Question

B. Cole Dazice is admitted complaining that their entire body is cold except for their left leg. When an ice cube is placed on their leg they can only tell it's wet, but not that it's cold. When tested further it is found that a warm compress does not feel warm to the patient and when poked with a needle, they feel no pain, but they do feel the pressure. It is determined they must have a lesion or damage within their spinal cord. Which specific pathway is affected (4 pts)? How do you know it is that specific pathway (4pts)? Which side of the spinal cord is the lesion and which funiculus must the lesion be located (4 pts)? How do you know the specific funiculus and the side (where does it decussate) (4pts)? What is the signal direction within this pathway and what is the final destination of this information (2 pts)? 2 pts for essay formatting, grammar, spelling. Be specific in your answers.

Answer 1

1. Lateral Spinothalamic pathway is affected after spinal cord injury.

2. In Lateral Spinothalamic pathway is responsible of transmission of pain, temperature to the thalamus. in this case since the patient is experiencing loss of pain and temperature, so this leads the above diagnosis. Bcos the patient feels the pressure anterior Spinothalamic pathway is working fine.

3. Since the patient left leg has problem so possibly right side of the spinothalamic tract is affected. since this spinal coed lesion deficit will be in the opposite side. The axons of the second order neurons cross at every segmental level in the spinal cord. This fact helped us to determine the lesion location.

3. Anterior half of the lateral funicles is affected after the injury. bcos the pain & temperature is conduted by lateral spino thalamic pathway and it is now impaired. Pressure sensation is good in the patient which is conduced by ventral spinothamic tract located in anterior funiculus. So only lateral funiculus is affected.

4. The lateral funiculus & lateral spino thalamic tract crosses at the level of spinalcord.

5. The first order neuron start from the sensory receptors of perifery and they enter spinal cord. they go upto the 1 or 2 vertebral levels and synapse at yhe substantia gelatinods from there 2nd order neurons carry information decussate within spinal cord and then form a separate tract for pain and temperature as lateral spino thalamic tract. then reach thalamus to the ipsilateral side of the cortex of the brain.