Cranial Nerve Examination

Question 1

What are the nerves 1-12?

Answer 1

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

Question 2

What order do you exam the cranial nerves?

Answer 2

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

Question 3

Why exam olfactory? what possible problems do you get with them?

Answer 3

Possible problem – trauma, tumour

Question 4

how do you test cranial nerve one?

Answer 4

the olfactory nn

Test using standard smell bottles

Question 5

What problems can you get with optic nerve?

Answer 5

Possible problem – trauma, tumour, multiple sclerosis, stroke

Question 6

how do you test cranial nerve 2?

Answer 6

Test acuity, visual fields to confrontation

Question 7

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?

Answer 7

1) diabetes, increased intracranial pressure

2) Dilated pupil, ptosis (dropping of eyelid), eye movements

Question 8

1) what could cause a problem with the trochlear nerve?
2) which mm does it supply?
3) a problem causes what?

Answer 8

1) trauma
2) superior oblique mm
3) diplopia (double vision)

Question 9

What can cause a problem with the abducens nn?

Answer 9

multiple sclerosis, stroke

Question 10

what happens when you have a problem with the abducens nn?

Answer 10

Inability of the eye to look laterally

The eye is deviated towards the nose

Question 11

true or false

trigeminal nerve is sensory and motor

Answer 11

true

Question 12

why are 3 ,4 and 6 examined together?

Answer 12

they control eye movement

Question 13

what could cause a sensory problem with the trigeminal nn?

Answer 13

idiopathic, trauma, IDN/lingual nerve damage

Question 14

what could cause a motor problem with the trigeminal nerve?

Answer 14

bulbar palsy (presents with problem in 9, 10,11 and 12 too)

Question 15

how do you test V nn?

Answer 15

Test sensation in all three nerve divisions

Test/estimate the power of the muscles of mastication

Question 16

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

Answer 16

abducens

Question 17

abducens supplies which mm?

Answer 17

the lateral rectus muscle - one of the extraocular muscles.

Question 18

These a problems that occur in association with which nerve?
Dilated pupil, ptosis (dropping of eyelid), eye movements
2) what does the nn innervate?

Answer 18

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)

Question 19

what are the 2 type of facial motor nn lesions?

What is the difference?

Answer 19

1) upper and lower

2) upper eyebrows can still move due to bilateral innervation,

Question 20

lower motor facial neurone lesions can be caused by?

Answer 20

skull fracture, parotid tumour, Bell’s Palsy (when you don’t know cause/ viral), poor IDB

Question 21

uppermotor facial neurone lesions can be caused by?

Answer 21

Upper motor neurone – stroke, tumour

Question 22

What can cause problems with the Vestibulo-cochlear Nerve?

2) how is it tested?

Answer 22

excess noise, Paget’s, acoustic neuroma

2) simple hearing tests(More complex audiometric testing may be used in some cases)

Question 23

What can cause problems with the Glossopharyngeal Nerve?

2) how is it tested?

Answer 23

1) trauma, tumour

2) say awww (problem moves uvula to impaired side?) , causes impaired gag reflex

Question 24

What can cause problems with the Vagus Nerve?

2) how is it tested?

Answer 24

1) – trauma, brainstem lesions

2) Impaired gag reflex, soft palate moves to the normal side on saying “AAH”

Question 25

What can cause problems with the Accessory Nerve?

2) how is it tested?

Answer 25

Possible problem – polio, stroke

Weakness turning head away from affected side/shrugging shoulders

Question 26

What can cause problems with the Accessory Nerve?

2) how is it tested?

Answer 26

Possible problem – trauma, brainstem lesions

Tongue deviated to affected side on protrusion