Blood supply to Tracts

Question 1

What artery supplies the ALS tract in the midbrain?

Answer 1

Medial choroidal A.

Question 2

What artery supplies the ALS tract in the rostral pons?

Answer 2

Basilar A. branches and the Superior Cerebellar A.

Question 3

What artery supplies the ALS tract in the caudal pons?

Answer 3

Basilar A. branches and the AICA - Anterior Inferior Cerebellar A.

Question 4

What artery supplies the ALS tract in the medulla?

Answer 4

PICA - Posterior Inferior Cerebellar A.

Question 5

Results of an occlusion of the Anterolateral tract/Spinothalamic tract in the brainstem?

Answer 5

CONTRALATERAL loss of pain/nociception, temperature and non-discriminative touch

Question 6

What artery supplies the ALS in the spinal cord?

Answer 6

Arterial Vasocorona and the Anterior Spinal A.

Question 7

Results of an occlusion of the Anterolateral tract/Spinothalamic tract in the spinal cord?

Answer 7

Patchy CONTRALATERAL loss of pain/nociception, temperature and non-discriminative touch starting 2 segments BELOW occlusion

Question 8

What artery supplies the Medial Longitudinal Fasciculus (MLF) most of the time in the brainstem?

Answer 8

Paramedian branches of the basilar A.

Question 9

What is the blood supply to the CST in the pons and rostral medulla?

Answer 9

Basilar A. and some of its branches

Question 10

Where does the CST fibers cross?

Answer 10

Pyramids of medulla (caudal)

Question 11

Where does the ALS fibers cross?

Answer 11

Anterior white commissure at the level they enter the posterior horn of the SC

Question 12

Results of a lesion to the CST?

Answer 12

CONTRALATERAL spastic paralysis, babinski’s sign, hyperreflexia

Question 13

Results of a lesion to the LCST?

Answer 13

IPSILATERAL paralysis of distal limb musculature

Question 14

Results of a unilateral MLF lesion?

Answer 14

CONTRALATERAL horizontal gaze disturbance

• Ipsilateral eye unable to ADDuct
• Contralateral eye has nystagmus

Internuclear Opthalmoplegia

Question 15

What is the blood supply to the spinal trigeminal nucleus in the medulla?

Answer 15

PICA

Question 16

Results of a spinal trigeminal nucleus/tract lesion in the medulla or pons?

Answer 16

IPSILATERAL loss of pain and temp. from the face

Question 17

What will lateral medullary/lateral pontine syndrome most likely affect the most?

Answer 17

ALS and spinal trigeminal nucleus

Question 18

Damage to the spinal trigeminal tract?

Answer 18

Onion-peel sensory loss

Question 19

Occlusion of ______ gives lateral medullary syndrome?

Answer 19

PICA

Question 20

Deficits seen with lateral medullary syndrome?

Answer 20

ALS - contralateral loss of pain and temp

Ipsilateral loss of pain and temp from the face

Question 21

Dissociated sensory loss

Answer 21

Loss of one sensory modality but another is within normal limits

Question 22

Occlusion of _____ gives lateral pontine syndrome?

Answer 22

Long circumferential branches of basilar and

i) if rostral = superior cerebellar
ii) if caudal = AICA

Question 23

Deficits seen with lateral pontine syndrome?

Answer 23

ALS - contralateral loss of pain and temp
Ipsilateral loss of pain and temp from the face
Disturbed horizontal gaze – PPRF

Question 24

Ipsilateral trigeminal anesthesia and contralateral spastic hemiplegia

Answer 24

Alternating trigeminal hemiplegia

Question 25

What is destroyed with alternating trigeminal hemiplegia

Answer 25

Spinal trigeminal nucleus and CST fibers

Question 26

What artery supplies the medial lemniscus in the medulla?

Answer 26

Anterior spinal A.

Question 27

What tracts are found laterally?

Answer 27

ALS, Spinal trigeminal tract/nucleus

Question 28

What tracts are found medially?

Answer 28

Medial lemniscus, MLF, CST

Question 29

What cranial nerves are found medially?

Answer 29

3, 4, 6, 12

Question 30

What is often also seen with lateral medullary syndrome along with damage to ALS and spinal nucleus?

Answer 30

Damage to nucleus ambiguus - hoarse voice