Neuro: Cranial Nerves Flashcards
CN I: Olfactory PE ?
Test sense of smell
Check patency b/l ( occlude on nostril)
Close eyes
One nostril at a time
Nonirritating odor
-Cloves, vanilla, soap
Not often checked, “CN’s II – XII grossly intact”
not commonly a problem and not commonly checked
CN II: Optic PE ?
Visual acuity - snellens
Funduscopic exam
Visual fields by confrontation - they are looking in your eyes as you move fingers, they tell you when they seat to see your fingers in their preperfera
CN II and III: Optic and Oculomotor PE ?
Size and shape of pupils
Pupillary reaction
Near response - when they convert and constrict - assuming accommodation
**Near response– pupillary constriction, convergence and accommodation of the lens
shine light 4 times
anesacoria - different sized pupil ) more than 0.4)
3rd nerve palsy - abnormal pupil constriction
and check for ptosis **
CN III, IV and VI: Oculomotor, Trochlear and Abducens PE ?
Extraocular movements – 6 cardinal directions
make an H
Nystagmus- horizontal, vertical, rotary, mixed
Ptosis
**little bit of ptosis is always opposite , double vision if they do not move together - the eyes **
CN V: Trigeminal PE - motor ?
Clench jaw, palpate temporal and masseter
Move jaw side to side
CN V: Trigeminal PE - Corneal reflex ?
Look up and away
Touch cornea with a wisp of cotton
not reliable if they were contact readily
CN V: Trigeminal PE - Sensory ?
Sharp/dull in 3 areas bilaterally
If abnormal, check temperature
Light touch
**opthalmic, maxillary , mandibular **
CN VII: Facial PE ?
Inspect face
Raise eyebrows
Frown
Close both eyes tightly
Show upper and lower teeth
Smile
Puff out both cheeks
Taste: Anterior 2/3 of tongue
Salty, sweet, sour and bitter
CN VII: Facial PE- taste ?
Taste: Anterior 2/3 of tongue
Salty, sweet, sour and bitter
CN VIII: Acoustic PE ?
Auditory acuity – whispered voice
Rinne - put on mastoid ( AC > BC)
Weber - should go to both ears symmetrically
Vestibular function rarely included
CN IX and X: Glossopharyngeal and Vagus PE ?
Listen to voice
Swallowing
Rise and fall of soft palate with phonation
Midline uvula
Gag reflex
**hoarse voice
trouble swallowing?
say ahh - looking a pharynx or for drainiage or looking to see if the soft palpate lifts symmetrically on phonation - equally
uvula - should hang midline ( some are bend - this is okay) just dont want to see it markedly shifted to one side **
CN XI: Spinal Accessory PE ?
Atrophy or fasciculations of trapezius
Shrug shoulders against resistance
Turn head against hand
CN XII: Hypoglossal PE ?
Articulation of words
Atrophy or fasciculation ( fine tremor) of tongue
Tongue protrusion - look for deviation
Tongue against cheek
**ability to speak ( is it from no dentures)
deviates to right side if problem on the right
**
CN I - Olfactory- function ?
Sensory
Olfaction - smell
CN II - Optic- function ?
Sensory
vision
CN III- Oculomotor- function ?
Both
serves muscles of the eye
CN IV- Trochlear- function ?
Both
serves the superior oblique eye muscle
CN V- Trigeminal- function ?
Both
sensory from face and mouth; motor to muscles of mastication - chewing
CN VI- Abducens- function ?
Both
serves the laster rectus eye muscle
CN VII- Facial- function ?
Both
serves the muscles of facial expression, lacrimal glands, and salivary glands
CN VIII- Vestibulocochlear - function ?
sensory
equilibrium and hearing
CN IX - Glossopharyngeal- function ?
Both
serves the pharynx ( throat) for swallowing, posterior 1/3 of tongue, parotid salivary gland
CN X- Vagus- function ?
Both
sensation from visceral organs, and parasympathetic motor regulation of visceral organs
CN XI- Spinal accessory- function ?
Both
serves muscles that move head, neck, and shoulders
CN XII - hypoglossal - function ?
Both
serves muscles of the tongue
CN function own notes ?
lid elevation problems = ptosis
LR6 SO4
facial -anyerior 2/3 of taste
VC - hearing mostly
GP - for swallowing, taste on posterior 1/3
V - more from visceral , lifting the palate
SA - head neck and shoulders
