Cranial Nerve and Motor Examination

Question 1

What is CN 1? and what does it control?

Answer 1

Olfactory

Smell

Question 2

What is CN 2? and what does it control?

Answer 2

Optic

Sight, pupils

Question 3

What is CN 3? and what does it control?

Answer 3

Oculomotor

Eye Movements

Question 4

What is CN 4? and what does it control?

Answer 4

Trochlear
Eye Movements
Superior Oblique

Question 5

What is CN 6? and what does it control?

Answer 5

Abducens
Eye Movements
Lateral Rectus

Question 6

What is CN 5? and what does it control?

Answer 6

Trigeminal
Facial sensation
Jaw muscles

Question 7

What is CN7? and what does it control?

Answer 7

Facial

Facial expressions

Question 8

What is CN8? and what does it control?

Answer 8

Vestibulocochlear

Hearing and balance

Question 9

What is CN 9? and what does it control?

Answer 9

Glossopharyngeal
Taste, Pharynx
(Carotid body and sinus, middle ear cavity and Eustachian tube. Plus parotid gland)

Question 10

What is CN 10? and what does it control?

Answer 10

Vagus

Larynx and epiglottis

Question 11

What is CN 12? and what does it control?

Answer 11

Hypoglossal

Muscles of the tongue

Question 12

What is CN 11? and what does it control?

Answer 12

Accessory

Trapezius and sternocleidomastoid

Question 13

How do you test CN1?

Answer 13

Any changes in smell?

Question 14

How do you test CN2?

Answer 14

Any changes in vision?
Visual field
Insect pupils
Pupillary reflexes x2
Accommodation
Blind spot
(acuity, colour blind, ophthalmoscopy)

Question 15

How do you test CN3,4,6?

Answer 15

Eye movement (-H-)
Cover test

Question 16

How do you test CN5?

Answer 16

Sensation - cotton wool and neurotip
Motor - Jaw clench (x2 muscles) and open mouth against resistance
Reflex - Jaw jerk
(corneal reflex)

Question 17

How do you test CN7?

Answer 17

Inspect face
Show teeth
Purse lips, add resistance
Blow out cheeks, add resistance
Raise eyebrows, add resistance
Close eyes tightly, add resistance

Question 18

How do you test CN8?

Answer 18

Any changes in hearing?
Gross hearing test
Rinne's test
Weber's test
(halpike's)
(plus gait and turning test, but will do that later)

Question 19

How do you test CN9,10,12?

Answer 19

Open mouth, say ahh
Look with pen torch for wasting/asymmetry
Stick out tongue
Push tongue into cheek, add resistance

Question 20

How do you test CN11?

Answer 20

Shrug shoulders, add resistance

Turn head, against resistance

Question 21

How do you assess gait and balance?

Answer 21

Walk to the other end of the room and back
Heel-to-toe walk
Walk on heels
Walk on toes
Turning test
Romberg's sign

Question 22

How do you inspect limbs? What are you looking for?

Answer 22

SWIFT
scars
wasting
involuntary movements
fasciculations
tremor

Upper Limb - pronator drift

Question 23

How do you investigate tone in the lower limb?

Answer 23

Leg roll
Leg lift
Ankle clonus

Question 24

How do you investigate power in the lower limb?

Answer 24

Against resistance, supporting the joint:
Hip - flexion, extension, abduction, adduction
Knee - flexion, extension
Ankle - plantarflexion, dorsiflexion, inversion, eversion

Question 25

How do you investigate reflexes in the lower limb?

Answer 25

Knee jerk Ankle jerk Plantar reflex

Question 26

How do you investigate tone in the upper limb?

Answer 26

Full range of movement, support joint: Wrist - flexion, extension, pronation, supination Elbow - flexion, extension Shoulder - flexion, extension, abduction, adduction

Question 27

How do you investigate power in the upper limb?

Answer 27

``` Against resistance, support joint: Shoulders - abduction, adduction Elbow - flexion, extension Wrist - flexion, extension Fingers - abduction, extension Thumb - abduction ```

Question 28

How do you investigate reflexes in the upper limb?

Answer 28

Bicep Tricep Supinator