Assessing Neurologic System

Question 1

order of cranial nerves

Answer 1

• olfactory (sensory)
• optic (sensory)
• oculomotor (motor)
• trochlear (motor)
• trigeminal (both)
• abducens (motor)
• facial (both)
• acoustic, vestibulocochlear (sensory)
• glossopharyngeal (both)
• vagus nerve (both)
• spinal accessory (motor)
• hypoglossal (motor)

Question 2

olfactory

Answer 2

• sensory

- carries smell impulses from nasal mucous membrane to brain.

Question 3

optic

Answer 3

• sensory

- carries visual impulses from eye to brain

Question 4

oculomotor

Answer 4

• motor

- contracts eyes muscles to control eye movements, constricts pupils, and elevates eyelids

Question 5

trochlear

Answer 5

• motor

- contracts one eye muscle to control inferomedial eye movement

Question 6

trigeminal

Answer 6

• both
• carries sensory impulses of pain, touch, and temperature from the face to the brain. influence clenching and lateral jaw movements (biting, chewing)

Question 7

abducens

Answer 7

• motor

- controls lateral eye movement

Question 8

facial

Answer 8

• both
• contains sensory fibers for taste on anterior two thirds of tongue, and stimulates secretions from salivary glands (submaxillary and sublingual) and tears from lacrimal glands.
• supplies facial muscles and affects facial expression

Question 9

acoustic

Answer 9

• sensory

- contains sensory fibers for hearing and balance

Question 10

glossopharyngeal

Answer 10

• both
• contains sensory fibers for taste on posterior third of tongue and sensory fibers of the pharynx that result in the gag reflex when stimulated.
• provides secretory fibers to the parotid salivary glands; promotes swallowing movements.

Question 11

vagus

Answer 11

• both
• carries sensations from the throat, larynx, heart, lungs, bronchi, gastrointestinal tract, and abdominal viscera.
• Promotes swallowing, talking, and production of digestive juices.

Question 12

spinal accessory

Answer 12

• motor
• Innervates neck muscles that promote movement of the shoulders and head rotation. Also promotes some movement of the larynx.

Question 13

hypoglossal

Answer 13

• motor

- innervates tongue muscles that promote the movement of food and talking

Question 14

how to test olfactory nerves

Answer 14

-ask patient to clear nose then close eyes, place a scented object under one nostril and ask to identify

Question 15

normal findings of olfactory nerve

Answer 15

patient correctly identifies scent

Question 16

abnormal findings of olfactory nerve

Answer 16

• can’t smell or correctly identify, may indicated olfactory tract lesion or tumor or lesion of frontal lobe
• caused by nasal or sinus problems
• caused by injury of nerve tissue due to viral upper respiratory infection

Question 17

how to test optic nerve

Answer 17

• use a Snellen chart
• ask patient to read to assess near vision
• assess visual fields of each eye by confrontation
• use ophthalmoscope to view the retina and optic disc of each eye

Question 18

normal findings of optic nerve

Answer 18

• client has 20/20 vision
• client reads print at 14 without difficulty
• full visual fields
• round red reflex is present, optic disc is 1.5 mm, round or slightly oval, well-defined margins, creamy pink with paler physiologic cup. Retina is pink

Question 19

abnormal findings of optic nerve

Answer 19

• difficulty reading Snellen chart, missing letters, squinting
• patient reads by holding print closer or farther away, presbyopia
• loss of visual fields due to retinal damage or detachment with lesions of optic nerve or of parietal cortex
• papilledema (swelling of the optic nerve), blurred optic disc margins and dilated, pulsating veins