Cranial nerves and lymph nodes (finish after watching vids) Flashcards
What is CN1
What type is it
What is the function
Olfactory
S
Smell
What is CN2
What type is it
What is the function
optic
s
vision
What is CN3
What type is it
What is the function
oculomotor
m
eye movement
What is CN4
What type is it
What is the function
trochlear
M
eye movement
What is CN5
What type is it
What is the function
trigeminal
B
S - facial movement, M - jaw movement
What is CN6
What type is it
What is the function
abducens
M
eye movement
What is CN7
What type is it
What is the function
facial
B
S - taste, M - facial movement
What is CN8
What type is it
What is the function
Vestibulochochlear
S
hearing
What is CN9
What type is it
What is the function
Glossopharyngeal
B
S – palate sensation, M – palate movement
What is CN10
What type is it
What is the function
vagus
B
S – palate sensation, M – palate movement
What is CN11
What type is it
What is the function
accessory
M
Shoulder/neck/head movement
What is CN12
What type is it
What is the function
Hypoglossal
M
Tongue movement
What do you do before starting a cranial nerve exam
- Introduce yourself to the patient (name/role).
- Check the patients details (name/DOB).
- Explain what you are going to do and gain consent for this.
- Position the patient appropriately for the examination (sat
facing you). - Check if the patient is in any pain currently.
- Ensure you have the appropriate equipment.
- Wash your hands.
- Ensure dignity and comfort throughout the examination.
what do you generally inspect
- Bedside clues – e.g. glasses, hearing aid, PEG.
- Level of consciousness – AVPU/GCS.
- Stance/gait – observe patient standing with eyes open/eyes
closed; observe patient walking. - Speech – observe patient speaking.
- Asymmetry – e.g. facial weakness, pupils.
- Abnormal movements – e.g. tremors.
- Muscle wasting.
- Fasciculation.
How do you test for CN1
- check sense of smell
- get pt to smell something strong e.g. coffee or orange
How do you test for CN2
visual acuity- chart, see how far down they can read
visual field- 4 fields
blind spots- hold objects in fields, ask when they no longer see
papillary reflex- shine light
accomadation- look at finger, look behind
colour vision- weird numbers
funascopy
How do you test for CN3, 4 + 6
- h pattern, eyes should follow
- any double vision or pain
CN3 palsy- eyes will be downwards and outwards
CN4 palsy- eyes will be upwards or inwards
CN6 palsy- middle, cant abduct
How do you test for CN5
- opthalmic
- maxillary
- mandibular
sharp feeling on face on- all 3
corneal reflex
MoM- trismus, crepitus, hypertrophy?
jaw jerk reflex- hammer on chin, jaw should close
How do you test for CN7
- ask pt if they’ve had any recent changes to taste
- check for asymmetry
- check facial movements (raise eyebrows, scrunch eyes, blow out cheeks, smile, purse lips)
How do you test for CN8
hearing test - stand 60cm away, whisper number or word and get pt to repeat
rinne’s test - place tuning frk on mastoid process, air conduction > bone conduction
webbers test - place tuning fork in the midline of forehead, sound is heard equally in both ears
How do you test for CN9 + 10
- ask pt of any issues with swallowing
- inspect soft palate and uvula
- gag reflex
- swallow assessment - cough
How do you test for CN11
- ask pt to raise shoulders and push down on them
- ask pt to turn head left and right and resist their movement
How do you test for CN12
- ask pt to open mouth and check tongue for wasting and fasciulations
- protrude tongue and check for deviation
- place finger on pt’s cheek and ask them to push tongue against it
acronym to remember whether CN is sensory, motor or both
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