Neuro-Cranial Nerves

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Neuro-Cranial Nerves
2011-09-20 23:09:13
cranial nerves

Identification & Assessment of Cranial Nerves
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  1. Cranial Nerve I?

    - Sensory

    - Function: sense smell

    - Assessment: each nostril should be patent. Patient occludes one and then the other during testing. With closed eyes, patient should be able to identify common smells such as cinnamon, coffee, vanilla or cloves.
  2. Cranial Nerve II?

    - Sensory

    - Function: vision

    - Assessment: Snellen Eye Chart from a distance of 20 feet (6 meters) for acuity. To test visual fields, stand about 2 feet (60 cm) away from the patient. Ask the patient to concentrate his gaze on your nose or directly into your eyes. Spread your arms so that your hands are about 2 feet apart and lateral to the patient's ears. Wave your fingers as you slowly draw your hands in towards the patient's line of gaze. Ask him to tell you when he first visualizes your wiggling fingers. DO this from all quadrants of the visual field. The patient should see both hands simultaneously and from all directions.
  3. Cranial Nerve III?

    - Sensory & Motor

    - Function: control the extraoccular muscles involved in eye movement & pupillary dilation

    - Assessment: tested with Cranial Nerves III, IV and VI by eye movements & pupillary response to light
  4. Cranial Nerve IV?

    - Motor

    - Function: control the extraoccular muscles involved in eye movement

    - Assessment: tested with Cranial Nerves III, IV and VI by eye movements
  5. Cranial Nerve V?

    - Sensory & Motor

    - Function: controls the muscles of mastication (chewing) and provides sensory information regarding touch and pain in the face

    - Assessment: jaw clenching for muscle strength & symmetry, dull & sharp pain for sensation and symmetry
  6. Cranial Nerve VI?

    - Motor

    - Function: function is eye movement

    - Assessment: tested with Cranial Nerves III, IV and VI. Tested with the patient following the H movement only with eyes
  7. Cranial Nerve VII?
    Facial Nerve

    - Sensory & Motor

    - Function: taste on the anterior 2/3 of the tongue and salivary glands, transmission of sensory info from the ear to the brain, control of muscles used in facial expression.

    - Assessment: have the patient repeat a sentence. Observe facial expression for any asymmetry, tics, or other facial movements. Next ask the patient to smile, frown, puff out cheeks. Look for symmetry especially in the nasolabial folds. Close his eyes tightly and you try to open them to test strength. For taste, drop a few drops of sweet or salty water on the front part of the tongue.
  8. Cranial Nerve VIII?
    Vestibulocochlear aka Acoustic/Auditory Nerve

    - Sensory

    - Function: Has 2 branches; the Cochlear which transmits sound messages to the brain; and Vestibular which controls balance or equilibrium.

    - Assessment: have the patient occlude one ear, softly whisper a word with two distinct syllables such as football, baseball, or doorbell. Equilibrium can be tested using the Romberg test.
  9. Cranial Nerve IX?

    - Sensory & Motor

    - Function: includes taste on the posterior 1/3 of the tongue, some swallowing muscle function, and transmitting sensory information from the tongue, tonsils and pharynx.

    - Assessment: Cranial Nerves IX and X are tested together as they both have a function that innervates the pharynx.
  10. Cranial Nerve X?

    - Sensory & Motor

    - Function: autonomic, sensory and motor functions of viscera such as glands, heart rate and digestion.

    - Assessment: patient to swallow sweet or salty water and test for taste sensation & ability to swallow. Ask patient to open wide and say "ah" while you observe the uvula and palate move symmetrically. Test gag reflex.
  11. Cranial Nerve XI?
    Spinal aka Accessory

    - Motor

    - Function: control of the trapezius and sternocleidomastoid muscles in movement of the head

    - Assessment: resistance against pt's shoulders from the back, jaw, & neck.
  12. Cranial Nerve XII?

    - Motor

    - Function: control of the muscles of the tongue.

    - Assessment: listen to the pt's articulation, have pt stick his tongue out and move it from side to side checking for symmetry.