4.19 Cranial Nerves

Question 1

testing olfactory

Answer 1

• use some scent (lavender, coffee, vanilla, etc.)

- 1 nostril at a time

Question 2

Why is it important to test olfactory?

Answer 2

• REALLY important for safety (i.e. fire, caustic agents, gas, smoke, bleach, etc)
• can be a predictor for other conditions
• smell if they’ve crapped their pants

Question 3

fancy can’t smell word

Answer 3

anosmia

Question 4

What can anosmia be a predictor for?

Answer 4

Pts often complain of loss of sense of smell before getting Parkinsons or Alzheimers

Question 5

big letter chart at the eye doctor

Answer 5

Snellen chart

Question 6

What does 20/20 mean with vision?

Answer 6

Things that are 20 feet away look like they’re 20 feet away

Question 7

How are peripheral vision fields tested?

Answer 7

“confrontation”

• Ally assaulted in the chair
• can stand behind and move hands around until they see

Question 8

Why do we often miss testing vision? What should we be asking?

Answer 8

• hospital

- Do you wear glasses? What are they for?

Question 9

visual field: up

Answer 9

60˚

Question 10

visual field: down

Answer 10

70˚

Question 11

visual field: nasally

Answer 11

60˚

Question 12

visual field: laterally

Answer 12

90˚

Question 13

What other nerve is also tested with the oculomotor nerve?

Answer 13

optic

Question 14

Why do cognitive issues come into play with oculomotor testing?

Answer 14

pt has to understand what you’re asking them to do

Question 15

Things to consider when testing oculomotor with respect to movements and tracking

Answer 15

• Are they yoked?
• Lazy eye?
• Do the eyes follow?

Question 16

testing pupillary/consensual reflexes

Answer 16

• Shine light only in left eye (Moe, Curly, Larry finger defense shield)
• Both pupils should shrink

Question 17

What may cause ptosis?

Answer 17

problem with oculomotor nerve

Question 18

What problems can occur with bilateral ptosis?

Answer 18

problems with walking

Question 19

What may be done with bilateral ptosis?

Answer 19

tape ‘em open

Question 20

What is convergence? Why is it tested?

Answer 20

• look at something close/far/ back and forth

- showing it can focus like the aperture on a camera

Question 21

What problem can happen with convergence?

Answer 21

can get stuck with one depth of field

Question 22

Which other two eye movements are tested together? (give the CNs)

Answer 22

trochlear

abducens

Question 23

trigeminal: testing sensation

Answer 23

• sharp
• dull
• hot
• cold
• etc.

Question 24

Where is the sensation for the trigeminal nerve?

Answer 24

over the face in the areas you already know

also inside the mouth and teeth of those areas

Question 25

trigeminal motor testing

Answer 25

- excursion - clenching - etc.

Question 26

What can often injure the trigeminal nerve?

Answer 26

- TBI - car wrecks (mild concussions) - punch to the face - airbags - etc