Cranial Nerve Examination Flashcards

1
Q

What is it useful to do when examining an older child?

A

Consider each area of the nervous system individually - the cranial nerves, cerebellum, upper limb, lower limb, and gait

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2
Q

What is cranial nerve I (1)?

A

Olfactory

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3
Q

What is cranial nerve II (2)?

A

Optic

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4
Q

What is cranial nerve III (3)?

A

Oculomotor

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5
Q

What is cranial nerve IV (4)?

A

Trochlear

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6
Q

What is cranial nerve V (5)?

A

Trigeminal

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7
Q

What is cranial nerve VI (6)?

A

Abducens

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8
Q

What is cranial nerve VII (7)?

A

Facial

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9
Q

What is cranial nerve VIII (8)?

A

Vestibulocochlear

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10
Q

What is cranial nerve IX (9)?

A

Glossopharyngeal

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11
Q

What is cranial nerve X (10)?

A

Vagus

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12
Q

What is cranial nerve XI (11)?

A

Accessory

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13
Q

What is cranial nerve XII (12)?

A

Hypoglossal

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14
Q

What does CN 3 innervate?

A
  • Ciliary muscles
  • Sphincter of pupils
  • All external muscles of eye except superior oblique and lateral rectus
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15
Q

What does CN 4 innervate?

A

Superior oblique muscle

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16
Q

What does CN 5 innervate?

A

Sensory to face, sinuses, and teeth

17
Q

What does CN 6 innervate?

A

Lateral rectus muscle

18
Q

What does CN 7 innervate?

A

Muscles of face

19
Q

What does CN 7 innervate via the intermediate nerve?

A
  • Motor to submandibular, sublingual, and lacrimal glands
  • Taste to anterior 2/3 of tongue
  • Sensory to soft palate
20
Q

What does CN 8 divide into?

A
  • Cochlear nerve

- Vestibular nerve

21
Q

What does CN 9 innervate?

A
  • Taste to posterior 1/3 of tongue
  • Sensory to tonsils, pharynx, and middle ear
  • Motor to stylopharyngess, upper pharyngeal muscle, and parotid gland
22
Q

What does the CN 10 innervate?

A
  • Motor to heart, lungs, palate, pharynx, larynx, trachea, bronchi, and GI tract
  • Sensory to heart, lungs, trachea, bronchi, larynx, pharynx, GI tract, external ear
23
Q

What does CN 11 innervate?

A
  • Sternocleidomastoid

- Trapezius

24
Q

What does CN 12 innervate?

A

Tongue

25
Q

How is CN 1 tested?

A

Asking patient if they have noticed any change in their sense of smell
If test done, each nostril in turn

26
Q

How is CN 2 tested?

A
  • Visual acuity
  • Visual fields
  • Pupillary reflexes
  • Fundoscopy
27
Q

What pupillary reflexes should be tested?

A

Direct and consensual responses to lift, then accommodation

28
Q

How should CN 3, 4, and 6 be tested?

A

Ask child to fix and follow on an object (light from pen torch is best in children)

29
Q

How should the motor component of CN 5 be tested?

A
  • Ask child to open their mouth whilst you try and close it

- Clench teeth together and feel muscle mass of masseters

30
Q

What will be found when you ask the child to open their mouth whilst you try to close in if there is a CN 5 lesion?

A

It will deviate to the side of weakness

31
Q

What divisions provide the sensory functions of CN 5?

A
  • Opthalmic
  • Maxillary
  • Mandibular
32
Q

How should you assess the sensory functions of CN 5?

A

Test each division and compare both sides

33
Q

Should you test the corneal reflex?

A

No

34
Q

How should you assess the motor component of the CN 7?

A

Ask child to close their eyes tightly, open their eyes really wide, blow out their cheeks, and show their teeth

35
Q

How should you assess CN 8?

A

Rinne’s and Weber’s test

36
Q

How should you assess CN 9 and 10?

A

Ask child to open their mouth and say ‘ahh’ whilst looking at palatal movement

37
Q

How should you assess CN 11?

A

Ask the child to shrug their shoulders, turn their head to the right, and place a hand on the left side of their face and ask to push against your hand

38
Q

How should you assess CN 12?

A

Ask the child to stick out their tongue and inspect for fasciculation and deviation

39
Q

What will be found on examination if there is a lesion of CN 12?

A

The tongue deviates to the side of the lesion