Cranial Nerve Examination Flashcards
What are the nerves 1-12?
I - Olfactory II - Optic III - Oculomotor IV - Trochlear V - Trigeminal VI - Abducens VII - Facial VIII - Vestibulo-cochlear IX - Glossopharyngeal X - Vagus XI - Accessory XII - Hypoglossal
What order do you exam the cranial nerves?
I - Olfactory II - Optic III - Oculomotor IV - Trochlear VI - Abducens
V - Trigeminal
VII - Facial VIII - Vestibulo-cochlear IX - Glossopharyngeal X - Vagus XI - Accessory XII - Hypoglossal
Why exam olfactory? what possible problems do you get with them?
Possible problem – trauma, tumour
how do you test cranial nerve one?
the olfactory nn
Test using standard smell bottles
What problems can you get with optic nerve?
Possible problem – trauma, tumour, multiple sclerosis, stroke
how do you test cranial nerve 2?
Test acuity, visual fields to confrontation
1) What problems can you get with oculomotor nerve?
2) what would you see as being the problem with teh eyes when oculomotor nerve is affected?
1) diabetes, increased intracranial pressure
2) Dilated pupil, ptosis (dropping of eyelid), eye movements
1) what could cause a problem with the trochlear nerve?
2) which mm does it supply?
3) a problem causes what?
1) trauma
2) superior oblique mm
3) diplopia (double vision)
What can cause a problem with the abducens nn?
multiple sclerosis, stroke
what happens when you have a problem with the abducens nn?
Inability of the eye to look laterally
The eye is deviated towards the nose
true or false
trigeminal nerve is sensory and motor
true
why are 3 ,4 and 6 examined together?
they control eye movement
what could cause a sensory problem with the trigeminal nn?
idiopathic, trauma, IDN/lingual nerve damage
what could cause a motor problem with the trigeminal nerve?
bulbar palsy (presents with problem in 9, 10,11 and 12 too)
how do you test V nn?
Test sensation in all three nerve divisions
Test/estimate the power of the muscles of mastication
What supplied this mm?
lateral rectus muscle - one of the extraocular muscles. The lateral rectus originates from the lateral part of the common tendinous ring, and attaches to the anterolateral aspect of the sclera
abducens
abducens supplies which mm?
the lateral rectus muscle - one of the extraocular muscles.
These a problems that occur in association with which nerve?
Dilated pupil, ptosis (dropping of eyelid), eye movements
2) what does the nn innervate?
three main motor functions: Innervation to the pupil and lens (autonomic, parasympathetic) Innervation to the upper eyelid (somatic) Innervation of the eye muscles that allow for visual tracking and gaze fixation (somatic)
what are the 2 type of facial motor nn lesions?
What is the difference?
1) upper and lower
2) upper eyebrows can still move due to bilateral innervation,
lower motor facial neurone lesions can be caused by?
skull fracture, parotid tumour, Bell’s Palsy (when you don’t know cause/ viral), poor IDB
uppermotor facial neurone lesions can be caused by?
Upper motor neurone – stroke, tumour
What can cause problems with the Vestibulo-cochlear Nerve?
2) how is it tested?
excess noise, Paget’s, acoustic neuroma
2) simple hearing tests(More complex audiometric testing may be used in some cases)
What can cause problems with the Glossopharyngeal Nerve?
2) how is it tested?
1) trauma, tumour
2) say awww (problem moves uvula to impaired side?) , causes impaired gag reflex
What can cause problems with the Vagus Nerve?
2) how is it tested?
1) – trauma, brainstem lesions
2) Impaired gag reflex, soft palate moves to the normal side on saying “AAH”
What can cause problems with the Accessory Nerve?
2) how is it tested?
Possible problem – polio, stroke
Weakness turning head away from affected side/shrugging shoulders
What can cause problems with the Accessory Nerve?
2) how is it tested?
Possible problem – trauma, brainstem lesions
Tongue deviated to affected side on protrusion
