Cranial Nerves-testing and abnormals Flashcards
how to test CN 1-olfactory
CN 1 abnormal
occlude one nostril and ask the patient to identify a scent from a vial.
abnormal: Anosmia-decrease or loss of smell occurs bilaterally
how to test CN 2-optic
CN 2 abnormal
Visual Acuity-Test with Snellen Chart
Opthalmoscope- assess ocular fundus
abnormal are: Decreased visual acuity, visual defects, optic atrophy, papilledema
how to test CN 3-occulomotor
CN 3 abnormal
EOM’s, light reflex, PERRLA
abnormal: Ptosis Eyes not parallel Strabismus Nystagmus Pupils do not react to light and accommodate
how to test CN 4 trochlear
CN 4 abnormal
testing: EOM’s
abnormal: Ptosis
Eyes not parallel
Eyes do not track in a consensual manner
how to test CN 5 trigeminal
CN 5 abnormals
Palpate masseter muscle
Brush cornea with cotton tip
Light touch on the face with cotton wisp: forehead, cheeks, & chin
Week or asymmetric masseter muscle Asymmetry in jaw movement No corneal reflex blink Decreased or unequal sensation with light touch on facial areas Paresthesias
how to test CN 6 abducens
CN 6 abnormal
testing: EOM’s
abnormal:
Ptosis
Eyes not parallel
Eyes do not track in a consensual manner
how to test CN 7 facial
CN 7 abnormal
testing: Smile, frown, show teeth, lift eyebrows, close eyes tightly
against resistance
Press person’s puffed cheeks in and air should escape equally
abnormal: Facial asymmetry Flattening of nasolabial fold Drooping of one side of the face Escape of air from one cheek Unable to keep eye lids closed against resistance Loss of taste Bell’s Palsy (PNS)
how to test CN 8 vestibulocochlear
CN 8 abnormal
Whispered Voice Test
Ability to hear normal conversation
Romberg
CN 8 abnormals:
Unable to state words from whispered voice testing
Sound lateralizes (sensorineural loss)
Vertigo
how to test CN 9 glassopharyngeal
testing: Depress tongue with tongue blade & say “ahhh”
Gag reflex with cotton tip applicator
abnormal: Uvula and or soft palate do not rise in the midline Tonsillar pillars do not move medially Loss of gag reflex Voice strained, not smooth Hoarse or brassy voice Difficulty swallowing
how to test CN 10 vagus
CN 10 abnormals
Depress tongue with tongue blade & say “ahhh”
Gag reflex with cotton tip applicator
Uvula and or soft palate do not rise in the midline Tonsillar pillars do not move medially Loss of gag reflex Voice strained, not smooth Hoarse or brassy voice Difficulty swallowing
how to test CN 11 spinal accessory
CN 11 abnormal
Shrug shoulders and turn head against resistance
Weakness or asymmetrical movement of these muscles
No movement of these muscles
how to test CN 12 hypoglossal
Inspect tongue for wasting or tremors stick tongue out
Speak: light, tight, & dynamite
CN 12 abnormals Tongue deviates from the midline Atrophy Fasciculations Sounds l,t, & d not clear and distinct
