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CN Assessments

NDT CN Assessments Lab Exam 1

Olfactory Cover one nostril (do each nostril separately) Waft non-noxious odors toward patient (don't allow them to breathe deeply)
Optic- Visual Acuity Snellen Chart- visual acuity (numerator- distance pt stands from chart/denominator- # smallest line read on chart) Test 1 eye at a time Read smallest line possible
Optic- Peripheral Vision Pt's arms outstretch to side, watches stationary object & move hands in, says when he sees hands Watch PT nose while PT moves arms out to sides; pt tells PT when he can see hands Normal horizontal peripheral vision = 85 deg from midline
Oculomotor- Pupillary Reflex Equality & size of pupils, rxn to light Put hand b/t eyes, shine light on 1 & observe direct effect where pupil receiving light constricts & other pupil simultaneously does the same
Oculomotor, Trochlear, Abducens- Strabismus (ocular alignment) Follow moving target w/o head mvmt Use an H pattern (horizontal- 3 & 6; vertical- 4) Check for nystagmus by holding an end range Convergence of eyes- CN 3 Ptosis of eyelid- CN 3
Trigeminal Ssy- sharp/dull, lt touch Motor- open/close jaw vs resistance; jaw jerk reflex Corneal reflex (CN 7) Open mouth- jaw may deviate to weak side Move jaw side to side with mouth open
Facial Assess asymmetry of face Ask pt to frown, puff out cheeks (resist one cheek at a time) Corneal reflex- tests orbicularis oculi
Vestibulocochlear- Auditory acuity tuning fork placed on vertex of skull/middle of forehead Pt indicates on which side tone is louder (should be equal) Louder on one side- "bad" ear
Vestibulocochlear Rub fingers together at a distance & gradually bring toward pt, note distance when first head Alter conversatoin volume
Rinne Test for vestibulocochlear n. Air v. Bone conduction Hit tuning fork w/ hand Hold fork against mastoid process Pt signals when he can't hear vibrations, then you move vibrating fork over ear canal Pt says when sound stops AC should be 2x > BC = (+) test BC>AC = (-) test
Hearing Loss Conductive- normal BC, impaired AC, can't hear any sound when tuning fork near ear Sensorineural- equal reduction of AC & BC; normal pattern prevails
Glossopharyngeal Taste on posterior 1/3 of tongue Gag reflex Do this test last!
Vagus Swallowing Observe uvula & soft palate for asymmetry Listen for hoarseness/nasal quality Have pt say ah & look for asymmetry of structures Ask pt/caregiver if there have been voice changes
Cranial Accessory Nerve tested with Vagus. Spinal Accessory... Strength of SCM/Upper Traps
Hypoglossal Tongue protruded- move tongue rapidly side to side Protrude tongue & don't move (tongue deviates to side of lesion) Problems with articulation Strength of tongue- apply resistance through cheek bilaterally
Created by: 1190550002