Neuro Cranial exam Flashcards
CN2 test
Snellens for visual acuity- higher number is worse (Eg: 6/60)
Colour vision-ishiara test
Light reflexes-direct, indirect, and swinging light test (RAPD)
Accomodation (distance, then close -> pupils constrict)
visual fields
look first- asymettry etc
look straight ahead-point at hand they can see moving (and move around)-fast field changes, visual neglect
Then close one eye and look ahead and finger wiggle thing-different side-hemianopia-chiasm, both on same side-cortical
Blind spot mapping
opthalmoscope (practice, and use it well)-correct for your and pt vision!-ask
use same eye and same hand, turn off light
look at disc!, look at the arteries etc
dont make things up
dilating eye can come up
CN3,4,6
eye movements
ask to follow the finger/tip
ask them for double vision
H or + sign- is fine
nystagmus
either simple-1 nerve
or complex- more than 1 nerve-MG
CN5
sensory and motor
look first
motor- masseter and temporalis-ask to clench-asymetry
Sensory- forehead, zygomatic, chin
cotton wool, or pin prick(offer)
same side as lesion
cornea reflex- touch the cornea- blink (sensory if 5, motor in 7)
and Jaw Jerk- UMN sign in SBP-gently tap finger on jaw-master
CN7
Facial- mainly motor
5 branches
eyebrows-NON forehead sparing in bells
eye closing and closing-try and open
puff cheeks
smile and frown
sensory on taste-
CN8
Hearing loss, gross testing by rubbing or whispering number in ear
if any issues, offer—
Otoscopy
Webber and Rinnes 512 Hz
webber in the middle (w is symetrical)
Rinne in ear
CN 9/10
glossopharyngeal, vagus
dysarhtria, dyphaghia
say yellow lorry, red lorry- see if can see
look for NG/peg
Look inside mouth and say AAA- uvula central. uvula away from lesion
gag reflex
Palate elevation SYMETRICAL
side that doesnt elevate- is the issue
CN11
acessory- SCM and trapezius
observe,
shrug shoulders
head turn
CN12
look in mouth at rest
then stick tongue out- straight is good
deviate towards lesion
push tongue in cheek
