Crainial Nerves, HEENT

Question 1

IPPA

Answer 1

Inspection, palpation, percussion, auscultation

Question 2

Inspection

Answer 2

Look for size, shape, color, symmetry, position

Question 3

Palpation

Answer 3

Touch to gather info
Diff parts of the hands for diff areas of the body
Start with light, end with deep

Question 4

Percussion

Answer 4

Tap skin with fingertips to vibrate underlying tissue
Sound determines location, size, and density
Denser = quieter

Question 5

Auscultation

Answer 5

Use stethoscope
Measure for frequency, loudness, quality, duration

Question 6

CN I

Answer 6

Olfactory (S)
Smell

Test:
Occlude one nostril and have patient identify smell

Question 7

Epistaxis

Answer 7

Nose bleed

Question 8

Rhinitis

Answer 8

Nasal inflammation

Question 9

Rhinorrhea

Answer 9

Nasal discharge

Question 10

Sinusitis

Answer 10

Inflammation of sinuses leading to pain on cheek, gums, and teeth

Question 11

Deviated septum

Answer 11

Ingrowth of lower nasal septum

Question 12

Nasal polyp

Answer 12

Non painful growth of nasal mucosa

Question 13

Anosmia

Answer 13

Decreased or loss of smell occurring bilaterally

Question 14

CN II

Answer 14

Optic (S)
Vision

Test:
SLOAN lettering
Numerator - distance person is from chart
Denominator - distance at which a normal eye can read that line

Question 15

CN III

Answer 15

Oculomotor (M)
Eye movement/ PERRLA

Test:
1) Accommodation
- have follow finger from a distance (pupils dilated) then bring closer to patient nose (constrict)

2) React to light
- consensually and directly

3) Extra ocular movements
- 6 points, not jerky… clean movements
- both up, in, and down/out

Question 16

Strabismus

Answer 16

Both eyes dont look in the same place due to poor muscle control
Can lead to vision loss

Cover/uncover test
- ask patient to stare straight ahead, cover one eye for a while, uncover and assess for movement

Question 17

CN IV

Answer 17

Trochlear (M)
Extra ocular movement

Test:
- 6 points
- responsible for down/in

Question 18

Exophthalmos

Answer 18

Protruding eyes

Question 19

Conjunctivitis

Answer 19

Inflammation of the conjuctiva
Pink eye
Bacterial

Question 20

Hordeolum

Answer 20

Stye
Localized staphylococcal infection of hair follicles

Question 21

Myopia

Answer 21

Nearsightedness (can see near better)

Question 22

Hyperopia

Answer 22

Farsightedness (can see far better)

Question 23

Astigmatism

Answer 23

Refraction of light causes blurred/double vision

Question 24

CN V

Answer 24

Trigeminal (B)
Clench jaw and sensation in face

TEST:
-Have patient clench jaw and feel massater and temporal muscles

• test sensation on opthalmic (forehead), maxillary (cheek bone), and mandible (jaw)

-corneal reflex

Question 25

CN VI

Answer 25

Abducens (M) Extra ocular eye movement Test: - 6 points of eye movement - responsible for lateral eye movement

Question 26

CN VII

Answer 26

Facial (B) Facial expression and sweet/salty taste Test: -have patient raise eyebrows, frown, smile, close eyes tight

Question 27

Presbycusis

Answer 27

Age related hearing loss

Question 28

Sensorineural Hearing Loss

Answer 28

Impaired cranial nerve transmission or inner ear dysfunction Permanent Cant be fixed

Question 29

Conductive Hearing Loss

Answer 29

Impaired sound transmission to inner ear; sounds cannot get through outer/middle ear Can be fixed

Question 30

CN VIII

Answer 30

Auditory (S) Hearing Testing: - whispered voice test - Weber test (tuning fork) -Romberg (balance)

Question 31

CN IX

Answer 31

Glossopharyngeal (B) Tongue and pharynx Test: Hold down tongue, say “ahh”, uvula should rise

Question 32

CN X

Answer 32

Vagus (B) Pharynx, larynx, and trachea Test: Assess ability to swallow, speak, and gag reflex

Question 33

CN XI

Answer 33

Accessory (M) Trapezius and sternocleidomastoid Test: - against pressure, rotate head nose to shoulder - against pressure, shrug

Question 34

CN XII

Answer 34

Hypoglossal (M) Movement of tongue Test: Have patient stick out tongue and move it around