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SF2.10_Cranial Nerve Testing_SEIDEN > Cranial Nerve Testing > Flashcards

Cranial Nerve Testing Flashcards

1
Q

How to test CN1 (olfactory):

A
  • Recognition of odors (avoid irritants).
  • Test one nostril at a time.
  • Be sure you are testing CN I and not CN V (olfaction, not general sensation).
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2
Q

Using a caustic substance when testing the olfactory nerve will stimulate:

A
  • CN5: trigeminal general sensory innervation of the nasal mucosa
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3
Q

How to test CN2 (optic) visual field:

A
  • Examiner holds one eye, patient holds same eye.
  • Look at each other noses.
  • Examiner brings hand from periphery while wiggling finger.
  • Should see at same time.
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4
Q

Why is the finger moved/wiggled when testing the visual field?

A
  • Rods detect peripheral vision.
  • Rods are not good for visual acuity, but are very good for detecting movement.
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5
Q

Draw visual field diagram with optic chiasm:

A
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6
Q

What would this lesion lead to?

A

right anopsia

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7
Q

What would this lesion lead to?

A

left homonymous hemianopsia

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8
Q

What would this lesion lead to?

A

bilateral heteronymous hemianopsia

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9
Q

What kind of vision loss would occur from the pituitary gland tumor impinging the optic chiasm from below?

A

Bitemporal Heteronymous Hemianopsia

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10
Q

Type of pupil constriction in the eye the light is shined into during a pupillary reflex test:

A

direct constriction

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11
Q

Type of pupil constriction in the eye the light is NOT shined into during a pupillary reflex test:

A

consensual constriction

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12
Q

Pupillary light reflex afferent and efferent limbs:

A
  • Afferent: CN2 (optic). Detects light.
  • Efferent: CN3 (oculomotor). Causes pupillary constriction.
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13
Q

What kind of brain herniation will lead to a fixed, dilated pupil?

A

uncal herniation

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14
Q

Steps in uncal herniation:

A
  1. increasing intracranial pressure in supratemporal compartment pushes brain downward
  2. uncus herniates from supra-tentorium compartment into sub-tentorium compartment via tentorial notch.
  3. CN3 compressed against the brain stem (parasympathetics first).
  4. loss of pupil constriction.
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15
Q

What does the uncal herniate over to get from the supra-tentorium compartment into the sub-tentorium compartment?

A

tentorial notch

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16
Q

How to test both CN3 inferior and superior divisions:

A

capital H

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17
Q

How to test both CN3 inferior division only:

A

convergence/accomodation reflex

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18
Q

Accomodation reflex components and cranial nerves involved:

A
  1. convergence of eyes (CN3-inf; medial recti)
  2. thickening of lens (CN3-inf; parasympathetics)
  3. pupil constriction (CN3-inf; parasympathetics)
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19
Q

Oculomotor palsy will lead to:

A
  • lateral strabismus
  • (medial rectus will be paralyzed)
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20
Q

Abducens palsy will lead to:

A
  • medial strabismus
  • (lateral rectus will be paralyzed)
21
Q

Label sensory innervation:

22
Q

Sensation above the eyes:

A

V1: ophthalmic division

23
Q

Sensation between eyes and mouth:

A

V2: maxillary division

24
Q

Sensation below the mouth:

A

V3: mandibular division

25
How many areas need to be tested in order to test all sensory innervation of CN5?
* 6 * V1, V2, and V3 on each side
26
How to test V3 motor division (muscles of mastication):
* clench jaw and palpate temporalis and masseter muscles. * deviate the jaw from side to side to test pterygoids. * open jaw against resistance = lateral pterygoid test.
27
Signs of CN7 lesion:
* loss of nasolabial folds * drooping of mouth * loss of forehead wrinkles
28
How to test CN7:
* muscles of facial expression: * smile, close eyes tightly, clench lips while puffing out cheeks
29
How to test CN8:
Weber test and Rinne test
30
How to test CN9:
* Gag reflex * Sensation from mucosa of oropharynx
31
Gag reflex afferent and efferent limbs:
* Afferent: CN9 * Efferent: CN10
32
Corneal blink reflex afferent and efferent limbs:
* **afferent:** V1 (corneal sensation via nasciliary) * **efferent:** CN7 (muscles facial expression)
33
Uvula deviation:
* indicative of vagus (CN10) lesion * deviates **OPPOSITE** side of lesion due to levator palati paralysis
34
A person with a hoarse and nasally voice may have a lesion of what cranial nerve?
* vagus (CN10) * hoarse = laryngeal muscle paralysis * nasally = levator palati paralysis
35
How to test CN11:
* Shoulder shrug against resistance (trapezius) * head turn against resistance (sternocleidomastoid)
36
If both trapezius and sternocleidomastoid are paralyzed, where is CN11 lesioned?
before the posterior triangle
37
If trapezius is paralyzed and sternocleidomastoid is functioning, where is CN11 lesioned?
posterior triangle
38
How to test CN12:
* Tongue protrusion (genioglosus) * Tongue deviates TOWARD the side of the lesion * due to paralysis of genioglossus.
39
Symptoms of Horner’s Syndrome:
**LOSS OF SYMPATHETICS** 1. **Ptosis** (paralysis of smooth muscle component of levator palpebrae superioris) 2. **Miosis** (paralysis of dilator pupillae muscle) 3. **Anhydrosis** (loss of sweat gland innervation)
40
Taste Sensation Anterior 2⁄3 of tongue & soft palate:
CN7
41
Taste Sensation Posterior 1⁄3 of tongue:
CN9
42
Taste Sensation Base of tongue and epiglottis:
CN10
43
Muscles innervated by V3 (mandibular):
1. temporalis 2. medial pterygoid 3. lateral pterygoid 4. masseter 5. tensor tympani 6. tensor palati 7. mylohyoid 8. anterior digastric
44
Muscles innervated by CN7:
* facial expression * stapedius * stylohyoid * posterior digastric
45
Innervation to all muscles of pharynx:
CN10; except stylopharyngeus (CN9)
46
Innervation to all muscles of palate:
CN10; except tensor palati (V3)
47
Innervation to all muscles of tongue:
CN12; except palatoglossus (CN10)
48
Contents and target of lesser palatine nerve:
**from pterygopalatine fossa to SOFT palate** 1. general sensory (V3) 2. taste (CN7) 3. postgang para (CN7) 4. postgang symp
49
Contents and target of greater palatine nerve:
**from pterygopalatine fossa to HARD palate** 1. general sensory (V3) 2. postgang para (CN7) 3. postgang symp

SF2.10_Cranial Nerve Testing_SEIDEN (1 decks)

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