Test 1: Cranial Nerves

Question 1

CN I name, function, test

Answer 1

olfactory

smell

have pt identify familiar smells

Question 2

CN II name, function, test

Answer 2

optic

vision

read close and distant items

Question 3

CN III name, function, test

Answer 3

oculomotor

eye movement/pupil reflex

eye tracking in all directions, pupillary response to light

• damaged = eye slightly depressed and rotated toward nose

Question 4

CN IV name, function, test

Answer 4

trochlear

superior oblique eye muscle innervation

observe eye position at rest; elevated if there is a problem

Question 5

CN V name, function, test

Answer 5

trigeminal

muscles of mastication and face sensation

observe jaw motion, can palpate temporalis

Question 6

CN VI name, function, test

Answer 6

abducens

lateral rectus of eye innervation

look at eye movement,

** damaged = cant look outward

Question 7

CN VII name, function, test

Answer 7

facial

muscles of facial expression, taste to anterior 2/3 of tongue

look for facial asymmetries, observe motions; taste with common liquids

Question 8

CN VIII name, function, test

Answer 8

vestibulocochlear

hearing and vestibular

rub test next to ear; tuning fork; observe balance

Question 9

CN IX name, function, test

Answer 9

glossopharyngeal

sensation and tasts to posterior tongue and pharynx

ask about swallowing, gag reflex

Question 10

CN X name, function, test

Answer 10

vagus

innervates epiglottis and larynx, parasympathetic innervation of internal organs

voice hoarsness with increased HR and RR are signs

Question 11

CN XI name, function, test

Answer 11

acessory n

trapezius and SCM innervation

observe quality of shoulder shrug and turn head both ways

Question 12

CN XII name, function, and test

Answer 12

hypoglossal

tongue muscles

observe tongue protrusion and mobility

** lateral movement indicates unilateral lesion

Question 13

pneumonic for sensory, motor, or both function of cranial nerves

Answer 13

Some
Say
Marry
Money
But
My
Brother
Says
Big
Brains
Matter
More

Question 14

what SPECIAL senses do cranial nerves control

Answer 14

taste
vision
hearing
smell
balance

Question 15

CNs are most likely injured how

Answer 15

fx to base of cranium
head trauma/excessive brain movement
compression from tumor, aneurysm, or inflammation

Question 16

how does scent travel through the olfactory n

Answer 16

nasal chemoreceptors to the olfactory bulb

Question 17

How does vision travel via the optic n

Answer 17

from retina to thalamus to other projections to the visual cortex

Question 18

describe the 2 tests for optic n

Answer 18

visual acuity = snellen chart; quadrant test of each eye

pupillary light reflex = shine light in one eye and see of both eyes constrict

Question 19

specific function of occulomotor n

Answer 19

medial inferior, superior rectuc, and levator palpebrae muscles innervation

constriction of pupil

Question 20

tests for occulomotor n (CN III)

Answer 20

visual oculomotor = H test; smooth pursuits; convergence/divergence

pupillary light reflex testing

observe for ptosis (droopy eyelid)

Question 21

specific function of CN IV trochlear

Answer 21

medial/downward eye movement

innervates superior oblique m

Question 22

test for CN IV trochlear n

Answer 22

visual oculomotor test (H test)

smooth pursuit inferiorly

Question 23

specific function of CN V trigeminal

Answer 23

sensory for face, eye, anterior ear

touch sensation only of anterior 2/3 of tongue

muscles for mastication

Question 24

what are the 3 branches of the trigeminal n

Answer 24

1 = opthalamic
2= maxillary
3= mandibular

Question 25

tests for the trigeminal n

Answer 25

sensory testing of face; pinprick and light touch resisted opening of jaw/palpation of mastication muscles corneal blink reflex (touch cornea) jaw jerk reflex; strike finger on pt jaw and observe for movement; no movement is normal

Question 26

specific function of CN VI abducens

Answer 26

innervates lateral rectus lateral eye movement

Question 26

tests for CN VI abducens

Answer 26

visual oculomotor test (H test) smooth pursuit laterally

Question 26

specific function of CN VII facial

Answer 26

motor for facial n sensory for special sensory taste of anterior 2/3 of tongue ANS: tearing/salvation

Question 26

tests for CN VII facial; injury to this n is called what?

Answer 26

muscles of face- look for symmetry: smile, show teeth, puff cheeks, raise eyebrows, frown taste foods on tip of tongue; sweet, sour, salty, and bitter **injury to this n is called bells palsy

Question 26

specific function of CN VIII vestibulocochlear

Answer 26

vestibular branch = head position cochlear = sound special sense of hearing and equilibrium

Question 27

tests for CN VIII vestibulocochlear n

Answer 27

cochlear branch: -fingertip rub by ear -weber test - tuning fork on top of head -rinne test - tuning fork on mastoid process vestibular branch -VOR testing - i.e. head thrust -caloric testing

Question 28

CN IX glossopharyngeal specific function

Answer 28

touch sensation to posterior 2/3 of tongue special sensory taste to posterior 2/3 innervates pharyngeal muscle and parotid salivary gland

Question 29

tests for CN IX glossopharyngeal

Answer 29

gag reflex -afferent signal -touch pharynx taste of posterior tongue

Question 30

function of CN X vagus

Answer 30

throat and visceral muscles and sensory nerves larynx, pharynx, and viscera ANS control of throat, lungs, heart, GI, pancreas, gall bladder important for flight or fight

Question 31

tests for CN X vagus

Answer 31

phonation -have pt say ah -check for deviation of uvula gag/swallow -efferent/motor response of muscles -observe swallow on command

Question 32

CN XI specific function

Answer 32

innervates trapezius and SCM

Question 33

test for CN XI accesssory

Answer 33

muscle resistance check for asymmetry -resisted shoulder shrug -resisted head RT

Question 34

specific function of CN XII

Answer 34

innervates muscles of tongue ipsilateral muscles

Question 35

tests for CN XII hypoglossal

Answer 35

stick tongue out; look for deviation (weakness is on side it deviates to) LMN injury; being pushed to ipsilateral weaker side by contralateral/stronger side UMN injury; stroke will deviate to OPPOSITE side (i.e. R side CVA = L side deviation)

Question 36

explain this difference between UMN and LMN injury that results in a R side facial droop

Answer 36

Injury to the L CNS could cause a R side facial droop; pt would still have some input just not a full smile injury to CN VII in the PNS would also lead to a R side facial droop; pt would not be able to move R side at all. No input present for facial muscles

Question 37

when is CN VII vulnerable to compression

Answer 37

when a viral infection produces inflammation and swelling of the n just before emerging from the stylomastoid foramen

Question 38

what should be the response to the pupillary light reflex in a healthy person

Answer 38

if you shine a light in one eye, both eyes constrict

Question 39

steps involved in the pupillary light reflex

Answer 39

Light picked up by CN II (ipsilateral side) goes to brain for processing goes to CN III on both sides CN III causes pupils to constrict