cranial nerves
how to test cranial nerve I
Close both eyes and push one nostril closed and have them smell something (pleasant) to identify it. Check each side. If they can't smell, they can't smell danger! So we need to make sure they have smoke detectors in their house in case of fire. Smell can also affect the way you taste.
how to test tongue movement
Stick out your tongue your done!! Make sure tongue is not flat on one side or curved in on one side. Use a tongue blade to push down on each side.
how to test sensory
With the patient's eyes closed, we are going to get them to identify light touch. Use a gauze to touch three parts of their face. Ophthalmic which is above their eye, ophthalmic maxillary which is your cheek, and then the mandibular with is under their lip. We do it on both sides of the face and see if they can feel them.
a 2 with verbal response, what can the patient do?
no words only sounds
how to check motor function in the face?
Get them to clinch their teeth and we are going to feel that muscle then get them to open their mouth against resistance.
bow to test crorneal reflex
Get them to make faces at us like raise their eye brows, close their eyes tightly, make them smile, make them frown, puff out their cheeks, keep their eyes closed without resistance. We are looking for their sensory. If they had a stroke or bell's palsy, some of these sensory movements they can't do.
CN IX CN X test what
Glossopharyngeal and vagus gag and cough reflexes
Romberg tests
Have the pt stand still with their eyes closed for 30 seconds. When they first close their eyes, they may sway a little bit and that is normal. But if they start to sway a lot and almost fall, that would be a positive Romberg test and that's abnormal.
CN III test what
Oculomotor
how to test gag and cough reflexes
Test with a tongue blade by touch the sides of the pharynx or soft palate to make sure they can gag. If the pt is intubated, we can test this by bringing the suction down to see if they will gag or cough.
CN I test what? what to do?
This is a test of the nose and smell
how to test visual field
We have them stand arm's length away, have them look at our nose, then we hold fingers out to the side so they can tell you how many fingers you are holding up. You will do this in all 6 fields of gaze.
how to test hearing for cranial nerve VIIII
We stand behind the patient and rub your fingers together and get closer and closer to their ear to see when they can hear it. You can do it on both sides. You can also whisper common words to see if they can repeat what you said by holding a finger to close one ear so you can test each ear.
how to test visual acuity?
We use a chart; they stand 6 feet away and have them read all the letters. Check one eye at a time. Then check them together.
cranial nerve VI
abducens
CN XI test what?
accessory movement so shoulder movement
craniel nerves III. IV, VI makes what doe tricks?
eyes, We need to check their 6 fields of gaze and have them follow with their eyes and we are seeing if we see any movement while they are doing this. Any jumpiness. check PERRELA Eye drooping
what does VIIII test? 2
hearing balance
what will be if the pt withdraws to pain
if they try to move away from pain
what does cranial nerve CN VII test 2
motor and test discrimination
CN V test what
sensory, motor, and corneal reflex
how to test if the patient responds to localized pain for a 5 response
slap your hand to the pain
a 3 with verbal response, what can the patient do?
talk but its not coherent
Hyoglossal nerver CN XIIII test what
tongue movement
cranial IV
trochlear
a 4 with verbal response, what can the patient do?
very disoriented speech
what does optic nerve II test
visual field and acuity
how to test for pain with eye opening
we can pinch them (may take them 30 secs before a response)
