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!
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!
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.
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!
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.
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.
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...
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.
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)
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 :)
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.
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
This channel saved my degree.
Same here🤣
@@shionafernandes4343 unfortunately just found it but it's killer for boards
Hahahahahaha same, so succinctly put
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!
You are definitely going to heaven 🤗
heheeee my thoughts exactly heeheeee
You deserve all the happiness in the universe. Thank you so much for your videos!
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 😅
This is the MOST incredible video ever! Im soooo thankful for your existence! lol saving med students lives!!!!! THANK YOU!
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!
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!!
Many Thanks! I used to have a hard time getting into it when I was a preclinical student. And I just understood this NOW! 😢
This helped so much! Thanks for saving us medical students!
Very good teacher
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?
Thanks so much for your videos on neurology, they are excellent!
Thank you for making it simple i was so confused with all these tracts
wonderfully explained. You are better than my professor.
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
This is best bro.
17:14 - Decreased pin prick refers to decreased pain sensation not discriminative touch and would indicate a lateral spinothalamic tract problem, right?
Yup
Wrangle concept,well explained
God sent! Thanks so much
Nina Sowah agreed
Very good.
Awesome explanation 👍
God bless this man
This was so helpful!!!
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 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!
Please make video on varoius brain herniations and their syndromes. Havent found one good video on it here on YT.
Thank you from 🇦🇺
Thank you so much!!🥹
Thanks
Thanks for this 😭😭😭😭😭
Thank you sm! that was extremely helpful!!
I got my med school diploma from Dirty Medicine School of Medicine
can you do one on medullary syndromes?
Thank you so much 🙏🙏🙏
Great video!
Pls make some videos on microbiology topics, will be waiting
Thanks for the refresher! Great summary.
Great video..... thanks
AMAZING
😀
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.
Perfection
I swear God send you to save us all!
I love your videos!
you are,,, genius.
Amazing!!!!!
Jaani had de pe oko 🤧❤️
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.
Help me understand why a common term used is spinel cord
The actual name is Brain cord, protected by the spine.
Thank you LOve from Pakistan
you are a king
We should know the blood supply to all of these tracts though, right?
love it
osteopathic schools have anatomist with a Master's teach this. If there is any disagreement please let me know.
Thank you for the big picture review!
Is there a video about vestibular ocular reflex VOR ? If not, we need one please.
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...
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
Did they ever catch the guy who did the stabbing?
You saved me omg.
I love u
you are fast no need to speed the video
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!
t🐐
I fucking hated neuroanatomy, now I am ok with it.
I don't usually comment but I just wanted to say - I passed my neuro block because of you. Thank you Dirty Medicine!!!
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 ??
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)
WOW. you are just....amazing. thanks for this.
Just Wow! You Sir have a gift at making everything so understandable. Thank you.
You saved many medical students. We will be grateful to you
Sorry, isn't it flipped in 6:49? Blue is UMN and red is LMN?
Yes, you are correct.
The 3 pathways mentioned at the beginning are the most important
dammm =))) thank you so much for this crazy mnemonic
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 :)
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
Great channel for physios too! Hats off.
This was so great, thank you
why do you loose pain and temp 2 segments below when the decussate at the level of the lesion?
Very very helpful! Thank you so much!
Amazing work, keep it up please
Oh GOD you saved my life! Thank youuu
This channel is GOD SENT
Thank you 😊
I LOVE YOU!!!
You are great
You deserve a medal 🏅
Thank you so much, take love 💕
don't know where i'd be without you
You're simply the best 😍😍
Bless you bro you are helping a lot
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!
You're Godsent