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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:

A
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
Q

How many areas need to be tested in order to test all sensory innervation of CN5?

A
  • 6
  • V1, V2, and V3 on each side
26
Q

How to test V3 motor division (muscles of mastication):

A
  • 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
Q

Signs of CN7 lesion:

A
  • loss of nasolabial folds
  • drooping of mouth
  • loss of forehead wrinkles
28
Q

How to test CN7:

A
  • muscles of facial expression:
  • smile, close eyes tightly, clench lips while puffing out cheeks
29
Q

How to test CN8:

A

Weber test and Rinne test

30
Q

How to test CN9:

A
  • Gag reflex
  • Sensation from mucosa of oropharynx
31
Q

Gag reflex afferent and efferent limbs:

A
  • Afferent: CN9
  • Efferent: CN10
32
Q

Corneal blink reflex afferent and efferent limbs:

A
  • afferent: V1 (corneal sensation via nasciliary)
  • efferent: CN7 (muscles facial expression)
33
Q

Uvula deviation:

A
  • indicative of vagus (CN10) lesion
  • deviates OPPOSITE side of lesion due to levator palati paralysis
34
Q

A person with a hoarse and nasally voice may have a lesion of what cranial nerve?

A
  • vagus (CN10)
    • hoarse = laryngeal muscle paralysis
    • nasally = levator palati paralysis
35
Q

How to test CN11:

A
  • Shoulder shrug against resistance (trapezius)
  • head turn against resistance (sternocleidomastoid)
36
Q

If both trapezius and sternocleidomastoid are paralyzed, where is CN11 lesioned?

A

before the posterior triangle

37
Q

If trapezius is paralyzed and sternocleidomastoid is functioning, where is CN11 lesioned?

A

posterior triangle

38
Q

How to test CN12:

A
  • Tongue protrusion (genioglosus)
  • Tongue deviates TOWARD the side of the lesion
  • due to paralysis of genioglossus.
39
Q

Symptoms of Horner’s Syndrome:

A

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
Q

Taste Sensation Anterior 2⁄3 of tongue & soft palate:

A

CN7

41
Q

Taste Sensation Posterior 1⁄3 of tongue:

A

CN9

42
Q

Taste Sensation Base of tongue and epiglottis:

A

CN10

43
Q

Muscles innervated by V3 (mandibular):

A
  1. temporalis
  2. medial pterygoid
  3. lateral pterygoid
  4. masseter
  5. tensor tympani
  6. tensor palati
  7. mylohyoid
  8. anterior digastric
44
Q

Muscles innervated by CN7:

A
  • facial expression
  • stapedius
  • stylohyoid
  • posterior digastric
45
Q

Innervation to all muscles of pharynx:

A

CN10; except stylopharyngeus (CN9)

46
Q

Innervation to all muscles of palate:

A

CN10; except tensor palati (V3)

47
Q

Innervation to all muscles of tongue:

A

CN12; except palatoglossus (CN10)

48
Q

Contents and target of lesser palatine nerve:

A

from pterygopalatine fossa to SOFT palate

  1. general sensory (V3)
  2. taste (CN7)
  3. postgang para (CN7)
  4. postgang symp
49
Q

Contents and target of greater palatine nerve:

A

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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