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SHF 204 OSPE > CNS testing > Flashcards

CNS testing Flashcards

1
Q

Motor

A

Occulomotor
Trochlear
Abducens
Accessory
Hypoglossal

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2
Q

Sensory

A

Olfactory
Optic
Vestibulocochlear

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3
Q

Both

A

Trigeminal
Facial
Glossopharyngeal
Vagus

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4
Q

CN1

A

Olfactory
Sensory

  • Cribriform plate
  • Sense of smell
  • Ask Pt about their smell
  • Use different odours (citrus, coffee, mint), unilateral test (cover one nostril)
  • Anosmia- genetics, Parkinson’s, fracture of cribriform plate
  • Parosmia- bacterial or viral infection
  • Hypersomnia- migraine, genetics, epilepsy
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5
Q

CN2

A

Optic
Sensory

  • Optic foramen
  • Sight
  • Visual activity- Snellen wall chart (unilateral test)
  • Visual fields test- face Pt, cover one eye, practitioner direct opposite eye, raise hand out so the practitioner can see it, ask PT if they can see it, move up/down/closer if they cant see it
  • Visual acuity- if PT reads 6/6 lines but gets 2 letters incorrect you would record it as 6/6 -2
  • Would not be able to see hand if +ve
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6
Q

CN3

A

Occulumotor
Motor

  • Superior orbital fissure
  • Supplies all extracellular muscles except superior oblique (CN4) and lateral rectus (CN6)
  • Parasympathetic- pupillary reflex
  • H-test (CN3, 4, 6)
  • Light-pupillary reflex
  • Down and out
  • Pupil dilation
  • Eye movement restricted
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7
Q

CN4

A

Trochlear
Motor

  • Superior orbital fissure
  • Innervates superior oblique- ability to look down
  • H-test
  • Vertical diplopia- when looking inferiorly, due to loss of superior oblique’s action of pulling eye downwards
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8
Q

CN6

A

Abducens
Motor

  • Superior orbital fissure
  • Innervates lateral rectus- ability to look laterally
  • H-test
  • Medial gaze- if lateral rectus falls, medial rectus will pull eye inwards
  • Inability to look laterally
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9
Q

CN5

A

Trigeminal
Both

  • Ophthalmic (superior orbital fissure)
  • Sensory to scalp, forehead, nose and upper eyelid
  • Maxillary (foramen rotundum)
  • Sensory to palate, upper jaw, upper teeth, lower eyelid and nasal cavity
  • Mandibular (foramen ovale)
  • Sensory to lower lip, lower teeth, ant 2/3 of tongue, lateral cheek, temporal region
  • Motor to muscles of mastication, digastric, mylohyoid and middle ear
  • Sharp and soft sensory test- pin and cotton wool- loss of distinction between sharp and soft
  • Mastication test- weakness/inability to masticate
  • Loss of sensation
  • Corneal reflex- loss of blinking reflex
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10
Q

CN7

A

Facial
Both

  • Internal auditory meatus
  • Sensory- taste from ant 2/3 of tongue, sensation of ext ear and palate
  • Motor- muscles of facial expression, innervation of stapedius (smallest muscle)
  • Parasympathetic- innervation of salivary glands
  • Ask Pt about their taste., hearing and saliva
  • Facial expression test- smile, angry, pursed lips, eyebrow raise. Resist Pt opening eyes, blowing out cheeks
  • Hypogeusia- reduced taste
  • Ageusia- loss of taste
  • Loss of hearing
  • Facial palsy
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11
Q

CN8

A

Vestibulocochlear
Sensory

  • Int auditory meatus
  • Sense of hearing + balance
  • Ask Pt about hearing
  • Numbers repetition test
  • Weber’s- 512Hz tuning fork on forehead
  • Rinne’s test- 512Hz onto mastoid process (bone conduction), once they can no longer hear place Infront of ear (air conduction)
  • Number test- air conduction loss
  • Weber’s- if they hear the noise louder in one ear that means conductive deafness in ear perceiving louder sound or sensory neural deafness in other ear
  • Rinne’s- bone conduction or air conduction loss
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12
Q

C9/10

A

Glossophayngeal/vagus
Both

  • Jugular foramen
  • Sensory to post 1/3 tongue, taste loss in this area
  • Motor to pharyngeal muscles and laryngeal muscles
  • Parasympathetic to parotid salivary gland and thoracic/abdominal vicera
  • Ask Pt to cough
  • Recognise if their voice sounds hoarse
  • Swallowing test
  • Test for uvula deviation (Ah)- away from palsied side (should go up)
  • Loss of gag reflex
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13
Q

CN11

A

Accessory
Motor

  • Foramen magnum
  • Motor to pharynx, trapezius and SCM
  • SCM test- Pt rotates head, resist movement
  • Trapezius- resist Pt trying to shrug shoulders
  • Weakness/muscle wasting= +ve
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14
Q

CN12

A

Hypoglossal
Motor

  • Hypoglossal canal
  • Motor to tongue and throat muscles
  • Resisted tongue movement
  • Tongue protrusion
  • Tongue deviation- towards palsy side
  • Tongue weakness
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15
Q

Upper motor neuron symptoms

A

HyperTonia (could lead to Spasticity), HypeReflexia, some Weakness/Paralysis, Clonus, Disuse Atrophy (chronic)

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16
Q

Lower motor neuron symptoms

A

HypoTonia, Weakness (Muscle Contraction) w/ flaccid Muscle, Hyporeflexia, Fasiculations, Muscle Wasting (Atrophy)

SHF 204 OSPE (10 decks)

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