1. CRANIAL NERVES Health Assessment NUR 211

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

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

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

5. 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)

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

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

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

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

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

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

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

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

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

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

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

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