Cranial Nerves

Question 1

CN I

Answer 1

Olfactory nerve
Sensory
Identify a typical smell
Anosmia= loss of smell

Question 2

CN II

Answer 2

Optic nerve
Sensory
difficulty reading or vision
Snellen chart
Neuritis typical in MS
Glaucoma, high intraocular pressure

Question 3

CN III

Answer 3

Oculomotor nerve (motor)
- alterations in vision
- pupils reaction to light
- convergence: finger to nose
- diplopia, ptosis, neuropathy by space- occupying

Question 4

CN IV

Answer 4

Trochlear nerve (motor)
- alterations or unsteadiness
- vertical eye movements! aDduction of the eye
- nerve palsy in adduction by injury or small vessel infarction (diabetes)

Question 5

CN V

Answer 5

Trigeminal nerve (mixed)
- alterations while eating, chewing
- recent alterations in taste
- test strength/ function of the jaw
- test facial sensation
- an aberrant loop can compress the nerve at its root

Question 6

CN VI

Answer 6

Abducen nerve (motor)
- alterations of vision
- horizontal eye movement, aBduction
- impaired eye abduction due to nerve infarction, pressure!

Question 7

CN VII

Answer 7

Facial nerve (mixed)
- alterations in taste, smile
- herpes zoster, Epstein Barr virus, mumps, rubella, adenovirus
- Bell's palsy
- cornea reflex: blinking by touching the cornea
Puff out your cheeks, raise your eyebrows, wrinkle one's nose

Question 8

CN VIII

Answer 8

Vestibulocochlearis nerve (sensory)
- is hearing affected
- balance issues
Test: whisper, rub fingers close to the ear
tuning fork at ear vs. mastoid proces= Rinne test
Place tuning fork at the middle of the forehead= Weber's test

Question 9

CN IX

Answer 9

Glossopharyngeal nerve (mixed)
- alterations in swallowing?
- hoarse voice, coughing quality
Test
- ask to swallow deliberately
- gag reflex with tongue depressor

Question 10

CN X

Answer 10

Vagus nerve ( mixed, autonomic)
-see CN IX
Test: say "Aaaah" and observe palate and uvula symmetry

Question 11

CN XI

Answer 11

Accessory nerve
co-innervates Trapezius and SCM
check for diminished muscle mass, dropped shoulder, winged scapula
-vulnerable at post neck triangle
- aneurysm
- "Eagle syndrome": elongated and calcified styloid proces at temporal bone.
-symptoms like: stuck in the throat, shooting pain throat to ear, ringing or buzzing in ears

Question 12

CN XII

Answer 12

hypoglossal nerve (motor)
alterations in eating, swallowing, speech, tongue function
- protrude your tongue ( check for symmetry, flicking or fasciculation)
- tongue deviates to the weak side
- test strength of tongue: push your tongue against the cheek! Therapist push against!