Cranial Nerves Flashcards
What is the purpose of a cranial nerve exam?
To identify any dysfunction that could indicate a serious underlying condition such as increased intracranial pressure, brainstem lesions, brain tumors, or aneurysm.
How do you assess Cranial Nerve 1 (olfactory)?
Observe for any obstruction of the nostrils. If no obstruction is observed, the patient should correctly identify a test odor from 10cm away.
What are the indications for testing Cranial Nerve 2 (optic)?
Spots in vision and visual disturbances.
What should you observe during the examination of Cranial Nerve 2?
Check if the eyes are conjugated, signs of inflammation, size of pupils, signs of mydriasis, and signs of myosis.
How is visual acuity tested for Cranial Nerve 2?
Using a Snellen eye chart, the patient reads the smallest line they can see, first with both eyes and then with one eye. 6/6 vision is expected.
What is the procedure for testing near to far pupillary reaction?
The patient stares at a finger and then at a wall behind the practitioner, observing pupil dilation and constriction.
How do you test peripheral fields for Cranial Nerve 2?
Cover one eye and wiggle your hand out of direct sight, asking the patient if they can see it. Repeat for the other eye.
What does the ophthalmoscopic examination assess?
It observes surface anatomy such as the optic disc, optic cup, macular, and retina for any abnormalities.
What does the pupillary light reflex test for Cranial Nerves 2 and 3 involve?
With the patient’s hand covering half their face, shine light in one eye and observe constriction in both eyes.
What is assessed during extraocular movements for Cranial Nerves 3, 4, and 6?
Look for nystagmus and conjugate movements.
How is convergence tested?
Move a finger towards the center of the patient’s nose and observe for cross-eye (normal).
What is assessed for Cranial Nerve 5 (trigeminal)?
Sensory component for loss or exaggeration of sensation and motor examination of masseter and temporalis.
What does the corneal reflex test for Cranial Nerve 5 involve?
A light touch to the cornea should elicit blinking or tearing.
What is assessed for Cranial Nerve 7 (facial nerve)?
Evaluate facial expression muscles for symmetry through actions like smiling, frowning, and blowing out cheeks.
What are the indications for testing Cranial Nerve 8 (vestibulocochlear)?
Establish if the patient can detect low frequency sounds and perform the Weber and Rinne tests.
What does the Weber test assess?
It tests for conduction by placing a tuning fork on the patient’s head to see if vibrations are sensed equally in both ears.
What does the Rinne test evaluate?
It tests for conduction defects by comparing bone conduction and air conduction.
What is observed during the examination of Cranial Nerves 9 and 10?
Movement of the soft palate and uvula, as well as the gag reflex.
What indicates a normal test outcome for Cranial Nerves 9 and 10?
The soft palate rises symmetrically, the uvula remains midline, and the gag reflex is intact bilaterally.
How do you assess Cranial Nerve 11 (accessory nerve)?
Assess the upper trapezius and sternocleidomastoid by resisting movement and evaluating symmetry.
What is assessed for Cranial Nerve 12 (hypoglossal nerve)?
Articulation, inspection of the tongue for atrophy or fasciculations, and evaluation of tongue movements.
