Cranial Nerves Examination Flashcards
What are the cranial nerves?
Olfactory
Optic
Oculomotor
Trochlear
Trigeminal
Abducens
Facial
Vestibulocochlear
Glossopharyngeal
Vagus
Accessory
Hypoglossal
How do you test CN I
Olfactory
Ask patient if notices any change in smell
How do you test CN II (the overview)
Optic
Inspection first
AFRO (3 tests for each)
Acuity
Fields
Reflexes
Optic disc
What needs to be inspected for optic nerve?
Visual aids Pupil size and symmetry Screening test (ask if can see whole face clearly)
How do you test visual acuity overview?
Ask patient to cover one eye with hand and test each eye in turn
- distant vision
- near vision
- colour vision
how do you test distant vision?
test with snellen chart
with glasses on
6m away to start with
record as distance/ smallest font size e.g 6/9
how do you test near vision
read a line of a magazine/letter
do you test colour vision?
ishihara plates
how do you test visual fields?
patient in front of you 1m away
visual inattention
visual fields
blind spots
how do you test visual inattention
patient keeps both eyes open and focused on me
hold out hands in outer visual fields
point to the hand which are moving
check one then other then both
how do you test visual fields?
ask patient to cover one eye and i close eye on same side
stay focused on my eye
use white visual fields pin at mid-distance between us
bring in pin from periphery and ash when see it
moving diagonally from 4 quadrants
test both eyes individually comparing field loss with yours
what does mononuclear field loss suggest?
intraocular pathology or ipsilateral optic nerve lesion
what does bitemporal hemianopia suggest?
optic chiasm compression
what does left/right homonymous hemianopia suggest?
contralateral optic tract/ radiation lesion
or occipital cortex if macular sparing is present
how do you test blind spots?
offer to test
keep both eyes open and focused on me
use redpin mid-distance
check can see red in the middle
