caloric test - okt3

[ArchivalUser]

I think A or C...

[ArchivalUser]

caloric test generally done in comatosed patient in order to find the intactness of the brain stem.....

so it might be pons/medulla..this much i can reach OKT3..beyond this it requires the explanation of you...waiting for the answer

[ArchivalUser]

can not be midbrain because Cold-water irrigation of the right external auditory canal leads to deviation of both eyes to the right for 2 min, that mean CNIII is intact.

[ArchivalUser]

lines from kaplan:

THE INTEGRTY OF THE VESTIBULO-OCULAR REFLEX CAN BE AN INDICATOR OF BRAIN STEM INTEGRITY IN A COMATOSE PATIENT..TO TEST THIS REFLEX,A VESTIBULAR NYSTAGMUS IS INDUCED BY PERFORMING A CALORIC TEST...

[ArchivalUser]

COWS= COLD OPPOSITE but in this case deviation of both eyes to the right, so lesion is somewhere else.

[ArchivalUser]

CCCC?

[ArchivalUser]

i think its e

[ArchivalUser]

agree.. cant be stem. and ur say no to pons. and A.. wouldnt that b unilateral maybe? all i can think is its vestibular nystagmus. and that projects to 4 places... MLF, cerebellum, spinal cord and thalamus. kaplan only talks about lesions in MLF and brstem.. not sure what the other ones would look like!

pls explain!

[ArchivalUser]

abducens nerve lesion.EE may be the answer.

[ArchivalUser]

The answer is E.
Bilateral conjugate eye movement to the side of the caloric stimulation indicates integrity of

the brainstem pathways from the medulla to the midbrain (where the third nerve originates),

as do full conjugate oculocephalic motions (doll™s-eye maneuvers). The absence of the rapid

corrective phase manifested by nystagmus-like leftward gazing indicates a bilateral

hemispheric lesion. Failure of an eye to adduct properly in the initial phase of the caloric

response indicates a lesion in the ipsilateral third nerve (midbrain) or in the medial

longitudinal fasciculus producing internuclear ophthalmoplegia. In the former case, the pupil

would be dilated and the eye would be abducted at rest.