Cranial nerves

Question 1

CN 1 lesion

Answer 1

loss of smell (anosmia)

Question 2

CN 2 lesion

Answer 2

loss of pupillary constriction, visual field deficits

Question 3

CN 3 lesion

Answer 3

dilated pupil, decreased pupillary reflex, eye turned down and out

Question 4

CN 4 lesion

Answer 4

inability of eye to look down when eye is adducted

Question 5

CN 5 lesion

Answer 5

loss of pain and touch sensation to a lot of the face, decreased ability to move mouth (masseter and temporal is don’t contract)

Question 6

CN 6 lesion

Answer 6

hard time moving the eye laterally

Question 7

CN 7 lesion

Answer 7

paralysis of facial muscles, can have change in taste to the anterior 2/3 of tongue

Question 8

CN 8 lesion

Answer 8

may have loss of hearing, may have change in balance, may have ringing in ear

Question 9

CN 9 lesion

Answer 9

loss of taste on posterior 3rd of tongue, loss of sensation on soft palate

Question 10

CN 10 lesion

Answer 10

can have damage to vocal cords and difficulty speaking

Question 11

CN 11 lesion

Answer 11

paralysis or weakness of sternocleidomastoid and trapezius (drooping of shoulder example)

Question 12

CN 12 lesion

Answer 12

difficulty with some kind of tongue movement

Question 13

Olfactory CN 1

Answer 13

Sensory:

• smell
  test: patient smell coffee grounds, orange peels, etc

Question 14

Optic CN 2

Answer 14

Sensory:

• vision
  test: acuity (snellen chart), color (ishihara plates), visual fields, visual reflexes with a pen torch

Question 15

Oculomotor CN 3

Answer 15

Motor:

• eye movement of superior/middle/inferior rectus, inferior oblique, and legator palpebrae
  test: patient follows finger clinician is drawing 2 adjoining H’s

Question 16

Trochlear CN 4

Answer 16

Motor:

• eye movement of superior oblique muscle of eye
  test: patient follows finger clinician is drawing 2 adjoining H’s

Question 17

Trigeminal CN 5

Answer 17

Sensory and motor:

• general sensation (top, middle, jaw), opening/closing mouth (mastication)
  test: touch face with cotton swab then a blunt pin in 3 places on each side of face (jawline, cheek, forehead)

Question 18

Abducens CN 6

Answer 18

Motor:

• eye movement of lateral rectus
  test: patient follows finger clinician is drawing 2 adjoining H’s

Question 19

Facial CN 7

Answer 19

Sensory and motor:

• taste to anterior 2/3 of tongue, facial movement
  test: crease forehead, keep eyes closed against resistance, puff out cheeks, reveal teeth (smile big)

Question 20

Vestibulocochlear CN 8

Answer 20

Sensory:

• balance (vestibular nerve), hearing (cochlear nerve)
  test: vibration from tuning fork against forehead and mastoid process to test in ears

Question 21

Glossopharyngeal CN 9

Answer 21

Sensory and motor:

• taste to posterior 3rd of tongue, swallowing
  test: gag reflex or by touching arches of pharynx

Question 22

Vagus CN 10

Answer 22

Sensory and motor:

• initial part of swallowing, parasympathetic for sensory
  test: observe uvula while patient says “ahhh”

Question 23

Accessory CN 11

Answer 23

Motor:

• sternocleidomastoid and trapezius, movement of head and shoulders
  test: patient shrugs shoulders against resistance, patient turns head against resistance

Question 24

Hypoglossal CN 12

Answer 24

Motor:

• movement of tongue
  test: do tongue movements