Anatomy

Question 1

Weber’s Syndrome

Answer 1

a syndrome of ipsilateral third nerve palsy and contralateral face and body weakness

Lesion in paramedian midbrain

Question 2

Benedikt’s syndrome

Answer 2

a syndrome of ipsilateral third nerve palsy and contralateral choreiform movements.

lesion of ipsilateral red nucleus and neighboring 3rd CN in rostral midbrain

Question 3

Claude’s syndrome

Answer 3

a syndrome of ipsilateral third nerve palsy and contralateral ataxia

injury to the post-decussation superior cerebellar fibers and neighboring third nerve in the caudal midbrain

Question 4

Locked-in syndrome

Answer 4

Injury to basis pontis and ventral paramedian pontine tegmentum

Question 5

Dysarthria-clumsy hand syndrome

Answer 5

a syndrome of contralateral face and upper extremity weakness with preserved lower extremity strength due to restricted paramedian pontine injury–within the basis of the pons, from medial to lateral, lie the face, arm, and leg fibers and only face and arm fibers are injured

Question 6

Wallenberg’s syndrome

Answer 6

AKA dorsal lateral medullary syndrome. Posterior inferior cerebellar artery (PICA) territory infarct caused by a branch occlusion of a vertebral artery.
Patients typically present with dizziness, incoordination, double vision, trouble swallowing, sensory disturbance, and pupillary asymmetry.
Exam reveals unilateral cerebellar ataxia; loss of pain and temperature sensation in the face and body (typically on opposite sides); ipsilateral Horner’s syndrome (ptosis, anhidrosis, and miosis); dysarthria and impaired gag reflex; ocular skew; and nystagmus, and wild swings in heart rate with pronounced bradycardia.

Question 7

Dejerine’s syndrome

Answer 7

Injury to medial medulla.
Dysarthria and tongue deviation result from injury to the contralateral hypoglossal nucleus.
Large fiber sensory deficit is from injury to the contralateral medial lemniscus tract.
Weakness from injury to the contralateral medullary pyramid.

Question 8

Triangle of Guillain Mollaret

Answer 8

Inferior Olive in medulla sends climbing fibers to contralateral dentate n. of cerebellum, which projects back to contralateral red nucleus and then down to inferior olive of origin via the central tegmental tract

Question 9

Foster Kennedy Syndrome

Answer 9

Triad: ipsilateral anosmia, ipsilateral optic atrophy, contralateral papilledema.
Classically associated with a mass involving the olfactory groove or sphenoid ridge, compressing one optic nerve an increases intracranial pressure, resulting in papilledema of the contralateral eye.

Question 10

Anterior Interosseus Nerve syndrome

Answer 10

• Pain in arm or forearm
• weakness of forearm pronation (due to weakness of pronator quadratus)
• weakness of flexion of the terminal phalanx of the thumb (due to flexor pollicis longus weakness) and the terminal phalanges of the 2nd and 3rd digits (due to weakness of the FDPI and II).
• Normal sensation (AI nerve is a pure motor nerve branch of median nerve).

Question 11

C2 dermatomal landmark

Answer 11

jaw + back of head

Question 12

C3/C4 dermatomal landmark

Answer 12

neck

Question 13

C6 dermatomal landmark

Answer 13

thumb

Question 14

C5 dermatomal landmark

Answer 14

upper lateral arm

Question 15

C7 dermatomal landmark

Answer 15

middle finger

Question 16

C8 dermatomal landmark

Answer 16

little finger

Question 17

T4 dermatomal landmark

T10 dermatomal landmark

Answer 17

nipple

navel

Question 18

L4 dermatomal landmark

Answer 18

patella

Question 19

L5 dermatomal landmark

Answer 19

great toe

Question 20

S1 dermatomal landmark

Answer 20

little toe