Cranial Nerve Examinations Flashcards

1
Q

what tests would you do for Cranial Nerve 1?

A
  1. observation of the external nose
  2. test each side with a different scent
  3. internal exam of the nose
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2
Q

what tests would you do for CN2?

A
  1. Pupillary light reflex
  2. Observation of the eyes
  3. Ophthalmoscopic exam
  4. Peripheral vision
  5. visual acuity (Snellen’s chart)
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3
Q

what tests are for CN 3,4,6?

A
  1. Accommodation
  2. Corneal light reflex
  3. Observation of the eyes
  4. Pupillary light reflex
  5. 6 Cardinal field of gaze (watch for Nystagmus)
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4
Q

what are the tests for CN5?

A
  1. inspect muscles volume and strength
  2. corneal blink reflex
  3. Sensory exam of the face
    - Light touch and pain (sharp and dull)
  4. Jaw jerk reflex
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5
Q

what tests for CN7?

A
  1. check musculature of the face (smile, look up)

2. Check taste (Anterior 2/3 of tongue)

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6
Q

what tests for CN8?

A
  1. Caloric irrigation
  2. Swivel chair test
  3. Observation otoscope exam of the internal ears
  4. Rinne test
  5. Rotating of the head for Dizziness
  6. Observation of the external ears
  7. Weber test
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7
Q

what test for CN9, 10?

A
  1. Patient say AHHHH (soft palate should elevate)
  2. Gag reflex (posterior 1/3 of tongue)
  3. Phonation (kuh, la, Mi)
    4 Check taste (posterior 1/3 of tongue)w
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8
Q

what test for CN11?

A
  1. shoulder elevation, lateral bend, rotate

2. muscle strength (SCM and trapezius) same movements with resistance

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9
Q

what tests for CN12?

A
  1. stick out tongue

2. tongue in cheek test

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10
Q

what are the four general reasons for a cranial nerve abnormality?

A

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

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11
Q

when might a lesion affect multiple cranial nerves?

A

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)

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12
Q

a lesion at the cerebellopontine angle would have what affect on the cranial nerves?

A

unilateral effect on CN 5, 7, and 8

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13
Q

a lesion at the cavernous sinus would have what affect on the cranial nerves?

A

unilateral effect on 3, 4, 5 and 6

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14
Q

jugular foramen syndrome would have what affect on the cranial nerves?

A

unilateral effect on 9, 10, and 11

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15
Q

when CN 10,11, and 12 are bilaterally affected from a lower motor neuron lesion its called? and upper motor neuron lesion is called?

A

lower motor is bulbar palsy

upper motor is pseudobulbar palsy

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16
Q

what is the most common cause of an intrinsic brain stem lesion in a younger patient? in an older patient?

A

multiple sclerosis in younger patient

vascular disease in older patient

17
Q

where is the Edinger-westphal nucleus?

A

level of superior colliculus

MOTOR

18
Q

the sensory cranial nerve nuclei develop where?

A

within the Dorsal or Alar plate of the neuro tube

19
Q

where do the cranial nerve motor nuclei develop?

A

within the basal plate of the neuro tube

20
Q

in the hindbrain, where does the alar plate lie?

A

lateral to the basal plate in the floor of the 4Th ventricle

21
Q

where is the trochlear nucleus?

A

in the mid-brain at the level of the inferior colliculus

MOTOR

22
Q

where is the motor nucleus of the trigeminal nerve?

A

level of mid pons

MOTOR

23
Q

where is the nucleus of abducens?

A

dorsal pons

MOTOR

24
Q

where is the motor nucleus of facial nerve?

A

near caudal border of pons

MOTOR

25
Q

where is the nucleus salivatorius superior and inferior?

A

at border of pons and medulla
superior is facial nerve
inferior is glossopharyngeal
MOTOR

26
Q

where is the dorsal motor nucleus of Vagus nerve?

A

dorsal medulla

MOTOR

27
Q

where is nucleus ambiguous and what cranial nerves is it associated with?

A

in dorsal medulla
associated with glossopharyngeal. vagus, spinal accessory
MOTOR

28
Q

where is the hypoglossal nucleus located?

A

in medulla beneath 4th ventricle

MOTOR

29
Q

where is the mesencephalic nucleus of trigeminal located?

A

mid brain

SENSORY

30
Q

where is the main sensory nucleus of trigeminal nerve located?

A

Pons

SENSORY

31
Q

where is the vestibular and cochlear nuclei of acoustic nerve located?

A

IN Pons and Medulla

SENSORY

32
Q

where is the nucleus of Tractus Solitarius located?

A

Dorsal Medulla
CN 7 and 9
SENSORY

33
Q

where is the nucleus of spinal tract of trigeminal nerve located?

A

Dorsal Lateral Medulla

SENSORY