Cranial nerve exam Flashcards
(30 cards)
How do explain cranial nerve exam to your patient?
Hello, my name is ….. I am one of PA students at UCLan.
Can I confirm your full name and DOB please?
How would you like to be addressed today?
Today I will be examining your cranial nerves, these are the nerves that supply your face and neck. This will involve me looking at your face, eyes mouth, nose and I will be asking your to do some movements, would that be okay?
before I begin, are you in any pain/discomfort?
What does cranial nerve I check?
Olfactory
What does cranial nerve II check?
Optic
What does cranial nerve III check?
Oculomotor
What does cranial nerve IV check?
Trochlear
What does cranial nerve V check?
Trigeminal
What does cranial nerve VI check?
Abducens
What does cranial nerve VII check?
Facial
What does cranial nerve VIII check?
Vestibulochoclear
What does cranial nerve IX check?
Glossopharyngeal
What does cranial nerve X check?
Vagus
What does cranial nerve XI check?
Accessory
What does cranial nerve XII check?
Hypoglossal
How do you check olfactory (I) nerve?
- Any change in sense of smell recently?
- Any changes in your sensation of your taste recently?
How do you check optic (II) nerve?
- Reflexes
Focus on the wall behind me, I will shine a light but you
continue to focus on the wall. - Visual field
Keep focusing on the wall behind me and I will introduce
my finger into your field of vision and bring it closer to
you, would that be okay? - Visual acuity (snellen chart)
Start from the top, read as many lines as possible
When checking for optic nerve reflexes, what do you look for?
Check for:
- Direct (one eye)
- Consensual (both eyes)
When checking for optic nerve visual field, what do you look for?
Accomedation reflex
- Constriction
- Convergence
Ask the patient to keep at the wall in front of them and then look at the tip of the pen
How do you check trigeminal (II) nerve?
- Cutaneous sensation
Use cotton wool/pin prick to check sensation on both
sides:
- Forehead
- Maxilla (cheek)
- Mandible (jaw)
- Motor
Ask patient to chew motion, side to side.
Chinch their teeth and feel the following muscles:
- Temporalis
- Masseters
- Reflex
Relax their jaw and perform jaw jerkWhy is jaw jerk performed and what is it indicative of if positive?
Jaw jerk is performed when checking trigeminal nerve.
- Negative: absent or very slight
- Positive: if jaw moves upwards briskly
Positive jaw jerk is indicative of upper motor neurone lesion of the 5th cranial nerve.
How do you check facial (VII) nerve?
- Inspection
- Flattening of the nasal groove
- Unilateral drooping of the mouth
- Forehead wrinkling
- Movements:
- Look up and wrinkle your forehead
- Show me your teeth
- Close your eyes, as tightly as you can, stop me from
opening them
How do you check vestibulocochlear (VIII) nerve?
Whisper test
- Obstruct your hearing in one ear and whispering
a word into your other ear.
- I would like you to repeat that work to me.
- Word: 99
-
How do you check vestibulocochlear (VIII) nerve?
Whisper test
- Obstruct your hearing in one ear and whispering
a word into your other ear.
- I would like you to repeat that work to me.
- Word: 99
- Repeat with other ear.
How do you check glossopharyngeal and vagus (IX / X) nerve?
- Ask patient to open mouth and say AHH
- Palate should move upwards
- Uvula should be centrally located
How do you check accessory (XI) nerve?
- Can you lift your shoulders and keep them there (T)
- You push it down
- Look to one side (S)
- Stop me from pushing you to the middle
