CRANIAL NERVES Health Assessment NUR 211

Anatomy and Physiology Central Nervous System –Brain, spinal cord, motor and sensory pathways Peripheral Nervous System –Spinal nerves, cranial nerves, autonomic nervous system

Focused Health Assessment Present Health/Illness Status –numbness, difficulty with speech, vision, hearing, medications, changes in behavior, lifestyle Family History –headaches, mental illness, depression

Continued: Past Health History –seizures, headaches –head injury –surgeries –stroke

Equipment Needed: Cotton ball, safety pin, snellen chart Tongue blade Tuning fork Reflex hammer pen light pencil and paper sweet/sour substances Familiar aromatic substance (coffee, vanilla)

CN I: Olfactory Sensory: smell Apply simple odors to one nostril at a time Do not test unless history indicates

CN II: Optic Sensory: vision Snellen Visual fields (confrontation) Ophthalmoscopic examination

CN III: Oculomotor Motor: upward, downward, medial eye movement Corneal Light reflex Cover test EOM: 6 cardinal positions Observe lids

CN IV: Trochlear Motor: downward, medial eye movement EOM Same as CN III Pupillary light reflex Accommodation

CN V: Trigeminal Sensory: face, scalp Motor: Tactile and pain sensation on entire face

CN VI: Abducens Motor: lateral eye movement EOM Same as CN III

CN VII: Facial Sensory: Taste to anterior 2/3 of tongue Motor: Ability to frown Smile, show teeth Puff out checks whistle, close eyes

CN VIII: Acoustic Sensory: Hearing acuity Rinne test: on mastoid process Weber test: on center of forehead Otoscopic examination Rhomberg test

CN IX: Glossopharyngeal Sensory: Taste Motor: Able to swallow Gag reflex

CN X: Vagus Sensory –listen to person talk (hoarseness) Motor –ask person to say “ah” (soft palate contract and uvula stays midline)

CN XI: Spinal Accessary Motor: Turn head side to side shrug shoulders with resistance

CN XII: Hypoglossal Motor: protrude tongue move tongue from side to side with resistance