The nurse notices that a patient's *palpebral
fissures* are not symmetrical. On examination, A patient says that she has recently noticed a
the nurse may find that there has been damage lump in the front of her neck below her "Adam's
to cranial nerve: - -ANS: VII. apple" that seems to be getting bigger. During the
assessment, the finding that leads the nurse to
Facial muscles are mediated by cranial nerve suspect that this may not be a cancerous thyroid
(CN) VII; asymmetry of palpebral fissures may be nodule is that the lump (nodule): - -ANS: is
due to CN VII damage (Bell's palsy). mobile and not hard.
Painless, rapidly growing nodules may be
A patient is unable to differentiate between cancerous, especially the appearance of a single
*sharp and dull stimulation to both sides of her nodule in a young person. However, cancerous
face*. The nurse suspects: - -ANS: nodules tend to be hard and fixed to surrounding
damage to the trigeminal nerve. structures, not mobile.
Facial sensations of pain or touch are mediated
by cranial nerve (CN) V, which is the trigeminal The nurse notices that a patient's submental
nerve. Bell's palsy is associated with CN VII lymph nodes are enlarged. In an effort to identify
damage. Frostbite and scleroderma are not the cause of the node enlargement, the nurse
associated this problem. would assess the patient's: - -ANS: area
proximal to the enlarged node.
A patient comes to the clinic complaining of neck When nodes are abnormal, the nurse should
and shoulder pain and is unable to turn her head. check the area they drain for the source of the
The nurse suspects damage to cranial nerve problem. Explore the area proximal (upstream) to
(CN) _____ and proceeds with the examination the location of the abnormal node.
by _____. - -ANS: XI; asking the patient to
shrug her shoulders against resistance
The nurse needs to palpate the
The major neck muscles are the sternomastoid temporomandibular joint for crepitation. This joint
and the trapezius. They are innervated by CN XI, is located just below the temporal artery and
the spinal accessory. The innervated muscles anterior to the: - -ANS: tragus.
assist with head rotation and head flexion,
movement of the shoulders, and extension and The temporomandibular joint is just below the
turning of the head. temporal artery and anterior to the tragus.
When examining a patient's cranial nerve (CN) A visitor from Poland who does not speak English
function, the nurse remembers that the muscles seems to be somewhat apprehensive about the
in the neck that are innervated by CN XI are the:nurse examining his neck. He would probably be
- -ANS: sternomastoid and trapezius. most comfortable with the nurse examining his
thyroid from: - -ANS: the front with the
The major neck muscles are the sternomastoid nurse's thumbs placed on either side of his
and the trapezius. They are innervated by CN XI, trachea and his head tilted forward.
the spinal accessory.
Examining this patient's thyroid from the back
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