Cranial Nerve Assessment

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Author:
JARoberts
ID:
110289
Filename:
Cranial Nerve Assessment
Updated:
2011-10-19 16:09:35
Tags:
NURS1921 Cranial Nerve Assessment
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Cranial Nerve Assessment
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  1. Olfactory Nerve
    • CNI
    • Located in the nose
    • Controls the sense of smell
    • Assessment:
    • 1. Have patient smell coffee or soap w/ eyes closed, one nostril at a time
  2. Optic Nerve
    • CNII
    • Located in and behind the eyes
    • Controls central and peripheral vision
    • Assessment:
    • 1. Central - One eye at a time, have patient read and count how many fingers are being held up 6in. in front of patient.
    • 2. Peripheral - One eye at a time, have the patient look at your nose. Use index fingers to check superior and inferior fields one at a time and ask the patient to note any movement in the peripheral field.
  3. Oculomotor Nerve
    • CNIII
    • Located in and behind the eyes
    • Controls pupillary constriction
    • Assessment:
    • 1. Dim the lights and bring the light of the penlight from the outside periphery to the center of each eye and note the response. Use mm chart to describe pupil size.
    • 2. Check where the eyelid falls on the pupil, if it droops, note that the patient has ptosis.
  4. Trochlear Nerve
    • CNIV
    • Acts as a pulley to move the eyes down - toward the tip of the nose.
    • Assessment:
    • 1. Instruct the patient to follow your finger while you move it down toward their nose (not too close)
  5. Trigeminal Nerve
    • CNV
    • Covers most of the face - of a patient has a problem with this nerve, it usually involves the forehead, cheek or jaw.
    • Assessment:
    • 1. Check sensation in all 3 areas (forehead, cheek and jaw) using a soft and dull object.
    • 2. Test the motor function of the temporal and masseter muscles by assessing jaw opening strength.
  6. Abducens Nerve
    • CNVI
    • Controls Eye Movement to the Side
    • Assessment:
    • 1. Ask the patient to look at one of your ear then have them follow your fingers through the six cardinal fields of gaze or with your finger, make a big X in the air and then draw a horizontal line across it. Observe the patient for nystagmus (twitching of the eye)
  7. Facial Nerve
    • CNVII
    • Controls facial movement and expression
    • Assessment:
    • 1. Assess for facial symmetry. Have patient wrinkle forehead, close their eyes, smile, pucker their lips, show their teeth and puff out their cheeks.
    • When patient smiles, observe the nasolabial folds for weakness or flattening.
  8. Acoustic Nerve
    • CNVII
    • Located in the ears
    • Assessment:
    • 1. Check hearing by rubbing your fingers together by each ear
  9. Glossopharyngeal & Vagus Nerve
    • CNIX & CNX
    • Innervate the tongue and throat (pharynx & larynx)
    • Assessment:
    • 1. Assess the sense of taste on the back of the tongue.
    • 2. Observe the patient's ability to swallow by noting how they handle secretions.
    • 3. Ask the patient to open his mouth and say "Ahhhh". The uvula should be in the midline and the palate should rise.
  10. Spinal Accessory Nerve
    • CNXI
    • Controls neck and shoulder movement
    • Assessement:
    • 1. Ask the patient to raise their shoulders against your hands to assess the trapezius muscle.
    • 2. Ask the patient to turn their head against your hand to assess the sternocleidomastoid muscle.
  11. Hypoglossal Nerve
    • CNXII
    • Innervates the tongue
    • Assessment:
    • 1. Ask the patient to stick out their tongue; it should be in the midline.

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