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Free notes, MCQs, tables & flowcharts for USMLE Step 1 Anatomy
A 63-year-old woman comes to the office because of a 2-year history of upper and lower extremity weakness and neck pain that is worse with sneezing. She has had difficulty swallowing and speaking for the past 8 months. Musculoskeletal examination shows spasticity and decreased muscle strength in all extremities. There is bilateral atrophy of the trapezius and sternocleidomastoid muscles. Neurologic examination shows an ataxic gait and dysarthria. Deep tendon reflexes are 4+ bilaterally. Babinski sign is positive. Sensation is decreased below the C5 dermatome bilaterally. An MRI of the neck and base of the skull is shown. Which of the following is the most likely cause of this patient's symptoms?
AAmytrophic lateral sclerosis
BCerebral glioblastoma multiforme
CSyringomyelia
DCerebellar astrocytoma
EForamen magnum meningioma
A 45-year-old patient presents with difficulty speaking and swallowing following a stroke. MRI reveals an infarct in the medulla. Which of the following cranial nerve nuclei is most likely affected?
AVestibulocochlear nucleus
BTrigeminal nerve nucleus
CFacial nerve nucleus
DNucleus ambiguus
A patient with a known spinal cord ependymoma presents to his neurologist for a check up. He complains that he has had difficulty walking, which he attributes to left leg weakness. On exam, he is noted to have 1/5 strength in his left lower extremity, as well as decreased vibration and position sensation in the left lower extremity and decreased pain and temperature sensation in the right lower extremity. Which of the following spinal cord lesions is most consistent with his presentation?
AAnterior cord syndrome
BPosterior cord syndrome
CSyringomyelia
DRight-sided Brown-Sequard (hemisection)
ELeft-sided Brown-Sequard (hemisection)
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