4 Written Questions

1. 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.
2. 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.
3. 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.
4. 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.

4 Multiple Choice Questions

1. 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.
   1. Olfactory
   2. Vagus
   3. Optic
   4. Facial
2. 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.
   1. Trochlear
   2. Olfactory
   3. Abducens
   4. Spinal Accessory
3. 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.
   1. Trochlear
   2. Optic
   3. Olfactory
   4. Oculomotor
4. 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!
   1. Facial
   2. Vagus
   3. Optic
   4. Abducens

4 True/False Questions

1. 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.

   True        False

2. 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.

   True        False

3. 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.

   True        False

4. Abducens → 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!

   True        False