Cranial Nerve Examinations Flashcards
what tests would you do for Cranial Nerve 1?
- observation of the external nose
- test each side with a different scent
- internal exam of the nose
what tests would you do for CN2?
- Pupillary light reflex
- Observation of the eyes
- Ophthalmoscopic exam
- Peripheral vision
- visual acuity (Snellen’s chart)
what tests are for CN 3,4,6?
- Accommodation
- Corneal light reflex
- Observation of the eyes
- Pupillary light reflex
- 6 Cardinal field of gaze (watch for Nystagmus)
what are the tests for CN5?
- inspect muscles volume and strength
- corneal blink reflex
- Sensory exam of the face
- Light touch and pain (sharp and dull) - Jaw jerk reflex
what tests for CN7?
- check musculature of the face (smile, look up)
2. Check taste (Anterior 2/3 of tongue)
what tests for CN8?
- Caloric irrigation
- Swivel chair test
- Observation otoscope exam of the internal ears
- Rinne test
- Rotating of the head for Dizziness
- Observation of the external ears
- Weber test
what test for CN9, 10?
- Patient say AHHHH (soft palate should elevate)
- Gag reflex (posterior 1/3 of tongue)
- Phonation (kuh, la, Mi)
4 Check taste (posterior 1/3 of tongue)w
what test for CN11?
- shoulder elevation, lateral bend, rotate
2. muscle strength (SCM and trapezius) same movements with resistance
what tests for CN12?
- stick out tongue
2. tongue in cheek test
what are the four general reasons for a cranial nerve abnormality?
1) specific lesions to the nerve
2) lesion in the nucleus
3) lesion in a communicating pathways to and from the cortex, diencephalon (thalamus and associated structures), cerebellum or other parts of the brain stem
4) generalized problems of nerve or muscle
when might a lesion affect multiple cranial nerves?
1) if the lesion is where several cranial nerves run together either in the brain stem or within the skull
2) when they are affected by a generalized disorder (Myasthenia Gravis)
3) following multiple lesions ( multiple sclerosis, cerebral vascular disease)
a lesion at the cerebellopontine angle would have what affect on the cranial nerves?
unilateral effect on CN 5, 7, and 8
a lesion at the cavernous sinus would have what affect on the cranial nerves?
unilateral effect on 3, 4, 5 and 6
jugular foramen syndrome would have what affect on the cranial nerves?
unilateral effect on 9, 10, and 11
when CN 10,11, and 12 are bilaterally affected from a lower motor neuron lesion its called? and upper motor neuron lesion is called?
lower motor is bulbar palsy
upper motor is pseudobulbar palsy
what is the most common cause of an intrinsic brain stem lesion in a younger patient? in an older patient?
multiple sclerosis in younger patient
vascular disease in older patient
where is the Edinger-westphal nucleus?
level of superior colliculus
MOTOR
the sensory cranial nerve nuclei develop where?
within the Dorsal or Alar plate of the neuro tube
where do the cranial nerve motor nuclei develop?
within the basal plate of the neuro tube
in the hindbrain, where does the alar plate lie?
lateral to the basal plate in the floor of the 4Th ventricle
where is the trochlear nucleus?
in the mid-brain at the level of the inferior colliculus
MOTOR
where is the motor nucleus of the trigeminal nerve?
level of mid pons
MOTOR
where is the nucleus of abducens?
dorsal pons
MOTOR
where is the motor nucleus of facial nerve?
near caudal border of pons
MOTOR
where is the nucleus salivatorius superior and inferior?
at border of pons and medulla
superior is facial nerve
inferior is glossopharyngeal
MOTOR
where is the dorsal motor nucleus of Vagus nerve?
dorsal medulla
MOTOR
where is nucleus ambiguous and what cranial nerves is it associated with?
in dorsal medulla
associated with glossopharyngeal. vagus, spinal accessory
MOTOR
where is the hypoglossal nucleus located?
in medulla beneath 4th ventricle
MOTOR
where is the mesencephalic nucleus of trigeminal located?
mid brain
SENSORY
where is the main sensory nucleus of trigeminal nerve located?
Pons
SENSORY
where is the vestibular and cochlear nuclei of acoustic nerve located?
IN Pons and Medulla
SENSORY
where is the nucleus of Tractus Solitarius located?
Dorsal Medulla
CN 7 and 9
SENSORY
where is the nucleus of spinal tract of trigeminal nerve located?
Dorsal Lateral Medulla
SENSORY
