Cranial Nerve I: Olfactory - AnswersWhat cranial nerve is being evaluated if one nostril is
occluded and the ability to smell is tested and then the sides are compared?
Cranial Nerve II- Optic - AnswersWhich cranial nerve is being evaluated by performing a vision
acuity test, pupil reactivity, and pupil accommodation?
Cranial Nerve III: Oculomotor
Cranial Nerve IV- Trochlear- Extraocular muscle only - AnswersWhich cranial nerve is being
evaluated if pupillary response is tested and the ability of the eye to move up, down, laterally,
and diagonally?
Cranial Nerve V- Trigeminal - AnswersWhich cranial nerve is being evaluated when the ability of
the jaw to open and close against hand is tested and the patients ability to feel touch on their
face?
Cranial Nerve VI- Abducens - AnswersWhich cranial nerve is being evaluated when the patient is
asked to move the eyes from side to side?
Cranial Nerve VII- Facial - AnswersWhich cranial nerve is being evaluated when the patient is
asked to smile, raise eyebrows, keep eyes and lips closed while you try to open them, or be able
to identify salt or sugar on tongue?
Cranial Nerve VIII- Vestibularcochlear - AnswersWhich cranial nerve is being evaluated when a
tuning fork, rubbing fingers, or whispers are used to test hearing?
Cranial Nerve IX-Glossopharyngeal
Cranial Nerve X- Vagus - AnswersWhich cranial nerve is being evaluated when the patient's
ability to swallow, cough, gag, or voice changes is tested?
Cranial Nerve XI- Spinal Accessory - AnswersWhich cranial nerve is being evaluated when the
patient is asked to shrug shoulders and turn head from side to side?
Cranial Nerve XII: Hypoglossal - AnswersWhich cranial nerve is being evaluated when the patient
is asked to stick out tongue and move it internally from cheek to cheek?
Pronator drift
Upper extremity strength- deltoid muscle and hand grip
Lower extremity strength- iliopsoas, foot dorsiflexion and plantar flexion
mass, tone, and speed of movement proximal and distal - AnswersHow can the motor system
be evaluated during a neurologic exam?
,0=Absent
1= hypoactive
2=normal
3= brisk/hyperactive
4= markedly hyperactive with clonus
**Hyper excitability associated with cortico-spinal dysfunction - AnswersHow are reflexes
graded 0-4? What do they mean?
Pinprick or temp, vibration, proprioception done on all 4 extremities with eyes closed -
AnswersHow are sensory functions evaluated in a neurological assessment?
Tests the ability to maintain an upright position with feet together and eyes closed. Tests
vestibular function and proprioception
Positive Romberg sign if patient sways with eyes closed - AnswersWhat is the Romberg test?
Rapid alternating movements
Finger to nose
Heel to shin
Heel toe walking - AnswersWhat are some methods of testing coordination during a
neurological assessment?
Kernig's Test - AnswersThis test is done by having the person lie flat on the back, flex the thigh
so that it is at a right angle to the trunk, and completely extend the leg at the knee joint. If the leg
cannot completely extend due to pain the test is positive.
Brudzinski's Test - AnswersIn this test the patient lies supine with examiner at head of table,
passively flexes patient's head to chest
observing for buckling of knees. If hips and knees flex the test is positive.
5-15mmHg - AnswersWhat is a normal range for Intracranial pressure?
>20mmHg for a sustained period of time - AnswersWhat is considered an elevated ICP?
MAP should be between 65-150mmHg - AnswersWhat does the mean arterial pressure need to
be at in order to auto-regulate intracranial pressure?
Systolic BP + diastolic BP x2 /3
, (Multiply by 2 divide by 3) - AnswersHow is the MAP calculated?
CPP= MAP-ICP - AnswersHow is the Cerebral Perfusion Pressure calculated?
between 60-100mmHg - AnswersWhat is the normal range for CPP?
<50mmHg - AnswersWhat CPP level is associated with ischemic and neuronal death?
Highest score is 15
lowest score is 3 - AnswersWhat is the highest and lowest GCS score?
Compressed cranial nerve III - AnswersWhat can a single dilated pupil indicate?
Pons damage or drug use
(also direct injury to CN III or from atropine) - AnswersWhat can pinpoint pupils indicate?
It is a cranial nerve test for unconscious patients
Head is turned while eyelids are opened- eyes should move opposite of movement. -
AnswersWhat is the doll's Eye (Oculocephalic Reflex) used to test and why?
Cycles of hyperventilation and apnea - AnswersDescribe Cheyne-Stokes breathing?
Prolonged inspiratory phase or pauses with expiratory pauses - AnswersDescribe apneustic
breathing
Keep HOB elevated
Prevent extreme neck flexion
Turn patient slowly
Have patient avoid coughing, straining, or valsalva
Avoid hip flexion - AnswersWhat are interventions to optimize ICP and CPP? 5
Widening pulse pressure
bradycardia with full and bounding pulse
Altered respirations - AnswersWhat are the symptoms of Cushing's triad- signs of intracranial
decompensation?
A decrease in arterial O2 (<50mmHg) or an increase in arterial CO2
cause cerebrovascular dilation and increased cerebral blood flow - AnswersHow does O2 & CO2
play a role in cerebral blood flow?