Cranial Nevre Examinations Flashcards Preview

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Flashcards in Cranial Nevre Examinations Deck (5)
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1
Q

How would you test CN I?

A

Olfactory Nevre:
Ask patient about any changes in sense of smell.
If they can smell, is it unilateral or bilateral?

Test each nostril by using a strong smelling substance if clinically indicated.

2
Q

How would you test CN II?

A

Optic nerve:
Visual acuity - Ask patient if they can see equally well in each eye. Snellen chart; ask patient what is the lowest line on the chart they can read. Test one eye at a time with the other eye closed.

Pupillary responses - Inspect size and shape of each pupil, checking for symmetry. Test pupil response to light, moving light in from the side of the head while patient fixes on a distant point. look for constriction of the pupil Need to test direct and indirect response in each eye.

Visual Fields - Compare patients visual fields to your own by sitting them at same level as you about 1m apart. Ask patient to cover one eye and look at your nose. You cover opposite eye and bring finger from furthest periphery to centre and ask patient to ask yes when they see your finger. Test each quadrant in turn on both eyes.

Visual inattention - sit facing patient and ask them to look at face. Get them to point to which one of your fingers is moving. Test in upper and lower visual fields. Then move fingers on both sides together.

Accommodation - ask patient to focus on finger as you move it closer to them. The pupils should constrict as the eyes converge.

Fundoscopy.

3
Q

How would you test CN III?

A

Oculomotor nerve:
Inspect eyes looking for ptosis or abnormality of gaze.
Ask patient to keep head still.
Ask patient to follow your finger as it moves in a slow H. Start in midline.
Ask them to tell you if they get any double vision.
Note if their eyes always move in parallel.
Look for nystagmus.

4
Q

How would you test CN IV?

A

Trochlear nerve:

Test same as CN III. H movement.

5
Q

How would you test CN V?

A

Trigeminal Nerve:
Sensation - using a piece of cotton wool and then neurotip to touch the forehead, cheek, and lower jaw, patient should have eyes closed and say yes when they feel it.

Motor V3 - Palpate the bulk of master muscle and ask patient to clench teeth. Ask patient to open jaw against resistance to test Pterygoid muscles.

Afferent V1 - Corneal reflex, ask the patient to look up to the left and touch the cornea of the right eye on the lateral side with a wisp of cotton wool. Look for a blink response which should be bilateral. ask about contacts as response can be blunted in wearers

Afferent and Efferent V3 - Jaw jerk reflex; Place finger on lower jaw just below the lips, mouth should be slightly open. Tap finger downward with a tendon hammer, watch for masseter muscles jerking jaw upwards. Normally absent or slight, exaggerated in UMN lesion.