Shared Flashcard Set

Details

Overview of Cranial Nerve Testing
Cole 6/29/11 lecture 1 hr
38
Anatomy
Undergraduate 4
06/06/2011

Additional Anatomy Flashcards

 


 

Cards

Term
1) aging
2) cribiform plate fractures(car accident)
3) minor brain anomalies
4) colds/allergies
Definition
how can the sense of smell become impaired?
Term
left and right are tested separately by closing their eyes and 1 nostril and the patient is asked if they can smell, and if they can recognize a strong scent (coffee, lemon, mint)
Definition
how do you test CN 1?
Term
1) eye chart with glasses/contacts in place
2) asking them to count fingers in different parts of their visual field

-test eyes separate, a specialist can make more specific diagnoses than this to determine (corneal/retinal/CN2/CNS) problems
Definition
how is visual acuity tested?
Term
1) tell patient to gaze straight ahead
2) clinician can move a finger into the periphery and asks when it is seen

visual field problems are also better diagnosed by a specialist
Definition
how do you test the extents of the visual fields?
Term
superior oblique paralysis from a lesion to CN IV (Trochlear)
Definition
what nerve lesion can be mistaken for torticollis?
Term
sup. rectus: elevate and abducted eye
med rectus: adduct from resting position
inf rectus: depress an abducted eye
inf oblique: elevate and adducted eye
Definition
what muscles are innervated by CN 3 and how do you test them?
Term
just superior oblique: depress an adducted eye
Definition
what muscle(s) are innervated by CN 4 and how do you test them?
Term
just lateral rectus, have patient abduct their eye
Definition
what muscles are innervated by CN VI and how are they tested?
Term
head tilt to unaffected side
Definition
if you paralyze superior oblique (CN 4), how does the patient tilt their head?
Term
get medial strabismus, turn head to side of lesion to restore vision
Definition
how do you restore vision if lateral rectus is paralyzed? what eye movement will you have
Term
CN 3 para innervates the ciliary muscles and constrictor pupillae

a light shined in 1 eye would cause both pupils to constrict

this is the pupillary light reflex
Definition
how are the parsympathetic components of CN III tested? (What reflex is this)
Term
if a finger is brought toward the patients nose, the pupils should constrict a little, also the somatic motor part will adduct both eyes

this is the accomodation/convergence reflex
Definition
constrictor pupillae acts in accomodation, so how can this be tested? what reflex is it?
Term
some CNS disorders (like syphillis) can cause this response which is when the pupil constricts with accommodation, but not when a light is shined in the eye
Definition
what is the Argyll Robertson response?
Term
1)clench their teeth and palpate the superficial muscles of mastication

2) then clench while the chin is pulled down to try to open the mouth

3) bite down on a tongue depressor across the premolars

look for strength and symmetry

4) then open the mouth with/without resistance to check lateral pterygoid
Definition
how is the motor component of CN V tested?
Term
chin deviates toward the affected side
Definition
if there is weakness/paralysis of lateral pterygoid(or its innervation CN V), what direction does the chin deviate to with opening the mouth?
Term
you have to test each component because they all go to different nuclei in the brain
Definition
how do you test sensory of CN V in general?
Term
have patient close their eyes and touch the skin with a cotton swab and say "touch" when something is felt
Definition
how do you test light touch of CN V?
Term
have the patient close their eyes and touch them with the head or the tip of the pin saying dull or sharp
Definition
how is pain tested for CN V?
Term
touch the patient with test tubes of hot and cold water and distinguish them
Definition
how is temperature tested for CN V?
Term
V1: above the eyebrow away from the midline (Test both sides)

V2: below the lower eyelid away from the nose and above the lower lip

V3: lateral to the chin on each side
Definition
where is V1 tested for sensory? V2? V3? (the dermatomes)
Term
look at upper face for strength and symmetery in the exercises and nasolabial folds, wrinkles, smiling, and blinking

1) show teeth (lower face)
2) raise eyebrows (upper face)
3) tightly shut eyes (upper face)
4) puff out cheeks with air (lower face)
Definition
how is somatic motor tested for CN VII?
Term
corneal reflex CNV sense and CN VII motor

touch one eye with a cotton swab, both should blink
Definition
how do you test the relationship between the facial and trigeminal nerves?
Term
V1, nasociliary nerve does cornea sensation

VII closes the eye with orbicularis oculi
Definition
what nerve caries sensation from the cornea? what muscle closes the eye and what nerve?
Term
CN 8, the eyes will close with a loud noise
CN 2, or with bright light
Definition
what else forms a reflex loop with CN V besides the facial n?
Term
strong flavored paper strips on the sides of the tongue with the tongue sticking out
Definition
how is the taste component of CN VII Tested?
Term
check if the lacrimal gland is secreting with special paper strips
Definition
how is the parasymptathetic component of CN VII tested?
Term
not really, they all open into the same space
Definition
is it possible to taste individual salivary glands?
Term
via a specialist (hearing/balance/equilibrium)
Definition
how is most testing for CN VIII done?
Term
Weber and Rinne tests, rely on the fact that bone conducts sound well, bone conduction can stimulate the inner ear by bypassing the tympanic membrane and middle ear
Definition
what are the preliminary hearing tests? what do they rely on?
Term
a tuning fork is struck and placed on the vertex of the skull, if CN VIII is intact on both sides, equal volume should be heard via bone conduction

test symmetry
Definition
describe the Weber test
Term
this tests bone conduction and middle ear function

1)strike the fork and place on the mastoid process

2) then place by the ear to hear air conduction and test MIDDLE EAR FUNCTION
Definition
describe the Rinne test
Term
middle ear - bones bypass the middle ear
Definition
if the Weber test is passed( hearing via bone conduction) and the patient still cannot hear, where is the problem likely located?
Term
you can't really, but MAYBE
1) loss of sensation to the middle ear and pharynx
2) paralysis of stylopharyngeus
3) loss of taste/somatic sensation to the posterior 1/3 of the tongue
4) loss of secretion from the parotid
5) problems with chemoreception and baroreception (visceral afferents)

these symptoms are all usually compensated for by other things
Definition
how can you test isolated unilateral lesions of CN IX?
Term
the GAG reflex

CN IX is sensory, CN X is the motor part
Definition
how can you test CN IX?
Term
levator palati: look at the uvula at rest then say AHHH, weakness will cause the uvula to deviate to the INTACT side

other signs are hoarseness, stridor, and difficulty breathing with exercise
Definition
how is somatic motor for CN X tested?
Term
not really, too much stuff overlaps with parasympathetics and such
Definition
can you test the function of the vagus nerve besides motor?
Term
it only innervates SCM and trapezius, so

SCM: have the patient run their head with resistance, weakness turning the head to one side indicates a problem with the opposite side muscle(SCM turns head to opposite side)

TRAPEZIUS: is tested by abducting and elevating the arm with/without resistance and shrugging the shoulders
Definition
how is CN XI tested?
Term
stick out the tongue

UMN has no atrophy and fasiculations, tongue always goes toward the paralyzed muscle, so the opposite side the UMN is on will be where the tongue deviates

LMN has flaccid paralysis and atrophy, tongue goes toward the muscle (and the nerve)
Definition
how is a hypoglossal nerve lesion tested?
Supporting users have an ad free experience!