Cranial Nerves Exam.

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Presentation transcript:

Cranial Nerves Exam

12 pairs of cranial nerves.

Functions of cranial nerves 􀂇 Some of these nerves bring information from the sense organs to the brain; 􀂇 Others control muscles; 􀂇 Others are connected to glands or internal organs such as the heart and lungs.

The innervation areas of the cranial nerves

[Experimental method & procedure] CN I: Olfactory: smell 1. Ask the subject if he/she has a subjective olfactory problem. 2. Check for rash, deformity of nose.

CN II: Optic: vision 􀂇 There are two main aspects to this nerve: 􀂄 1. Examine visual acuity 􀂄 2. Examine visual fields

CN III, IV, VI: Oculomotor, Trochlear, Abducens 􀂇 CN III Oculomotor: 􀂄 Eyelid and eyeball movement 􀂇 CN IV Trochlear: 􀂄 Innervates superior oblique 􀂄 Turns eye downward and laterally 􀂇 CN VI Abducens: 􀂄 Turns eye laterally 􀂇 Cranial Nerves III, IV and VI supply the muscles of eye movement and are tested as a unit.

1. Appearance of eyes: 2. Eyeball movement: 3. Look at pupils: 4. Test pupillary light reaction: 5. Pupillary reaction to convergenceتقارب and accommodation reflex

CN V: Trigeminal 􀂇 Functions: - Chewing - Face & mouth touch & pain 􀂇 1. Facial sensation: 1) Use sterile sharp item on forehead, cheek and jaw. 2) If abnormal, then test temperature

2. Motor: Subject opens mouth, clenches teeth اطبق الاسنان. 1) Palpate temporal, masseter muscles as they clench. 2) Subject opens mouth; assess the symmetry of the mouth.

􀂇 3. Test jaw jerk: 1) Examiner places finger on tip of jaw. 2) hold patellar hammer halfway up shaft and tap examiner’s finger lightly. 3) Usually nothing happens, or just a slight closure.

CN VII: Facial Functions: controls most facial expressions, secretion of tears & saliva, taste

CN VIII: Vestibulocochlear 􀂇 Functions: hearing; equilibrium sensation 􀂇 Auditory acuity 1. Rinne test: 2. Weber test:

CN IX, X: Glossopharyngeal, Vagus 􀂇 CN IX Glossopharyngeal: 􀂄 taste 􀂄 senses carotid blood pressure 􀂇 CN X Vagus: 􀂄 senses aortic blood pressure 􀂄 slows heart rate 􀂄 stimulates digestive organs

CN IX, X: Glossopharyngeal, Vagus 􀂇 Some useful tests for detection of deficiencies in motor function of the palate, pharynx, and larynx are . 1. Palatal Elevation 2. Gag reflex 3. Voice Quality 5. Taste test .

CN XI: Accessory 􀂇Functions: Controls trapezius & sternocleidomastoid Controls swallowing movements

Sternocleidomastoid Trapezius muscle

CN XI: Accessory 􀂇 1. Sternocleidomastoid Press a hand against the patient's jaw and have the patient rotate the head against resistance. Pressing against the right jaw tests the left sternocleidomastoid and vice versa. 􀂇 2. Trapezius Have the patient shrug shoulders against resistance and assess weakness.

CN XII: Hypoglossal Function: controls tongue movements 1. Listen to articulation نطق. 2. check tongue in mouth . 3. Protrude tongue: deviates to affected side.