Cranial Nerve

Question 1

Carries smell impulses from nasal mucous membrane to brain

Answer 1

Olfactory (1) (S)

Question 2

Visual impulses from eye to brain. Visual Acuity, Visual Fields, Fundoscopic Exam

Answer 2

Optic (2) (S)

Question 3

Contracts eye muscles to control eye movements (interior, lateral, medial, and superior), constricted pupils and elevates eyelids. Cardinal Field of Gaze (EOM), Doll’s eye phenomenon

Answer 3

Oculomotor (3) (M)

Question 4

Contracts one eye muscle to control inferomedial eye movement EOM

Answer 4

Trochlear (4) (M)

Question 5

Carries sensory impulses of pain, touch, and temperature from face to the brain. Influences CLENCHING and LATERAL JAW MOVEMENTS (biting, chewing)

Answer 5

Trigeminal (5) (S) (M)

Question 6

Strength of temporalis and masseter muscles.

Answer 6

Trigeminal (M)

Question 7

Light touch, superficial pain and temperature to face, corneal reflex

Answer 7

Trigeminal (S)

Question 8

Controls lateral eye movement

Answer 8

Abducens (M)

Question 9

Taste, anterior 2/3 of tongue. Stimulates secretions from salivary glands (submaxillary and sublingual). Stimulates tears from lacrimal glands

Answer 9

Facial (S) (7)

Question 12

Facial movement and facial expressions (smiing, frowning, closing eye)

Answer 12

Facial (M)

Question 13

Cochlear - contains sensory fibers for hearing and balance. Gross hearing, Weber and Rinne tests. Vestibular - vertigo, equilibrium, nystagmus

Answer 13

Acoustic/ Vestibulocochlear (S) (8)

Question 14

Taste, posterior 1/3 of tongue. Sensory fibers of the pharynx that result in the gag reflex when stimulated

Answer 14

Glossopharyngeal (S) (9)

Question 15

Provides secretory fibers to parotid salivary glands. promote swallowing movements.

Answer 15

Glossopharyngeal (M) (9)

Question 16

Carries sensation from the throat, larynx, heart, lungs, bronchi, and gastrointestinal tract

Answer 16

Vagus (10) (S)

Question 17

Innervates neck muscles (sternocleidomastoid and trapezius) that promotes movement of the shoulder and head rotation. Promotes some movement of the larynx

Answer 17

Spinal Accessory (M) (11)

Question 18

Promotes swallowing , talking, and production of digestive juices

Answer 18

Vagus (M)

Question 19

Innervates tongue muscles that promotes the movement of food and talking

Answer 19

Hypoglossal (M) (12)

Question 20

• Have client sit in a comfortable position at your eye level
• Ask the client to clear the nose to remove any mucus
• Close eyes, occlude one nostril, and identify a scented
  object that you are holding such as soap, coffee, or
  vanilla
• Repeat procedure for the other nostril

Answer 20

Assessment for CN 1

Question 21

▪ Client correctly identifies scent presented to each
nostril
▪ Some older clients’ sense of smell may be
decreased

Answer 21

Normal (Olfactory)

Question 22

Inability to smell or identify the correct scent

Answer 22

Neurogenic Anosmia

Question 23

▪ olfactory tract lesion
▪ frontal lobe tumor
▪ congenital, nasal or sinus problems
▪ nerve tissue injury
▪ smoking and use of cocaine

Answer 23

Deviations for Olfactory

Question 24

Use a Snellen chart to assess vision in each eye

Answer 24

Assessment for Visual Acuity in far vision (Optic)

Question 25

Client has 20/20 vision OD (right eye) and OS (left eye) – (distance vision)

Answer 25

Normal (Visual Acuity)

Question 26

* difficulty reading Snellen chart * missing letters * squinting

Answer 26

Deviations for Visual Acuity

Question 27

Ask the client to read a newspaper or magazine paragraph to assess near vision

Answer 27

Assessment for near vision

Question 28

* reads print at 14 inches without difficulty * until the patient is in the late 30s to the late 40s, reading is generally possible at a distance of 14 inches

Answer 28

Normal for near vision

Question 29

Reads print by holding closer than 14 inches or holds print farther away as in presbyopia, which occurs with aging

Answer 29

Deviations for near vison

Question 30

Assess visual fields of each eye by confrontation. Normal peripheral vision

Answer 30

Normal

Question 31

Loss of visual fields may be seen in retinal damage or detachment * lesions of the optic nerve * lesions of the parietal cortex

Answer 31

Deviations

Question 32

Inspect margins of the eyelids of each eye ▪ Assess extraocular movements ▪ Assess pupillary response to light (direct and indirect) and accommodation in both eyes

Answer 32

Assessment for OCULOMOTOR, TROCHLEAR, ABDUCENS

Question 33

* Eyelid covers about 2 mm of the iris * Eyes move in a smooth, coordinated motion in all directions (the six cardinal fields) * Bilateral illuminated pupils constrict simultaneously * Pupil opposite the one illuminated constricts simultaneously

Answer 33

Normal

Question 34

Drooping of the eyelid is seen with weak eye muscles.

Answer 34

Ptosis

Question 35

o cerebellar disorders o increased ICP o paralytic strabismus

Answer 35

Possible causes of abnormal eye movements

Question 36

o oculomotor nerve paralysis o Argyll Robertson pupils o narcotics abuse o CN III damage o lesions of the sympathetic nervous system o PNS or CNS dysfunction o CN V lesion

Answer 36

Possible causes of pupil abnormalities

Question 37

▪ Ask the client to clench the teeth while you palpate the temporal and masseter muscles for contraction

Answer 37

Test motor function (trigeminal)

Question 38

Temporal and masseter muscles contract bilaterally

Answer 38

Normal

Question 39

* Decreased contraction in one of both sides * Asymmetric strength in moving the jaw may be seen with lesion or injury of the 5th cranial nerve * Pain occurs with clenching of the teeth

Answer 39

Deviations from normal

Question 40

Tell the client: “I am going to touch your forehead, cheeks, and chin with the sharp or dull side of this paper clip. Please close your eyes and tell me if you feel a sharp or dull sensation. Also tell me where you feel it”. Vary the sharp and dull stimulus in the facial areas and compare sides. Repeat test for light touch with a wisp of cotton.

Answer 40

Test sensory function (Trigemninal)

Question 41

Correctly identifies sharp and dull stimuli and light touch to the forehead, cheeks, and chin

Answer 41

Normal

Question 42

* Inability to feel and correctly identify facial stimuli * lesions of the trigeminal nerve * lesions in the spinothalamic tract or posterior columns

Answer 42

Deviations from normal

Question 43

Ask the client to look away and up while you lightly touch the cornea with a fine wisp of cotton.

Answer 43

Test corneal reflex

Question 44

Eyelids blink bilaterally

Answer 44

Normal

Question 45

* Absent corneal reflex * lesions of the trigeminal nerve * lesions of the motor part of cranial nerve VII (facial)

Answer 45

Deviations from normal

Question 46

- Smile ▪ Frown and wrinkle forehead ▪ Show teeth ▪ Puff out cheeks ▪ Purse lips ▪ Raise eyebrows ▪ Close eyes tightly against resistance

Answer 46

Test motor function (Facial)

Question 47

What is the normal for facial moto functions?

Answer 47

* Smiles, frowns, wrinkles forehead, shows teeth, puffs out cheeks, purses lips, raises eyebrows, and closes eyes against resistance * Movements are symmetric

Question 48

What is the deviations for motor function of CN7?

Answer 48

* Inability to close eyes, wrinkle forehead, or raise forehead along with paralysis of the lower part of the face on the affected side * Bell's Palsy- Paralysis of the lower part of the face on the opposite side affected may be seen with a central lesion that affects the upper motor neurons * Stroke

Question 49

▪ Not routinely tested, if testing is indicated, however, touch the anterior twothirds of the tongue with a moistened applicator dipped in salt, sugar, or lemon juice ▪ ask the client to identify the flavor ▪ If the client is unsuccessful, repeat the test using one of the other solutions ▪ If needed, repeat the test using the remaining solution

Answer 49

Testing sensory function for facial

Question 50

What is the normal for sensory (facial)?

Answer 50

Identifies correct flavor

Question 51

* Inability to identify correct flavor on anterior two-thirds of the tongue * Impairment of cranial nerve VII

Answer 51

Deviations from normal

Answer 52

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