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
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
