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shmvii
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anosmia
- inability to detect smells
- seen w frontal lobe defects
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anosognosia
- lack of self awareness
- person w disability unaware of disability
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CN II
optic -- vision, no motor
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fancy words for nearsighted and farsighted
- myopia - nearsighted, impaired far vision
- presbyopia/hyperopia - farsighted, impaired near vision
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CN III
oculomotor -- visual tracking (up, down, in), pupillary reflexes / pupillary constriction, maintaining open eyelid
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anisocoria
unequal sizes of pupils (possibly due to CN III defect)
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Horner's syndrome - describe
- 1 sided ptosis, constricted pupil, anhydrosis
- 2/2 problem w symp NS
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CN IV
- trochlear
- pulls adducted eye down -- it innervates only the superior oblique muscle (which also does IR and ER)
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strabismus / heterotropia
eyes aren't aligned 2/2 lack of coordination between extraocular muscles
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esotropia
- eye pulled inward, can't look laterally
- 2/2 impairment of CN VI
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CN V - roles
- trigeminal
- sensory: face and cornea
- motor: temporal and masseter muscles (if impaired on one side, jaw will deviate to other side)
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CN VII
name
does what
condition if it's impaired
- facial -- facial expression muscles - raise eyebrows, frown, show teeth, smile, close eyes tightly, puff out both cheeks
- taste to ant 2/3 of tongue
- Bell's palsy
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CN VIII
- vestibulocochlear
- hearing and balance
- eye-head coordination (vestibulocular reflex VOR)
-
Weber's test
describe
for what nerve
- tuning fork on top middle of head, see if it sounds equally in both ears
- CN VIII - vestibulocochlear
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Rinne's test
describe
for what nerve
2 bad results
- put tuning fork on mastoid, and when it's no longer heard move it to just outside the ear canal - should be heard thru air after it can't be heard thru bone
- CN VIII vestibulocochlear
- conductive loss: sound heard thru bone equal or longer than air
- sensorineural loss: heard longer thru air, but timing thru air and bone are both greatly reduced
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CN IX
- glossopharyngeal
- sensory: tonsils, pharynx, middle of outside of ear, post 1/3 of tongue (taste), carotid bodies, carotid sinus (senses changes in pH and pressure)
- motor: stylopharyngeus muscle
- secretion/drool from parotid gland
contributes to phonation, swallowing, and gag reflex
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dysphonia
- hoarseness denoting vocal cord paralysis
- nasal quality denotes palatal weakness
- 2/2 CN IX/X problems
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dysphagia
- difficulty swallowing
- often 2/2 CN IX/X impairments
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how to test palatal, pharynx control
which CN?
- CN IX and X, but I think more X
- have pt say "ah" and look for whether palate elevates and if uvula stays midline
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how to test gag reflex
which CN
- lightly stim back of each side of throat
- lesion of IX, maybe X
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signs of impaired CN XI
- inability to shrug ipsilat shoulder
- shoulder droops
- can't turn head to contralat side
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CN XII
- hypoglossal
- tongue movements
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