4.19 Cranial Nerves 2 Flashcards
testing facial nerve: facial expressions
- raise eyebrows
- close eyes tight
- smile
looking for symmetry
facial nerve: testing taste
won’t do this
What usually causes trigeminal (and facial) nerve palsy?
usually a bad stroke with a lot of CN involvement
What happens with trigeminal and facial nerve palsy?
food gets pocketed, drooling out of this side
Why is food pocketing such a big problem?
at risk for
- choking
- aspiration pneumonia
aspiration pneumonia
can’t produce force to bring it back up out of the lungs
NPO
nothing by mouth
OG
orogastric tube
NG
nasogastric tube
PEG
paraepigastric tube
What causes aspiration pneumonia?
- no sensation
- no motor
*always tell someone if you think they’re unsafe eating
cochlear part of CN 8
q-tip problem
- 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
testing hearing
- finger rub
- Rinne/Weber tests
Rinne/Weber tests
use a tuning fork to localize to one ear or the other
Weber test is for
lateralization
Weber test procedure
- 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
What does the Weber test tell us and how?
- tells what side the problem is quickly
- hear it louder in affected ear
What does the Rinne test compare?
air vs. bone conduction
How does air conduct compared to bone in general?
2x as long as bone
Rinne test procedure
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
What does the Rinne test tell you?
whether it’s an air conduction or nerve conduction issue
What are the important things we’re testing for CN IX
- gag reflex
- saliva
- We aren’t testing this
- Speech does this
Why does ST try to evoke gag reflex in therapy?
help them learn how to swallow again
CN IX dysfunction and saliva (pts)
get dry mouth
