A patient with a small lacunar infarction complains of left hemisensory loss involving the face, arm, and leg equally. On exam, her has hemisensory loss to pin prick, temperature, and proprioception on the entire left side including the trunk. Which thalamic subnucleus is likely affected contralaterally?
Correct Answer: Ventral posterolateral
Description: (D) Ventral posterolateral > Thalamus comprises a subcortical collection of nuclei that surrounds the third ventricle> This structure serves as a relay center not only for sensory projections (including vision and hearing), also for basal ganglionic, cerebellar, limbic and cortical structures.> Most of the thalamic subnuclei named for their anatomic position within the structure itself.> Following subnuclei are named with their corresponding efferent projections. Ventral posterolateral (VPL) a primary sensory cortex Pulvinar a inferior parietal lobule Lateral geniculate (LG) a primary visual cortex (occipital lobe) Medial geniculate (MG) a auditory cortex (temporal lobe) Dorsomedial (DM) a prefrontal cortex Ventrolateral (VL) a primary motor cortex. Anterior a cingulate gyrus> These same subnuclei have important afferent connections also that correspond with their output projections: Medial lemniscus and spinothalamic tracts a VPL Mammillary body & mammillothalamic tract a anterior nucleus (limbic) Optic tract a LG lateral lemniscus and inferior colliculus a MG amygdala & temporal neocortex a DM dentate nucleus, globus pallidus, & substantia nigra a (cerebellar & basal ganglionic)
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