Cranial Nerve Exam Flashcards
What are you looking for in pupil inspection
Size and alignment
What do you take if the patient cannot read at 6 metres from the Snellen chart
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
If the patient does not score at least 6/9 in the Snellen chart, what could you do
Repeat visual acuity test with pinhole
What does the accommodation reflex test
Constriction and convergence
What could you use in the visual field test for a more detailed assessment
Hat pin
What do you note in the H-test
Ptosis (oculomotor lesion)
Any restriction of eye movements
Nystagmus
What nerves do you test during the facial sensation test
forehead - Ophthalmic Branch (V1)
Cheek - Maxillary Branch (V2)
Chin - Mandibular Branch (V3)
What do you look for in the jaw resistance test
Any weakness or deviation
What do you look for in the jaw jerk reflex
An exaggerated upwards movement (UMN lesion) as it should normally be very minimal
How much of the tongues sensation does the facial nerve supply
Anterior 2/3
What does an increase in loudness of hearing indicate
Stapedius paralysis causing hyperacusis
What lesions could you find on the external auditory meatus
Herpes zoster lesions
What two distances do you test during the hearing exam
15cm then 60cm
How do you mask the ear not being used in the hearing exam
By covering using a tragal rub
What tuning fork do you use in the Rinne and Weber’s test
512Hz
What sign can be seen when marching on the spot
It tests vestibular function and pathology is indicated by turning to the side of the lesion
What do you assess in the open mouth ‘Aaah’
Assess soft palate and uvula
- Symmetry
- Uvula movement
What do you look for when asking the patient to cough
Bovine cough - non-explosive cough of someone unable to close their epiglottis (vagus nerve lesion)
What do you look for when asking the patient to swallow water
Any delay in swallowing or coughing
What do you look for on the tongue
fasciculations
Deviation on protrusion
What exams can you do to complete findings
Motor sensory exam of the upper and lower limbs
