Cranial nerves

Question 1

Cranial nerve 1

Answer 1

olfactory - smell

Question 2

Cranial nerve 2

Answer 2

optic - visual acuity, pupil response

Question 3

Cranial nerve 3

Answer 3

Oculomotor - eye movement

Question 4

Cranial nerve 4

Answer 4

Trochlear - eye movement

Question 5

Cranial nerve 5

Answer 5

trigeminal - facial sensation and movement

Question 6

cranial nerve 6

Answer 6

abducens - eye movement

Question 7

cranial nerve 7

Answer 7

facial - facial expression

Question 8

cranial nerve 8

Answer 8

Vestibulocochlear - hearing and balance

Question 9

cranial nerve 9

Answer 9

Glossopharyngeal - swallowing and speech

Question 10

cranial nerve 10

Answer 10

vagus - swallowing and speech

Question 11

cranial nerve 11

Answer 11

accessory - sternocleidomastoid and trapezius

Question 12

cranial nerve 12

Answer 12

Hypoglossal - tongue movement

Question 13

what 2 cranial nerves concern swallowing and speech?

Answer 13

9 and 10
- glossopharyngeal and vagus

Question 14

which 3 cranial nerves are involved in eye movement

Answer 14

oculomotor, trochlear, abducens
3,4,6

Question 15

speech abnormalities suggest pathologies involving which cranial nerves

Answer 15

glossopharyngeal and vagu

Question 16

eyelid or pupil abnormalities suggests a pathology involving which cranial nerve

Answer 16

oculomotor (3)

Question 17

how to first inspect before cranial nerve exam?

Answer 17

speech abnormalities
facial dropp/ asym
muscle bulk
eyelid/pupil abnorm
facies
scars
hearing aids
limbs

Question 18

how would you test the olfactory nerve (1)

Answer 18

px smell orange stick (or lemon peppermint coffee) eyes shut and tell you

Question 19

give some causes for changes to sense of smell

Answer 19

mucus blockage
head trauma
genetics
parkinsons
covid 19

Question 20

when testing the optic nerve (2) what inspection would you do

Answer 20

check pupils same sizew and shape

Question 21

how can visual acuity be checked when doing an assessment on cranial nerve 2/ the optic nerve

Answer 21

snellen chart

test one eye at a time to see changes. reaching line 6 at 6m = 6/6 = 20/20 vision

Question 22

what score on a snellen chart would prompt you to need to wear glasses when driving

Answer 22

6/12

Question 23

how can visual fields be checked when assessing the optic nerve

Answer 23

confrontation

Question 24

causes of visual field changes

Answer 24

stroke
tumour
abscess
ms
ocular disease

Question 25

how can homonymous defects be detected when assessing the optic nerve

Answer 25

finger waggling

Question 26

what 2 pupillary reflexes are checked in an assessment of the optic nerve

Answer 26

direct and consensual and accomodation

Question 27

what equipment is used to carry out fundoscopy

Answer 27

ophthalmoscope

Question 28

causes for abnormalities in pupillary responses

Answer 28

retinal damage central vein occlusion optic neuropathy glaucoma compression due to tumour or abscess

Question 29

causes of changes in acuity

Answer 29

refractive errors retinal diseases cataracts neuritis lesions in visual pathway

Question 30

optic nerve exam (2)

Answer 30

pupils reflex - direct and consensual/accommodation, visual fields, visual acuity, homonymous defects, fundoscopy

Question 31

how do you test cranial nerves 3, 4 and 6 (oculomotor, trochlear and abducens)

Answer 31

ask if diplopia (double vision), track H finger, repeat with each eye shut.

Question 32

what are you looking for when drawing a h, what may irregular eye movement suggest?

Answer 32

nystagmus which may suggest a stroke or vestibular nerve pathology

Question 33

to check the trigeminal nerve (5) facial sensation in all 3 branches is touched lightly to indentify pain, what are the 3 areas that must be checked

Answer 33

ophthalmic maxillary mandibular forehead, cheek, jaw

Question 34

cranial nerve 5 exam

Answer 34

facial sensations forehead, cheek and jaw. open jaw against resistance and side to side against resistance, inspect bulk.

Question 35

how are the muscles of mastication checked when assessing trigeminal nerve function

Answer 35

inspect jaw open jaw against resistance jaw side to side

Question 36

what muscles are being tested when looking at the muscles of mastication

Answer 36

masseter temporalis pterygoid

Question 37

before investigating the facial nerve (7) what should the face be examined for

Answer 37

asymmetry

Question 38

to test the facial nerve patients are asked to make a series of movements, what are these

Answer 38

raise eyebrows show teeth purse lips blow out cheeks screw eyes shut- try to open

Question 39

what is the most common cause of LOWER motor neuron lesions

Answer 39

bell's palsy

Question 40

facial nerve palsy caused by LOWER motor neurone lesion presents with?

Answer 40

weakness of ipsilateral muscles of facial expression due to loss of innervation to all muscles on the affected side

Question 41

facial nerve palsy caused by UPPER motor neurone lesion presents with?

Answer 41

unilateral facial muscle weakness. upper facial muscles partially spared

Question 42

most common cause of UPPER motor neuron lesion

Answer 42

stroke

Question 43

what 4 tests can be used to check the vestibulocochlear nerve (nerve 8)

Answer 43

whispering weber rinnes turning

Question 44

how does the whispering test work

Answer 44

stand behind patient and ask patient to repeat words mask other ear with rubbing tragus start at normal volume and reduce to whisper then at 60cm

Question 45

if you detect hearing loss with the weber and rinnes test you should determine if it is sensorineural or

Answer 45

conductive

Question 46

how is the turning test done and what are the results

Answer 46

ask patient to march on spot arms outstretched eyes closed normal patient stays in same position vestibular lesion patient will turn towards side with lesion

Question 47

whats the webers test?

Answer 47

tuning fork thing on forehead and should hear on both sides ... determine whether there is a unilateral problem but cant localise

Question 48

normal Rinne's test result

Answer 48

air conduction better than bone conduction

Question 49

how to do Rinnes tets?

Answer 49

tuning fork thing on bone behind ear then air by ear... conductive deafness: bone conduction > air normal: air> bone

Question 50

cranial nerve 9 and 10 exam (glossopharyngeal and vagus)

Answer 50

ask px had difficulty swallowing/ changes to voice or cough assess speech for dysarthria/ dysphonia look at palate and uvula and say ah ask pt to cough swallow test gag reflex

Question 51

how are the accessory nerves (11) checked

Answer 51

1. turn cheek in hand - sternocleidomastoid muscle palsy = weakness in this 2. shrug shoulders to assess trapezius muscle

Question 52

cranial nerve 12 exam (hypoglossal)

Answer 52

stick out tongue look for deviation move from side to side through check to assess power

Question 53

bells palsy vs stroke in terms of muscle innervation

Answer 53

when cortex injured muscle weakness in contralateral lower face only when facial nerve injured weakness in ipsilateral upper and lower face bells palsy- eye may remain slightly open when try to close

Question 54

the innervation of the muscles of the upper face originates on both sides of the brain whereas the innervation of the lower face comes from the x side of the brain only

Answer 54

opposite

Question 55

what is the coordination of swallowing controlled by?

Answer 55

trigeminal, facial, glossopharyngeal, vagus and hypoglossal