4.19 Cranial Nerves 2

Question 1

testing facial nerve: facial expressions

Answer 1

• raise eyebrows
• close eyes tight
• smile

looking for symmetry

Question 2

facial nerve: testing taste

Answer 2

won’t do this

Question 3

What usually causes trigeminal (and facial) nerve palsy?

Answer 3

usually a bad stroke with a lot of CN involvement

Question 4

What happens with trigeminal and facial nerve palsy?

Answer 4

food gets pocketed, drooling out of this side

Question 5

Why is food pocketing such a big problem?

Answer 5

at risk for

• choking
• aspiration pneumonia

Question 6

aspiration pneumonia

Answer 6

can’t produce force to bring it back up out of the lungs

Question 7

NPO

Answer 7

nothing by mouth

Question 8

OG

Answer 8

orogastric tube

Question 9

NG

Answer 9

nasogastric tube

Question 10

PEG

Answer 10

paraepigastric tube

Question 11

What causes aspiration pneumonia?

Answer 11

• no sensation
• no motor

*always tell someone if you think they’re unsafe eating

Question 12

cochlear part of CN 8

q-tip problem

Answer 12

• wax is good for you

- can get too much, but higher likelihood of getting temporary deafness from wax plug if you dig in with a q-tip

Question 13

testing hearing

Answer 13

• finger rub

- Rinne/Weber tests

Question 14

Rinne/Weber tests

Answer 14

use a tuning fork to localize to one ear or the other

Question 15

Weber test is for

Answer 15

lateralization

Question 16

Weber test procedure

Answer 16

• put it on top of the head
• vibration conducted to ossicles and creates sound
• should be equal: may lateralize to the side of the injury

Question 17

What does the Weber test tell us and how?

Answer 17

• tells what side the problem is quickly

- hear it louder in affected ear

Question 18

What does the Rinne test compare?

Answer 18

air vs. bone conduction

Question 19

How does air conduct compared to bone in general?

Answer 19

2x as long as bone

Question 20

Rinne test procedure

Answer 20

place tuning fork right behind ear (process)

• hear vibration
• ask them when they can’t hear it anymore
• slowly remove it and bring it next to the ear

Question 21

What does the Rinne test tell you?

Answer 21

whether it’s an air conduction or nerve conduction issue

Question 22

What are the important things we’re testing for CN IX

Answer 22

• gag reflex
• saliva
• We aren’t testing this
• Speech does this

Question 23

Why does ST try to evoke gag reflex in therapy?

Answer 23

help them learn how to swallow again

Question 24

CN IX dysfunction and saliva (pts)

Answer 24

get dry mouth

Question 25

Which nerve is CN IX tested with?

Answer 25

X

Question 26

How do you test the vagus nerve?

Answer 26

• look at the uvula

- say ahhhhhh

Question 27

How does ST work on swallowing?

Answer 27

• work on chin tucks before swallowing to get muscles in a better position to contract

Question 28

What is thickit? Why is it used?

Answer 28

• makes liquid thicker
• people choke on thin liquids
• consistency changes the flavor (guh-ross)

Question 29

CN XI testing

Answer 29

• shoulder shrug

- SCM

Question 30

CN XII: what are we testing?

Answer 30

• tongue movement

- tongue strength

Question 31

testing tongue movement (12)

Answer 31

have them stick it out

Question 32

testing tongue strength

Answer 32

• tongue deviated to the side of weakness

- should be symmetrical

Question 33

deviation to the right

Answer 33

right muscle is affected

Question 34

Which CNs do we really care about as PTs?

Answer 34

• optic
• 3, 4, 6
• facial
• vestibulocochlear (vestibular more)
• hypoglossal

Question 35

Why do we care about hypoglossal nerve?

Answer 35

tongue and facial issues typically bundled with swallowing issues