Practical Exam - Anatomy and Physiology

Cranial Nerve I

Olfactory

Cranial Nerve II

Optic

Cranial Nerve III

Oculomotor

Cranial Nerve IV

Trochlear

Cranial Nerve V

Trigeminal

Cranial Nerve VI

Abducens

Cranial Nerve VII

Facial

Cranial Nerve VIII

Vestibulocochlear (auditory nerve)

Cranial Nerve IX

Glossopharyngeal

Cranial Nerve X

Vagus

Cranial Nerve XI

Accessory

Cranial Nerve XII

Hypoglossal

Conductive hearing loss sounds ____

louder

Sensorineural hearing loss sounds ___

quieter

In conductive hearing loss,

affected ear will achieve some length of time at the bone, but will not achieve 2x in the air on the affected side

In sensorineural hearing loss,

the effected ear will be a reduced ratio compared to the normal/non-effected ear.

Order of tests for cranial nerve evaluation

Close eyes and smell, follow fingers in directions, follow fingers going in (cross-eyed), penlight in eyes, smile, close/open eyes, ask how day was, cough into elbow, stick out tongue, brush cheeks, open jaw down, move jaw left/right, turn head left/right against hands, shrug shoulders with pressure applied

Air conduction

Sound waves -> external auditory canal -> eardrum -> ossicular chain -> oval window -> cochlea -> CNVIII

Bone conduction

Sound waves -> cranial bone -> cochlea -> CNVIII

How many ways is sound conducted into the ear?

2

Conductive hearing loss is a problem with what part of the ear?

damage/blockage to the outer and/or middle ear

Sensorineural hearing loss is a problem with what part of the ear?

damage to the cochlea and/or auditory nerve (CNVIII)

Shoulder abduction

C5

Wrist extensors

C6

Wrist flexors

C7

Finger flexors

C8

Finger adductors

T1

Hip flexors

L1-3

Ankle dorsiflexion

L4

Toe extensors

L5

Ankle plantar flexion

S1

Wrist extensors/flexors bracing hand location

around wrist

Finger flexors bracing hand location

across the palm

Ankle dorsiflexion/plantar flexion bracing hand

around ankle

Toe extensors bracing hand location

over top of the foot (shoelaces)

Biceps

C5, C6

Brachioradial

C5, C6

Triceps

C7, C8

Patellar

L2, L3, L4

Achilles

S1, S2

Deep tendon reflexes testing checks ___

gross neurological integrity

Motor strength testing checks the ___

gross integrity of the motor nerves

Reflex grading 2+

Active or expected response (textbook normal)

Strength grading 5/5

Normal strength

Clonus

muscles keep responding to the stimulus even after the stimulus is removed

Small/pointy side of the reflex hammers are used for ___

upper extremities of adults (small surface areas) or all extremities of children (because they're small)

Large/flat side of the reflex hammers are used for ___

lower extremities of adults (larger surface areas)

Weber and Rinne

used to determine type of hearing loss (conductive or sensorineural) and basic severity

CN 1 instruction

"Close your eyes and tell me what you smell"

CN II, III, IV, VI Instruction

"I want you to follow the tips of my fingers without moving your head"

"Continue watching" when you move the fingers inward.

"I want you to look straight ahead for me now" for the light test

CN VII Instruction

"Close your eyes and then open again."

"Give me a big smile"

CN IX, X Instruction

"How has your day been going?

"Can you cough into your elbow for me?"

CN XII Instruction

"Stick out your tongue for me please"

CN V Instructions

"I'm going to touch your face, and I want you to tell me if it feels about the same on the other side"

"I want you to open your jaw down. Now left. Now right"

CN XI Instructions

"I want you to turn your head against my hand"

"I want you to shrug your shoulders"

What does C stand for in the basic neurological tests

Cervical nerve root

What does L stand for in the basic neurological tests

Lumbar

What does S stand for in the basic neurological tests

Sacrial

(Motor strength testing) Higher up the body =

Higher up the spine

What should you not strike when testing the reflexes of the triceps?

The ulnar nerve

Order of deep tendon reflexes tests

Biceps, brachioradial, triceps, patellar, achilles

Order of motor strength tests

Shoulder abduction, wrist extensors, wrist flexors, finger flexors, finger adductors, hip flexors, ankle doriflexion, toe extensors, ankle plantar flexion