The following tests are designed to help identify the functioning of the twelve pairs of cranial nerves on a patient or “test subject”. Review the following cranial nerve tests. study the case scenarios to determine which cranial nerve (there may be more than 1 for some) may be damaged in each scenario based on the results of cranial nerve tests “you” (as a pretending physician) have performed on some patients. Note that “CN” stands for “cranial nerve”. Use the images attached to help.   Case Scenario #1 You are a neurologist seeing a patient who is having trouble with her hearing. You perform a cranial nerve test by having her try to identify an object by its sound. Behind your back you jingle a bell, clap your hands, snap your fingers. The patient indicated that she heard the jingling of the bell, but not the other two sounds. You perform another test where you have the patient walk along a line on the floor. The patient walks in a zig-zag type pattern. What nerve might be damaged in this person?  Case Scenario #2 You are a family doctor, and a mother brings in her child who has fallen off his jungle gym in the backyard. She wants you to check to make sure that he is okay. She noticed that he didn’t seem to have any broken bones, but wants him to be “checked over” for sure. After you check his arms and legs and skull for broken bones and wounds, and have ruled out a concussion, you do a couple of cranial nerve tests. You show the child a funny picture, have him smell some vinegar, and you note his responses. After performing these tests, you snap a photo of the child. This is what he looked like (after viewing the funny picture and smelling something unpleasant). The child had a straight face. You have a suspicion that one of his cranial verves is damaged. Which one do you suspect?                              Case Scenario #3 A wife brings her husband to the medical office, complaining that he is slurring his words. She is worried that he may have had a stroke. You are able to rule that out, but you perform a cranial nerve test by asking the patient to stick out his tongue and move it first to the left and then to the left. The patient is only able to move his tongue in one direction. What is your assessment after this nerve test? Case Scenario #4 Your neighbor, Jim, comes into your clinic complaining that he is having some issues turning his head, that his neck muscles seem weak. You perform a cranial nerve test on Jim and find that he cannot lift his right shoulder when you ask him to shrug his shoulders. You notice also that his right shoulder is not even with his left shoulder. You are concerned that Jim may have nerve damage to his ______________ nerve.

Human Anatomy & Physiology (11th Edition)
11th Edition
ISBN:9780134580999
Author:Elaine N. Marieb, Katja N. Hoehn
Publisher:Elaine N. Marieb, Katja N. Hoehn
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Cranial Nerve Tests

The following tests are designed to help identify the functioning of the twelve pairs of cranial nerves on a patient or “test subject”. Review the following cranial nerve tests. study the case scenarios to determine which cranial nerve (there may be more than 1 for some) may be damaged in each scenario based on the results of cranial nerve tests “you” (as a pretending physician) have performed on some patients. Note that “CN” stands for “cranial nerve”. Use the images attached to help.

 

Case Scenario #1

You are a neurologist seeing a patient who is having trouble with her hearing. You perform a cranial nerve test by having her try to identify an object by its sound. Behind your back you jingle a bell, clap your hands, snap your fingers. The patient indicated that she heard the jingling of the bell, but not the other two sounds. You perform another test where you have the patient walk along a line on the floor. The patient walks in a zig-zag type pattern. What nerve might be damaged in this person? 

Case Scenario #2

You are a family doctor, and a mother brings in her child who has fallen off his jungle gym in the backyard. She wants you to check to make sure that he is okay. She noticed that he didn’t seem to have any broken bones, but wants him to be “checked over” for sure.

After you check his arms and legs and skull for broken bones and wounds, and have ruled out a concussion, you do a couple of cranial nerve tests. You show the child a funny picture, have him smell some vinegar, and you note his responses. After performing these tests, you snap a photo of the child.

This is what he looked like (after viewing the funny picture and smelling something unpleasant). The child had a straight face. You have a suspicion that one of his cranial verves is damaged. Which one do you suspect? 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Case Scenario #3

A wife brings her husband to the medical office, complaining that he is slurring his words. She is worried that he may have had a stroke. You are able to rule that out, but you perform a cranial nerve test by asking the patient to stick out his tongue and move it first to the left and then to the left. The patient is only able to move his tongue in one direction. What is your assessment after this nerve test?

Case Scenario #4

Your neighbor, Jim, comes into your clinic complaining that he is having some issues turning his head, that his neck muscles seem weak. You perform a cranial nerve test on Jim and find that he cannot lift his right shoulder when you ask him to shrug his shoulders. You notice also that his right shoulder is not even with his left shoulder. You are concerned that Jim may have nerve damage to his ______________ nerve. 

-sensory fibres
-motor fibres
Optic (II)
sensory: eye
Trochlear (IV)
motor: superior
oblique muscle
Abducent (VI)
motor: external Oculomotor (III)
rectus muscle
Trigeminal (V)
sensory: face,
sinuses, teeth, etc.
motor: muscles
of m
motor: all eye
muscles except
those supplied by
IV and VI
© 2007 Encyclopædia Britannica, Inc.
Olfactory (1)
sensory: nose
VII
VIII
IX
X
XI
V
XII
IV
Facial (VII)
motor:
muscles
of the
face
VI VI
III
intermediate
nerve
IV
V
VII
XII
VIII
IX
XI
X
Intermediate
motor:
submaxillary and
sublingual gland
Hypoglossal (XII)
motor: muscles
of the tongue
sensory:
anterior part of tongue
and soft palate
Vestibulocochlear (VIII)
sensory:
inner ear
Ⓡ
vestibular
cochlear
$
Glossopharyngeal (IX)
motor:
pharyngeal
musculature
sensory:
posterior part
of tongue,
tonsil, pharynx
Vagus (X)
motor:
heart, lungs,
bronchi,
gastrointestinal
tract
sensory:
heart, lungs,
bronchi, trachea,
larynx, pharynx,
gastrointestinal
tract, external ear
Accessory (XI)
motor: sterno-
cleidomastoid and
trapezius muscles
Transcribed Image Text:-sensory fibres -motor fibres Optic (II) sensory: eye Trochlear (IV) motor: superior oblique muscle Abducent (VI) motor: external Oculomotor (III) rectus muscle Trigeminal (V) sensory: face, sinuses, teeth, etc. motor: muscles of m motor: all eye muscles except those supplied by IV and VI © 2007 Encyclopædia Britannica, Inc. Olfactory (1) sensory: nose VII VIII IX X XI V XII IV Facial (VII) motor: muscles of the face VI VI III intermediate nerve IV V VII XII VIII IX XI X Intermediate motor: submaxillary and sublingual gland Hypoglossal (XII) motor: muscles of the tongue sensory: anterior part of tongue and soft palate Vestibulocochlear (VIII) sensory: inner ear Ⓡ vestibular cochlear $ Glossopharyngeal (IX) motor: pharyngeal musculature sensory: posterior part of tongue, tonsil, pharynx Vagus (X) motor: heart, lungs, bronchi, gastrointestinal tract sensory: heart, lungs, bronchi, trachea, larynx, pharynx, gastrointestinal tract, external ear Accessory (XI) motor: sterno- cleidomastoid and trapezius muscles
Mnemonic #
On
Old
Olympus III Oculomotor
Tops
Towering IV Trochlear
A
Finn
And
German
I Olfactory
II Optic
Some
Hops
Name
V Trigeminal
VI Abducens
, VII Facial
VIII
Viewed. X Vagus
Auditory
(Vestibulocochlear)
IX Glossopharyngeal
XI Spinal Accessory
XII Hypoglossal
Function
(S/M/B)
Smell (S)
Vision (S)
Eye movements
(M)
Eye movements
(M)
Sensory/motor-
face (B)
Eye movements
(M)
Motor - face,
Taste (B)
Hearing/balance
(S)
Motor - throat
Taste (B)
Motor/sensory -
viscera
(autonomic) (B)
Motor - head and
neck (M)
Motor - lower
throat (M)
Central connection (nuclei)
Olfactory bulb
Hypothalamus/thalamus/midbrain
Oculomotor nucleus
Trochlear nucleus
Trigeminal nuclei in the midbrain,
and medulla
pons,
Abducens nucleus
Facial nucleus, solitary nucleus,
superior salivatory nucleus
Cochlear nucleus, Vestibular
nucleus/cerebellum
Solitary nucleus, inferior salivatory
nucleus, nucleus ambiguus
Medulla
Spinal accessory nucleus
Hypoglossal nucleus
Peripheral
connection
(ganglion or
muscle)
Olfactory epithelium
Retina (retinal
ganglion cells)
Extraocular muscles
(other 4), levator
palpebrae superioris,
ciliary ganglion
(autonomic)
Superior oblique
muscle
Trigeminal
Lateral rectus
muscle
Facial muscles,
Geniculate ganglion,
Pterygopalatine
ganglion
(autonomic)
Spiral ganglion
(hearing), Vestibular
ganglion (balance)
Pharyngeal muscles,
Geniculate ganglion,
Otic ganglion
(autonomic)
Terminal ganglia
serving thoracic and
upper abdominal
organs (heart and
small intestines)
Neck muscles
Muscles of the
larynx and lower
pharynx
JOKE
PO
Transcribed Image Text:Mnemonic # On Old Olympus III Oculomotor Tops Towering IV Trochlear A Finn And German I Olfactory II Optic Some Hops Name V Trigeminal VI Abducens , VII Facial VIII Viewed. X Vagus Auditory (Vestibulocochlear) IX Glossopharyngeal XI Spinal Accessory XII Hypoglossal Function (S/M/B) Smell (S) Vision (S) Eye movements (M) Eye movements (M) Sensory/motor- face (B) Eye movements (M) Motor - face, Taste (B) Hearing/balance (S) Motor - throat Taste (B) Motor/sensory - viscera (autonomic) (B) Motor - head and neck (M) Motor - lower throat (M) Central connection (nuclei) Olfactory bulb Hypothalamus/thalamus/midbrain Oculomotor nucleus Trochlear nucleus Trigeminal nuclei in the midbrain, and medulla pons, Abducens nucleus Facial nucleus, solitary nucleus, superior salivatory nucleus Cochlear nucleus, Vestibular nucleus/cerebellum Solitary nucleus, inferior salivatory nucleus, nucleus ambiguus Medulla Spinal accessory nucleus Hypoglossal nucleus Peripheral connection (ganglion or muscle) Olfactory epithelium Retina (retinal ganglion cells) Extraocular muscles (other 4), levator palpebrae superioris, ciliary ganglion (autonomic) Superior oblique muscle Trigeminal Lateral rectus muscle Facial muscles, Geniculate ganglion, Pterygopalatine ganglion (autonomic) Spiral ganglion (hearing), Vestibular ganglion (balance) Pharyngeal muscles, Geniculate ganglion, Otic ganglion (autonomic) Terminal ganglia serving thoracic and upper abdominal organs (heart and small intestines) Neck muscles Muscles of the larynx and lower pharynx JOKE PO
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