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DEN303 Neurology > CN Assessment > Flashcards

CN Assessment Flashcards

1
Q

What is CNI - what does is supply and what test?

A

Olfactory nerve - sensory to sense of smell

Examination

  1. Ask if any change of smell
  2. Use recognisable smell - hold one nostril, clothes eye and see if can smell
  3. Avoid irritating smells -can stimulate pain receptor
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2
Q

What is loss of smell called and what are possible causes?

A

Anosmia

Lesions, nasal congestion, base of skull or frontal fracture

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3
Q

What is CNII - what does is supply and how test?

A

Optic nerve - sensory - provide vision

Examination

  1. Visual acuity - snellen 6m away
  2. Colour test - Ishihara
  3. Visual fields - test blind spot
  4. Accommodation
  5. Light reflex
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4
Q

What is mydriasis and causes?

A

Dilated pupils
Unilateral - third nerve palsy (may see ptosis)
Bilateral - iatrogenic/ drugs

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5
Q

What is mitosis and causes?

A

Constricted pupils?
Unilateral - horner’s syndrome
Bilateral - pontine stroke/ pilocarpine drops

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6
Q

How does CNII supply vision?

A

Nasal and temporal visual fields - temporal aspect of retina supplied nasal visual field
Crossing chiasmi of nasal visual fields

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7
Q

What does CNIII supply and how would you examine?

A

Oculomotor - motor to eye movements

Examination

  1. Inspect ptosis
  2. H test - 6 cardinal position of eye
  3. Examine pupils
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8
Q

What does IIIrd nerve palsy cause?

A

Ptosis, eyes down and out

Failure adduction muscle

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9
Q

What does CNIV supply and how would examine?

A

Trochlear nerve - motor to superior oblique

Examination w/ CNIII - H test and lid lag

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10
Q

What is IVth nerve palsy?

A

Double vision when looking straight down

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11
Q

What is the VIth CN and how would examine?

A

Abducens nerve - motor to lateral rectus

Examine
- H test

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12
Q

Problem w/ VIth nerve palsy?

A

Can’t rotate eye laterally - at rest eye move medially

Cause: pontine lesions, trauma, microvascular

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13
Q

What is CNV and how examine?

A

Trigeminal nerve - sensory and motor
Sensory face, motor - MOM

Examination - Sensory

  1. Test for soft touch all divisions with eyes closed
  2. Test both sides
  3. V1 =opthalmic, V2= maxillary, V3= mandibular

Examination - Motor

  1. Grit teeth - palpate muscle for contraction (master and temporaries)
  2. Ask pt to open mouth - try close - look deviation
  3. Corneal reflex
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14
Q

What is trigeminal neuralgia?

A

Neuropathic pain in any distribution of trigeminal - sharp burning pain
Tx: neurosurgery, antidepressants

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15
Q

What is VIIth CN and how examine?

A

Facial nerve - motor and sensory
Motor MOFE, sensory - anterior 2/3rd tongue and stapedius

Examination- MOTOR

  1. Raise eyebrows
  2. Close eyes as tight as can - try open
  3. Puff out cheeks - not let me push in cheek
  4. Purse lips
  5. Bare teeth
  6. Ask any change in taste/ hearing sounds louder usual
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16
Q

Why is UMN forehead sparing?

A

Movement preserved due to bilateral supra-nuclear innervation

17
Q

What is CNVIII and how to examine?

A

Vestibulocochlear - sensory: hearing and balance

Examination - Hearing

  1. Rinne’s - told at mastoid process - when can’t hear movie infront auditory meatus - if head better bone = Rinne’s negative conductive hearing loss
  2. Weber’s - hold mastoid process at forehead - should hear sound centrally

Examination- Balance
1. Ask to march on spot with eyes closed and arms outright

18
Q

What are CNIX and X and how examine?

A

Glossophargneal and vagus - both motor and sensory

Glossop - motor pharyngeal muscle and parotid, sensory posterior 1/3 tongue
Vagus - parasympathetic nervous system and plataglossal

Examination

  1. Assess s+p and uvula - say ahh and look for deviation
  2. Get pt to cough - test febrile cough
  3. Ask pt to swallow water
  4. Ask pt to stick out tongue
  5. Would do gag reflex
19
Q

What is Xth nerve palsy?

A

Deviation of uvula - unilateral (move to good side)

Cause: bulbul palsy

20
Q

What is CNXI and how would test?

A

Accessory nerve - motor to sternocleidomastoid and trapezius

  1. Ask pt to sharing shoulder - resist
  2. Ask pt to turn head - resist pushing
21
Q

What is CNXII and how would test?

A

Hypoglossal nerve - motor to tongue

Examine

  1. Inspect tongue at rest
  2. Ask to protrude tongue
  3. Get to place tongue in cheek - test for strength
22
Q

How would CNXII palsy present?

A

Tongue deviate bad side

If damage both sides = unable to protrude

DEN303 Neurology (5 decks)

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