Cranial Nerve Examination

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Author:
jaz_walker
ID:
189945
Filename:
Cranial Nerve Examination
Updated:
2012-12-17 14:28:06
Tags:
OSCE medicine
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Description:
OSCE medicine
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  1. 0. Prepare the patient (4)
    • verbal consent,
    • hand hygeine. 
    • Position patient sitting upright.
    • Ask if the patient can hear you and see you
  2. 1. General inspection from head of bed (2)
    •  head position 
    • ptosis / partial ptosis or proptosis
  3. 2. Looking around the bed (0)
  4. 3. CN I (1)
    • Olfactory nerve
    • Ask for changes
    • If indicated, check nostils individually
  5. 4. CN II (8)
    • Optic nerve
    •  periorbital appearance and lacrymal appearance
    • Ask patients to put glasses on
    • Test visual neglect
    • Test visual field
    • Eye reflexes
    • Accomodation
    • Use Snellen chart
    • Use Ishiguro plates
  6. 5. CN III, IV, VI (4)
    • (oculomotor, trochlear and abducens)
    • Check eye position and symmetry
    • Move 'H' shape without moving head
    • Check for double vision and nystagmus
    • Check horizontal and vertical saccades
  7. 6. CN V (4)
    • (trigeminal)
    • Check sensory areas
    • Motor branch
    • Corneal reflexJaw jerk reflex
  8. 7. CN VII (4)
    •  (facial)
    • Raise eyebrows
    • Scrunch up eyes
    • Puff out cheeksshow teeth
    • If in doubt, then do against resistance
  9. 8. CN VIII (4)
    •  (vestibulocochlear)
    • noticed any dizziness?
    • Whisper a number with occlusion
    • Weber's test (forehead)
    • Rene's test
  10. 9. CN IX (1)
    • Glossopharyngeal
    • Say 'ah'
  11. 10. CN X (2)
    • Vagus nerve
    • Cough
    • Swallow
  12. 11. CN XI (2)
    • Accessory nerve
    • Shrug shoulders against resistance
    • Turn face against resistance
  13. 12. CN XII (2)
    • Hypoglossal nerve
    • Tongue stuck out and wiggle
    • Look for fasciculation
    • If problem, then will deviate towards weak side
  14. To complete examination (1)
    Examination of peripheral nerves

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