Question of the Day
Study for the USMLE Step 2, daily.
A 45-year-old male comes to his primary care physician because he is having difficulty moving his head and neck. On examination, the physician notes the patient has decreased strength and motion in the muscles of the neck. His balance is unaffected, he has a normal gait, and the tone in the rest of his limbs is within normal limits. Which of the following is the most likely pathway affected that might cause this deficit?
Correct Answer:
Explanation:
The medial vestibulospinal tract arises from the medial vestibular nucleus and descends in the MLF to cervical levels, where it controls lower motor neurons (LMNs), which innervate (flexor) muscles controlling the position of the head.
The lateral vestibulospinal tract (answer A) extends down to the lumbar region and is involved with posture by controlling the extensor muscles of the legs. The reticulospinal tracts (answers C and D) modulate the muscle tone of the limbs.
The rubrospinal tract (answer E) facilitates flexor motor neurons of the limbs.
Quick Concepts:
Medial vestibulospinal tract
- Controls lower motor neurons which innervate flexor muscles controlling the position of the head
Summary:
The medial vestibulospinal tract arises from the medial vestibular nucleus and descends in the MLF to cervical levels, where it controls lower motor neurons (LMNs), which innervate (flexor) muscles controlling the position of the head.
Explanation:
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