CLINICAL NEUROANATOMY
MADE RIDICULOUSLY SIMPLE
6TH EDITION
• AUTHOR(S)STEPHEN
GOLDBERG, M.D.
TEST BANK
) Hemicord lesion and crossed findings
Reference: Ch. 1 — General Organization — Long Tracts and
Decussation
Clinical/Applied Stem:
A 29-year-old man has a stab wound to the left side of the
cervical spinal cord. He develops weakness of the left leg and
loss of pain and temperature on the right side of the body
beginning a few segments below the injury. Vibration and
position sense are reduced on the left below the lesion.
,Options:
A. The dorsal columns cross in the spinal cord, while the
corticospinal tract crosses in the medulla
B. The corticospinal tract crosses in the spinal cord, while the
spinothalamic tract crosses in the medulla
C. The corticospinal tract crosses in the medulla, while the
spinothalamic tract crosses in the spinal cord
D. Both the corticospinal and spinothalamic tracts cross in the
medulla
Correct Answer: C
Rationales:
Correct: The corticospinal tract decussates in the caudal
medulla, so a left spinal cord lesion produces ipsilateral motor
weakness below the lesion. Pain and temperature fibers cross
near the spinal cord entry level, so the opposite side is affected
below the lesion after a short ascent.
A: Reverses the key crossing sites for two major tracts.
B: Incorrect because the corticospinal tract does not cross in
the spinal cord.
D: Incorrect because the spinothalamic tract crosses in the
spinal cord, not the medulla.
Teaching Point: Crossed sensory-motor findings usually localize
to a spinal cord hemisection.
Citation: Goldberg, S. (2022). Clinical Neuroanatomy Made
Ridiculously Simple (6th ed.). Ch. 1.
,2) Dorsal root lesion
Reference: Ch. 1 — General Organization — Dorsal Roots
Clinical/Applied Stem:
After a shingles-like radicular pain syndrome, a patient loses
pinprick and light-touch sensation in a single dermatomal strip
on the trunk. Strength, tone, and reflexes remain normal in the
same region. The problem is limited to the sensory input route.
Options:
A. Dorsal root
B. Ventral root
C. Anterior horn cell
D. Peripheral motor nerve only
Correct Answer: A
Rationales:
Correct: The dorsal root carries afferent sensory fibers into the
spinal cord. A lesion there causes sensory loss in a dermatomal
distribution without primary motor weakness.
B: Ventral root injury would produce motor deficits, not isolated
sensory loss.
C: Anterior horn cell disease produces lower motor neuron
weakness, not isolated sensory loss.
D: A motor nerve lesion would not explain a purely sensory
deficit.
, Teaching Point: Dorsal roots are sensory; ventral roots are
motor.
Citation: Goldberg, S. (2022). Clinical Neuroanatomy Made
Ridiculously Simple (6th ed.). Ch. 1.
3) Ventral root lesion
Reference: Ch. 1 — General Organization — Ventral Roots
Clinical/Applied Stem:
A patient develops flaccid weakness and reduced reflexes in
muscles supplied by one spinal segment after a foraminal disc
herniation. Sensation in the same dermatome is intact. The
lesion interrupts the motor outflow before it joins the spinal
nerve.
Options:
A. Dorsal root
B. Ventral root
C. Dorsal root ganglion
D. Posterior horn
Correct Answer: B
Rationales:
Correct: The ventral root carries efferent motor fibers from the
spinal cord to the periphery. Injury causes lower motor neuron
weakness and hyporeflexia with preserved sensation if the
dorsal root is spared.
MADE RIDICULOUSLY SIMPLE
6TH EDITION
• AUTHOR(S)STEPHEN
GOLDBERG, M.D.
TEST BANK
) Hemicord lesion and crossed findings
Reference: Ch. 1 — General Organization — Long Tracts and
Decussation
Clinical/Applied Stem:
A 29-year-old man has a stab wound to the left side of the
cervical spinal cord. He develops weakness of the left leg and
loss of pain and temperature on the right side of the body
beginning a few segments below the injury. Vibration and
position sense are reduced on the left below the lesion.
,Options:
A. The dorsal columns cross in the spinal cord, while the
corticospinal tract crosses in the medulla
B. The corticospinal tract crosses in the spinal cord, while the
spinothalamic tract crosses in the medulla
C. The corticospinal tract crosses in the medulla, while the
spinothalamic tract crosses in the spinal cord
D. Both the corticospinal and spinothalamic tracts cross in the
medulla
Correct Answer: C
Rationales:
Correct: The corticospinal tract decussates in the caudal
medulla, so a left spinal cord lesion produces ipsilateral motor
weakness below the lesion. Pain and temperature fibers cross
near the spinal cord entry level, so the opposite side is affected
below the lesion after a short ascent.
A: Reverses the key crossing sites for two major tracts.
B: Incorrect because the corticospinal tract does not cross in
the spinal cord.
D: Incorrect because the spinothalamic tract crosses in the
spinal cord, not the medulla.
Teaching Point: Crossed sensory-motor findings usually localize
to a spinal cord hemisection.
Citation: Goldberg, S. (2022). Clinical Neuroanatomy Made
Ridiculously Simple (6th ed.). Ch. 1.
,2) Dorsal root lesion
Reference: Ch. 1 — General Organization — Dorsal Roots
Clinical/Applied Stem:
After a shingles-like radicular pain syndrome, a patient loses
pinprick and light-touch sensation in a single dermatomal strip
on the trunk. Strength, tone, and reflexes remain normal in the
same region. The problem is limited to the sensory input route.
Options:
A. Dorsal root
B. Ventral root
C. Anterior horn cell
D. Peripheral motor nerve only
Correct Answer: A
Rationales:
Correct: The dorsal root carries afferent sensory fibers into the
spinal cord. A lesion there causes sensory loss in a dermatomal
distribution without primary motor weakness.
B: Ventral root injury would produce motor deficits, not isolated
sensory loss.
C: Anterior horn cell disease produces lower motor neuron
weakness, not isolated sensory loss.
D: A motor nerve lesion would not explain a purely sensory
deficit.
, Teaching Point: Dorsal roots are sensory; ventral roots are
motor.
Citation: Goldberg, S. (2022). Clinical Neuroanatomy Made
Ridiculously Simple (6th ed.). Ch. 1.
3) Ventral root lesion
Reference: Ch. 1 — General Organization — Ventral Roots
Clinical/Applied Stem:
A patient develops flaccid weakness and reduced reflexes in
muscles supplied by one spinal segment after a foraminal disc
herniation. Sensation in the same dermatome is intact. The
lesion interrupts the motor outflow before it joins the spinal
nerve.
Options:
A. Dorsal root
B. Ventral root
C. Dorsal root ganglion
D. Posterior horn
Correct Answer: B
Rationales:
Correct: The ventral root carries efferent motor fibers from the
spinal cord to the periphery. Injury causes lower motor neuron
weakness and hyporeflexia with preserved sensation if the
dorsal root is spared.
