The document provides instructions for assessing the 12 cranial nerves by listing the procedures to test each nerve's sensory, motor and reflex functions. It includes tests for smell, vision, eye movement, facial expression, hearing, taste, swallowing and shoulder/neck movement. The assessment is to be documented by indicating whether the patient is able to perform each test independently, with assistance, or not at all.
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The document provides instructions for assessing the 12 cranial nerves by listing the procedures to test each nerve's sensory, motor and reflex functions. It includes tests for smell, vision, eye movement, facial expression, hearing, taste, swallowing and shoulder/neck movement. The assessment is to be documented by indicating whether the patient is able to perform each test independently, with assistance, or not at all.
The document provides instructions for assessing the 12 cranial nerves by listing the procedures to test each nerve's sensory, motor and reflex functions. It includes tests for smell, vision, eye movement, facial expression, hearing, taste, swallowing and shoulder/neck movement. The assessment is to be documented by indicating whether the patient is able to perform each test independently, with assistance, or not at all.
Copyright:
Attribution Non-Commercial (BY-NC)
Available Formats
Download as DOC, PDF, TXT or read online from Scribd
The document provides instructions for assessing the 12 cranial nerves by listing the procedures to test each nerve's sensory, motor and reflex functions. It includes tests for smell, vision, eye movement, facial expression, hearing, taste, swallowing and shoulder/neck movement. The assessment is to be documented by indicating whether the patient is able to perform each test independently, with assistance, or not at all.
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CRANIAL NERVE ASSESSMENT
Name of Student: ___________________________ ___________________________ Year & Section: ____________________________ ____________________________ Date: C.I.:
Procedure
A !e to "erfor m
A !e to "erform #it$ a%%i%tance
&na !e to "erform
1. Introduce self and verify clients identity. 2. Explain the procedure to the patient and his/her ability to participate in the assessment procedure. 3. Gather necessary equipment. . !ash hands and start the assessment. ". #$ I%chec&s patency of nostrils' chec&s one nostril at a time for clients ability to identify the smell of common substances. (. #$ II%tests a. acuity is easily tested )ith *nellen #hart' b. #olour vision is tested usin+ Ishihara plates c. ,isual fields % patient to loo& directly at you )hilst you )i++le one of your fin+ers in each of the four quadrants. -s& the patient to identify )hich fin+er is movin+. d. .. #$ III' I,' and ,I% a. /ests E01s by havin+ the client move the eyes throu+h the ( cardinal fields of +a2e )ith the head held steady. b. ,isual reflexes 3 4lace one hand vertically alon+ the patients nose to bloc& any li+ht from enterin+ the eye )hich is not bein+ tested. *hine a pen torch into one eye and chec& that the pupils on both sides constrict. /his should be tested on both sides 5. #$ ,' motor function%has client move his 6a) from side to side' clenchin+ his 6a)' and bitin+ do)n on a ton+ue blade. 7. #$ ,' sensory function%has the client close his eyes and identify )hen nurse is touchin+ his face at the forehead' chee&s' and chin bilaterally8first )ith the fin+er and then )ith a toothpic&. 19. /ests corneal reflex by touchin+ the cornea )ith a )isp of cotton or puffin+ air from a syrin+e over the cornea. /his should cause the patient to shut their eyelids. 11. #$ ,II' motor function%has the client ma&e faces' such as raisin+ eyebro)s' smile' fro)n' close their eyes and &eep them closed a+ainst resistance' puff out their chee&s and reveal their teeth. 12. #$ ,II' taste%tests taste on the anterior portion of the ton+ue by placin+ s)eet :su+ar;' salty :salt;' or sour :lemon;
substance on tip of ton+ue. 13. #$ ,III%<ses= a. !atch3tic& test for hearin+. b. /o carry out the >inne test' place a soundin+ tunin+ for& on the patients mastoid process and then next to their ear and as& )hich is louder. - normal patient )ill find the second position louder. c. /o carry out the !ebers test' place the tunin+ for& base do)n in the centre of the patients forehead and as& if it is louder in either ear. $ormally it should be heard equally in both ears. d. >omber+ test for balance. 1 . #$ I? and ?%observes ability to tal&' s)allo)' and cou+h. 1". #$ I? and ?' motor function%as&s client to say @ahA )hile depressin+ ton+ue )ith a ton+ue blade and observin+ the soft palate and uvula to rise. 1(. #$ I? and ?' sensory function%touches bac& of pharynx )ith ton+ue blade to induce a +a+ reflex. 1.. #$ I? and ?' taste :s)eet' salty' sour;% tests on posterior portion of ton+ue. 15. #$ ?I a. 4laces hands on clients shoulders and has client shru+ his shoulders a+ainst resistance. b. Bave client turn his head from side to side a+ainst resistance. 17. #$ ?II%have the client= a. *ay @d' l' n' t.A b. 4rotrude the ton+ue and move it from side to side. c. as& the patient to push ton+ue a+ainst chee& 29. !ash Bands 21. Cocument findin+s T'TAL SC'RE (INAL RATIN) De+end= 2 % -ble to perform 1 % -ble to perform )ith assistance 9 % <nable to perform EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE *IG$-/<>E 0F */<CE$/ 0,E> 4>I$/EC $-1E
