Cranial nerves Flashcards by Thivyaa Gangatharan

Which tra

2 3 4 6

9 and 10

How well did you know this?

Not at all

Perfectly

How do you assess smell?

Ask patient whether they’ve noticed any changes to sense of smell

Ask them to

How well did you know this?

Not at all

Perfectly

Causes of anosmia?

Head trauma
Tumour
Viral URTI 
COVID-19
Meningitis
Parkinson's disease
Blocked nostril (mucous/nasal polyp)
Genetic (Kallman syndrome)

How well did you know this?

Not at all

Perfectly

How do you inspect

Size
Shape
Symmetry

How well did you know this?

Not at all

Perfectly

Asymmetry in pupil size is caused by

Anisocoria

Horner’s
Physiological
Third nerve palsy
Holmes-Adle syndrome

How well did you know this?

Not at all

Perfectly

Describe how you’d assess which eye is abnormal

More pronounced in bright light, larger pupil is abnormal

In dull light????

How well did you know this?

Not at all

Perfectly

Eye chart is called

Snellen chart

How well did you know this?

Not at all

Perfectly

How far should the patient stand?

stand 6m away

pt should wear glasses

How well did you know this?

Not at all

Perfectly

How do you record the results of the snellen test?

Like a fraction

Top number - distance teh chart should be read from

the bottom number is which line they can get to on the chart

How well did you know this?

Not at all

Perfectly

If unable to read top line

Move patient closer (3m/1m)
Count fingers
Hand movements
Light perception

How well did you know this?

Not at all

Perfectly

What is visual inattention or neglect?

Deficit in awareness of one side of visual field

How well did you know this?

Not at all

Perfectly

Describe findings with pin hole

If improvement with pin hole, refractory problem - can be corrected with glasses/

Optic nerve pathology if no correction with pinhole

How well did you know this?

Not at all

Perfectly

Describe a finding of visual inattention or neglect

Pt can see both of your hands individually, but when you move both at the same time, the pt can only see one hand

How well did you know this?

Not at all

Perfectly

What do you call the visual field red pin thing?

Hap pin

How well did you know this?

Not at all

Perfectly

What do you call the visual field red pin thing?

Hat pin

How well did you know this?

Not at all

Perfectly

Pupillary light reflex (optic nerve 2)

Direct
Consensual
Swinging

Describe the direct and consensual light reflex test

Shine light in eye and observe pupil constriction in THAT eye

Then shine the light in the same eye but observe the consensual light reflex in the opposite side

Describe the direct and consensual light reflex test

Shine light in eye and observe pupil constriction in THAT eye

Then shine the light in the same eye but observe the consensual light reflex in the opposite side

Swinging light reflex

Relative afferent pupillary defect - optic neuritis caused by MS

See slide about causes of RAPD

Retinal damage

Optic neruoapthy

Accommodation reflex

Hold finger out and ask pt to look at your finger
Eyes should converge and constrict

Lens is pulled thin and pupil is large when you look at somethign close by

????

Describe how you’d test oculomotor nerve

Inspect ptosis

Causes of a ptosis

Oculomotor nerve palsy
Neuromascular pathology - myasthenia gravis (bilateral ptosis)
Congenital
Horner’s

Describe how you’d test for CN 3, 4 and 6

Inspect eyes - neutral position
Deviation
Nystagmus

Describe how you'd assess eye movements

Ask pt to follow your finger with their eyes (H) Ask them to tell you if they get double vision or pain Restriction of eye movement

Describe oculomotor nerve palsy

Inferiolaterally (down and out) Ptosis (drooping of eye lid in that eye) Pupil dilatation

Causes of nystagmus

Congenital Central e.g. mid brain or cerebellar lesion Peripheral e.g. vestibular system Physiological (normal)

Rinner's test

Sensorineural deafness - air is louder than bone conduction, but weber's test - sound louder in normal ear Conductive Bone louder than air Weber's test - louder in affected air Normally air should be louder than the bone

Weber's test

non vibrating end of tuning fork held to forehead Pt should hear the sound both side

CN 9 and 10

gag reflex Inspect soft palate and uvula Look for uvula deviation (away from affected side) Soft palate - reduced elevation on affected side Ask: have you experienced any swallowing difficulties or changes to your voice or cough? - ask patient to cough Swallow sip water gag reflex ?

CN 11

Inspect SCM and trapezius Muscle wasting and fasciulations Test power - ask patient to shrug against resistance scm - ask pt to turn their head (opposite scm causes the head turn)

CN 12

stick tongue out wasting fasciculations deviation (towards) Power - ask pt to press their tongue against the cheek, whilst you feel and compare sides

Further examinations

full neuro examination mini mental exam asssessmetn of gait and balance

Facial nerve 7 palsy is called

Bell's palsy

Distinguish between a

Stroke - forehead sparing (can wrinkle both sides) Facial nerve palsy, forehead is affected