Question 7

After an ischemic stroke, the patient has a hoarse voice and difficulty swallowing, which you attribute to damage to nucleus ambiguus or the exiting 10th nerve. In addition, he has lost the ability to detect pain or hot and cold when these stimuli are applied to his right arm and leg or to the left side of his face. You attribute this pattern of pain and temperature loss to disruption of the spinothalamic tract (which crossed in the spinal cord), and the descending tract of 5 (which is composed of uncrossed primary sensory axons of the 5th nerve). Indicate ALL of the statements about this patient that are correct.

a. The stroke was produced by a reduction of blood flow in the carotid circulation.
b. The stroke was produced by a reduction of blood flow in the vertebral-basilar circulation.
c. The stroke affects neuroanatomic structures located in medial parts of the brainstem.
d. The stroke affects neuroanatomic structures located in dorsolateral parts of the brainstem.
e. The infarcted tissue is located in the pons
f. The infarcted tissue is located in the medulla
g. The infarcted tissue producing his signs/symptoms is all located on the left side of the nervous system
h. There must be infarcted tissue on both sides of the nervous system to account for his signs/symptoms.