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Extra > Cranial Nerve Exam > Flashcards

Cranial Nerve Exam Flashcards

1
Q

What are the tests we use to test the olfactory nerve?

A

Discrimination test

Noxious test

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2
Q

What are we looking for when testing the olfactory nerve?

A

Can they smell it?
Is it a normal/noxious smell?
Are there differences between R and L

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3
Q

Impairment of the olfactory nerve is…

A

Anosmia

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4
Q

What are 4 tests we use to test the optic nerve?

A 
Visual acuity
Visual field
Pupillary response to light
Accommodation
Color discrimination
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5
Q

What does the snellen chart test in PT?

A

Visual acuity (sharpness/blurriness)

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6
Q

When testing visual fields for the optic nerve, make sure to test all _______________ of each eye, __________.

A

4 quadrants

Individually

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7
Q

When testing pupillary response we look ______ and ________responses.

A

Direct and consensualu

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8
Q

What Cranial Nerves are you testing with the Big H test?

A

3, 4 ,and 5

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9
Q

What impairment is usually seen during the big H test?

A

Dysconjugate gaze.

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10
Q

How to we test the sensation components of the Trigeminal N?

A

Light touch

Sharp/dull (pinprick)

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11
Q

How do you perform the Light Touch test for the Trigeminal N?

A

Have pt close eyes and lightly touch 5 areas for each branch. If possible, start on the intact side for comparison.

Mainly seeing if they can feel the touch. Being able to tell you where you touched is a bonus.

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12
Q

How do you touch the motor branch of the Trigeminal N?

A 
Bite strength (testing muscles of mastication)
Perform by palpating the masseter
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13
Q

How do you test the reflexes of the trigeminal N? What other nerve does this test?

A

Corneal reflex with a q-tip

Facial Nerve

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14
Q

What are you looking for in the bite test for the trigeminal N?

A

Palpable contraction?

Does it feel symmetrical?

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15
Q

How do you test the motor component of the Facial N?

A

Testing facial expressions

Smile, raise your eyebrows, puff out cheeks, purse your lips, close your eyes tightly (test your strength)

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16
Q

How do you test the sensory compartment of the Facial N?

A

Taste (typically don’t test)

Secretomotor function

17
Q

Usually you can test the facial nerve by…

A

Observation

18
Q

What are you looking for when testing the Facial N?

A

does it look/feel symmetrical

19
Q

What is an Upper Motor Neuron?

A

Neurons that descend from cortex to brainstem or brainstem to spinal cord

20
Q

Atrophy and fasciculations are signs of damage in what type of motor neuron? (Upper/lower)

A

Lower motor neuron

21
Q

What motor neurons exit the CNS and innervate peripheral targets?

A

Lower motor neuron

22
Q

Decreased tone and reflex is a sign for lesion in what motor neurons? (Upper/lower)

A

Lower motor neuron

23
Q

Increased tone and reflexes are signs for lesions in what motor neurons? (Upper/lower)

A

Upper motor neuron

24
Q

Why will an upper motor neuron lesion in the Facial nerve not impact the forehead, while a lower motor neuron lesion impact the forehead?

A

The forehead receives bilateral innervation from the facial nerve. When one side of the brain (upper motor neuron) is impacted, the other side can make up for it.

Lower motor neuron lesions are blocking information coming from both sides.

25
Q

How do we test the Vestibulocochlear N?

A

Auditory screen- Weber and Rinne test

26
Q

The Weber and Rinne test can identify auditory loss AND differentiate between ________ and _________ hearing loss

A

Conductive (physical disruption)

Sensorineural

27
Q

During the Weber test, those with conductive loss will hear the noise in the ______________ ear and those with sensorineural loss will hear in the __________ ear.

A

Same

Opposite

28
Q

The Rinne test has 2 components:

A

Air conduction

Bone conduction

29
Q

Normal results for the Rinne test: pt will hear air conduction better than bone conduction.

Conductive loss: ?
Sensorineural Loss: ?

A

Conductive loss: bone conduction > air conduction

Sensorineural loss: absent or diminished in both AC and BC

30
Q

How do we assess the Glossopharangeal N?

A

Palatal activation “say ahhhh”

31
Q

What are we looking for in palatal activation?

What will an UMN lesion look like? LMN lesion?

A

Symmetry
UMN lesion: will deviate away from the involved side
LMN lesion: deviates towards the involved side

32
Q

The gag reflex tests what cranial nerves? Which is sensory and which is motor?

A

Sensory: 9
Motor:10

33
Q

What is a symptom is seen in damage to CN 9 and 10?

A

Voice hoarseness

34
Q

How to we test CN11?

A 
Shrug shoulders (Trap) 
Side bend and rotate (scm)
35
Q

What will an UMN lesion look like for CN11?

A

Contralateral trap weakness, sparing of the SCM

36
Q

What will a LMN lesion look like on CN 11

A

Ipsilaterally impacts on Trap and SCM

37
Q

How do we test CN 12?

A

“ stick out tongue “
Direction of deviation can indicate UMN or LMN lesion.
Look at tongue musculature for atrophy

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