Random Sensory System Facts

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Introduction:

There is an ascending connection between the sensory neurons of the skin and the brain, and these sensory neurons enter the brain from the posterior horn cells (where as motor system neurons enter through the anterior horn cells). There are three types of fibers: lateral spinothalamic tracts, posterior column tracts, and dorsal column.

Brown-Sequard Syndrome:

This is a hemisection of the spinal cord in which you'll have ipsilateral posterior column involvement and contralateral spinothalamic tract involvement. For example, if there is damage on the right side, the lower right side will have posterior column loss while the left lower extremity will have pain and temperature loss.

Romberg Test:

This is a test for posterior column involvement and may be used to confirm Brown-Sequard Syndrome. Basically, the patient sways with their eyes closed and not with eyes open. Note that in cerebellar involvement, the patient sways with eyes open and eyes closed.

Cauda equina vs Conus medullaris lesions:

Both complain of lower back pain, but how do you differentiate between the two by the bedside? Conus medullaris lesion: S3-S5 nerves involved; bilateral saddle anesthesia; bladder and bowel involved; anal reflex gone. Cauda equine lesion: asymmetrical sensory loss;

Brain stem injury:

In brain stem injury, there is contralateral hemiplagia and ipsilateral cranial nerve damage. This is called cross paralysis.

Additional Reading:

Random USMLE Facts

1. Random USMLE Facts volume 1-1
2. Random USMLE Facts volume 2-1
3. Random USMLE Facts volume 3-1
4. Random USMLE Facts volume 4-1
5. Random USMLE Facts volume 5-1
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