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Neuro: Cranial Nerves - NPTE studying - Scorebuilders

Terms in this set (24)

CN I
Olfactory
Afferent: Smell - nose
How to test CN I
Pt. sitting with eyes closed or blindfolded. PT places familiar odor under pt's nostril and asks pt. to identify.
CN II
Optic
Afferent: Sight - eye
How to test CN II
Pt. standing a selected distance from chart/diagram. PT asks pt. to identify or read from chart/diagram.
CN III
Oculomotor
Efferent: *Voluntary motor - levator palpebral superioris (eyelid); superior, medial, and inferior recti; inferior oblique muscles of eyeball
*Autonomic - smooth muscles of eyeball -> pupillary constriction and accommodation
REMEMBER: SO4LR6AO3
How to test CN III
Pt. sitting and is asked to follow an object with their eyes vertically, horizontally, and diagonally (in "H" pattern). Eyes should be inspected for asymmetry or ptosis. Also perform pupillary light reflex.
**Specifically: upward, downward, and medial gaze, as well as reaction to light
CN IV
Trochlear
Efferent: Voluntary motor - superior oblique muscle of eyeball
REMEMBER: SO4LR6AO3
How to test CN IV
Pt. is sitting and asked to follow an object with their eyes, particularly in an inferior direction.
**Specifically: downward and lateral gaze.
CN V
Trigeminal
Afferent: Touch and pain of skin of face, mucous membranes of nose, sinuses, mouth, and anterior tongue
Efferent: Voluntary motor - muscle of mastication
How to test CN V
Sensory: Pt. is sitting with eyes closed. PT performs touch with cotton and/or sharp/dull test on face in three different spots for Opthalmic, Maxillary, and Mandibular branches.
Motor: Ask pt. to perform mandibular protrusion, retrusion, and lateral deviation.
CN VI
Abducens
Efferent: Voluntary motor - lateral rectus muscle of eyeball.
REMEMBER: SO4LR6AO3
How to test CN VI
Pt. is sitting and asked abduct eyes without rotating head. Pt. can follow object into abduction like with other eye muscle tests.
CN VII
Facial
Afferent: Taste - anterior tongue (2/3)
Efferent: *Voluntary motor - Facial muscles
*Autonomic - Lacrimal, submandibular, and sublingual glands
How to test CN VII
-Pt. positioned in sitting and asked to distinguish between sweet and salty substances placed on anterior tongue.
-Muscles of face -> Ask pt. to wrinkle forehead. Have pt. shut eyes tightly while PT tries to open them. Ask pt. to smile. See if pt. can do these and if there is asymmetry.
-Can also test corneal blink reflex (Fehrer's notes)
CN VIII
Vestibulocochlear
Afferent: Hearing - ear; Balance - ear
How to test CN VIII
Pt. positioned in sitting in quiet location. PT, positioned behind and to one side of pt., slowly brings a ticking watch toward the pt's ear. PT records the distance from ear when pt. can identify ticking sound. Inability to hear ticking sound at 18-24inches or significant bilateral difference is a positive test.
CN IX
Glossopharyngeal
Afferent: *Touch and pain of posterior tongue and pharynx
*Taste for posterior tongue (1/3)
Efferent: *Voluntary motor - select muscle of pharynx
*Autonomic - parotid gland
How to test CN IX
-Gag reflex: Pt. is sitting. PT touches pharynx with tongue depressor. Positive test = lack of gagging or inability to feel tongue depressor touch the back of throat.
-Ability to swallow
-Distinguish taste after substance placed on posterior tongue.
CN X
Vagus
Afferent: *Touch and pain of pharynx, larynx, and bronchi
*Taste for tongue and epiglottis
Efferent: *Voluntary motor - muscles of palate, pharynx, and larynx
*Autonomic - thoracic and abdominal viscera
How to test CN X
-Gag reflex: Pt. is sitting. PT touches pharynx with tongue depressor. Positive test = lack of gagging or inability to feel tongue depressor touch the back of throat.
-Ability to swallow
-Say "AHHH" and examine uvula and palate. They should elevate symmetrically.
CN XI
Accessory
Efferent: Voluntary motor - sternocleidomastoid and trapezius muscles
How to text CN XI
-Pt. is sitting with arms at their sides. PT asks the pt. to shrug shoulders and maintain with position while PT applies resistance in the direction of depression.
-Pt. turns head against PT's hand while sternocleidomastoid is being palpated.
CN XII
Hypoglossal
Efferent: Voluntary motor - muscles of tongue (ipsilateral)
How to test CN XII
Pt. in sitting. PT asks the pt. to protrude the tongue. Positive test is pt. unable to protrude tongue or tongue deviates to one side. (Tongue will protrude to the weak/injured side.)
THIS SET IS OFTEN IN FOLDERS WITH...