Crainal Nerves
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56 terms
Terms | Definitions |
|---|---|
 anosmia | loss of sense of smell due to trauma, infections, tumors, metabolic disease |
| hyperosmia | an increase in sensitivity to smell; common in early pregnancy |
| Cranial Nerve I | Olfactory |
| Cranial Nerve I Olfactory | only system of sensory fibers that go directly to cerebral cortex without first synapsing in thalamus or one of its extensions |
| Cranial Nerve I Olfactory | sense of smell, interpreting smells |
| CN I -Olfactory Test | Pt.'s eyes closed; •Ask pt. to identify familiar odors, i.e. coffee, cloves, test each side |
| Cranial Nerve II Optic Nerve | Originates from deepest portions of the retina |
| Cranial Nerve II Optic Nerve lesions | -partial: restricted visual field -Complete: destruction blindness of involved eye •lesions of occipital lobe if right lobe damaged can result in left homonymous hemianopsia |
| Cranial Nerve II | Optic Nerve |
| Testing CN II Optic Nerve | 1. pt. covers 1 eye; PTA starts at periphery of each quadrant of vision, the PTA moves their finger or a cotton tip applicator in front of the patient toward the center of vision; •patient is asked to indicate as soon as they see the finger or applicator |
| Cranial Nerve III Oculomotor Nerve (motor) | Supplies nerves which constrict the pupils, elevate the lids, and moves the eye up, down, & medially |
| Cranial Nerve III Oculomotor Nerve Lesions (motor) | •Lesion to oculomotor nerve would result in pupil dilation, pstosis of the lid, and the patient would not be able to look up, down, or medially •Pt would complain of double vision and drooping eyelid |
| Cranial Nerve III | Oculomotor Nerve |
| Cranial Nerve IVTrochlear Nerve (motor) | •Provides ability to look down, and laterally with involved eye |
| Cranial Nerve IVTrochlear Nerve (motor) Lesion | If lesion patient would not be able to look down or laterally, and c/o double vision |
| Cranial Nerve IV | Trochlear Nerve |
| Cranial Nerve VI Abducens (motor) | Provides ability to look laterally with involved eye |
| Cranial Nerve VI Abducens (motor) Lesion | •Lesion patient would not be able to look laterally |
| Cranial Nerve VI (motor) | Abducens Nerve |
| Nystagmus | rhythmic oscillation or tremor of one of both eyes |
| External Strabismus | outward deviation of eye |
| Mydriasis | dilation of the pupil |
| Diplopia | means double vision |
| Convergence | coordinated simultaneous movement of both eyes when following an object from far away to the bridge of the nose |
| CNIII, IV, VI Oculomotor, trochlear, and abducens nerves Test | 1 Patient is asked to follow the movement of the examiner's fingers as they are moved in all directions of gaze Lesion : -Oculomotor: pt. won't be able to look up, down, or medially with affected eye, their pupil will be dilated, and there will be ptosis of the lid -Trochlear: pt. unable to look down and laterally -Abducens: pt., won't be able to look laterally |
| Cranial Nerve V Trigeminal Nerve (sensory & motor) | Functions of this nerve include: 1. Exteroceptive infor. (pain, temperature, and touch) from skin of face & anterior scalp; mucous membranes of mouth & nose, the eye, & dura mater of most of cranial cavity |
| Cranial Nerve V Trigeminal Nerve (sensory & motor) | Divided into 3 branches: 1.Ophthalmic: sensory from forehead, nose, eye 2.Maxillary: sensory from cheeks and upper lip 3.Mandibular: a.Sensory from lateral face and lower jaw b.Proprioceptive fibers from muscles of mastication c.Innervates muscles of mastication |
| Cranial Nerve V Trigeminal Nerve Lesion | •atrophy & weakness of muscles of mastication •loss of corneal reflex (eyes should close when object touches cornea; if damaged eye will not close) •Trigeminal Neuralgia: disorder causing severe pain lasting anywhere from seconds to hours over 1 or more branches of trigeminal nerve) |
| Testing for CN VTrigeminal Nerve | •1. Touch face with cotton forehead, cheeks, and jaw both sides of face •2. Palpate masseter and temporal muscles by palpating them with pt.'s jaws clamped •3. Look for deviation of the jaw with mouth open •4. Reflex test to maxillary "jaw |
| Cranial Nerve VII Facial Nerve Functions: | 1.Carries sensation from external auditory meatus and skin of ear 2.Responsible for taste sensation from anterior 2/3 of tongue, as well as sensation from salivary glands & hard & soft palate 3.Innervation of lacrimal glands in eye, submandibular & sublingual salivary glands, & mucous membranes of nose and pharynx 4.Innervation of muscles of facial expression (wrinkling, smiling, puckering, closing the eyes, frowning) temporalis, zygomatic,buccal,mandibular,cervical |
| Cranial Nerve VII Facial Nerve | The facial nerve passes through the internal auditory canal outward through the temporal bone, then leaves the skull below the ear, passes through the parotid gland on the side of the face and jaw and goes to the face, eyes, and mouth |
| Cranial Nerve VII | Facial Nerve |
| Bell's Palsy | (loss of facial nerve due to compression of nerve, resulting in ipsilateral paralysis of facial muscles movement) seen in complications of diabetes, AIDS, lyme disease, tumors, inflammation of area around nerveTesting |
| Cranial Nerve VII Facial Nerve Damage or lesion | Damage to facial nerve can result in the following: •Paralysis of facial muscles on ipsilateral side (drooping face) •Disturbed secretion of tears and saliva •Absent taste on anterior 2/3 of tongueBell's Bell palsy |
| Testing CN VII Facial Nerve | 1. Ask pt. to imitate you as you look at the ceiling, wrinkle your forehead, frown, smile, and raise eyebrows •2. Ask pt. to keep eyelids closed while you attempt to open them. •to test sensation; place sugar and salt on anterior part of each side of tongue; tongue should be protruded -(if pt. retracts their tongue or swallows test is not accurate.) Pt. should take sip water after each test |
| Cranial Nerve VII IAcoustic or Vestibulocochlear | Composed of 2 division: •1. cochlear (mediates sense of hearing) •2.Vestibular (subserves the sense of balance and orientation of the body inspace) |
| Cranial Nerve VIII Acoustic or Vestibulocochlear | Acoustic or Vestibulocochlear |
| •Cochlear Lesions | •if affect only 1 temporal lobe will not affect hearing •injury to 8th CN causes hearing loss and tinnitus (ringing in ears) |
| Vestibular Lesions CN VIII | 1.Nystagmus tremor like oscillation of eyes and/or deviation of eyes to one side 2.Vertigo; sensation of whirling caused by stimulation of vestibular apparatus 3. Motion sickness 4.Meniere's Disease: * Condition caused by edema and increased pressure in vestibular labyrinth *Characterized by sudden attacks of severe vertigo, nausea, vomiting, unilateral deafness, and tinnitus |
| Testing CV III acoustic nerve | •Move ticking watch away from ear until pt. can no longer hear; test each ear |
| Cranial Nerve IX Glossopharyngeal Nerve Functions: | •Sensation from posterior 1/3 of tongue and pharynx •Carries impulses from carotid body and sinus (which is a receptor organ in the carotid artery related to the control of BP & HR) •Taste from posterior 1/3 of tongue •Plays role in gag reflex Lesions isolated to this nerve are rare. |
| Cranial Nerve X Vagus Nerve | •The vagal system is complex and VITAL for SURVIVAL •The vagal nerve carries motor, sensory, a parasympathetic impulses. Fibers of the vagus nerve serve various organ systems, including heart, vocal cords, lungs, and GI tract |
| Cranial Nerve IX | Glossopharyngeal Nerve |
| Cranial Nerve X | Vagus Nerve |
| Cranial Nerve X Vagus Nerve Functions: | •Innervate palate, pharynx, larynx and is responsible for vocal cord movement •Innervates trachea, esophagus, heart, stomach, and intestinal tract; stimulation of the vagus nerve causes the HR to slow, constricts the bronchi, relaxes intestinal sphincters, results in peristalsis |
| Cranial Nerve X Vagus Nerve Lesions may result in: | Vagus function may be impaired by any lesion that affects the nerve, nuclei in the brain stem, neck or chest •dysphonia (hoarseness) •dysphagia (esophagus and swallowing mechanisms are disturbed) •abnormal gag reflex due to inability to retract soft palace on side of lesio |
| Testing CN IX and CN X Glossopharyngeal and Vagus nerves | •Touch each side of pharynx with a tongue depressor to elicit gag reflex |
| Cranial Nerve XISpinal Accessory | •Cranial portion accompanies fibers of vagus nerve & supplies some muscles of larynx •Spinal portion innervates sternocleidomastoid & upper trapezius muscles Damage to this nerve results in: •paralysis of sterocleidomastoid ( weakness in rotating head to opposite side) •paralysis of upper trapezius (sagging shoulder, weakness in attempt to shrug shoulder) |
| Cranial Nerve XI | Spinal Accessory |
| Cranial Nerve XII Hypoglossal Nerve Functions include: | •Proprioceptive fibers from lingual muscles •Innervation of muscles of tongue •Injury to this nerve causes a paralysis & atrophy of the tongue muscles on the side of the lesion. This results in the tongue deviating to the side of the lesions when protruded (tongue deviates to paralyzed side) |
| Cranial Nerve XII | Hypoglossal Nerve |
| Many pathologic processes affect the sensory and motor functions of the cranial nerves. These include: | •Infections •Tumors •Metabolic insults •Inflammation |
| Trigeminal Neuralgiaaffects CN V | Characterized by brief intense and recurring attacks of pain confined to the distribution of one or more divisions of the nerve •Occurs in both sexes, usually after age 40 •Presence of "trigger zones" if stimulated produce an attack; usually along nerve distribution; can be triggered by shaving, washing the face, chewing, or moving the tongue •Often patients go and have teeth extracted because of site of pain •Treatment consists of drugs & if they don't work surgical procedures to resection the nerve behind its ganglia; this results in sensory loss to the face •Spontaneous remission sometimes occurs |
| Glossopharyngeal NeuralgiaDisorder of CN IX | •Unknown etiology •Symptoms occur in brief episodes, usually perceived in tonsillar area, radiating toward the ear, neck, or posterior portion of the jaw •Triggering may occur with yawning, swallowing, or coughing •Treatment drugs or surgery |
| Bell's Palsy CN VII | •Unilateral peripheral facial paralysis of acute onset •Unknown etiology-suspected viral or inflammatory etiologies •On affected side: the patient cannot close the eye, wrinkle forehead, mouth droops •90 % of pt.'s will experience full or almost full recovery •Differential diagnosis to eliminate UMNL, tumors, •Important complication of the disorder -corneal injury due to inability to close eye on involved side •Steroids most frequent treatment, facial massage, protection of eye with patch |
| Meniere's Disease | •Affects cochlear and labyrinthine portions of CN 8 •Characterized by recurring attacks of vertigo (spinning), and tinnitus (ringing in ears) & progressive deafness •Onset usually middle age •Vertigo leads to falls, nausea, vomiting •Suspected etiology allergic, infection, vascular with fluid accumulation causing distended labyrinth •Treatment aimed at reducing fluid accumulation & anti vertigo drugs |
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