The names of the pathways also tell you a bit about what the pathways do. Ex. Cortico-spinal can be translated to cortex to spine which means it's going from the head to body. You can then deduce this is motor related. Ex. Spinothalamic can be translated to from spine to cortex. You can then assume that this is sensory. If you're short on time, this can at least help you eliminate some choices even if you don't know exactly what it is.
Dude, this is hilarious. I was reading this comment and thought.. wow super helpful, guy must be smart. And then I saw your name and picture !! totally checks out haha
I'm in my second last year of medicine and honestly, I have never understood these concepts as clearly as I do now, after watching your videos. Thank you so much!
3 synapses in DCML pathway : Sensory neuron in the fingers/toes >> Dorsal column nuclei (sensory neuron projects upto the DCN in medulla where it decussates in the medial lemniscus and projects upwards to the thalamus) Dorsal column nuclei >> Thalamus Thalamus >> Primary sensory cortex (cortical centre of the brain responsible for processing all sensory input from the body)
These pathways are so forgettable that I have to re-learn it every now and then. These mnemonics make it easier. Btw, my teacher taught me a mnemomic for Brown-Sequard syndrome which makes it very easy that I remember it upto this point. I want to share it. DISC LION DISC is for SENSORY loss (below the lesion) DI = Dorsal column (Ipsilateral), SC = Spinothalamic tract (contralateral) For those wondering what about "At the level of the lesion", it's obvious. You can deduce that there'll be hyperesthesia on the same side, and nothing will happen on the opposite side. LION is for MOTOR loss. LI = Lesion (ipsilateral), ON = Normal (opposite) So, at the level of the lesion, you'll have LMNL and below the level of the lesion, UMNL. Even though motor is said to be "normal" for opposite site of the lesion, there will be some deficit in axial and proximal muscles because of ACST damage.
Good vid but kind’ve counterintuitive on the colorings for the Corticospinal tract where you put the LCST (UMN) in red in writing but the picture that’s up has it as a blue tract, and the Anterior Horn (LMN) is blue in writing but red on the drawing 😅
i passed step 1 dirty!!! i 100% think it was because i discovered your videos 3 days before my test LOL. now i'm watching the rest of them to keep learning in m3 year!
17:14 - Decreased pin prick refers to decreased pain sensation not discriminative touch and would indicate a lateral spinothalamic tract problem, right?
I must have missed something...since the Corticospinal Tract and the Medial Lemniscus decussate in the medulla, aren't their effects contralateral? The video says ipsilateral, so I'm confused. Help!
LST crosses instantly at spinal level, which is why in BSS you'll see contralateral effects for it. The other two tracts cross in Medulla. Their normal functions are contralateral, but BSS will show ipsilateral effects since it is dealing with a spinal (not cortical) injury. Hope that made sense!
Because the first two pathways decussate at the brain stem level (not the spinal cord level) and we're dealing with SPINAL CORD injuries here and so the only pathway among the three that decussate at the SC level is the Spinothalamic (hence its effect is gonna be Contralateral). Hope it helped :)
Why are there no pain and temp sensation loss at the level of Brown squard lesion? If the signal comes to dorsal nucleus then it need to cross to the opposite side via the lissauer tract which is destroyed…😅 Also I don’t remember adding 2-3 levels when localizing the level of lesion of spinal cord injury using either motor or sensory deficit like in ASIA classification.
when you say that the effect for first two tracts(corticospinal tract and posterior colum) is ipsilateral you say that because of the variation of the decussation of the tract compared to the Spinothalamic tract( as in the decussation for the first two happens in the medulla and the decussation for the lateral spinothalamic tract happens in the spinal cord level). please correct me if im wrong.
question i always get wrong, i had to look up again, is where does it cross in the LST. The answer i am seeing is the Anterior White Commissure. So thinking that in sports, Commissioners allow trades, as this trades sides. Hope this is correct, thanks for this video, helped a ton w the other mnemonics.
After doing synapsis with the second neuron, does its axon go by the dorsal column? Or is there a colateral way to the medulla oblongata neuron? I couldn't understand your scheme just at this point...
This is a common feature for any spinal cord lesion, as the UMNs generally act to modulate mainly via inhibition the LMNs. With spinal cord injury, the damaged UMN and LMN at the level cause a LMNL picture at the lesion level, but below this, the LMNs are released from inhibition from the descending UMNs, causing UMNL features below the lesion level. If it helps, I have 2 animated videos on my channel; one on spinal cord injury that helps visualise the UMNL and LMNL issue, and a Brown-Sequard video also
If it helps, I've created an animated Brown-Sequard video on my channel that goes into much more detail. For example, it covers why you also lose spinothalamic loss ipsilaterally approx 2 levels below, then contralaterally all the way down.
This channel saved my degree.
Same here🤣
@@shionafernandes4343 unfortunately just found it but it's killer for boards
Hahahahahaha same, so succinctly put
I don't usually comment but I just wanted to say - I passed my neuro block because of you. Thank you Dirty Medicine!!!
The names of the pathways also tell you a bit about what the pathways do.
Ex. Cortico-spinal can be translated to cortex to spine which means it's going from the head to body.
You can then deduce this is motor related.
Ex. Spinothalamic can be translated to from spine to cortex.
You can then assume that this is sensory.
If you're short on time, this can at least help you eliminate some choices even if you don't know exactly what it is.
Thank you! This makes so much sense.
I never realised this and it makes so much sense... Thank you!!!
Dude, this is hilarious. I was reading this comment and thought.. wow super helpful, guy must be smart. And then I saw your name and picture !! totally checks out haha
I'm in my second last year of medicine and honestly, I have never understood these concepts as clearly as I do now, after watching your videos. Thank you so much!
Are you kidding me man?! How are you so damn good? We don't deserve you! Glad to have you!
2 weeks away from my step 1 and I have never understood brown sequard syndrome so clearly as I do now. THANK YOU DIRTY
Hi how did your step go ??
How'd it goo? How did you prepare for ur step 1? Have you attempted step 2 yet?
3 synapses in DCML pathway :
Sensory neuron in the fingers/toes >> Dorsal column nuclei (sensory neuron projects upto the DCN in medulla where it decussates in the medial lemniscus and projects upwards to the thalamus)
Dorsal column nuclei >> Thalamus
Thalamus >> Primary sensory cortex (cortical centre of the brain responsible for processing all sensory input from the body)
These pathways are so forgettable that I have to re-learn it every now and then. These mnemonics make it easier.
Btw, my teacher taught me a mnemomic for Brown-Sequard syndrome which makes it very easy that I remember it upto this point. I want to share it.
DISC LION
DISC is for SENSORY loss (below the lesion)
DI = Dorsal column (Ipsilateral), SC = Spinothalamic tract (contralateral)
For those wondering what about "At the level of the lesion", it's obvious. You can deduce that there'll be hyperesthesia on the same side, and nothing will happen on the opposite side.
LION is for MOTOR loss.
LI = Lesion (ipsilateral), ON = Normal (opposite)
So, at the level of the lesion, you'll have LMNL and below the level of the lesion, UMNL.
Even though motor is said to be "normal" for opposite site of the lesion, there will be some deficit in axial and proximal muscles because of ACST damage.
wow.. that makes sense... best best!!
You deserve all the happiness in the universe. Thank you so much for your videos!
You saved many medical students. We will be grateful to you
Good vid but kind’ve counterintuitive on the colorings for the Corticospinal tract where you put the LCST (UMN) in red in writing but the picture that’s up has it as a blue tract, and the Anterior Horn (LMN) is blue in writing but red on the drawing 😅
Just Wow! You Sir have a gift at making everything so understandable. Thank you.
This is the MOST incredible video ever! Im soooo thankful for your existence! lol saving med students lives!!!!! THANK YOU!
You are definitely going to heaven 🤗
heheeee my thoughts exactly heeheeee
Many Thanks! I used to have a hard time getting into it when I was a preclinical student. And I just understood this NOW! 😢
i passed step 1 dirty!!! i 100% think it was because i discovered your videos 3 days before my test LOL. now i'm watching the rest of them to keep learning in m3 year!
In Brown Sequard, there would also be LMN findings ipisilaterally AT the level of the lesion, correct? Not just UMN below level on the lesion? Thanks!
Correct.
What about Transverse myelitis?
This helped so much! Thanks for saving us medical students!
17:14 - Decreased pin prick refers to decreased pain sensation not discriminative touch and would indicate a lateral spinothalamic tract problem, right?
Yup
WOW. you are just....amazing. thanks for this.
Great channel for physios too! Hats off.
Sorry, isn't it flipped in 6:49? Blue is UMN and red is LMN?
Yes, you are correct.
Thanks so much for your videos on neurology, they are excellent!
The 3 pathways mentioned at the beginning are the most important
You deserve a medal 🏅
Thank you so much, take love 💕
At 7:28 you say upper motor neuron is red and lower motor neuron is blue, your picture shows the opposite just FYI.
I was confused for a moment myself
Thank you for this, i thought i was alone in noticing that !
thank you for telling. i was so confused
7:00 did you reverse the red and blue colors of the upper and lower motor neurons on the left and right side of the screen?
wonderfully explained. You are better than my professor.
I must have missed something...since the Corticospinal Tract and the Medial Lemniscus decussate in the medulla, aren't their effects contralateral? The video says ipsilateral, so I'm confused. Help!
LST crosses instantly at spinal level, which is why in BSS you'll see contralateral effects for it. The other two tracts cross in Medulla. Their normal functions are contralateral, but BSS will show ipsilateral effects since it is dealing with a spinal (not cortical) injury. Hope that made sense!
@@AsadR43 Now I get it...thanks!
@@AsadR43 I had the same doubt! And your comment appropriately cleared it. Thank you!
Thank you for making it simple i was so confused with all these tracts
Why wouldn't we consider ipsilateral vs contralateral manifestations of the lesions based on if the lesion is above or below the decussation?
Because the first two pathways decussate at the brain stem level (not the spinal cord level) and we're dealing with SPINAL CORD injuries here and so the only pathway among the three that decussate at the SC level is the Spinothalamic (hence its effect is gonna be Contralateral). Hope it helped :)
God sent! Thanks so much
Nina Sowah agreed
Awesome. Thank you!!!
Why are there no pain and temp sensation loss at the level of Brown squard lesion?
If the signal comes to dorsal nucleus then it need to cross to the opposite side via the lissauer tract which is destroyed…😅
Also I don’t remember adding 2-3 levels when localizing the level of lesion of spinal cord injury using either motor or sensory deficit like in ASIA classification.
Oh GOD you saved my life! Thank youuu
This channel is GOD SENT
This was so great, thank you
This is best bro.
Very very helpful! Thank you so much!
when you say that the effect for first two tracts(corticospinal tract and posterior colum) is ipsilateral you say that because of the variation of the decussation of the tract compared to the Spinothalamic tract( as in the decussation for the first two happens in the medulla and the decussation for the lateral spinothalamic tract happens in the spinal cord level).
please correct me if im wrong.
you are right...spinothalamic tract descussate immediately in spinal cord thats why opposite side
injury occurs at the spinal cord and decussation is in medulla in first two tracts,so decusation occurs before the injury ,so ipsilateral
Very good teacher
Thank you so much 🙏🙏🙏
Thank you 😊
question i always get wrong, i had to look up again, is where does it cross in the LST. The answer i am seeing is the Anterior White Commissure. So thinking that in sports, Commissioners allow trades, as this trades sides. Hope this is correct, thanks for this video, helped a ton w the other mnemonics.
God bless this man
You saved me, thank you so much
We should know the blood supply to all of these tracts though, right?
😭 thank you so much for majing this vedio ❤❤
You are great
Thank you so much!!🥹
Please make video on varoius brain herniations and their syndromes. Havent found one good video on it here on YT.
Wrangle concept,well explained
Very good.
Thank you from 🇦🇺
Help me understand why a common term used is spinel cord
The actual name is Brain cord, protected by the spine.
Amazing work, keep it up please
don't know where i'd be without you
Awesome explanation 👍
After doing synapsis with the second neuron, does its axon go by the dorsal column? Or is there a colateral way to the medulla oblongata neuron? I couldn't understand your scheme just at this point...
why do you loose pain and temp 2 segments below when the decussate at the level of the lesion?
You're simply the best 😍😍
can you do one on medullary syndromes?
Bless you bro you are helping a lot
Pls make some videos on microbiology topics, will be waiting
This was so helpful!!!
Thank you!
Thank you sm! that was extremely helpful!!
Is there a video about vestibular ocular reflex VOR ? If not, we need one please.
Thanks
Great video..... thanks
Great video!
Thanks for the refresher! Great summary.
Jaani had de pe oko 🤧❤️
you are,,, genius.
I love your videos!
I swear God send you to save us all!
osteopathic schools have anatomist with a Master's teach this. If there is any disagreement please let me know.
AMAZING
😀
Thanks for this 😭😭😭😭😭
Perfection
you are a king
I got my med school diploma from Dirty Medicine School of Medicine
Amazing!!!!!
Love how I pay 60k/year in tuition and not even a doc can teach this at my med school.
Unfortunately this is not unusual
I LOVE YOU!!!
why sensation is lost at level (LMN) and UMN below the level of lesion ?
This is a common feature for any spinal cord lesion, as the UMNs generally act to modulate mainly via inhibition the LMNs. With spinal cord injury, the damaged UMN and LMN at the level cause a LMNL picture at the lesion level, but below this, the LMNs are released from inhibition from the descending UMNs, causing UMNL features below the lesion level. If it helps, I have 2 animated videos on my channel; one on spinal cord injury that helps visualise the UMNL and LMNL issue, and a Brown-Sequard video also
Thank you LOve from Pakistan
Thank you for the big picture review!
Did they ever catch the guy who did the stabbing?
love it
dammm =))) thank you so much for this crazy mnemonic
You're Godsent
Some Doctors Don’t Think Politically -> to add Decussation into the mnemonic
Why did this video come to me after the exam? It's hurts
better late than never
Kind of annoyed i’ve only found this channel in the second half of my final year
You saved me omg.
It is a good video overall, thanks. But I believe that it is too superficial. May be used as a last review only.
If it helps, I've created an animated Brown-Sequard video on my channel that goes into much more detail. For example, it covers why you also lose spinothalamic loss ipsilaterally approx 2 levels below, then contralaterally all the way down.
@@NeurologyAnalogy Thanks! I'll check it out. Thank you for your contribution. I'm sure you made so many medical students' day!
New posterior column acronym: Sucks Dat Trumps Prez
t🐐
I love u