3. SESSION 3.2 Cranial Nerves: Function & Assessment

Question 0

Cranial Nerve 2

• Name (S or M?)
• Functions (3)

Answer 0

Cranial Nerve 2: OPTIC NERVE (S)
Functions: 
- Visual Acuity
- Visual fields
- Ocular fundi.

Question 1

Cranial Nerve I

• Name (S or M?)
• Function (1)

Answer 1

Cranial Nerve I: OLFACTORY (S)

Function: SMELL

Question 2

Cranial Nerve 3

• Name (S or M?)
• Functions (2)

Answer 2

Cranial Nerve 3: OCULOMOTOR (M)

• Pupillary reaction
• Extraocular movements

Question 4

Cranial Nerve 3

Assessment (4)

Answer 4

Cranial nerve 3: Oculomotor (S):

• Palpebral fissures are usually equal in width or nearly so.
• Check pupils for size, regularity, light reaction and accommodation. - Assess extraocular movements by the cardinal positions of gaze.
• Assess for nystagmus (only normal in extreme / end point gaze)

Question 4

Cranial Nerve 1

Assessment (1)

Answer 4

Cranial Nerve 1: OLFACTORY (S)

• Present pt with familiar, non-irritating odors.
• Seldom included in routine neurological exam.

Question 5

Cranial Nerve 2

Assessments (3)

Answer 5

Cranial nerve 2: OPTIC NERVE (S) Assessment

• Test visual acuity
• Test visual fields by confrontation
• When indicated, use the opthalmoscope to examine the optic fundus.

Question 6

Cranial Nerve IV

• Name (S or M?)
• Function

Answer 6

Cranial Nerve IV: TROCHLEAR (M)

- Extraocular Movements

Question 7

Cranial Nerve VI

• Name (S or M?)
• Function (1)

Answer 7

Cranial Nerve VI: Abducens

Function: Extraocular Movements

Question 8

Cranial Nerve IV

Assessment

Answer 8

Trochlear Nerve (M)

Whisker test

Question 9

Cranial Nerve V

• Name (S or M?)
• Function

Answer 9

Cranial Never V: TRIGEMINAL (S&M)

• Corneal Reflexes
• Facial Sensation
• Jaw movements

Question 10

Cranial Nerve V

Assessment

Answer 10

Cranial Nerve V: TRIGEMINAL

To assess MOTOR:

• Palpate the temporal and masseter muscles as pt clenches teeth.
• Try to separate jaws by pushind down on the chin.
• Muscles should feel equally strong bilaterally.

To Assess SENSORY:
- Have pt close eyes. Touch forehead, chin, and cheeks bilaterally while patient says, “now” each time touch was felt.

Question 11

Cranial Nerve VII

• Name (S or M?)
• Function

Answer 11

Cranial Nerve VII: FACIAL (S&M)

Function: Facial Movements

Question 12

Cranial Nerve VI

Assessment

Answer 12

Cranial Nerve VI: ABDUCENS (M)

Whisker Test

Question 13

Cranial Nerve VII

Assessment

Answer 13

Note mobility and facial symmetry as the person responds to the following requests:

• Smile
• Frown
• Puff out cheeks
• Raise eyebrows
• Close eyes and keep them closed against my attempts to open them

Question 14

Cranial Nerve VIII

• Name (S or M?)
• Function

Answer 14

Cranial Nerve VIII: VESTIBULOCOCHLEAR (S)

Function - Acoustic. Hearing.

Question 15

Cranial Nerve VIII

Assessment

Answer 15

Assess hearing acuity. If hearing loss is present…

• Test for lateralization (Weber test)
• Compare air and bone conduction (Rinne test)

**Note: Specific tests of vestibular function are seldom included in the routine neurological examination.

Question 16

Cranial Nerve IX

• Name (S or M?)
• Function

Answer 16

Cranial Nerve IX: Glossopharyngeal (S & M)

Function: Swallowing, rise of the palate, gag reflex.

Question 17

Cranial Nerve IX

Assessment

Answer 17

Cranial Nerve IX: GLOSSOPHARYNGEAL (S&M)

• Assess the patient’s ability to swallow
• Check the voice for a hoarseness or nasal quality
• Ask the person to say “ahh” or to yawn as you watch the movements of the soft palate and pharynx. The uvula should remain midline.
• Test the gag reflex by touching the back of the throat lightly.

Question 18

Cranial Nerve X

• Name (S or M?)
• Function

Answer 18

Cranial Nerve X: VAGUS NERVE (S&M)

Functions: Swallowing, rise of the palate, gag reflex

Question 19

Cranial Nerve X

Assessment

Answer 19

Cranial Nerve X: VAGUS NERVE (S&M)

IDENTICAL ASSESSMENT TO CN IX
Cranial Nerve IX: GLOSSOPHARYNGEAL (S&M)
- Assess the patient’s ability to swallow
- Check the voice for a hoarseness or nasal quality
- Ask the person to say “ahh” or to yawn as you watch the movements of the soft palate and pharynx. The uvula should remain midline.
- Test the gag reflex by touching the back of the throat lightly.

Question 20

Cranial Nerve XI

• Name (S or M?)
• Function

Answer 20

Cranial Nerve XI: ACCESSORY / SPINAL ACCESSORY (M)

- Movement of the trapezius muscles

Question 21

Cranial Nerve XI

Assessment

Answer 21

Cranial Nerve XI: ACCESSORY (M) Assessment:

• Ask patient to shrug both shoulders upward against your hands. Note the strength and contraction of the trapezii.
• Ask the person to turn his head to each side against your hand. Note the strength and contraction of the OPPOSITE sternomastoid.

Question 22

Cranial Nerve XII:

• Name (S or M?)
• Function

Answer 22

Cranial Nerve XII: HYPOGLOSSAL (M)

- Function: Voice and speech, tongue movement.

Question 23

Cranial Nerve XII

Assessment

Answer 23

Cranial Nerve XII: HYPOGLOSSAL (M) Assessment:

• Listen to the articulation of the person’s words.*
• Ask the person to stick out tongue. Note any asymmetry, atrophy, or deviation from the midline.

*Precise articulation also depends on CN V, VII and X.