95 A 53-year-old woman is brought to the physician by her husband who is concerned about her 1-year history of progressive numbness of the hands. He says that 2 days ago she unknowingly burned her left hand because she had no pain. Ophthalmologic examination shows a smaller pupil on the left than on the right and left plosis. Sensation to pinprick and temperature is absent bilaterally over the upper thorax and upper extremities. Sensation to vibration and joint position is intact. There is weakness and atrophy of the intrinsic hand muscles bilaterally. Which of the following is the most likely initial location of the lesion in this patient? A) Anterior white commissure of the spinal cord B) Dorsal root ganglia C) Large myelinated nerves D) Midline thalamus E) Ventral roots

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95 A 53-year-old woman is brought to the physician by her husband who is concerned about her 1-year history of progressive numbness of the hands. He says that 2 days
ago she unknowingly burned her left hand because she had no pain. Ophthalmologic examination shows a smaller pupil on the left than on the right and left plosis.
Sensation to pinprick and temperature is absent bilaterally over the upper thorax and upper extremities. Sensation to vibration and joint position is intact. There is
weakness and atrophy of the intrinsic hand muscles bilaterally. Which of the following is the most likely initial location of the lesion in this patient?
A) Anterior white commissure of the spinal cord
B) Dorsal root ganglia
C) Large myelinated nerves
D) Midline thalamus
E) Ventral roots
Transcribed Image Text:95 A 53-year-old woman is brought to the physician by her husband who is concerned about her 1-year history of progressive numbness of the hands. He says that 2 days ago she unknowingly burned her left hand because she had no pain. Ophthalmologic examination shows a smaller pupil on the left than on the right and left plosis. Sensation to pinprick and temperature is absent bilaterally over the upper thorax and upper extremities. Sensation to vibration and joint position is intact. There is weakness and atrophy of the intrinsic hand muscles bilaterally. Which of the following is the most likely initial location of the lesion in this patient? A) Anterior white commissure of the spinal cord B) Dorsal root ganglia C) Large myelinated nerves D) Midline thalamus E) Ventral roots
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