CRANIAL NERVES Flashcards
Cranial Nerve I
is for which nerve?
OLFACTORY NERVE
Smell, a function of the 1st (olfactory) cranial nerve, is usually evaluated only after head trauma or when lesions of the anterior fossa (eg, meningioma) are suspected or patients report abnormal smell or taste.
Smell is part of which Cranial Nerve ?
CRANIAL NERVE I
Smell, a function of the 1st (olfactory) cranial nerve, is usually evaluated only after head trauma or when lesions of the anterior fossa (eg, meningioma) are susSmell is a function of which Cranial Nervepected or patients report abnormal smell or taste.
Which Cranial Nerve do you test
* AFTER A HEAD TRAUMA OR
* WHEN LESIONS OF THE ANTERIOR FOSA (E.G
MENINGIOMA) OR
* WHEN PATIENTS REPORT ABNORMAL SMELL OR
TASTE ?
CRANIAL NERVE I (OLFACTORY NERVE) IS TESTED WHEN:
Smell, a function of the 1st (olfactory) cranial nerve, is usually evaluated only after head trauma or when lesions of the anterior fossa (eg, meningioma) are suspected or patients report abnormal smell or taste.
IS THE CRANIAL NERVE I SENSORY, MOTOR OR BOTH ?
CRANIAL NERVE I (OLFACTORY NERVE) IS A SENSORY NERVE
Some say marry money, but my brother says big brains matter more.
Cranial Nerve II is for which nerve ?
CRANIAL NERVE II is for the OPTIC NERVE
Visual acuity is tested using a Snellen chart for distance vision or a handheld chart for near vision; each eye is assessed individually, with the other eye covered.
Color perception is tested using standard pseudoisochromatic Ishihara or Hardy-Rand-Ritter plates that have numbers or figures embedded in a field of specifically colored dots.
Visual fields are tested by directed confrontation in all 4 visual quadrants. Direct and consensual pupillary responses are tested.
Funduscopic examination is also done.
Which nerve is being tested when we test for
Visual acuity
Color Perception
Visual Fields
Fundoscopic examination ?
CRANIAL NERVE II is for the OPTIC NERVE
Visual acuity is tested using a Snellen chart for distance vision or a handheld chart for near vision; each eye is assessed individually, with the other eye covered.
Color perception is tested using standard pseudoisochromatic Ishihara or Hardy-Rand-Ritter plates that have numbers or figures embedded in a field of specifically colored dots.
Visual fields are tested by directed confrontation in all 4 visual quadrants.
Direct and consensual pupillary responses are tested.
Funduscopic examination is also done.
When using a Snellen Chart, what are we testing ?
Visual Acuity (Cranial nerve II the Optic Nerve)
Visual acuity is tested using a Snellen chart for distance vision or a handheld chart for near vision; each eye is assessed individually, with the other eye covered.
When using a pseudoisochromatic Ishihara or Hardy-Rand-Ritter plates what are you testing for and which cranial nerve is being tested ?
Color perception (color blind) is tested using standard pseudoisochromatic Ishihara or Hardy-Rand-Ritter plates that have numbers or figures embedded in a field of specifically colored dots.
Cranial Nerve II - Optic Nerve
When testing for Visual fields what are you testing for and which cranial nerve is being tested ?
Visual field are being tested by direct confrontation in all 4 visual quadrants
Have the patient look directly at your eye or nose
and test each quadrant in the patient’s visual field
by having them count the number of fingers that
you are showing. Test of one eye at a time. It is
useful for the examiner to close one eye so that
one can determine if the patient is seeing
appropriately in their visual field.)
Cranial Nerve II - Optic Nerve
What is PERRLA ?
Pupils are Equal & Round and Reactive to Light and Accommodation
What is direct and consensual pupillary response and which Cranial Nerve is being tested ?
Direct and consensual pupillary responses are tested.
check for pupillary response by shining light to one
eye. The pupil should constrict.
Consensual pupillary response or pupillary reflex is
when shining a light to the right eye and the left
eye’s pupil constricts.
WHAT TYPE OF EXAMINATION IS DONE TO GET A
VISUALIZATION OF
THE RETINA,
THE OPTIC DISK AND
THE BLOOD & RETINAL VESSELS ?
Fundoscopic examination
Ophthalmoscopy (also called fundoscopy) is an exam your doctor, optometrist, or ophthalmologist uses to look into the back of your eye. With it, they can see the retina (which senses light and images), the optic disk (where the optic nerve takes the information to the brain), and blood vessels
What Cranial Nerve is being examined with a Fundoscopic examination ?
Cranial Nerve II - Optic Nerve
Is the Optic Nerve (Cranial Nerve II) a sensory, Motor or both ?
SENSORY
Some(1) say(2) Marry(3) money(4), but(5) my(6) brother(7) says(8) big(9) brains(10) matter(11) more(12)
Which Cranial Nerves test is for EXTRAOCULAR MOVEMENTS
* Symmetry of movement,
* Globe position,
*Asymmetry or droop of the eyelids (ptosis),
* twitches or flutters of globes or lids.
* nystagmus and palsies of the ocular muscles ?
CN III (oculomotor),
CN IV (trochlear),
CN VI (abducens)
MOTOR
The eyes are observed for
symmetry of movement,
globe position,
asymmetry or droop of the eyelids (ptosis),
and twitches or flutters of globes or lids.
Extraocular movements controlled by these nerves(III, IV, VI) are tested by asking the patient to follow a moving target (eg, examiner’s finger, penlight) to all 4 quadrants (including across the midline) and toward the tip of the nose; this test can detect
nystagmus and palsies of ocular muscles.
Brief fine amplitude nystagmus at end-lateral gaze is normal.
Anisocoria or differences in pupillary size should be noted in a dimly lit room.
The pupillary light response is tested for symmetry and briskness. (nerves II sensory response-afferent and III motor response-efferent)
WHICH NERVE IS THE TROCHLEAR NERVE?
CN IV
WHICH NERVE TESTS FOR THE Ability to move your eyes up and down or back and forth ?
CN IV TROCHLEAR NERVE
MOTOR
Some(1) say(2) Marry(3) money(4), but(5) my(6) brother(7) says(8) big(9) brains(10) matter(11) more(12)
WHICH NERVES TEST FOR THE ABILITY TO follow a moving target (eg, examiner’s finger, penlight) to all 4 quadrants (including across the midline) and toward the tip of the nose ?
WHAT PROBLEMS CAN THIS TEST DETECT ?
TESTING THE EXTRAOCULAR MOVEMENTS
NERVE III OCULOMOTOR (MOTOR)
NERVE IV TROCHLEAR (MOTOR)
NERVE VI ABDUCENS (MOTOR)
asking the patient to follow a moving target (eg, examiner’s finger, penlight) to all 4 quadrants (including across the midline) and toward the tip of the nose.
THE TEST CAN Detect
NYSTAGMUS, PALSIES OF OCULAR MUSCLES
(NORMAL IS A Brief fine amplitude nystagmus at end-lateral gaze)
WHICH NERVE TESTS FOR THE Ability to move and blink your eyes ?
CN III OCULOMOTOR
MOTOR
Anisocoria or differences in pupillary size should be tested on what type of light ?
BRIGHT LIGHT
DIMMED LIGHT
RED LIGHT
DIMMED LIGHT
EXTRAOCULAR MOVEMENTS
CN III (oculomotor),
CN IV (trochlear),
CN VI (abducens)
MOTOR
The eyes are observed for
symmetry of movement,
globe position,
asymmetry or droop of the eyelids (ptosis),
and twitches or flutters of globes or lids.
Extraocular movements controlled by these nerves(III, IV, VI) are tested by asking the patient to follow a moving target (eg, examiner’s finger, penlight) to all 4 quadrants (including across the midline) and toward the tip of the nose; this test can detect
nystagmus and palsies of ocular muscles.
Brief fine amplitude nystagmus at end-lateral gaze is normal.
Anisocoria or differences in pupillary size should be noted in a dimly lit room.
The pupillary light response is tested for symmetry and briskness. (nerves II sensory response-afferent and III motor response-efferent)
The pupillary light response is tested for ………… ?
The pupillary light response is tested for
SYMMETRY and BRISKNESS
NERVE II OPTICE NERVE (SENSORY) Response-afferent
and
NERVE III OCULOMOTOR NERVER (MOTOR Response-efferent
Direct and consensual pupillary responses are tested.
check for pupillary response by shining light to one
eye. The pupil should constrict.
Consensual pupillary response or pupillary reflex is
when shining a light to the right eye and the left
eye’s pupil constricts.
WHICH NERVE IS THE ABDUCENS NERVE?
CN VI
Ability to move your eyes.
WHICH CRANIAL NERVE INVOLVES Sensations in your face and cheeks, taste and jaw movements ?
Cranial nerve V
TRIGEMINAL NERVE
For the 5th (trigeminal) nerve, the 3 sensory divisions (ophthalmic, maxillary, mandibular) are evaluated by using a pinprick to test facial sensation and by brushing a wisp of cotton against the lower or lateral cornea to evaluate the corneal reflex. If facial sensation is lost, the angle of the jaw should be examined; sparing of this area (innervated by spinal root C2) suggests a trigeminal deficit. A weak blink due to facial weakness (eg, 7th cranial nerve paralysis) should be distinguished from depressed or absent corneal sensation, which is common in contact lens wearers. A patient with facial weakness feels the cotton wisp normally on both sides, even though blink is decreased.
Trigeminal motor function is tested by palpating the masseter muscles while the patient clenches the teeth and by asking the patient to open the mouth against resistance. If a pterygoid muscle is weak, the jaw deviates to that side when the mouth is opened
WHICH CRANIAL NERVE HAS 3 DIVISIONS AND IS Both (sensory and motor) ?
CN V
TRIGEMINAL NERVE
SENSORY & MOTOR