Cranial Nerve Considerations

Question 1

olfactory (1)

Answer 1

rarely involved, typically skipped

Question 2

optic (2)

Answer 2

• field cuts/visual loss

- reduced visual acuity (blurry vision)

Question 3

oculomotor, trochlear, abducens (3,4,6)

Answer 3

• gaze palsies –> double vision (diplopia)

- ptosis

Question 4

trigeminal (5)

Answer 4

• loss of facial sensory input
• asymmetrical jaw movement and strength
• loss of mastication –> choking risk –> aspiration risk

Question 5

facial (7)

Answer 5

• facial weakness, loss of sensory of the tongue, impairment of salivary glands –> choking risk –> aspiration risk
• impairment of lacrimal glands n–> impaired vision

Question 6

vestibulocochlear (8)

Answer 6

• hearing loss

- vestibular dysfunction –> vertigo, balance deficits

Question 7

glossopharyngeal (9)

Answer 7

• dysphagia
• reduced taste and sensation on tongue, loss of gag reflex –> choking risk –> aspiration risk
• ANS: CV dysfunction (HR, BP)

Question 8

vagus (10)

Answer 8

• pharyngeal and laryngeal weakness
• loss of gag reflex –> choking risk –> aspiration risk
• ANS: abnormalities of esophageal motility, gastric acid secretion, gallbladder emptying, CV dysfunction (HR)

Question 9

spinal accessory (11)

Answer 9

UT and SCM weakness –> inability to rotate head or shrug shoulders

Question 10

hypoglossal (12)

Answer 10

tongue weakness –> choking risk –> aspiration risk