
of sensory sensation.
A 17 year old male presents to your office with difficulty
walking. On physical examination, he has thoracic
kyphoscoliosis and multiple small scars on his hands.
When asked about these, he reports that he
repeatedly accidentally burns his hands because he “
cannot feel the heat”. Neurologic exams reveal that his
biceps reflex is 1+ and patella reflex 3+ bilaterally, as
well as decreased muscle strength in the upper and
lower extremities. What’s the cause of his complaint?
a.
Amyotrophic lateral sclerosis
b.
Guilain-Barre Syndrome
c.
Syringomyelia
d.
Multiple Sclerosis