The lacunar infarct is commonly associated with

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The lacunar infarct is commonly associated with hypertension, atherosclerosis and to a lesser degree with diabetes. 360
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The basis of the lucunar infarct is considered to be unusually severe atherosclerosis that has extended into the finest branch of large arteries. When the vessels are examined, they reveal atheroma, thrombosis and lipohyaline degeneration. 361
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Lacunae are situated in the descending order of frequency in: Putamen. Caudate nuclei. Thalamus. Basis ponds. Internal capsule. Deep hemispherical white matter. 362
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363
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Lacunar infarcts manifests as - a) Pure sensory weakness b) Pure motor weakness c) Ataxic paresis d) Dysarthria e) Quadriparesis A, B, C, D. 364
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Lateral medullary syndrome is caused by thrombosis of- (Dec 95) a) Anterior inferior cerebral artery b) Posterior interior cerebellar artery c) Vertebral artery d) Basilar artery 365
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Although the lateral medullary syndrome was traditionally attributed to occlusion in the course of Posterior inferior cerebellar artery (PICA) , careful studies have shown that in 8 out of 10 cases, it is the vertebral artery that is occluded by atherothrombosis. In the remainder, either the posterior inferior cerebellar artery or one of the lateral medullary arteries is occluded. 366
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367
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Wallenberg’s syndrome or lateral medullary syndrome occur due to infarction of the dorsolateral part of the medulla. Thus the structures located in the dorsolateral part of the medulla are affected in the lateral medullary syndrome. 368
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The structures which are involved in the lateral medullary syndrome are:- Nucleus ambiguus Vestibular nuclei Nucleus tractus solitarius Cuneate and Gracile nuclei Otolithic nuclei Descending sympathetic tract Spinothalamic tract Fibres of 9th and 10th nerve fibers 369
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Note that Nucleus ambiguus contribute fibres to the cranial part of accesory nerve, (cranial nerve XI). Hypoglossal or the twelth nerve is situated in the medial part of the medulla. Therefore quiet obviously it is spared in lateral medullary syndrome. (It will be involved in medial medullary syndrome). Medial part of medulla is supplied by anterior spinal artery. 370
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371
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Q) Lateral medullary syndrome (Wallenberg syndrome) is characterized by all, Except – (JUNE 97) a) Giddiness b) Dysphagia c) Crossed hemianaesthesia d) Horner’s syndrome is rare D 373
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All are features of Wallenberg’s syndrome, except- a) Ipsilateral loss of pain and temperature b) Ipsilateral loss of taste sensation c) Ipsilateral loss of posterior column sensations d) Ipsilateral involvement of lower cranial nerves. A 374
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MYASTHENIA GRAVIS 375
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Myasthenia gravis is caused by dysfunction of - (NBE/DNB Pattern) a) Pineal gland b) Thymus gland c) Pituitary gland d) Parathyroid gland B 376
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Thymus is believed to play an important role in autoimmune dysfunction in myasthenia gravis.
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  • Winter '16
  • jean grey

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