Cranial Nerve Exam Flashcards

1
Q

What are you looking for in pupil inspection

A

Size and alignment

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2
Q

What do you take if the patient cannot read at 6 metres from the Snellen chart

A

1) Move closer (3m)
2) Move closer again (1m)
3) If still unable - assess ability to count fingers
4) If still unable - detect ability to move hands
5) If still unable - assess light perception

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3
Q

If the patient does not score at least 6/9 in the Snellen chart, what could you do

A

Repeat visual acuity test with pinhole

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4
Q

What does the accommodation reflex test

A

Constriction and convergence

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5
Q

What could you use in the visual field test for a more detailed assessment

A

Hat pin

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6
Q

What do you note in the H-test

A

Ptosis (oculomotor lesion)
Any restriction of eye movements
Nystagmus

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7
Q

What nerves do you test during the facial sensation test

A

forehead - Ophthalmic Branch (V1)
Cheek - Maxillary Branch (V2)
Chin - Mandibular Branch (V3)

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8
Q

What do you look for in the jaw resistance test

A

Any weakness or deviation

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9
Q

What do you look for in the jaw jerk reflex

A

An exaggerated upwards movement (UMN lesion) as it should normally be very minimal

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10
Q

How much of the tongues sensation does the facial nerve supply

A

Anterior 2/3

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11
Q

What does an increase in loudness of hearing indicate

A

Stapedius paralysis causing hyperacusis

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12
Q

What lesions could you find on the external auditory meatus

A

Herpes zoster lesions

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13
Q

What two distances do you test during the hearing exam

A

15cm then 60cm

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14
Q

How do you mask the ear not being used in the hearing exam

A

By covering using a tragal rub

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15
Q

What tuning fork do you use in the Rinne and Weber’s test

A

512Hz

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16
Q

What sign can be seen when marching on the spot

A

It tests vestibular function and pathology is indicated by turning to the side of the lesion

17
Q

What do you assess in the open mouth ‘Aaah’

A

Assess soft palate and uvula

  • Symmetry
  • Uvula movement
18
Q

What do you look for when asking the patient to cough

A

Bovine cough - non-explosive cough of someone unable to close their epiglottis (vagus nerve lesion)

19
Q

What do you look for when asking the patient to swallow water

A

Any delay in swallowing or coughing

20
Q

What do you look for on the tongue

A

fasciculations

Deviation on protrusion

21
Q

What exams can you do to complete findings

A

Motor sensory exam of the upper and lower limbs