Segment 1: Question & Answer Deep Dive
Q1 (NEET PG 2024, Shift 2):
“A 30-year-old male presents with burning pain and temperature loss on the right side of his body below T8. Proprioception and fine touch are intact. Where is the lesion located?”
A. Left dorsal column at T8
B. Left lateral spinothalamic tract at T8
C. Right lateral spinothalamic tract at T8
D. Right dorsal horn at T8
Answer: B. Left lateral spinothalamic tract at T8
Explanation:Pain and temperature fibers cross within one or two segments of entry, so a right‐sided sensory loss below T8 indicates a lesion of the contralateral lateral spinothalamic tract. Proprioception spared because dorsal columns ascend ipsilaterally.
Pitfall to Avoid: Don’t reverse sides! Always map decussation: spinothalamic crosses early; dorsal columns cross in the medulla.
Q2 (NEET PG 2023):
“In syringomyelia, the most characteristic sensory loss pattern is:”
A. Ipsilateral loss of pain and temperature in a cape-like distribution
B. Ipsilateral loss of fine touch and vibration below lesion
C. Contralateral loss of pain and temperature below lesion
D. Ipsilateral LMN signs at level of lesion
Answer: A. Ipsilateral loss of pain and temperature in a cape-like distribution
Explanation:
Central canal expansion disrupts decussating spinothalamic fibers at that
segment, producing a bilateral “cape-like” loss over shoulders and arms. Motor signs may appear later but not the initial finding.
Pitfall to Avoid: Don’t confuse segmental LMN signs (ventral horn) with early sensory deficits—PYQs focus on sensory dissociation first.
Segment 2: Rollouts & Dangers
When tackling spinothalamic MCQs, remember:
1. Rollout Strategy:
Identify modality (pain/temp vs. touch/pressure).
Locate decussation (spinal cord vs. medulla).
Map side of deficit to lesion side (same for touch, opposite for pain).
2. Common Dangers:
Option Overlap: Distractors often mix up tract names (anterior vs.
lateral).
Level Traps: Lesions above T6 but deficits described below T6 – always
check dermatome maps!
Symmetry Tricks: Questions may phrase bilateral vs. unilateral—watch
adjectives like “cape-like” or “stocking-glove.”
Segment 3: Rapid-Fire MCQ Drill
I’ll read five true/false statements—say “true” or “false” out loud!
1. Lateral spinothalamic tract carries crude touch.
2. Pain and temperature cross at the anterior white commissure.
3. Anterolateral system = spinothalamic + spinoreticular tracts.
4. Syringomyelia first affects lower limb pain sensation.
5. Fine touch decussates in the brainstem.
Ready? Pause the podcast, decide, then play back for answers…
[3-second pause]
1 False (crude touch = anterior spinothalamic)
2 True
3 True
4 False (cape-like upper trunk)
5 True
Segment 4: Mnemonic Corner
Mnemonic:
“Love Pain Today”
Lateral = Pain/Temp
Anterior = Touch
Repeat it when you see “spinothalamic” in an MCQ option!