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Contributor score: 4
dysphagia from hit of nucleus ambiguus (CN IX/X/XI)
Sensation changes due to hit of lateral spinothalamic tract and spinal trigeminal
Check out rule of 4s if you haven't already
Yup, lateral meduallary syndrome or Wallenburg Syndrome. Whatever you want to call it. The hemifacial analgesia is from damage to the spinal trigeminal nucleus/tract, and you get the hoarseness from damage to the vagus and the body loss is from the spinal thalamic tract. You can also get Horner’s syndrome with this.
Lateral medullary syndrome = Wallenberg's syndrome
My FA2018 has “C7” bolded, meaning it is the main nerve root. But I also got this one wrong so I can’t be much help besides that.
Honestly just a guess but I have this vague understanding that intrinsic hand muscles are C8-T1 so we might’ve expected more hand motor findings as well with a C8 lesion.
I narrowed it down to C7 using the fact that the C7 myotome is elbow extension. I also learned that the C7 nerve root was the main contributor to the triceps DTR so I just went with that.
They also mentioned that the person had weakness pronating the right forearm which is performed by the biceps. Biceps is innervated by the musculocutaneous nerve which is C5-C7 and that's what helped me pick C7 > C8.
Sorry, I thought the biceps was a supinator of the forearm?
yes.. its the supinator not pronator