USMLE Step 1 Neuroanatomy Review 26 20 Pons (5_5)

USMLE Step 1 Neuroanatomy Review 26 20 Pons (5_5)

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  • USMLE Audio Review files from our “Gold Standard USMLE Reviews”
  • Transcriptions of those files
  • And videos (as they become available)

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  • Listening to the Audio
  • Following along with the transcription
  • Or by watching the video (if available)

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Let’s start our USMLE Review with Anatomy from the Gold Standard USMLE Step 1 Audio Review program.

Play USMLE Audio MP3 26 20 Pons (5_5)Below

Begin 26 20 Pons (5_5) Transcription

Now we’ll take a look at the lesions of the pons, please refer to the figure 10.3.

Student doctor, what is the name of the syndrome characterized by the following clinical features: lateral rectus paralysis, weakness of the lower face, hemiparesis of the trunk and lower extremities, limb and gait ataxia, and loss of tactile and proprioceptive sensation from the extremities?

  • This is the medial inferior pontine syndrome.

Alright, let’s turn this around to review it. What are the five clinical features of the medial inferior pontine syndrome?

  • First, lateral rectus paralysis.
  • Second, weakness of the lower face.
  • Third, hemiparesis of the trunk and extremities.
  • Fourth, limb and gait ataxia, and
  • fifth, loss of tactile and proprioceptive sensation from the extremities.

Now, what causes the medial inferior pontine syndrome?

  • Occlusion of the paramedian branches of the basilar arteries.

Student doctor, what is the syndrome characterized by the following features: loss of taste from the anterior two-thirds of the tongue, loss of the corneal and stapedial reflexes, central nerve deafness, nystagmus, nausea, vomiting, and vertigo, loss of pain and temperature from the face, limb and gait dystaxia, loss of pain and temperature sensation from the trunk and extremities, and Horner’s syndrome? This constellation of signs and symptoms constitutes the lateral inferior pontine syndrome.

This is also called, by abbreviation, what syndrome?

  • The AICA syndrome.

Alright, let’s turn that around. What are the signs and symptoms of the lateral inferior pontine syndrome, also known as the AICA syndrome?

  • Just simply pause and list as many as you can. Loss of taste from the anterior 2/3 of the tongue, loss of the corneal and stapedial reflexes, central nerve deafness, nystagmus, nausea, vomiting, and vertigo, loss of pain and temperature from the face, limb and gait dystaxia, loss of pain and temperature sensation from the trunk and extremities, and Horner’s syndrome.

Now what is the cause of the lateral inferior pontine syndrome?

  • Occlusion of the superior cerebellar artery.

Student doctor, what is the syndrome that results from ischemic injury to the descending corticospinal and corticobulbar tracts?

  • This is called the locked-in syndrome.

And what are the clinical features of the locked-in syndrome?

  • Quadriplegia and paralysis of the lower cranial nerves.

Student doctor, how are patients with the locked-in syndrome able to communicate?

  • By vertical eye movements.

Now to review, this syndrome, the locked-in syndrome, is caused by what mechanism of injury to what area?

  • By ischemic injury to the descending corticospinal and corticobulbar tracts.

****END OF TRANSCRIPTION****

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