Cranial Nerve - T&M

How would you test CN I?

Have patient smell from each nostril. Identify 2 different smells for each nostril.

Identifying common odors tests CN ___

CN I

How to test central acuity?

Traditional Eye Chart

How to test color perception?

Ishihara Images

How to test convergence?

Follow a stimulus towards face to midline

How to test peripheral/visual field

Patient looks directly ahead and therapist moves item into visual field

Central acuity, color perception, convergence, globe position, pupil symmetry, and peripheral/visual fields all test CN ____

CN II

Visual acuity tests CN ____

CN II

Globe position & symmetry of pupils tests CN ___

CN II

Color perception tests CN ___

CN II

Convergence tests CN ___

CN II

How to test CN II sensory & III motor?

Pupillary light reflex, accommodation

Pupillary light reflex tests CN ___ & ___

CN II & III

Accommodation tests CN ___ & ___

CN II & III

How to test pupillary light reflex?

Bring light towards eye; watch for pupil response

How to test for accommodation?

Shift focus from finger 8in away to an object in the distance

How to test CN III, IV, VI?

Ptosis, saccades, smooth pursuit

Define ptosis

Drooping of eyelid

Ptosis indicates the integrity of CN ____, ____ & ____

III, IV, & VI

Nystagmus indicates an issues with which CNs?

III, IV & VI

Which 2 tests are appropriate to test for nystagmus?

Saccades & Smooth Pursuit

How to test saccades?

Have patient look side to side at two different objects - observe for nystagmus & symmetry

How to test smooth pursuit?

Follow an object side to side; up & down; diagonal

How to test CN V sensory? How would you document?

Light touch sensation of cheeks, jaw, forehead

Document like sharp dull tests: EX intact 5/5

Clenching the jaw tests which muscle and CN?

Masseter; CN V (Motor)

Opening & deviating jaw side to side tests which muscle & CN?

Pterygoids; CN V (motor)

How would you test CN V motor?

Palpate temporal/masseter muscle and have patient clench teeth and open jaw

How to test CN VII? List the 5 muscles/facial movements to assess

Have patient raise eyebrows, smile, close eyes, pucker lips, platysma

After performing testing of CN VII, what are you observing?

Symmetry of facial folds & movements

How to test CN VIII?

• Rub fingers several inches from ears

• Weber Test

• Rinne Test

• Past pointing (nose to finger EO/EC)

Describe the weber test

Place tuning fork on top of head and ask pt which ear sound is louder in

Describe Rinne test

Place tuning fork on mastoid, once sound disappears place for parallel to ear

What is a positive Rinne test?

Bone is louder or sounds = to parallel sound

CN IX tests

• Gag reflex

• Taste

What tests would be performed to test CN X?

• Have patient stick out tongue - watch for tongue deviation

• Cough

How to test CN XI?

• Palpate SCM (resistance)

• Palpate Upper traps (resistance)

How to test CNXII?

• Observe speech

• Observe tongue movement