CNS Flashcards
how do you test for visual acuity
- get them to read something
- usually use a snellen chart
how do you do a pupillary light reflex
- Inspect the pupils for any discrepancy in size (anisocoria) or shape.
- Ask patient to look behind you, and tell them that you are going to shine a light in their eyes
- Using a pen torch shine the light in one eye by bringing it in from the side, and check for pupillary constriction in the illuminated eye, the direct reflex. Now remove light to allow pupils to relax, and shine the light in the same eye again but this time looking at the non-illuminated eye to check the consensual reflex.
- It can be deduced whether a defect is afferent or efferent. If the defect is in the afferent pathway from an eye, the direct reflex will be lost but the consensual will be intact. If the defect is in the efferent pathway to an eye, the direct and consensual reflex will be lost.
what do you say
do you wear glasses normally or have any contacts
When testing visual fields
- Comments that visual acuity can ideally be assessed by a Snellen chart and that colour vision can be tested using Ishihara plates.
- Comments that pupillary light reflexes and accommodation reflex can be done.
- Comments that they would also perform ophthalmoscopy/fundoscopy.
- Comments that visual acuity can ideally be assessed by a Snellen chart and that colour vision can be tested using Ishihara plates.
when assessing eye movement
- you say did you experience any main or diplopia
when assessing muscles of facial expression
- say jaw jerk reflex
- corneal reflex
any questions
need help getting dressed
what does clenching of the jaw test
- temporalsis and maester
what does opening mouth against resistance test
media ptyergoid
how far apart should you be sitting in a cranial nerve examination
1 metre
what cranial nerve does the mscuels of mastication
CNV
- temproalis
- masseter
- pterygoids
what movements are for the muscles of facial expression
o “Raise your eyebrows”
o “Closeyoureyestightly”
o “Showmeyourteeth”
o “Blowoutyourcheeks”