A 45 -old male comes to his primary care physician because he is having

USMLE Step 1 Forum

Mon, 08 Feb 2010 20:26:45 -0500

USTA

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?

Choice A . Lateral vestibulospinal tract
Choice B . Medial vestibulospinal tract
Choice C . Medial reticulospinal tract
Choice D . Lateral reticulospinal tract
Choice E . Rubrospinal tract

Mon, 08 Feb 2010 21:23:51 -0500

Janeway

i think its is it e ?

Tue, 09 Feb 2010 02:01:59 -0500

fuschiapetitspois

you',re right macusa.

Answer is Choice B .

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 muscle tone of the limbs.

The rubrospinal tract (answer E) facilitates flexor motor neurons of the limbs

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