cst q?? - atkal

[ArchivalUser]

A 68-year-old woman has the sudden onset of weakness in her right arm and leg. She can speak, but her words are not enunciated clearly. Neurologic examination 6 weeks later shows an extensor plantar reflex on the right. When she is asked to protrude her tongue, it deviates to the left, and the muscle in the left side of the tongue shows considerable atrophy. where is the lesion in the brainstem?

[ArchivalUser]

FA 2014 pg 460 “Medial medullary syndrome”

(problem here L medial medulla/medial lemniscus)

MC result: occlusion VA or AS artery

Pat here contralateral spastic hemiparesis due to loss of descending UMN (Pat has extensor plantar Babinski reflex ) +Paralysis/atrophy of tongue Ipsilateral to lesion (CN XII) exit medulla (btw inferior olive and medullarly pyramid)

LOOK at img at 7 o’clock
http://classconnection.s3.amazonaws.com/...875839.png

Hope that help u.

[ArchivalUser]

thanks..got it!!

[ArchivalUser]

Perfecto.