Module 11: Neurologic Examination Flashcards
Level of Consciousness
Awareness and cognitive function as assessed through behavior, arousability, and responses to stimuli
Orientation is a person’s ability to identify…
- Person – who they are
- Place – where they are
- Time – what the date is
Cranial Nerve
A nerve that arises directly from the brain as opposed to the spinal column
Olfactory Nerve
- Cranial nerve I
- Responsible for the sense of smell
Optic Nerve
- Cranial Nerve II
- Responsible for visual acuity
- Peripheral visual fields
- Sensory component of the pupillary reflex
Visual Acuity
The ability to see clearly in the central line of vision
Peripheral Fields
The areas of vision beyond a person’s central vision
The ophthalmoscopy exam allows the provider to directly visualize
- Optic disc
- Retina
- Fovea
- Macula
Direct Pupillary Reaction
Constriction of the pupil as light is shown into the eye being examined
Consensual Pupillary Reaction
Constriction of the pupil as light is shown into the opposite eye
Oculomotor Nerve
- Cranial Nerve III
- Responsible for constricting the pupil with pupillary reaction
- Keeping the eye open
- Extraocular movements through all positions of gaze except lateral & inferior movements
- Think 3 columns keeping the eyes open
Abducens Nerve
- Cranial Nerve VI
- Responsible for the movement of the eye in the lateral direction through innervation of the lateral rectus muscle
Trochlear Nerve
- Cranial Nerve IV
- Responsible for movement of the eye in the inferior, lateral (up & down) direction through innervation of the superior oblique muscle
Trigeminal Nerve
- Cranial Nerve V
- Responsible for the motor action of the muscles of mastication & sensation to the forehead, cheek, & jaw
Examine the Trigeminal Nerve
- Patient clenches teeth and you palpate mastication muscles
- Patient opens mouth -> check for symmetry
- Use soft touch/sharp object to test the sensory branch
Facial Nerve
- Cranial nerve VII
- Responsible for innervation of the muscles of facial expression
- The ability to close the eyes
- Taste sensation of the anterior 2/3 of the tongue
Disruption of the innervation of the CNVII can result in
- Weakness of facial muscles
- Can be seen as flattening of the forehead winkles
- Loss of nasolabial fold
- Drooping of the corner of the mouth
- Inability to close the eye fully
Vestibulocochlear Nerve
- Cranial Nerve VIII
- AKA acoustic nerve
- Responsible for balance (vestibular)
- Responsible for hearing (cochlear)
Nystagmus
Involuntary beating movements of the eyes in horizontal, vertical, or circular motions
Glossopharyngeal Nerve
- Cranial Nerve IX
- Responsible for taste sensation to the posterior 1/3 of the tongue
- Sensory component of the gag reflex
Signs of cranial nerve IX (CNIX) injury include
- Dry mouth
- Dysphagia
Vagus Nerve
- Cranial nerve X
- Responsible for the motor component of the pharynx (gag reflux)
- Larynx
- Providing parasympathetic innervation to thoracic & abdominal organs
Approximately ____% of people do not have a gag reflex
20%
Asymmetric findings in the vagus nerve are particularly indicative of
Pathology
CNIX provides the _____ _____ of the gag reflex while the CNX provides the ____ _____.
- Sensory component
- Motor reaction