Cranial Nerve Assessment Flashcards

(47 cards)

1
Q

CN I what is it?
Function?
Examined by?

A

Olfactory
Smell
Having patient occlude one nostril and identify a common scent (coffee, peppermint or cinnamon) placed under the other nostril

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2
Q

CN II what is it?
tests what?

A

Optic
Visual acuity
visual fields
funduscopic exam
pupillary light reflex

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3
Q

CN II
visual acuity is examined by?

A

having patient cover one eye placing snellen card appox 14” away.
have the patient read the letters on the card
examine each eye separately
patient should wear corrective lenses

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4
Q

CN II
Visual fields are examined by?

A

standing facing the patinet from 2 arms lengths away
close your righ eye while the patient closes their left eye
ask the patient to count 1 or 2 fingers presented in each of the four quadrants

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5
Q

CN II
funduscopic exam is performed how?

A

turn off lights in room
examint pt’s R eye by holding the opthalmoscope to your R eye in your R hand and vice versa
ask patient to look straight ahead and shine the beam of light on the pupil and look for the red reflex move closer to patients pupil staying focused on the red reflex.
locate optic disc and retinal vessels

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6
Q

CN III what is it?
What are its functions?

A

Oculomotor
eye movments
eye lid elevation
accommodation
pupillary light relfex

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7
Q

CN III
Eye movements: examine the eye for?
Have the patient do what?

A

ptosis
fixate on your finger held about 2 ft away
examine movements of eyes through the 6 cardinal points of gaze

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8
Q

CN III
Accommodation: ask the patient to?

A

look at a distant object and then at your finger
the pupils should constrict when the eye focuses on the near object

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9
Q

CN III
Pupillary light reflex

A

Shine a light on each pupil examining for both direct constriction of the pupil
the same size in addition to consensual reaction

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10
Q

CN IV what is it?
What are its functions?

A

Trochlear
Eye movement inward and down

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11
Q

CN IV
Eye movement inward and down is examined by?

A

having the pt fixate on your finger while you move it from a distant position to the patients nose

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12
Q

CN V what is it?
What are its functions?

A

Facial sensation
Muscles of Mastication
corneal reflex

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13
Q

CN V
Facial Sensation

A

Lightly touch both sides of the patients forehead, cheek and chin.
Ask if the stimuli felt the same

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14
Q

CN V
Muscles of Mastication

A

Ask the pt to clench teetch.
Palpate jaw muslces for tone and strength

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15
Q

CN V
Corneal Reflex

A

Typically not neccessary in the awake, alert patient

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16
Q

CN VI what is it?
What are its functions?

A

Abducens
Eye movement - lateral

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17
Q

CN VI
Eye movement - lateral

A

examine lateral eye movement

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18
Q

CN VII what is it?
what are its functions?

A

Facial
Facial movement
taste on anterior tongue

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19
Q

CN VII
Facial Movement

A

inspect symmetry of facial features with various expressions
eyelid closing
smile
frown
puffed cheeks
wrinkle forehead

20
Q

CN VII
Taste

A

typically not tested

21
Q

CN VIII What is it?
What are its functions?

A

Acoustic
Hearing and balance

22
Q

CN VIII
Hearing

A

Face the pt hold your fingers out near each ear
rub your fingers together softly asking the pt to identify the side they hear the rubbing.

23
Q

CN VIII
Hearing: Weber test

A

place the base of a vibrating tuning fork on midline of patients head
ask pt if sound is heard equally in both ears

24
Q

CN VIII
Hearing: Rinne

A

Place base of vibrating tuning fork against pt mastoid bone
ask the pt when the sound is no longer heard
position the still vibrating tines 1-2 cm from auditory canal
Air conduction should be > Bone conduction

25
CN VIII Balance
Not typically tested. Can perform Romberg test if c/o vertigo
26
CN IX what is it? What are its functions?
Glossopharyngeal taste sensation posterior tongue sensation posterior oropharynx palate movement
27
CN XI Palate movement
ask pt to swallow
28
CN XI Gag reflex
stimulate back of throat on each side
29
CN X what is it? what are its functions?
Vagus Uvula and soft palate movement muscles of larynx and pharynx
30
CN X Uvula and soft palate movement
ask the pt to say "Ah" Examine the soft palate and uvula for symmetry observe for swallowing difficulty
31
CN X Muscles of larynx and pharynx
Evaluate quality of speech
32
CN XI what is it? what are its functions?
Spinal Accessory Sternocleidomastoid and Trapezius muscles
33
CN XI Sternocleidomastoid and Trapezius muscles
Evaluate head turning and shoulder shrug
34
CN XII what is it? What are its functions?
Hypoglossal tongue movement
35
CN XII Tongue Movement
Ask pt to protrude tongue and move it side to side
36
Neuro assessment of stuporous or comatose pts includes?
LOC Brainstem Reflexes Motor Response
37
Neuro assessment of stuporous or comatose pts LOC
Describe pts spontaneous behavior and responses to stimuli
38
Neuro assessment of stuporous or comatose pts Arousability
Awake, alert, oriented arousable to voice or pain
39
Neuro assessment of stuporous or comatose pts CNs
Pupils Eye movements Cough Gag
40
Neuro assessment of stuporous or comatose pts CN Pupils
fixed dilated anisocoric papilledema
41
Neuro assessment of stuporous or comatose pts CN Eye movements
eye position, deviation gaze roving dolls eyes cold caloric response corneal reflexes
42
Neuro assessment of stuporous or comatose pts Motor Exam
Spontaneous movement, is it purposeful? Localize Withdrawal Posturing (decorticate, decerebrate) Myoclonus
43
Neuro assessment of stuporous or comatose pts Motor Exam Decorticate indicates dysfunction at what level?
cerebral cortex level or below
44
Neuro assessment of stuporous or comatose pts Motor Exam Decerebrate indicates dysfunction w/n what?
brainstem
45
GCS Eye opening Opens eyes spontaneously? Opens eyes in response to speech? Opens eyes in response to painful stimuli? Does not open eyes?
4 3 2 1
46
GSC Motor response Follows commands? Localizes in response to painful stimuli? Withdrawal to painful stimuli? Flexion to pain? Extension to pain? No motor response?
6 5 4 3 2 1
47
GSC Best Verbal response Oriented? Confused? Inappropriate words? Incomprehensible sounds? No verbal response?
5 4 3 2 1