ASSESSMENT
◉ cranial nerves order. Answer: olfactory, optic, oculomotor,
trochlear, trigeminal, abducens, facial, vestibulocochlear,
glossopharyngeal, vagus, accessory, hypoglossal
◉ olfactory nerve. Answer: smell
◉ optic nerve testing. Answer: -visual activity: cover one eye, read
smallest line at 20 ft away ; 20/20 numerator = distance,
denominator = what line read
-Confrontation test (peripheral vision): pencil brought into field of
vision from 8 separate directions
◉ oculomotor nerve, trochlear and abducens. Answer: III, IV, VI :
eyelid drooping, pupil size and equality and response to
light/accomidation, EOM
◉ trochlear nerve. Answer: eye movement
◉ trigeminal nerve testing. Answer: V
-clinch teeth and palpate temporal and masseter muscles (motor)
,-Pinprick close to midline of the face: manibular, maxillary,
opthalmic (sensory)
-corneal reflex
◉ abducens nerve testing. Answer: located in pons, injury will
deviate eye medially
◉ facial nerve testing. Answer: -VII
Test facial expressions (close eyes tightly, smile, and show teeth)
-Identify sweet and sour tastes
◉ vestibulochochlear (ACOUSTIC) nerve testing. Answer: VIII
-Hearing: rub 2 fingers equidistant from person's ear simultaneously
-Balance: balance test (one leg stance); caloric stimulation is a test
which uses differences in temp to diagnose ear nerve damage as a
cause of dizziness or vertigo
◉ glossopharyngeal nerve testing. Answer: IX
-Gag reflex; reserved for severely affected patients only
◉ vagus nerve testing. Answer: X
, -Say 'aah' watch movement of soft palate and pharynx; soft palate
should rise symmetrically and the uvula should remain in the mid-
line
-check phonation
◉ accessory nerve testing. Answer: XI
-resisted head and shoulder shrug (trapezius strenght)
resisted turning of head (sternocleidomastoid)
◉ hypoglossal nerve testing. Answer: XII
-have person stick out tongue, look for atrophy, asymmetry, or
deviation from mid-line, L, T, D, N sounds
◉ positioning for the prostate exam. Answer: rectal exam: knee
chest; lithotomy; left lateral with hips and knees flexed or standing
with hips flexed and upper body supported by exam table. If pt has a
prostate either standing or left lateral
◉ normal prostate exam findings. Answer: palpate on anterior wall.
pt may feel urge to urinate. should feel like a pencil eraser, firm,
smooth and slightle mobile. nontender. usually 4 cm with <1 cm into
rectum. If > 1 cm this is considered enlarged.
rubbery or boggy=BPH