EENT Midterm 1

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CN I a) What function? b) Sensory, Motor, or both?: a) Smell
b) Sensory
CN I What are the two tests performed for CN I?: 1. You are testing for patency (patency=freely open)
2. You are testing olfaction (the ability to smell things)
CN I Describe how to perform the CN I patency test.: Have patient press their finger and close one nostril, then inhale through the other to test to see if it is clear. Perform bilaterally.
CN I Describe how to perform the CN I olfaction test.: Ask patient to close their eyes and cover one nostril. Then place an odor vial near their nose and ask them to smell and identify what they are smelling. Use at least two different odors. Perform bilaterally.
Prior to performing a CN I test, what should the doctor ask the patient and say to the teacher?: a) Ask patient to tell you if they feel any pain or discomfort when performing exam.
b) Tell teacher you would perform a "Complete History and Review of Systems" prior to exam. Also indicate you would do a "Nose Exam" also.
CN II What is the function of CN II? What are the three tests associated with CN II?: a. It is the Optic nerve and its function is vision.
b. The Central Visual Acuity test, the Confrontation test, and the Consensual Light and Direct Light Reflex
CN II How would you perform a Central Visual Acuity test?: Patient is tested using the "Snellen Eye Chart."
Patient tests one eye at a time.
Patient reads the smallest line with two or less mistakes.
To test opposite eye, have patient read from opposite direction to avoid memorization.
CN II How would you perform the Confrontation Test? What does the Confrontation Test analyze?: To perform the Confrontation Test, you must test 3 fields bilaterally. 1) Upper Temporal Field, 2) Lower Temporal Field, 3) Lateral Field

The Confrontation Test analyzes peripheral vision.
CN II How would you perform the Consensual Light Reflex Test?: Patients put hand vertically along top of nose to block light from one side to the other. Doctor shines light into one eye, watches for that eye to constrict. Doctor shines light again in same eye, but watches other eye. This test is performed bilaterally.
CN II What would the doctor say to the patient and to the teacher prior to performing eye testing?: The doctor would ask patient to identify any pain or discomfort during the procedure. The doctor would tell teacher that a complete history and review of systems would be performed prior to the eye exam. The doctor will also tell teacher that a Fundoscopic Exam would also be performed.
CN III What is the function of CN III? What are the tests associated with CN III?: It is the Occulomotor nerve and its function is eye movement.

The tests are:
1) Cardinal Field of Gaze
2) Accomodation
3) Consensual Light Reflex - Size dilated pupils
CN III What are the 4 extraoccular muscles controlled by CN III?: 1) Superior Rectus
2) Inferior Rectus
3) Medial Rectus
4) Inferior Oblique
CN III How does the doctor perform a Cardinal Field of Gaze test?: Doctor makes and "H" in the air and asks patient to follow finger. Patient keeps head still and follows finger with eyes only. Doctor looks for smooth motion bilaterally.
CN III During the Cardinal Field of Gaze Test, what other cranial nerves are tested?: a) CN IV - Trochlear Nerve - Superior Oblique Muscle
b) CN VI - Abducens Nerve - Lateral Rectus Muscle
CN III When performing the Cardinal Field of Gaze Test, what abnormal findings would you be looking for?: The doctor is looking for abnormal motion of the eyes such as Strabismus and Nystagmus.

Strabismus = a lack of parallelism of the visual axes of the eyes

Nystagmus = rhythmical oscillation of the eyeballs, either pendular or jerky
CN III Describe how the doctor would perform an Accomodation Test on a patient?: Patient looks at a far wall and focuses on an object. Doctor then puts a card 8" in front of patients face and asks patient to read what is on card.
CN III What is the doctor looking for when doing an Accomodation Test on a patient?: Doctor is looking to see if the lens changes shape and the pupil constricts.
CN III During the CN II Consensual Light Reflex test, what CN III function is also present?: Constriction of the Constrictor Pupillae muscle and the Ciliary Muscles.
CN III What other muscles near or around the eye can also be checked?: The Levator Palpabre muscles and Ptosis of the eye (drooping)
CN IV What is the function of CN IV? What is the movement it controls?: It innervates the Superior Oblique muscle of the eye.

It controls the movement of the eye...down and medially.
CN IV What test is performed to anaylze the function of CN IV?: Cardinal Field of Gaze
CN V What is the name and function of CN V? Is CN V motor, sensory, or both?: The Trigeminal nerve

Both
CN V What tests are performed for CN V?: - Soft vs. hard stimulation
(use cotton whisp and stick on face)
- Corneal Reflex
(Touch the limbus of eye with cotton) Limbus = edge, or border

- Muscles of Mastication
(tests Masseter, Temporalis, Pterygoids)

- Occulocardio Reflex

- Taste on anterior 2/3 of tongue

- Jaw Jerk Reflex
CN VI What is the name and function of CN VI?: It is the Abducens nerve and it controls the Lateral Rectus Muscle of the eye.
CN VI What CN II Test is also associated with CN VI?: The Cardinal Field of Gaze test and movement of the eye.

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