GTC Paramedic Program: 12 Cranial Nerves

12 terms by cjchaillou 

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Cranial Nerves 1-12: name, type, function, and basic test for compliance.

Olfactory

Cranial Nerve I
Type: Sensory
Function: Sense of Smell
Test: Ask Pt. to close their eyes, then hold an alcohol swab up to nose and inquire about ability to smell.

Optic

Cranial Nerve II
Type: Sensory
Function: Sense of Sight
Test: Ask Pt. to cover one eye, then hold up a number of fingers and ask Pt. to announce number or fingers seen. Repeat for opposite eye.

Oculomotor

Cranial Nerve III
Type: Motor
Function: Eye movement, Pupil constriction
Test: Have Pt. hold head still while following your finger in H pattern. Test pupil response with penlight.
Diagnosis: Pinpoint pupils suggest opiate OD or trauma to pons; Dilated pupils suggest anxiey, seizure, or stimulant use (coke, meth, etc); Sluggish or fixed pupils suggest brain injury or swelling.

Trochlear

Cranial Nerve IV
Type: Motor
Function: Downward gaze
Test: Have Pt. hold head still while following your finger in H pattern, then inwards to touch nose.

Trigeminal

Cranial Nerve V
Type: Sensory and Motor
Function: (S) Facial sensation, branching to the forehead, cheek, and lower jaw. (M) Chewing
Test: Ask Pt. to open wide, then clench jaw while palpating lower jaw muscles. Touch each side of forehead, cheek and lower jaw to determine sensory ability.

Abducens

Cranial Nerve VI
Type: Motor
Function: Lateral Eye Movement
Test: Have Pt. hold head still while following your finger in H pattern, then inward to touch nose.

Facial

Cranial Nerve VII
Type: Sensory and Motor
Function: (S) Taste (M) Secretion of saliva, facial expressions
Test: Assess facial movement during interrogation, ask Pt. to smile, raise eyebrows, blow up cheeks. Any assymmetrical movement is bad, usually indicative of a stroke at the middle cerebral artery.

Acoustic (Vestibulocochlear)

Cranial Nerve VIII
Type: Sensory
Function: Senses of hearing and balance
Test: Stand behind Pt. then rub fingers together near each ear and inquire as to which side the sound is coming from.

Glossopharyngeal

Cranial Nerve IX
Type: Sensory and Motor
Function: (S) Taste sensation from posterior tongue and pharynx (M) Muscles of swallowing and gag reflex
Test: Ask Pt. to open mouth wide and say "Ah" while inspecting uvula. Pull to one side indicates possible stroke affecting CN9 on side opposite to uvula pull.

Vagus

Cranial Nerve X
Type: Sensory and Motor
Function: (S) Gag reflex and stretch receptors in gut (M) Decreases heart rate, increases peristalsis, contracts muscles for voice production.
Test: Test gag reflex by tickling back of throat, however not usually necessary and prone to create vomitus!

Spinal Accessory

Cranial Nerve XI
Type: Motor
Function: Shoulder movements, turning of head, and movements of viscera.
Test: Evaluate muscle strength against resistance in the trapezius and sternocleidomastoids via shrugging and looking left and right respectively.

Hypoglossal

Cranial Nerve XII
Type: Motor
Function: Tongue Movements
Test: Ask Pt. to protrude tongue then move it in all four cardinal directions. Note favoring of one side or absence of smooth, fluid motions.

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