Cranial Nerves

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Cranial Nerves
2010-08-18 09:52:55
cranial nerves

cranial nerves
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  1. I
    • Olfactory- sense of smell
    • First assess patency by occluding a nostril at a time. Then with eyes closed, occlude one nostril and present an aromatic substance.
  2. II
    • Optic- central and peripheral vision
    • Test visual acuity by confrontation.
  3. III
    • Occulomotor- Pupilary constriction
    • Dim lights, use penlight from side, and slowly bring to center, note response.
  4. IV
    • Trochlear- Move eyes down toward tip of nose.
    • Instruct patient to follow your finger while you move it down toward his nose
  5. V
    • Trigeminal- Face (forehead, cheek, jaw)
    • Check sensation in all three areas with cotton wisp. Use wisp to check corneal reflex-blink bilaterally
    • Palpate the temporal and masseter muscles as the person clenches teeth. Try to separate the jaws by pushing down on the chin.
  6. VI
    • Abducens- Eye movement to the sides
    • Ak patient to look toward each ear. Follow fingers through six cardinal fields of gaze. Observe for nystagmus or twitching.
  7. VII
    • Facial- facial movements and expression
    • Assess for facial symmetry. Blink, wrinkle forehead, close eyes, smile, puff cheeks, show teeth.
  8. VIII
    • Auditory
    • Whispered voice test, Weber, and Rinne tuning fork tests.
  9. IX
    • Glossopharyngeal- phonation and swallowing
    • Observe the patient's ability to swallow by noting how he handles secretions.
  10. X
    • Vagus- talking and swallowing
    • Ask patient to say Ahhhh. Uvula should be midline and palate should rise.
  11. XI
    • Spinal- neck and shoulder movement
    • Ask patient to raise shoulders against your hands. Turn head against your hand.
  12. XII
    • Hypoglossal- tongue
    • Stick out tounge, should be midline. Ask to say "light tight dynamite" and note lingual speech, letters l,t,d,n should be clear and distinct.