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  #1  
Old 06-04-2011
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Question Neuroanatomy - dissection of the aorta and paraplegia

A 60-year-old man was admitted to the emergency department, complaining of the sudden onset of excruciating, sharp, tearing pain localized to the back of the chest and the back. After a thorough physical and radiological examination, a diagnosis of dissection of the descending thoracic aorta was made. Within a few hours, the patient started to experience "girdle" pain involving the fourth thoracic dermatome on both sides. Later, he was found to have bilateral thermoanesthesia and analgesia below the level of the fourth thoracic dermatome.
Position sense, vibration, and light tough remained normal. Complete spastic paralysis of both legs quicly developed.

1.- The sudden onset of "girdle" pain in this patient was most likely caused by:

A) Pressure on the fourth thoracic spinal nerves
B) Blockage of the origins of the posterior intercostal arteries that give rise to the segmental spinal arteries by the aortic dissection
C) Discomfort caused by the expanding aneurysm
D) Osteoarthritis of the vertebral column

2.- The development of bilateral thermoanesthesia and analgesia below the level of the fourth thoracic segment of the cord and the later development of paraplegia could be caused by:

A) Absent circulation in the posterior spinal arteries
B) Cerebral hemorrhage
C) Absent circulation in the anterior spinal artery
D) Collapse of the fouth thoracic vertebral body
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Old 06-04-2011
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1.???b

2.c.
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Old 06-04-2011
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The ans. are
1.B
2.C
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Old 06-04-2011
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Quote:
Originally Posted by axax View Post
The ans. are
1.B
2.C
w/u
B & C
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Old 06-04-2011
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its c for both
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Old 06-04-2011
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My answers are:
B and C
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  #7  
Old 06-04-2011
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Embarrassed answers

1-b

2-c
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  #8  
Old 06-05-2011
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Correct Answer correct answer

Indeed..the answers are:

1 - B
2 - C
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