limone

My 5 things:
1. cold front. a deliciously chilly, windy cold front.
2. wearing jeans and one of my favorite waffle knit tees. as evidenced by my laundry day in and day out for the past month, all i seem to be wearing lately are scrubs and work out clothes. so... i feel pretty, oh so pretty..
3. sitting in lecture. paying attention in lecture. writing in lecture. printed out all of my notes instead of relying on my _______ pc. happy. not only that, but studying for four hours with chait after class. wow. neuro is just so heavy. glad to be staying on top of this mess.
4. calling my dad to ask him about brain stem lesions and how they affect eye movements. haaaa. i used to call him all the time when i was a pharmaceutical rep selling ophthalmic antibiotics. he's my go to guy for the eye. the smartest man i know. (i want to be just like him.)
5. chocolate milk for dessert. organic valley. it's the best.

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things i've been trying to understand today:
- if you have a stroke, your eyes will shift to the side of the lesion. so whatever hemisphere (R/L) your brain has had a stroke, your eyes will look in that direction.
- if you have a brain stem lesion, your eyes will look in the opposite direction of the side that the lesion is on.
- if you're having an epileptic seizure, your eyes will contravert* to the side opposite of the lesion because the neurons are getting constantly excited on one side and stimulating the eyes to look in the other direction. ... as far as my understanding goes.
- if you have a lesion in the MLF (medial longitudinal fasiculus), it causes internuclear ophthalmoplegia (which may be indicative of multiple sclerosis). This manifests as damage to the ipsilateral eye and nystagmus to the contralateral eye. The affected eye shows impairment of adduction (oculomotor nerve - CN III). The contralateral eye will abduct with nystagmus (CN VI - abducens). So if there is a lesion on the right side, the right eye will be unable to look medially (toward the left), and the left eye will abduct (look left/out) but with nystagmus. So whichever eye is unable to move at all has the lesion on its MLF.
- if there is a lesion involving the nucleus of cranial nerve VI (abducens nerve), it will cause paralysis of the contralateral medial rectus muscle so you cannot direct your eyes to the side of the lesion. (this type of lesion may also affect the nucleus/axons of the facial nerve (CN VII), so paralysis of the ipsilateral muscles of facial expression may present.

*i don't even know if i'm using that word correctly.

Did you get all of that? I don't know if I did. I need to draw these tracts out. we have a quiz tomorrow on brain lesions.

my dad just called me back so i could ask him more questions about eyes/lesions/nerve palsies/etc. (he's an ophthalmologist.)
His responses:
"i don't know that brainstem stuff."
"i always have to go look that up."
"oh, is that what happens?"

weellll, that makes me feel better that once boards are over, i can just look stuff up like every other doctor out there.

this was a helpful blip entry for me. sorry for you, dear reader.