Cranial Nerves

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Cranial Nerves
2012-10-20 15:07:29

Cranial Nerves 1-12
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  1. CN I - type, function, assessment method
    • Olfactory - sensory; smell
    • ask client to close eyes and identify diff. mild aromas, such as coffee, vanilla, peanut butter, orange/lemon, chocolate
  2. CN II - type, function, assessment method
    • Optic - sensory; vision and visual fields
    • ask client to read snellen-type chart; check visual fields by confrontation; and conduct an opthalmoscopic exam.
  3. CN III - type, function, assessment method
    • Oculomotor - motor; extraocular eye movement (EOM); movement of sphincter of pupil; movement of ciliary muscles of lens; moves eyes out and up on both sides (superior rectus muscle); moves eyes out and down on both sides (inf. rectus muscle); moves eyes medially centrally and medially upwards (medial rectus and inf. oblique muscles)
    • Assess six ocular movements and pupil reaction
  4. CN IV - type, function, assessment method
    • Trochlear - motor; EOM; specifically, moves eyeball downward and laterally or inward (superior oblique muscle)
    • Assess six ocular movements and pupil reaction
  5. CN V - type, function, assessment method
    • Trigeminal -
    • Sensory (Opthalmic Branch); sensation of cornea, skin of face, and nasal mucosa; to assess - have client look upward, lightly touch lateral sclera of the eye w/ sterile gauze to elicit blink reflex; to test light sensation, have client close eyes, wipe a wisp of cotton over client's forehead and paranasal sinuses; to test deep sensation, use alternating blunt and sharp ends of a safety pin over same areas
    • Sensory (Maxillary Branch); sensation of skin of face and anterior oral cavity (tongue and teeth); to assess - assess skin sensation as for opthalmic branch above
    • Motor and Sensory (Mandibular Branch); muscles of mastification, sensation of skin of face; to assess - ask client to clench teeth
  6. CN VI - type, function, assessment method
    • Abducens - motor; EOM; specifically, moves eyeball laterally (lateral rectus muscle on lateral sides of both eyes)
    • Assess directions of gaze
  7. CN VII - type, function, assessment method
    • Facial - motor and sensory; facial expression; taste (anterior two-thirds of tongue)
    • Ask client to smile, raise the eyebrows, frown, puff out cheeks, close eyes tightly; ask client to identify various tastes placed on tip and sides of tongue - sugar (sweet), salt, lemon juice (sour), and quinine (bitter); identify areas of taste
  8. CN VIII - type, function, assessment method
    • Auditory - 
    • Sensory (Vestibular Branch); equilibrium; to assess - use Romberg test (p. 652)
    • Sensory (Cochlear Branch); hearing; to assess - assess client's ability to hear spoken word and vibrations of tuning fork
  9. CN XI - type, function, assessment method
    • Glossopharyngeal - motor and sensory; swallowing ability, tongue movement, taste (posterior tongue)
    • Apply tastes on posterior of tongue for identification; ask client to move tongue from side to side and up and down
  10. CN X - type, function, assessment method
    • Vagus - motor and sensory; sensation of pharynx and larynx; swallowing; vocal cord movement
    • Assessed with cranial nerve IX; assess client's speech for hoarseness
  11. CN XI - type, function, assessment method
    • Accessory - motor; head movement; shrugging of shoulders
    • Ask client to shrug shoulders against resistance from your hands and turn head to side against resistance from your hand (repeat on other side)
  12. CN XII - type, function, assessment method
    • Hypoglossal - motor; protrusion of tongue; moves tongue up and down and side to side
    • Ask client to protrude tongue at midline, then move it side to side