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 Best of Five 3.26

 

   

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BOF: 3.26

You are called to see a patient in the surgical ward. He is recovering from surgery. He has had emergency surgery for dissecting aneurysm of the descending aorta. The postoperative period was complicated by pneumonia and pseudomembranous colitis. He has been transferred from the ITU to the surgical wards two days prior to you been called to see him. The patient is not moving his right lower limb normally and the surgical registrar thinks he may have had a stroke.

On examination, the patient is conscious and alert and has no abnormality in relation to speech. His cranial nerves are intact and there is no neurological deficit in the upper limbs. On examination of his lower limbs there is weakness of dorsiflexion and eversion of his right foot and there is weakness of toe extension. Sensation is impaired over the lateral aspect of the right lower leg and over the dorsum of the right foot.

The lesion in this patient is:

a)      Anterior spinal artery thrombosis

b)      Lacunar infarction of the left internal capsule

c)      Femoral nerve palsy

d)      Tibial nerve palsy

e)      Common peroneal nerve palsy

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