Cranial Nerve Examination Nursing | Cranial Nerve Assessment I-XII (1-12)

Summary

In this educational video, Sarah from RN.com conducts a comprehensive nursing assessment of the cranial nerves, covering functions from smell and vision to motor skills. She demonstrates tests for each of the 12 cranial nerves, including smelling with nerve one, visual field tests for nerve two, and pupillary reactions for nerves two and three. Sarah also checks for facial movements, hearing, swallowing, and tongue movement, providing a clear guide for nursing students and professionals.

Takeaways

• 👃 Cranial Nerve 1 (Olfactory) is tested by having the patient identify pleasant smells.
• 👀 Cranial Nerve 2 (Optic) involves testing peripheral vision and visual acuity using a Snellen chart.
• 🔍 For peripheral vision, the confrontation test is used where the patient focuses on one eye while the other eye is covered.
• 🌟 Visual acuity is assessed by asking the patient to read the lowest line possible from a distance of 20 feet.
• 👁️ Cranial Nerves 3, 4, and 6 (Oculomotor, Trochlear, and Abducens) are tested by observing eye movement in all cardinal fields of gaze.
• 💡 Pupil reactivity to light and accommodation are checked by shining a light and observing pupil constriction.
• 🦷 Cranial Nerve 5 (Trigeminal) is assessed by having the patient clench teeth and testing muscle strength against resistance.
• 😄 Cranial Nerve 7 (Facial) is evaluated by observing facial expressions and asking the patient to perform actions like closing eyes tightly or puffing out cheeks.
• 👂 Cranial Nerve 8 (Vestibulocochlear) is tested by whispering words in one ear while the other is occluded.
• 🗣️ Cranial Nerve 9 (Glossopharyngeal) is checked by observing the movement of the uvula when the patient says 'ah' and by eliciting a gag reflex.
• 📢 Cranial Nerve 10 (Vagus) is assessed by the patient's ability to speak and swallow without difficulty.
• 💪 Cranial Nerve 11 (Accessory) is tested by having the patient move their head and shrug shoulders against resistance.
• 👅 Cranial Nerve 12 (Hypoglossal) is evaluated by asking the patient to stick out and move their tongue side to side.

Q & A

What is the purpose of the video by Sarah with register nurse rn.com?

The purpose of the video is to demonstrate how to perform a nursing assessment of the cranial nerves 1 through 12.

How should the patient be prepared before testing the cranial nerves?

The patient should be provided privacy, the nurse should perform hand hygiene, and the patient should be explained what will be done.

What is the test for cranial nerve one and how is it conducted?

The test for cranial nerve one involves assessing the sense of smell. The patient is asked to close their eyes and identify a pleasant-smelling substance presented to their nose.

What is the purpose of using a pleasant-smelling substance for the smell test?

A pleasant-smelling substance is used to avoid eliciting a gag reflex or discomfort due to a sensitive nose.

How is the confrontation visual field test performed to assess cranial nerve two?

The patient covers one eye while the nurse covers the opposite eye and asks the patient to count fingers presented in the upper, lower, and middle visual fields.

What is the significance of the Snellen chart in testing visual acuity?

The Snellen chart is used to assess visual acuity by having the patient read the lowest line possible at a distance of 20 feet.

What does the term 'PERRLA' stand for in the context of eye assessments?

PERRLA stands for Pupils Equal, Round, Reactive to Light and Accommodation, which summarizes the findings from the eye assessments.

How is the function of cranial nerve three assessed?

Cranial nerve three function is assessed by looking for involuntary eye shaking (nystagmus) in the six cardinal fields of gaze and checking pupil reactivity to light.

What is the role of cranial nerve five in the nursing assessment?

Cranial nerve five, the trigeminal nerve, is responsible for mastication. Its function is tested by having the patient clench their teeth and trying to open their mouth against resistance.

How is the facial nerve (cranial nerve seven) tested?

The facial nerve is tested by asking the patient to close their eyes tightly, smile, and puff out their cheeks to observe facial movements.

What test is used to assess cranial nerve eight, the vestibulocochlear nerve?

Cranial nerve eight is assessed by occluding one ear and whispering two words into the other ear, asking the patient to repeat what they heard.

What does the 'ah' test indicate when assessing cranial nerve nine?

The 'ah' test indicates the movement of the uvula, which is controlled by cranial nerve nine, the glossopharyngeal nerve.

How is the gag reflex tested, and what does it indicate?

The gag reflex is tested by gently stimulating the back of the throat, which should elicit a gag response if cranial nerve nine and ten are intact.

What movements are used to test cranial nerve eleven, the accessory nerve?

Cranial nerve eleven is tested by having the patient move their head side to side and up and down, and by shrugging against resistance.

How is cranial nerve twelve, the hypoglossal nerve, assessed?

Cranial nerve twelve is assessed by asking the patient to stick out their tongue and move it from side to side.