NUR 112 Chap 25 Assessing Neurologic System

Chapter 25 Assessing Neurologic System
 Cranial Nerve Assessment*
o Cranial Nerves- 12 pairs, motor, sensory, mixed function
WHEN WRITING CRANIAL NERVES USE ROMAN NUMERALS
o CN 1 – OLFACTORY – smell (Sensory)
 Close eyes and have them smell something (coffee, vanilla, alcohol
wipe)
 Can decrease with age.
 If decreased sense of smell (older clients) make sure they have
working smoke alarms.
o CN 2 – OPTIC – sight (Sensory)
 SNELLEN test
o CN 3 – OCULOMOTOR - eye movements (Motor)
 Test 6 cardinal fields of gaze
o CN 4 – TROCHLEAR – eye movements (Motor)
 Downward, medial eye movement
o CN 5 – TRIGEMINAL – Chewing (and pain sensations) (Motor & Sensory)
 Use cotton tip applicator to check for sensation, smile, stick out
tongue.
o CN 6 – ABDUCENS – eye movements (Motor)
 Lateral Eye Movement
o CN 7 – FACIAL (motor) – facial expressions
 Smile, close their eyes, raise their eyebrows
o CN 8 – VESTIBULOCOCHLEAR (acoustic) – hearing
 Use the whisper test
o CN 9 – GLOSSOPHARYNGEAL– swallowing
 Have them swallow, or cough
o CN10 – VAGUS – swallowing, gag
 Have them swallow, can also check gag reflex (not checked on
everyone)

, o CN11 – SPINAL ACCESSORY – trapezius, sternomastoid muscles
 Shrug their shoulders while pressure is applied
o CN 12 – HYPOGLOSSAL – motor – tongue
 Can use gauze and glove, hold tongue and have pt move tongue
around
o On old Olympus’s Towering Top, a Finn and German viewed some hops
o Some say marry money, but my big brother says big brains matter more
 Sympathetic nervous system IS activated during stress; bronchiole dilation, increased
pulse rate, pupil dilation.
Which lobe is responsible for interpreting tactile sensations such as pain and
temperature? PARIETAL. Parietal lobe interprets tactile sensation.
 Stroke
o Stroke Risk
 Hypertension
 Diabetes mellitus
 Heart Disease
 Smoking and exposure to second-hand smoke
 Age and gender (males are more common)
 Race and ethnicity
 Personal or family history
 Brain aneurysms or arteriovenous malformations (AVMs)
 Alcohol and illegal drug use
 Certain medical conditions
 Overweight and obesity
 Unhealthy diet
 Use of NSAID medications
o Warning Signs
 DO NOT WAIT; treatment is time limited
 Call 911 immediately
o Stroke Symptoms