Cranial Nerves

s/s of cranial neuropathies

Pain, tingling sensation, numbness, and skin sensitive to touch on the face

Weak or paralyzed muscles causing drooling, slurred speech, and facial asymetries

Vision changes

Vertigo

7

Bell's palsy is an impairment of what cranial nerve?

bell's palsy

cranial nerve 7

virus puts pressure on the facial nerve (inflammation)

causes drooping of one side of the face

1

microvascular cranial nerve palsy effects ___ or more eye nerves

microvascular cranial nerve palsy

high blood pressure and diabetes

causes double vision and other eyesight issues

- droopy eyelids (tposis)

third nerve palsy

congenital, head injury, infection, tumor, aneurysm, diabetes, and migraines are causes

symptoms include:

- ptosis

- double vision

- difficulty moving eye

- enlarged pupil

fourth nerve palsy

- congenital, head injury, stroke, tumor

- causes eye to turn abnormally

- may cause double vision and lead to head tilt

sixth nerve palsy

Infection; stroke, tumor, increased ICP; migraines

• Causes abnormal eye movement and double vision

cranial nerve treatment

medication for infection, swelling, and pain

surgery

treat underlying health conditions

- nutritious foods, avoid smoking and alcohol

1

testing for CN ____

- identify common odors

- test each nostril separately

- lemon, coffee, cloves, etc.

2

testing for CN ____

- globe position and symmetry of pupils

- visual acuity (eye chart, can wear glasses if they use them)

- color perception

- convergence (eyes converge and pupils dilate, moving pen away)

- visual fields (checking peripheral vision w/ fingers/numbers)

2; 3

testing for cranial nerves ___ and ____

- pupillary light reflex (both should constrict)

- accomodation

3; 4; 6

testing for cranial nerves ____, ____, and ____

occulomotor, trochlear, and abducens

- ptosis observation

- symmetry of movement (double H)

- nystagmus (beating of eyes across horizontal plane)

- saccades (checking movement in vertical direction)

- smooth pursuit

refer

if someone has vertical nystagmus you should _____ immediately

5

testing for CN _____ (trigeminal)

- sharp/dull and light touch in all 3 areas that the nerve innervates (above both eyebrows, both cheekbones, and both sides of chin)

- do not test on the angle of the jaw as C2 also innervates this

- masseter (clench jaw)

- pterygoids (open jaw, look for deviation)

above the eyes, cheekbones, and chin

where are the three test points for sharp/dull and light touch for the trigeminal (V) nerve?

7

testing for cranial nerve ____

- symmetry of facial folds and fissures

- symmetry of facial movements

- raise eyebrows (frontalis)

- close eyes and don't let me open your eyelids (orbicularis oculi)

- smile (zygomatic major)

- pucker lips (orbicularis oris)

- look scared (platysma)

8

testing for cranial nerve ____ (vestibulocochlear)

- finger rub (identify side they hear fingers rubbing together)

- rinne: tuning fork on mastoid process and then parallel to ear

- normal response: louder with air conduction

- if bone is louder refer for possible conductive hearing loss

- vestibular

- nystagmus

- past pointing (nose to finger EO and EC)

10

testing for cranial nerve ____ (vagus)

- palate elevates with "ah" (deviates towards stronger side)

- cough (testing diaphragm)

11

testing for CN ____ (spinal accessory)

- SCM and UT

- screen for movement

opposite

when testing the SCM for CN XI, the therapist pushes against the patients head in the _____ direction that they turn their head

down

when testing the UT for CN XI, the therapist pushes ____ on the patient's elevated shoulders

12

testing for CN ____

- extend tongue and move side to side (look for symmetry, atrophy, and fasciculations)

LMN

this describes an _____ lesion of CN XII

- deviates to side of lesion with atrophy, fasciculations, and weakness

UMN

this describes an _____ lesion of CN XII

- no atrophy, less unilateral localization