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USMLE forum Jeoprady Game! - pepsi00
#21
spastic left
hemiparesis and an extensor plantar reflex on the left----so the lesion has to be on the RIGTH -affceting hands and legs -corticospinal tract



The right side of the patientâ„¢s face is numb,-FACIAL -IPSILATERAL PARALYSIS and the jaw
deviates to the left upon protrusion-facialis involvment

.Where is the most
likely location of a lesion?
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#22
E
Right rostral pons-
left hemiparesis -since its before medullary pyramidal decussation
right facial numbness- since the right main sensory nucleus-ipsilateral supply. not even sure if it should be right facial nerve lesion

left jaw deviation- was expecting it to be to the side of the lesion of motor nucleus of trigeminal.
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#23
well u almost got it
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#24
The correct answer is E. The patient has a long tract
sign and a cranial nerve sign, both of which are features
of a lesion inside the brainstem. The cranial nerve
involved is CN V (facial numbness and jaw deviation)
and localizes the lesion to the rostral pons on the right,
the site of emergence of CN V from the brainstem. The
corticospinal tract on the right also is involved, causing
left spastic hemiparesis and the Babinski sign on the left.
A lesion of the left cervical spinal cord (choice A) might
produce one or more long tract signs but no cranial
nerve deficits.
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#25
i am not gettin jaw deviation
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#26
so whats the answer coz I would still choose E but dont agree with the left jaw deviation for a right sided lesion
again plaese explain if the numbness is fcial nerve lesion - lower pons or trigeminal main sensory nucleus-rostral pons
ave rusted after a stupid break Damn!!
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#27
the jaw deviation story is wrong!!
jaw and tongue deviation are to the side of the lesion
uvula deviation and nystagmus are away from the side of the lesion

and the rest of the choices are incorrect

where are ua jeopardy qns from?
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#28
E is the answer.

Facial nerve doesnt it cross in the motor cerebral hempishere on the opposite side?
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#29

5.) You are called to perform thoracentesis (remove fluid from the pleural cavity). If you are to avoid injuring lung or neurovascular elements, where would you insert the aspiration needle?

a.)the top of interspace 8 in the midclavicular line
b.)the bottom of interspace 8 in the midclavicular line
c.)the top of interspace 9 in the midaxillary line
d.)the bottom of interspace 9 in the midaxillary line
e.)the top of interspace 11 in the scapular line
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#30
I do agree,it should be jaw protusion toward right not left. FAULTY QUESTION
Sorry Hypez!
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