Cranial Nerve Testing Flashcards
How is cranial nerve V tested?
Test facial sensation using a cotton wisp and a sharp object. Also test for tactile extinction using double simultaneous stimulation. Is the patient’s speech hoarse, slurred, quiet, breathy, nasal, low or high pitched, and so on? It is often important to ask if the patient’s speech has changed from baseline. Note that dysarthria, or abnormal pronunciation of speech, is not the same as aphasia, which is an abnormality in language production or comprehension.
How is cranial VII nerve tested?
Look for asymmetry in facial shape or in depth of furrows such as the nasolabial fold. Also look for asymmetries in spontaneous facial expressions and blinking. Ask patient to smile, puff out their cheeks, clench their eyes tight, wrinkle their brow, and so on. Old photographs of the patient can often aid your recognition of subtle changes.
Is the patient’s speech hoarse, slurred, quiet, breathy, nasal, low or high pitched, and so on? It is often important to ask if the patient’s speech has changed from baseline. Note that dysarthria (see Neuroanatomy through Clinical Cases, Key Clinical Concept 12.8), or abnormal pronunciation of speech, is not the same as aphasia, which is an abnormality in language production or comprehension.
How is cranial IX nerve tested?
Does the palate elevate symmetrically when the patient says, “Aah”? Does the patient gag when the posterior pharynx is brushed? The gag reflex needs to be tested only in patients with suspected brainstem pathology, impaired consciousness, or impaired swallowing.
Is the patient’s speech hoarse, slurred, quiet, breathy, nasal, low or high pitched, and so on? It is often important to ask if the patient’s speech has changed from baseline. Note that dysarthria (see Neuroanatomy through Clinical Cases, Key Clinical Concept 12.8), or abnormal pronunciation of speech, is not the same as aphasia, which is an abnormality in language production or comprehension.
How is cranial X nerve tested?
Does the palate elevate symmetrically when the patient says, “Aah”? Does the patient gag when the posterior pharynx is brushed? The gag reflex needs to be tested only in patients with suspected brainstem pathology, impaired consciousness, or impaired swallowing.
Is the patient’s speech hoarse, slurred, quiet, breathy, nasal, low or high pitched, and so on? It is often important to ask if the patient’s speech has changed from baseline. Note that dysarthria (see Neuroanatomy through Clinical Cases, Key Clinical Concept 12.8), or abnormal pronunciation of speech, is not the same as aphasia, which is an abnormality in language production or comprehension.
How is cranial XII nerve tested?
Note any atrophy or fasciculations (spontaneous quivering movements caused by firing of muscle motor units) of the tongue while it is resting on the floor of the mouth. Ask the patient to stick their tongue straight out and note whether it curves to one side or the other. Ask the patient to move their tongue from side to side and push it forcefully against the inside of each cheek.
