Question

Following an assessment of the oculocephalic reflex, the nurse suspects that the patient has an intracranial lesion. Which behavior of the patient supports the nurse's conclusion?

Movement of the eye in the opposite direction to the turning head
Movement of the eye in the upward direction when the neck is flexed
Movement of the eye in the sideward direction when the neck is extended
Movement of the eye in the downward direction when the neck is extended

Answer 1

The nurse's suspicion of an intracranial lesion is supported by the patient exhibiting eye movements in the opposite direction to head rotation, a sign of possible deficits in the vestibulo-ocular reflex.

Step-by-step explanation:

The behavior of a patient that supports the nurse's conclusion of an intracranial lesion following an assessment of the oculocephalic reflex would be movement of the eye in the opposite direction to the turning head. This is due to the vestibulo-ocular reflex (VOR), which coordinates eye and head movements to stabilize the visual field. If a patient's head rotates in one direction, the semicircular canals in the inner ear detect this movement and send information to the ocular nuclei to coordinate the eye muscles.

Contraction of the muscles responsible for eye movement, such as the lateral and medial rectus muscles, leads to the eyes rotating in the opposite direction of head movement to maintain fixation on a visual stimulus. Any deficits in the VOR may indicate vestibular damage or problems within the brain stem that affect the eye movement nuclei or their connections through the medial longitudinal fasciculus (MLF).