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Dorsal Column Function — FRCA Primary MCQ

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HardPhysiology - NeurophysiologyDorsal Column FunctionFRCA Primary

A hemicord lesion at T10 interrupts the right dorsal columns but spares the anterolateral tract. Which deficit is expected below the lesion after spinal shock has resolved?

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Correct answer: B — Ipsilateral loss of vibration and joint-position sense

The best answer is “Ipsilateral loss of vibration and joint-position sense”. Dorsal-column fibres ascend ipsilaterally in the spinal cord and decussate in the medulla, so a right T10 lesion causes right-sided loss of vibration and conscious proprioception below the lesion. Pain and temperature fibres enter the anterolateral system and cross near their spinal entry level, which makes the contralateral pain-temperature options inappropriate for an isolated dorsal-column lesion.

Reference: RCoA, Primary FRCA syllabus: https://www.rcoa.ac.uk/sites/default/files/documents/2026-01/Primary-FRCA-Syllabus.pdf; Postoperative Brown-Séquard syndrome: case report and review: https://pmc.ncbi.nlm.nih.gov/articles/PMC7765703/