USMLE Step 1 Neuroanatomy Review 27 16 Lesions to the Peripheral Nervous System, Part 2

USMLE Step 1 Neuroanatomy Review 27 16 Lesions to the Peripheral Nervous System, Part 2

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Play USMLE Audio MP3 27 16 Lesions to the Peripheral Nervous System, Part 2 Below

Begin 27 16 Lesions to the Peripheral Nervous System, Part 2 Transcription

Student doctor, what would be the result of an occlusion of the anterior spinal artery?

  • Please pause and list as many as you can.  An occlusion of the anterior spinal artery would result first in the destruction of the ventral horn, and then it would be as if there was a trans-section of the corticospinal, spinothalamic, dorsal and ventral spinocerebellar tracts.

What is the name of the syndrome characterized by the loss of voluntary control of bladder and rectal function involving the segments L4 to S2?

  • In other words, lower lumbar and upper sacral.  This is the epiconus syndrome. 

Does reflex functioning remain intact in the epiconus syndrome?

  • Yes, reflex functioning remains intact.

Now, what is the syndrome characterized by the destruction of the sacral parasympathetic nucleus?

  • This is the conus medullaris syndrome. 

Please pause and list as many as you can of the characteristics of the conus medullaris syndrome.  The conus medullaris syndrome includes impotence, paralytic bladder, fecal incontinence and sensory loss in the perianogenital region.

Student doctor, what are the segments involved in the cauda equine syndrome?

  • The spinal roots L3 all the way down to the coccygeal.

Student doctor, what are the clinical features of syringomyelia?

  • Syringomyelia presents with the clinical features of bilateral loss of pain and temperature sensation. 

Please pause, if you wish, and describe where the lesion is in syringomyelia.  The lesion in syringomyelia involves the destruction of the ventral white commissure areas as well as interruption of the decussating spinothalamic fibers.

Finally, what kind of lesion is multiple sclerosis?

  • Just simply pause and describe.  Multiple sclerosis is a demyelinating disease of the spinal cord white matter. 

Now, multiple sclerosis results in what three general types of dysfunction?

  • Motor, sensory, autonomic. 

****END OF TRANSCRIPTION****

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