Roger presents to the neurologist as he is experiencing some loss of balance, weakness and ‘funny feeling’ in his face, body, arms and legs. Neurological examination reveals the following (examination findings have been numbered for easy identification in your written responses).
test finding 1: Loss of fine touch sense on right side of body below neck (includes right upper and lower limbs)
test finding 2: Loss of ability to distinguish hot and cold on right side of body below neck (includes right upper and lower limbs)
test finding 3: Loss of pain and temperature sense on left side of face
test finding 4: Weakness/loss of strength in right upper limb, right lower limb and right trunk muscles. Facial muscles are not experiencing weakness or problems on either side.
Consider the information above and answer the following questions. Ensure you clearly state which question is being answered in your entered responses. Answers should be written clearly and concisely and in your own words. Bullet points are suitable for listing key points.
Which specific neuroanatomical structure might be affected that would explain EACH test finding? You should include a brief justification statement with your listed structure for each test finding.
What does the tests findings tell you about WHERE (in terms of anatomical area) the lesion/problem is most likely to be located? You need to consider sensory and motor pathways to answer this question.
Given your responses to above – where is the problem/lesion likely to be located that explains ALL the provided tests findings?