Cranial Nerves

s/s of cranial neuropathies

Symptoms include facial pain, tingling, numbness, muscle weakness or paralysis (resulting in drooling, slurred speech, facial asymmetry), vision changes, and vertigo.

7

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

Bell's palsy

Cranial nerve 7 inflammation from a virus leads to facial drooping on one side.

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

Causes include congenital issues, head injury, infection, tumor, aneurysm, diabetes, and migraines. Symptoms are ptosis, double vision, restricted eye movement, and 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